1,720,976 research outputs found
Universal Coverage Scheme in Thailand: Analysis of Factors Associated With and Reasons for Underutilization
Get PDFDespite nearly free health services offered by the Universal Coverage Scheme (UCS), the UCS services have been found to be underutilized. Thus, this study, employing the concept of unmet health needs, investigated factors and reasons for the underutilization. Specifically, performing logistic models with the national health survey of 2015, we analyzed who and why did not utilize the UCS services in availability, accessibility, and acceptability perspectives of the services. The study results indicated that among UCS beneficiaries who needed care, about 45% and 7% did not utilize the UCS outpatient and inpatient services, respectively. These non-users had a relatively higher socioeconomic status. Specifically, they were more likely to be high-income, employed, not chronically-ill, or urban people. Availability-related (e.g., long wait-time and unavailability due to emergencies) and acceptability-related reasons (e.g., time constraints and uncertainty of service quality) were major barriers of access to the UCS services. Although the UCS, by this study, was found to work better for socially vulnerable people, there are still concerns that some people, who actually wanted to use the UCS services, might be ultimately forced to use other private services due to such barriers. Particularly, employed people who have time constraints during daytime and people who need inpatient services due to emergencies are our main concerns. In the short term, the public-private partnership should be strengthened to support the urgent needs of emergency cases. In the long term, the expansion of the UCS services boundary should be continued by the National Health Development Plan
Langue des juges et des avocats
No full textAux États-Unis, la plupart des juges et des avocats sont monolingues et la plupart ont passé leur carrière à étudier les subtilités de l'anglais parlé et écrit. L'anglais écrit est la voie prédominante pour préserver les procédures judiciaires. Les habitants des tribunaux sont des rédacteurs prolifiques de mémoires, de motions, d'ordonnances et d'opinions. Cependant, l'anglais de la salle d'audience semble parfois conçu pour être à la fois étranger et aliénant les anglophones natifs et non natifs. Malgré le sentiment général que la salle d'audience américaine est ouverte et accessible à tous, le registre juridique unique de la salle d'audience est en fait à la limite de la plupart des compétences des anglophones. Cette complexité va au-delà de l'utilisation de mots plus longs ou moins courants; en effet, les mots eux-mêmes peuvent être clairs et intelligibles, mais le tout peut ne pas être compris dans le sens où le destinataire n'est pas en mesure de le relier à la situation de la salle d'audience. Les juges et les avocats ne sont pas inconscients du contrôle qu'ils peuvent exercer du fait qu'ils connaissent et parlent la langue du système juridique; en fait, c'est ainsi qu'ils exercent leur métier. Plusieurs spécialistes du droit et de la linguistique ont appliqué les connaissances émergentes sur le registre, l'analyse du discours, les actes de langage et la stylistique pour explorer comment les participants à la salle d'audience peuvent exercer leur pouvoir linguistique
Interaction des petites créances dans la salle d'audience judiciaire
No full textLe label des petites créances a été appliqué à un large éventail de procédures judiciaires visant à parvenir à une résolution simple et économique des litiges impliquant des sommes d'argent limitées. Malgré leurs différences, les tribunaux des petites créances partagent un certain nombre d'éléments communs, tels que des procédures simplifiées, des coûts réduits, des droits d'appel limités et la possibilité pour les justiciables de comparaître sans avocat. La plupart des recherches sur les tribunaux des petites créances se concentrent sur les parties concernées ou sur les caractéristiques et l'issue des affaires portées. Ce document a un objectif différent. Nous voulons savoir comment le caractère informel des procédures des petites créances influe sur la façon dont les justiciables racontent leurs histoires. Cette focalisation donne un aperçu significatif de la façon dont les parties au conflit conçoivent leurs problèmes et conçoivent des stratégies pour les résoudre tout en soulevant des questions sur l'efficacité et l'équité de la Cour des petites créances en tant que forum juridictionnel. L'analyse de la forme ainsi que du contenu des récits de petites créances révèle l'effet puissant des contraintes de preuve trouvées dans les litiges ordinaires
Older Adults Living Alone in Thailand: Socioeconomic Inequality and Its Relation to Unmet Health Needs
