415:
healthcare. When it comes to who pays the bills for healthcare, it may be the government or it may be the individual (sometimes either by direct payment, and sometimes through employer-run schemes, insurance companies etc.), or a combination of both. However, healthcare can never be truly “free” – someone somewhere will always have to pay, and the payer will always want the best value for money possible. "Affordability" of healthcare can be the insurmountable hurdle for some people. Value for money is hence another factor in assessing the true quality of healthcare.
745:
132:
195:
66:
25:
601:. "In competitive health care markets where patients have an increasing array of choices, quality is the most important differentiator for organizations striving for sustainability and both national and regional leadership. International accreditation has become a powerful indicator of a health care organization’s commitment to high-quality care and patient safety." Reflecting this, much of the discussion on
374:
are cared for after discharge from hospital, and the quality of the services provided for them. At the heart of these schemes is a list of standards which, ideally, serve to assess evaluate in a systematic and comprehensive way the standards of professional performance in a hospital. This includes not only hand-on patient care but also training and education of staff, credentials,
407:
information technology services (indeed, partial accreditation of this type should be publicly acknowledged as such by both the accreditation scheme and the hospital). The best accreditation schemes also assess academic and intellectual activity (such as teaching and research) within those hospitals that they survey (see later) and have a clear and declared interest in
693:
works to provide services to guide health professionals, providers, researchers, agencies, policy makers and consumers, to achieve excellence in healthcare delivery to all people, and to continuously improve the quality and safety of care. ISQua does not actually survey or accredit hospitals or clinics itself.
584:
in the USA, HIV, HTLV-1 etc.), and the social imponderables such as war, political change and natural disasters. Any of these factors may lead to a loss of public confidence in healthcare services, and a desire to seek out healthcare overseas. The environmental and political situation will constantly
406:
However, accreditation should ideally be independent of governmental control, and accreditation groups should assess hospitals “holistically”, and not just some isolated facet of the hospital’s activities or services such as the laboratories, pharmacy services, infection control, financial health or
657:
The above list is not exhaustive, but it represents a good start. Also, the intending medical tourist should check whether or not a hospital is wholly accredited by an international accreditation group, or if it is only partly accredited (e.g. for infection control), the latter being less inclined
394:
International standardization groups also exist, but it must be pointed out that the mere achieving of set standards is not the only factor involved in quality accreditation - there is also the significant matter of the incorporating into participating hospitals systems of self-examination, problem
369:
In countries such as the United
Kingdom, the United States, Australia, New Zealand and Canada, sophisticated accreditation groups have grown up to survey hospitals (and, in some cases, healthcare in the community). Furthermore, other accreditation groups have been set up with openly declared remits
616:
How does an individual contemplating becoming a medical tourist ensure that the overseas healthcare they are planning to access is as safe as possible and is of adequate quality? For sure, it is not simply a matter of looking at hospital buildings and at mattresses, and it is certainly not just an
373:
Accreditation systems are structured so as to provide objective measures for the external evaluation of quality and quality management. Accreditation schemes should ideally focus primarily on the patient and their pathway through the healthcare system – this includes how they access care, how they
712:
If a hospital or clinic simply wishes to improve its services to patients wherever those patients come from (locally or from further afield), or wishes to attract medical tourists, how do they choose whom to go to when contemplating accessing external peer review by an accreditation group such as
692:
The
International Society for Quality in Health Care (ISQua) is an umbrella organisation for such organisations providing international healthcare accreditation. Its offices are based in the Republic of Ireland. ISQua is a small non-profit limited company with members in over 70 countries. ISQua
386:
activity, ethical standards etc. The standards can also be used internally by hospitals to develop and improve their quality standards and quality management. Some international accreditation schemes believe that the standards applied should be fixed and are non-negotiable, while others operate a
752:
Other fields of accreditation pertain to general medical practices ("GP" or Family
Medicine) is some westernized countries. GP accreditation services, such as the Royal College of General Practitioners (RGCP) in the United Kingdom, and Australian General Practice Accreditation Limited (AGPAL) in
716:
For example, some countries, such as the USA, perform very poorly when it comes to providing anything close to universal access to healthcare of adequate quality to the population living within their own borders. Others, such as the United
Kingdom and Australia, have created state-funded systems
458:
Other countries have looked towards accessing the services of the major international healthcare accreditation groups based in other countries to assess their healthcare services. There are many reasons for this, including cost, a desire to improve healthcare quality for one’s own citizens (good
329:
The United States is a notable exception among developed
Western countries in regard to its availability and affordability of healthcare. In 2007, 45.7 million US citizens (i.e. 15.3% of the national population) had no health insurance whatsoever Despite this, in 2007 the USA spent nearly $ 2.3
