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1.
Sara Bennett Viroj Tangcharoensathien 《The International journal of health planning and management》1993,8(2):137-152
Compulsory health insurance schemes have received attention recently as a means of creating a reliable extra-budgetary source of health care funding. Yet, the full implications of such schemes in a developing country context are unclear; in particular, the impact on and relationship with private sector providers has infrequently been explored. This study examines patterns of public and private sector utilization under the Civil Servants' Medical Benefit Scheme (CSMBS) in Bangkok, Thailand. The CSMBS currently provides limited reimbursement for private inpatient care, but recent proposals suggest increasing benefit levels for care sought in the private sector. The study shows that despite high level of cost recovery in the public sector, charges were much lower than those in the private sector. Different patterns of diagnosis in the two sectors were found with private hospitals tending to treat a less complex case mix. Within the private sector, there was a limited tendency to specialize in certain types of care. It is concluded that under the current payment mechanism of fee-for-service reimbursement, measures to enhance access to private sector care should be approached with caution. In the long run, the scheme should merge with the recently established social security scheme. 相似文献
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Viroj Wiwanitkit 《Clinical and applied thrombosis/hemostasis》2006,12(1):93-95
Platelet glycoprotein (GP) IIb/IIIa is a membrane receptor for fibrinogen and von Willebrand factor. There is considerable controversy regarding the clinical role of the GPIIb/IIIa PIA1/A2 as a risk factor for myocardial infarction. A summative analysis is performed on the recent previous reports on the GPIIb/IIIa PIA1/A2 and its correlation to myocardial infarction. The metanalysis was performed to assess the correlation between the pattern of GPIIb/IIIa PIA1/A2 polymorphism and myocardial infarction. From 7 available case-control reports, 553 patients and 1,059 controls are evaluated. The overall frequencies of PIA2 allele for the patients and controls are 0.249 and 0.221, respectively. According to this study, 49.4% of subjects with PIA2 allele have myocardial infarction while 39.5% of subjects without PIA2 allele have cerebrovascular disease. From overall risk estimation, the subjects with PIA2 alleles have a 1.1 times higher risk to have myocardial infarction. According to this analysis, it is proposed that the pattern of GPIIb/IIIa PIA1/A2 polymorphism does not represent a useful marker of increased risk for myocardial infarction. In addition, the lack of association between the pattern of GPIIb/IIIa PIA1/A2 polymorphism and ethnicity of the patients was demonstrated in this study. 相似文献
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Viroj Wiwanitkit 《Sexuality and disability》2005,23(1):41-46
The incidence of sexual assault continues to escalate, and it is under-reported. Recent literature discusses the medical, legal, and psychological management of the female sexual assault victim, but little has been written regarding appropriate management of male sexual assault. This article focuses on the laboratory investigation in male rape case. 相似文献
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Wiwanitkit V 《Archives of gynecology and obstetrics》2007,276(6):629-631
Background Consequences of syphilis in mother, pregnancy, fetus and child are considerable, but preventable. Serological screening must
be offered at the first prenatal visit. Presently, the diagnosis of syphilis is dependent mainly on serological tests. The
most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR) and for confirmation the fluorescent
treponemal antibody (FTA) and the treponema pallidum hemagglutination (TPHA) tests.
Method The four alternative nodes for diagnosis of can be a) VDRL + FTA, b) VDRL + TPHA, c) RPR + FTA and d) RPR + TPHA. Here the
author reports an evaluation of cost utility of those tests in obstetrical practice. According to this study, it can be shown
that the cost per accurate diagnosis for VDRL + TPHA is the least expensive choice and for RPR + FTA is the most expensive
choice.
Conclusion Therefore, this alternative is the best method for serological diagnosis of syphilis, based on medical laboratory economics
principles. 相似文献
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