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[PMID]:27991985
[Au] Autor:Orozco-Núñez E; Alcalde-Rabanal J; Navarro J; Lozano R
[Ad] Endereço:Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
[Ti] Título:[Administrative efficiency in the Mexican Fund for the Prevention of Catastrophic Expenditures in Health].
[Ti] Título:Eficiencia de los procesos administrativos para la gestión del Fondo de Protección contra Gastos Catastróficos en México..
[So] Source:Salud Publica Mex;58(5):543-552, 2016 Sep-Oct.
[Is] ISSN:1606-7916
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Objective:: To show that the administrative regime of specialized hospitals has some influence on the administrative processes to operate the Mexican Fund for Catastrophic Expenditures in Health (FPGC, in Spanish), for providing health care to breast cancer, cervical cancer and child leukemia. Materials and methods:: The variable for estimating administrative efficiency was the time estimated from case notification to reimbursement. For its estimation, semistructured interviews were applied to key actors involved in management of cancer care financed by FPGC. Additionally, a group of experts was organized to make recommendations for improving processes. Results:: Specialized hospitals with a decentralized scheme showed less time to solve the administrative process in comparison with the model on the hospitals dependent on State Health Services, where timing and intermediation levels were higher. Conclusions:: Decentralized hospitals administrative scheme for specialized care is more efficient, because they tend to be more autonomous.
[Mh] Termos MeSH primário: Administradores de Instituições de Saúde
Seguro Médico Ampliado
[Mh] Termos MeSH secundário: Adulto
Idoso
Institutos de Câncer/organização & administração
Eficiência Organizacional
Feminino
Acesso aos Serviços de Saúde
Hospitais Especializados/organização & administração
Seres Humanos
Entrevistas como Assunto
Masculino
México
Meia-Idade
Modelos Teóricos
Programas Nacionais de Saúde
Neoplasias/economia
Neoplasias/terapia
Política
Mecanismo de Reembolso
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161220
[St] Status:MEDLINE


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[PMID]:27598931
[Au] Autor:Knaul FM; Arreola-Ornelas H; Méndez-Carniado O
[Ti] Título:[Financial protection in health: updates for Mexico to 2014].
[Ti] Título:Protección financiera en salud: actualizaciones para México a 2014..
[So] Source:Salud Publica Mex;58(3):341-50, 2016 Jun.
[Is] ISSN:1606-7916
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:UNLABELLED: Objetive: Document financial protection in health in Mexico up to 2014. MATERIALS AND METHODS: We up date the measures of impoverishing and catastrophic health expenditure to 2014, to analyse shifts since the implementation of the System for Social Protection in Health and the Seguro Popular using time series data from the Household Income and Expenditure Survey. RESULTS: Between 2004 and 2014 there has been a continued improvement in levels of financial protection. Excessive expenditure reached its lowest point: -2.0% in 2012 and 2.1% in 2014. Impoverishing expenditure dropped to 1.3% in 2004, compared to 0.5% in 2014, and catastrophic expenditures from 2.7% to 2.1%. CONCLUSIONS: The time series of data on financial protection show a clear pattern of improvement between 2000 and 2014 and level off and low levels in 2012 and 2014. Still, levels continue to be relatively high for households in the poorest quintile, in rural areas and with an elderly person.
[Mh] Termos MeSH primário: Doença Catastrófica/economia
Gastos em Saúde
Seguro Médico Ampliado
Previdência Social/organização & administração
[Mh] Termos MeSH secundário: Características da Família
Reforma dos Serviços de Saúde
Gastos em Saúde/estatística & dados numéricos
Gastos em Saúde/tendências
Seres Humanos
Renda
Seguro Médico Ampliado/legislação & jurisprudência
México
Pobreza
Previdência Social/economia
Previdência Social/legislação & jurisprudência
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160907
[St] Status:MEDLINE