414:
In some parts of the world, accessing healthcare can be very expensive, even prohibitively so. While some countries have elected to provide comprehensive healthcare services for all of their populations, others appear to be satisfied with leaving portions of their population without access to
402:
As governments and the general public have increasingly come to demand more and more openness about health care and its delivery, including and especially hospital quality and safety and the clinical performance of doctors, and these accreditation systems have generally adapted to fulfill this
365:
In the USA in the early 20th century, there was concern over how to best create an appropriate environment in which clinicians could work. Standards to improve the control of the hospital environment were thus generated, and these subsequently grew into accreditation schemes with the remit to
491:
is key issue in international healthcare accreditation. It is becoming increasingly important as millions of (especially) Europeans and
Americans seek healthcare overseas outside of their own countries for a variety of reasons, including and especially affordability. It represents a growing
330:
trillion on healthcare, roughly 16% of the country's gross domestic product, and more than twice as much per capita as the OECD average. Some US citizens unable to access adequate healthcare within the country are seeking healthcare internationally. This phenomenon is often referred to as
617:
issue of looking only at the prices charged. While architecturally pleasing rooms and easier access to satellite television and the internet may improve personal comfort, and a bargain basement price may help the wallet, what is often more important may include such issues as:
683:
The different accreditation schemes vary in approach, quality, size, intent, sourcing of surveyors and the skill of their marketing. They also vary in terms of how much they charge hospitals and healthcare institutions for their services. They all have web sites.
470:
In response to this marketing opportunity, some national accreditation groups have expanded internationally, and gone on to survey and accredit hospitals outside of their own national borders, providing "international healthcare accreditation".
704:, is a UK-based umbrella organisation for organisations providing healthcare accreditation. Its offices are based in London. Like ISQua, UKAF does not actually survey and accredit hospitals itself. India becomes 12th nation to join ISQua.
366:
facilitate and improve organisational development. Part of the process is not only about assessing quality, but also about promoting and improving quality. Similar accreditation schemes were soon developed elsewhere in the world.
740:
No single international accreditation scheme enjoys exclusive rights to be seen as an overall worldwide-relevant scheme. Some hospitals seek multiple accreditations to increase their credibility in different parts of the world.
652:
evidence of a robust, just and fair system to deal with complaints made by patients when things go wrong, as they inevitably will from time to time, and where appropriate to compensate the injured party in a fair and reasonable
661:
How does the person in the street access this type of quality information? This can be very difficult. Accreditation schemes well-recognised as providing services in the international healthcare accreditation field include:
348:"A self-assessment and external peer assessment process used by health care organisations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve"
713:
those listed above. No one healthcare system has a monopoly of excellence and no one provider country or scheme can claim to be the total arbiter of quality. The same is true of healthcare accreditation schemes.
474:
This process of accreditation has been made increasingly complicated by the fact that in many parts of the world, people are choosing to cross international borders to access healthcare, a phenomenon known as
320:
This occurs in most parts of the developed world— a setting in which people continue to express increasingly high expectations for the quality of care. This trend is especially strong in nations where
317:, or by a combination of the two. Healthcare can be provided in hospitals or be accessed through practitioners working in the community, such as general medical practitioners and dental surgeons.
753:
Australia provide accreditation services for these practices. The cost of such accreditation varies enormously and precise data are scarce; in the case of the Joint
Commission International,
463:
is at the basis of all high-quality healthcare), or a desire to market one’s healthcare services to “medical tourists”. Some hospitals pursue international healthcare accreditation as a
649:
the hospital may be located in a country where the environment and climate may bring a patient into contact with infectious and/or tropical diseases that are unfamiliar to them
1507:
797:
1343:
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the quality of the clinical staff, including their background educational attainment and training, and evidence of continuing professional development by those staff
552:(c) patients wish to access treatments not available at home (e.g. stem cell therapy, termination of pregnancy, unlicensed medications, gender re-assignment surgery)
76:
1023:
38:
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that is provided internally. Taking the USA as an example, numerous groups provide accreditation for internal healthcare organizations, including the AAAHC
428:
598:
593:, crystallizes the increasing relevance of international health care accreditation and its growing commercial importance, particularly in relation to
452:
827:
765:
761:
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the quality and ethical standards of the management and their personal and collective commitment to caring for patients and the wider community
142:
1402:
568:
Other new challenges include new medical developments which are not universally accessible, the emergence of the so-called “superbugs” (e.g.
