• Health Policy and Management
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• v.16 no.2
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• Journal of Practical Agriculture & Fisheries Research
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• v.13 no.1
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• pp.173-183
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• 2011

Gabensis village is one of the biggest village In the Wampar Local Level Government area within the Huon Gulf District of Morobe Province with a population of around 3,000. The major staple food is banana which is well complemented by minor staples yam, cassava, Singapore/Chinese taro and sweet potato. Apart from gardening for own consumption, the villagers engage in selling of vegetables, garden staples, cocoa beans, coconuts, timber, chicken, fish and pig meat to supplement their livelihood. Livestock like pigs and chickens are also kept for meat and for commercial purpose. Bettlenut which was once one of the main cash crops has now been overtaken by cocoa due to a disease that had attacked almost the entire bettlenut tree population in the area. Even though the Wau-Bulolo highway cuts through the village and all have access to transport infrastructure, the majority of the population still encounter problems in communication due to poor telecommunication coverage. On average most people earn not more than K50 per week due to constrains in production and marketing among others. Gabensis village has the potential to develop a tourism industry given its natural attraction of Lake Wanam. Beside there is also the natural eel farming and the fish pond at the nearby Potsie village. These natural attractions pose huge tourism potential for the community. As part of government services delivery and development, education and health issues is very much important in the community however there is lack of infrastructural development and poor service delivery especially in the area of health. However, the responsibility is on the community to organize themselves to realize that potential. A well developed agro-ecotourism investments would have positive spillover effects to the community thus contributing towards improving the livelihoods of the many farming families.