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[PMID]:27557377
[Au] Autor:Ventura-Alfaro CE; Torres-Mejía G; Ávila-Burgos Ldel S
[Ti] Título:Hospitalization and mortality in Mexico due to breast cancer since its inclusion in the catastrophic expenditures scheme.
[So] Source:Salud Publica Mex;58(2):187-96, 2016 Apr.
[Is] ISSN:1606-7916
[Cp] País de publicação:Mexico
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare trends in hospital discharges and mortality due to breast cancer (BC) in Mexico from 2004 to 2012 by insurance condition before and after incorporating BC comprehensive treatment into the System of Social Protection in Health (Sistema de Protrección Social en Salud, SPSS) in 2007. MATERIALS AND METHODS: Data on BC hospital discharges and mortality reported in women aged 25 years and over were obtained from the National Health Information System. Mortality rates were adjusted by age and state. RESULTS: At the national level, a growing tendency in hospital discharges was observed, mainly for women without social security, while mortality rate remained constant. Mortality rates by state show that lower marginalization index corresponded to higher mortality. CONCLUSIONS: A differential behavior was observed among women according to insurance condition, partly due to the inclusion of BC treatment in the SPSS.
[Mh] Termos MeSH primário: Neoplasias da Mama/mortalidade
Hospitalização/estatística & dados numéricos
Seguro Médico Ampliado/economia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Neoplasias da Mama/economia
Doença Catastrófica/economia
Doença Catastrófica/mortalidade
Feminino
Geografia Médica
Seres Humanos
Cobertura do Seguro/estatística & dados numéricos
Seguro Médico Ampliado/estatística & dados numéricos
Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos
México/epidemiologia
Meia-Idade
Mortalidade/tendências
Alta do Paciente/estatística & dados numéricos
Alta do Paciente/tendências
Estudos Retrospectivos
Marginalização Social
Previdência Social/economia
Previdência Social/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160825
[St] Status:MEDLINE


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[PMID]:27543700
[Au] Autor:Pickup L; Bowater S; Thorne S; Clift P; Hudsmith L
[Ad] Endereço:Department of Adult Congenital Heart Disease, University Hospital NHS Trust, Birmingham, UK. Electronic address: luke_pick11@hotmail.com.
[Ti] Título:Travel insurance in adult congenital heart disease - Do they declare their condition?
[So] Source:Int J Cardiol;223:316-317, 2016 Nov 15.
[Is] ISSN:1874-1754
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Confidencialidade/ética
Cardiopatias Congênitas/epidemiologia
Seguro Médico Ampliado/ética
Viagem/ética
[Mh] Termos MeSH secundário: Adolescente
Adulto
Revelação/ética
Feminino
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160821
[St] Status:MEDLINE


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[PMID]:27115255
[Au] Autor:Butler SM
[Ad] Endereço:Stuart M. Butler, PhD, is a senior fellow, Economic Studies, at the Brookings Institution in Washington, DC, where he focuses on developing new policy ideas. He is also an adjunct professor at Georgetown University's Graduate School, and serves on the boa.
[Ti] Título:Consensus Plans Emerge to Tackle Long-term Care Costs.
[So] Source:JAMA;315(14):1441-2, 2016 Apr 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Consenso
Assistência de Longa Duração/economia
[Mh] Termos MeSH secundário: Serviços de Saúde Comunitária/organização & administração
Defesa do Consumidor
Controle de Custos
Transição Epidemiológica
Serviços de Assistência Domiciliar/organização & administração
Seres Humanos
Seguro de Assistência de Longo Prazo
Seguro Médico Ampliado
Medicaid/organização & administração
Estados Unidos
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1605
[Cu] Atualização por classe:161017
[Lr] Data última revisão:
161017
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160427
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2016.2633


