Background The aim of this study was to construct a system dynamics (SD) model to estimate the future medical care expenditure and to address the dynamic issues of health care that should be resolved. In particular, the measures for promoting the spread of generic drug (GE drug) usage in Japan and reducing cancer-related medical expenses were investigated regarding their future impact on medical finances. Methods The SD model was constructed from FY 2018 to FY 2050. The change in the future GE drug quantity share was analyzed by using a regression equation. The impact of the increase in medical expense for cancer and the change in the future national medical care expenditure were also estimated. Results The annual total medical care expenditure in FY 2050 would arrive at 58.9–64.2 trillion JPY (US$ 535.1–584.0 billion) (1.3–1.5 times higher than that in FY 2018) with different trends in age groups. The cumulative total medical care expenditure was expected to decrease by about 787.0–989.4 billion JPY (US$ 7.2–9.0 billion) if the impact of the spread of GE drug usage was considered. On the other hand, due to the continuous increase in the cancer-related medical expense, the cumulative total medical care expenditure was estimated to increase about 7554.3–11715.0 billion JPY (US$ 68.7–106.5 billion). Conclusions If the cancer-related medical expense continues to increase in the future, an increase of 686.4–1104.2 billion JPY (US$ 6.2–10.0 billion) in FY 2050 is expected which suggests that this disease field should be prioritized regarding the measures to maintain medical finances.

discrete choice data was used. The comparison between the models was performed using the criteria of logical consistency, goodness of fit, and parsimony. Results: From 1056 participants who completed the interview, 2 met criteria that excluded them from the primary analyses. The characteristics of remaining 1054 respondents were very similar to those of the Indonesian population. Descriptive analysis showed that anxiety/depression and pain/discomfort are the two dimensions with most reported health problems. In the value set, values are ranged from -0.8506 for health state 55555 to 0,9426 for health state 11112. Mobility dimension affects most quality of life utility values, while Pain and Discomfort the least. Comparisons with healthy states values in other countries, and associations with demographic characteristics will be presented. ConClusions: This is the first value set of the EQ-5D-5L for Indonesia, and Indonesian preference on health states. We expect our survey to promote and facilitate research on health economic evaluations in Indonesia. PHP36Cost Variations of inPatient, DayCare anD outPatient HysterosCoPy in a tertiary-Care HosPital in Malaysia

This paper considers the dynamic incentive remuneration design for functional recovery care by applying dynamic principal-agent model, where the long-term care provider is formulated as the agent and the long-term care insurer as the principal. The insurer designs a dynamic incentive remuneration strategy to encourage the provider to provide functional recovery care. In particular, the insurer pays the remuneration to the provider based on the health improvement of the insured person at the end of a contract period. In addition, since it is possible that the cost incurred by the provider is not recoverable if less or excessive functional recovery care effort is made, an optimal functional recovery care effort level will be recommended to the provider.

Background: Falls are one of the most common adverse nursing events and sensitive indicators to measure nursing quality. The interventions for fall prevention are important; however, monitoring tools for the implementation are scarce.Methods: To explore the effects of monitoring the fall prevention process in reducing inpatients’ falls. Historically controlled trial and retrospective analysis. Explore and refer to the "structure-process-result" quality evaluation model. The design included assessment of fall risks, knowledge of prevention, participation of patients and their families, environment and management. The monitoring form for the implementation of fall prevention measures was used to monitor the effect and reduce the incidence rate of falls. Results: The incidence rate of falls among inpatients with different risk levels was compared and analyzed before monitoring (control group) and 12 months, 24 months, 36 months later after monitoring. The trend chi-square results showed that the incidence rate of falls decreased from 0.199‰ to 0.101‰, and the difference was statistically significant (p < 0.05). The probability of falls 12 months and 36 months later after intervention was 0.84 times and 0.51 times that of control group. The proportion of patients at high risk of falls had a decreasing trend.Conclusions: After the use of the monitoring form, the incidence rate of falls reduces, nurses' professional quality and personal ability are improved, the awareness of patients and family members participating in patient’s safety is strengthened, the environmental safety management is strengthened and the hardware facility is improved.

In this paper, curriculum development and practice based on systematically working process is given for summary and reflection ,in vocational education recent years.This document explains and demonstrates how to reconstruction vocational curriculum based on the capasity requirements of professional positions, how to develop teaching and learning projects through the application of industrial products, how to develop three-dimensional virtual resources through the aid of computer technology, how to allow students to carry out self-development learning, self-adapt to future work. As a case, The national quality programs, "Debugging and application of electronic circuits", to study and summary for curriculum development , and share experiences with readers.