Get PDFThis study aimed to investigate socioeconomic inequality and its relation to unmet health needs among older adults living alone in Thailand. Descriptive analyses with F-tests and chi-squared tests, and logistic regression analyses were conducted with the national health census 2017 data. The results indicated that older adults living alone, compared to those not living alone, had significantly low socioeconomic conditions and high unmet needs. They were more likely to be lower-income, older, female, lower-educated, unemployed, and chronically-ill people. Particularly for income, the proportion of people with income below the national poverty line among older adults living alone (38.75%) were almost two times and four times larger than those living with only one family (19.39%) and more than one families (10.98%), respectively. Additionally, we found that the residence type “living alone” and income were the most significant determinants for the unmet needs. Based on the results, we recommend that the government reinforce the current pension and community health volunteer programs. Particularly for the pension program, a simulation analysis that we conducted proposed that the current pension allowance (600–1,000 Baht) should be raised up to 3,500 Baht, which could substantially alleviate the unmet needs
L'interrogatoire des témoins dans une salle d'audience
No full textIl apparaît que ni le renforcement des propositions, ni le relâchement ou le transfert sémantique du sens de constituants spécifiques d'un énoncé donné ne se produisent nécessairement à l'insu des utilisateurs du langage. Les linguistes et les philosophes ont largement construit des théories de la signification basées sur des preuves introspectives. Il est reconnu depuis longtemps qu'une telle preuve est nécessairement limitée par l'imagination et l'expérience de la personne qui la produit. Lorsque les énoncés hypothétiques utilisés pour étayer un point sont examinés isolément, ils auront tendance à être interprétés comme faisant partie d'un type de contexte relativement banalisé, c'est-à-dire un type de contexte dont la plupart des gens peuvent être supposés avoir une vaste expérience personnelle, conversation non le doute étant le type de contexte non marqué par excellence. Dans cet article, j'ai tenté de montrer que les données empiriques d'un type de contexte marqué, à savoir celui de l'interrogatoire des témoins devant un tribunal, semblent remettre en cause certaines hypothèses actuellement à la mode concernant l'interface sémantique et pragmatique, en particulier , sur la notion de sens littéral, ou alternativement explicite. Il est vrai que les avocats peuvent être formés pour remarquer les écarts entre les significations codées et inférées, mais ils restent néanmoins des utilisateurs légitimes du langage. En tout état de cause, comme le montrent plusieurs des exemples analysés dans cet article, les locuteurs sans formation formelle juridique ou linguistique sont en effet en mesure de faire les mêmes distinctions si la situation l'exige. En outre, la loi est un domaine d’action important, largement constitué par et par le langage, qui a un impact significatif sur la vie des gens. En effet, pour certains individus, dans certaines cultures, l'utilisation de la langue dans des contextes médico-légaux peut littéralement devenir une question de vie ou de mort. Une théorie générale du sens viable et socialement responsable ne peut guère se permettre d'ignorer comment la distinction entre sens littéral / explicite et implicite est, ou peut être, exploitée dans de tels contextes
The Impact of Thailand’s Universal Coverage Scheme on Household Catastrophic Health Expenditure
Get PDFAs Thailand faced rapid demographic changes with economic growth, single-person households (e.g., elderly people living alone) have become emerging types of family. Thus, this study, using single-person and non-single-person household factors, examined the impact of the Universal Coverage Scheme (UCS) on household catastrophic health expenditure with the national-level health survey data 2015. Specifically, defining household catastrophic health expenditure as out-of-pocket expenditure exceeding 40% of household disposable income, this study analyzed whether the selected factors were related to the catastrophic expenditure by performing binary logistic regression analysis. The study findings indicated that among all households which received the UCS inpatient services, around 2.78% experienced the catastrophic expenditure. Lower- income and single-person households were more likely to encounter catastrophic expenditure. Among the single-person households, those with lower socioeconomic conditions had a higher incidence of the catastrophic expenditure. Specifically, the elderly, female, low-educated, unemployed, or had any chronic diseases were more likely to encounter the catastrophic expenditure. To address the issue, in the short term, the current copayment rate, which is equally levied to beneficiaries, should be adjusted by socioeconomic conditions. Additionally, the UCS should consider a copayment ceiling as a supplementary policy intervention in the situations where the copayment rate adjustment is not sufficient to prevent catastrophic expenditure. In the long-term, the government’s effort to expand the benefits package should be continued by health care needs on the demand side as well as the cost-effectiveness of the policy on the supply side