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[PMID]:26968977
[Au] Autor:Glueck CJ; Shah P; Goldenberg N; Prince M; Lee K; Jetty V; Kumar A; Goldenberg M; Wang P
[Ad] Endereço:From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA. cjglueck@mercy.com.
[Ti] Título:Eligibility for PCSK9 treatment in 734 Hypercholesterolemic patients referred to a regional cholesterol treatment center with LDL cholesterol ≥ 70 mg/dl despite maximal tolerated cholesterol lowering therapy.
[So] Source:Lipids Health Dis;15:55, 2016 Mar 12.
[Is] ISSN:1476-511X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: LDL cholesterol (LDLC) lowering has been revolutionized by PCSK9 inhibitors, Alirocumab (Praluent) and Evolocumab (Repatha), approved as adjuncts to maximally tolerated cholesterol lowering therapy in heterozygous (HeFH) or homozygous (HoFH) familial hypercholesterolemia, and/or clinical atherosclerotic cardiovascular disease (CVD) where LDLC lowering is insufficient. METHODS: We applied FDA and insurance eligibility criteria for PCSK9 inhibitor use in 734 hypercholesterolemic patients serially referred over 3 years who then received ≥ 2 months maximally tolerated LDLC lowering therapy with follow up LDLC ≥ 70 mg/dl, and in 50 patients approved by insurance for PCSK9 inhibitors. We documented the percentage of patients with HeFH and/or CVD who met FDA and insurance criteria for PCSK9 inhibitor therapy using LDLC goal-based guidelines. RESULTS: Of 734 patients with LDLC ≥ 70 mg/dl after ≥ 2 months maximally tolerated LDLC lowering therapy, 220 (30%) had HeFH and/or CVD with LDLC > 100 mg/dl, meeting FDA-insurance criteria for PCSK9 inhibitor therapy. Another 66 (9%) patients were statin intolerant, without HeFH or CVD. Of the 50 patients whose PCSK9 inhibitor therapy was approved for insurance coverage, 45 (90%) had LDLC > 100 mg/dl after ≥ 2 months on maximally tolerated LDLC lowering therapy. Seventeen of these 50 patients (34%) had HeFH without CVD (LDLC on treatment 180 ± 50 mg/dl), 15 (30%) had CVD without HeFH (LDLC on treatment 124 ± 26 mg/dl), 14 (28%) had both HeFH and CVD (LDLC on treatment 190 ± 53 mg/dl), and 4 (8%) had neither HeFH nor CVD (LCLC 142 ± 11 mg/dl). CONCLUSION: Of 734 patients referred for LDLC reduction, with LDLC ≥ 70 mg/dl after ≥ 2 months on maximally tolerated therapy, 220 (30%) had HeFH and/or CVD with LDLC > 100 mg/dl, meeting FDA-insurance criteria for PCSK9 inhibitor therapy as an adjunct to diet-maximally tolerated cholesterol lowering therapy in HeFH or CVD. If 30% of patients with high LDLC and HeFH-CVD are eligible for PCSK9 inhibitors, then specialty pharmaceutical pricing models (~$14,300/year) will collide with tens of millions of HeFH-CVD patients. We speculate that if there was a 50 % reduction in CVD, then there would be savings of $245 billion, in the middle of the range of estimated PCSK9 inhibitor costs of $185-342 billion. Whether the health care savings arising from the anticipated reduction of CVD events by PCSK9 inhibitors justify their extraordinary costs in broad population use remains to be determined.
[Mh] Termos MeSH primário: Anticolesterolemiantes/uso terapêutico
LDL-Colesterol/sangue
Definição da Elegibilidade
Hipercolesterolemia/tratamento farmacológico
Pró-Proteína Convertase 9/antagonistas & inibidores
[Mh] Termos MeSH secundário: Adulto
Anticorpos Monoclonais/uso terapêutico
Aterosclerose/sangue
Aterosclerose/tratamento farmacológico
Seres Humanos
Hipercolesterolemia/metabolismo
Hiperlipoproteinemia Tipo II/tratamento farmacológico
Seguro Médico Ampliado
Meia-Idade
Terapia de Alvo Molecular
Inibidores de Serino Proteinase/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Anticholesteremic Agents); 0 (Cholesterol, LDL); 0 (Serine Proteinase Inhibitors); EC 3.4.21.- (PCSK9 protein, human); EC 3.4.21.- (Proprotein Convertase 9); LKC0U3A8NJ (evolocumab); PP0SHH6V16 (alirocumab)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160313
[St] Status:MEDLINE
[do] DOI:10.1186/s12944-016-0227-2


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[PMID]:26795620
[Au] Autor:Masiye F; Kaonga O; Kirigia JM
[Ad] Endereço:Department of Economics, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
[Ti] Título:Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia.
[So] Source:PLoS One;11(1):e0146508, 2016.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. METHODS: Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households' out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. RESULTS: Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. CONCLUSION: Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of user fee removal on CHE among particularly poorest households.
[Mh] Termos MeSH primário: Dedutíveis e Cosseguros/economia
Assistência à Saúde/economia
Honorários e Preços/estatística & dados numéricos
Financiamento Pessoal/estatística & dados numéricos
Gastos em Saúde/estatística & dados numéricos
Atenção Primária à Saúde/economia
[Mh] Termos MeSH secundário: Seres Humanos
Seguro Médico Ampliado/economia
Classe Social
Fatores Socioeconômicos
Transportes/economia
Zâmbia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1607
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160123
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0146508


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[PMID]:26316502
[Au] Autor:Philip NE; Kannan S; Sarma SP
[Ad] Endereço:Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India neenaphilip87@gmail.com.
[Ti] Título:Utilization of Comprehensive Health Insurance Scheme, Kerala: A Comparative Study of Insured and Uninsured Below-Poverty-Line Households.
[So] Source:Asia Pac J Public Health;28(1 Suppl):77S-85S, 2016 Jan.
[Is] ISSN:1941-2479
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:We aimed to compare the sociodemographics, health care utilization pattern, and out-of-pocket (OOP) expenses of 149 insured and 147 uninsured below-poverty-line households insured under the Comprehensive Health Insurance Scheme, Kerala, through a comparative cross-sectional study. Family size more than 4 (odds ratio [OR] = 2.34; 95% confidence interval [CI] = 1.13-4.82), family member with chronic disease (OR = 2.05; 95% CI = 1.18-3.57), high socioeconomic status (OR = 2.95; 95% CI = 1.74-5.03), and an employed household head (OR = 2.69; 95% CI = 1.44-5.02) were significantly associated with insured households. Insured households had higher inpatient service utilization (OR = 1.57; 95% CI = 1.05-2.34). Only 40% of inpatient service utilization among the insured was covered by insurance. The mean OOP expenses for inpatient services among insured (INR 448.95) was higher than among uninsured households (INR 159.93); P = .003. These findings show that urgent attention of the government is required to redesign and closely monitor the scheme.
[Mh] Termos MeSH primário: Características da Família
Cobertura do Seguro/estatística & dados numéricos
Seguro Médico Ampliado/utilização
Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos
Pobreza
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Estudos Transversais
Feminino
Seres Humanos
Lactente
Recém-Nascido
Cobertura do Seguro/economia
Seguro Médico Ampliado/economia
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1606
[Cu] Atualização por classe:161020
[Lr] Data última revisão:
161020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150829
[St] Status:MEDLINE
[do] DOI:10.1177/1010539515602306


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[PMID]:26666092
[Au] Autor:Siemers RA
[Ti] Título:Catastrophic Medical Claimants After ACA's Removal of Annual and Lifetime Limits.
[So] Source:Benefits Q;31(4):46-53, 2015.
[Is] ISSN:8756-1263
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Among the many provisions of the Affordable Care Act, one that initially received lesser attention or concern was the removal of annual or lifetime dollar maximums on group and individual health insurance. It was a rare occurrence for claimants to even approach the formerly lofty limit of perhaps $1 million or $2 million lifetime. However, their removal has aligned with a significant uptick in severely catastrophic claimants--particularly those in excess of $1 million or more. The drivers are several, and alert plan sponsors need to take proper actions to protect the financial viability of their self-funded medical plans.
[Mh] Termos MeSH primário: Cobertura do Seguro/economia
Cobertura do Seguro/legislação & jurisprudência
Seguro Médico Ampliado/legislação & jurisprudência
Patient Protection and Affordable Care Act/legislação & jurisprudência
[Mh] Termos MeSH secundário: Seguro Médico Ampliado/economia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1603
[Cu] Atualização por classe:151215
[Lr] Data última revisão:
151215
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:151216
[St] Status:MEDLINE


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[PMID]:26625829
[Au] Autor:Yoo KB; Noh JW; Kwon YD; Cho KH; Choi Y; Kim JH
[Ad] Endereço:Department of Healthcare Management and Institute of Global Healthcare Research, Eulji University, Seongnam, South Korea E-mail : KJH0930@yuhs.ac.
[Ti] Título:Having Private Cancer Insurance in Korea: Gender Differences.
[So] Source:Asian Pac J Cancer Prev;16(17):7981-6, 2015.
[Is] ISSN:2476-762X
[Cp] País de publicação:Thailand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: As coverage of public insurance is not sufficient to cover diagnosis or treatment of cancer, having private health insurance is important to prepare for unexpected expenses of cancer. The purpose of this study was to assess factors associated with having private cancer insurance, considering gender among the socio- demographic factors and health behavior. MATERIALS AND METHODS: We used data from the 2011 Korea Health Panel, which included 10,871 participants aged 20 years and older. Socio-demographics, health behavior, and perceived cancer risk were the independent variables and having private cancer insurance was the dependent variable. Multivariable logistic regression analysis was used to identify factors associated with having private cancer insurance. RESULTS: The variables relating to middle age, higher education, higher household income, married men, and the perceived cancer risk groups of 1-10% and 11-30% were significantly associated with having private cancer insurance. Additionally, females who had private non-cancer health insurance were positively associated with the dependent variables (OR=1.36; 95% CI=1.17-1.57). Education, smoking status, exercise, and perceived cancer risk possibility were significantly associated with having private cancer insurance only among women. The men lowered the overall percentages of those having private cancer insurance (OR=0.53, 95% CI=0.45-0.63). CONCLUSIONS: We found that there were significant differences between men and women who had private cancer insurance. Women with private cancer insurance are more likely to follow precautionary health behavior than men. This could be interpreted as resulting from masculine ideologies. It is important to make males recognize the seriousness of the cancer risk. In general, household income was highly associated with private cancer insurance. These results reveal an inequity among the buyers of private cancer insurance in terms of economic status level, education level, and health condition.
[Mh] Termos MeSH primário: Cobertura do Seguro/estatística & dados numéricos
Seguro Médico Ampliado/estatística & dados numéricos
Neoplasias/economia
Fatores Sexuais
Sistema de Fonte Pagadora Única/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
República da Coreia
Fatores Socioeconômicos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1609
[Cu] Atualização por classe:170308
[Lr] Data última revisão:
170308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151203
[St] Status:MEDLINE



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