Health-Seeking Behavior of the Uninsured Before and After the Universal Coverage Scheme in Thailand
Get PDFBefore Thailand implemented the Universal Coverage Scheme (UCS) in 2002, 18 million people were uninsured. Thus, this study assessed the impact of the UCS on healthcare utilization by investigating the changes in health-seeking behavior among the previously uninsured before and after UCS. Using the nationwide Health and Welfare Survey data of 2001 and 2003–2005, multinomial logistic regression and mixed-effects multinomial logistic regression were used to investigate the relationship between health-seeking behavior and individual characteristics, and how the relationship changed over time. The study findings indicated that the UCS significantly increased utilization of public facility care and simultaneously decreased utilization of informal care. The observed changes were more significant in lower income, female, lower educated, and married people. But, there was no significant change in utilization of private facility care after the UCS. The changes in health-seeking behavior among lower income people from informal care requiring fully out-of-pocket (OOP) payment into public facility care requiring no or minimum OOP payment implied that UCS contributed to financial protection and equity in healthcare utilization. It also contributed to safety in healthcare utilization by decreasing the utilization of informal care which had the potential risk from inaccurate self-diagnosis and treatment. However, more than 50% of the beneficiaries still utilized care outside the UCS service boundary, which might be due to insufficient healthcare resources in public sector. Thus, the UCS should continue an effort to improve the infrastructure in public sector and to encourage the involvement of private sector in the scheme
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Scoping Review: Patient preference for Traditional Chinese Medicine (TCM) in China
Get PDFTraditional Chinese Medicine (TCM) is an important part of the medical and health system in China. However, an in-depth understanding of patients’ preferences and influencing factors for TCM services within China has yet to be explored in depth. Therefore, this scoping review aims to map out the relevant academic literature on the preferences and influencing factors of patients for TCM in China, identify relevant research gaps, and propose directions for future research in this area of knowledge. This scoping review adopted the protocol of the PRISMA-ScR. Searches in the PubMed, Science Direct, EMBASE, and China National Knowledge Infrastructure (CNKI) databases gleaned 16,552 results that were published from 2010 to 2019 that met pre-set criteria. Of these, 10,732 duplicates were removed, resulting in 5,820 articles being screened by title and abstract. Screening by title and abstract excluded 5,529 articles resulting in 291 articles left for full- text review. These 291 articles underwent full-text review, resulting in a total of 259 articles being excluded and 32 articles being deemed relevant to this scoping review. All data were charted and analyzed using charting tables to allow data to be mapped out, analyzed for gaps, and for directions for future research to be suggested. The gaps identified include complex factors influence TCM preference among patients in China, present research on TCM preference is neither extensive nor in-depth, low levels of research from the standpoint of personal characteristics as well as treatment process factors and external factors, and insufficient research on the relationship between different factors influencing preference and the complex mechanism of preference formation. Future directions of research include extensive and in-depth research on the relationship between different factors influencing TCM preference, the study of the complex mechanism of TCM preference formation, the influence of personal characteristics on TCM preference, and the complexity of factors that influence TCM preference among patients in China
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