941:
569:
523:, and this synergy has a clear "knock-on" effect for those organizations based within the developed world who are seeking to develop the
154:
91:
44:
1045:
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Different holistic accreditation schemes are sourced out of different parts of the world, for example in hospitals there is (see map):
606:
444:
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the clinical staff’s ethical standards and their personal and collective commitment to caring for patients and the wider community
1317:
1295:
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is about improving how care is delivered to patients and the quality of the care they receive. Accreditation has been defined as
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436:
370:
to look after just one particular area of healthcare, such as laboratory medicine or psychiatric services or sexual health.
1600:
1564:
1523:
1335:
1129:
964:
679:) The former Trent Scheme (which ended in 2010) was the first scheme to accredit a hospital in Asia, in Hong Kong in 2000
1481:
1554:
832:
701:
697:
987:
605:
blog sites reflects the increasing importance of international healthcare and hospital accreditation to this industry
1395:
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system of negotiation over standards - however, whatever approach is taken the every aspect of the process should be
256:
238:
176:
113:
52:
1369:
220:
986:
Hinchcliff, R; Greenfield, D; Moldovan, M; Westbrook, J.I; Pawsey, M; Mumford, V; Braithwaite, J (4 October 2012).
891:
95:
281:, is a complex and challenging process. Healthcare is a vital and pervasive issue; it influences all aspects of
212:
150:
83:
754:
666:
205:
757:, costs can be substantial. Variance in cost is based on the country, size and operations of an organization.
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1559:
492:
multibillion-euro/dollar/pound business of increasing importance to the economies of many countries, such as
768:) is often mistakenly considered to be an international healthcare accreditation scheme. However it is not.
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the healthcare providing establishment’s commitment to self-improvement, and to learn positively from errors
395:
solving and self-improvement, and hence there is more to accreditation than following some sort of overall "
1388:
748:
Locations of geographical bases of four of the world's leading international hospital accreditation schemes
362:. However, there is limited and contested evidence supporting the effectiveness of accreditation programs.
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1187:
812:
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1158:
672:
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1245:
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1100:
355:
1605:
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1471:
1071:
724:
ACSA International out of Spain: partnership with IBES - Brazilian
Healthcare Excellence Institute.
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909:
1425:
787:
782:
388:
216:
1497:
777:
424:
343:
933:
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1321:
1303:
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744:
309:
ramifications. In any part of the world healthcare services can be provided either by the
8:
1466:
1411:
448:
375:
322:
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581:
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to the economy of developing countries is increasingly the subject of academic study.
1435:
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792:
440:
278:
521:
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555:(d) patients wish for greater confidentiality than may be feasible at home (e.g.
535:
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484:
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331:
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vary throughout the world, and this will need to be factored into the equations.
1610:
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972:
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359:
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87:
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910:"Poverty and Share of Americans Without Health Insurance Were Higher in 2007"
869:
310:
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which provide everything without the assistance of the private sector.
460:
270:
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Due to the near-universal desire for safe, effective, and high quality
1380:
736:
Australian
Council on Health Care Standards International in Australia
892:"Contribution to the Reflection Process for a New EU Health Strategy"
501:
493:
306:
294:
223:. Statements consisting only of original research should be removed.
1372:. WHO Regional Office for the Eastern Mediterranean. Archived from
556:
505:
497:
383:
351:
302:
908:
Sherman, Arloc; Greenstein, Robert; Parrott, Sharon (2005-04-02).
451:, American Accreditation Commission International (AACI), and the
358:(see external links). Accreditation is one important component in
298:
286:
282:
988:"Narrative synthesis of health service accreditation literature"
676:
290:
1179:
379:
1508:
List of international healthcare accreditation organizations
1150:
897:. Office for International Public Health and Social Affairs.
798:
List of international healthcare accreditation organizations
646:
the infection control track record of the hospital or clinic
1266:
1209:"Australian Council on Health Care Standards International"
1237:
1208:
1092:
1063:
907:
337:
621:
the standards of governance in the hospital or clinic
580:), problems with the blood transfusion supply (e.g.
563:
treatment, gender re-assignment surgery, face lifts)
429:
94:, and by adding encyclopedic content written from a
727:
Joint Commission International (JCI) out of the USA
643:
the clinical track record of the hospital or clinic
447:, Inc. (ACHC), the "Exemplary Provider Program" of
16:
International healthcare accreditation organisation
1064:"International Society for Quality in Health Care"
277:. Providing healthcare, especially of an adequate
1582:
453:Healthcare Quality Association on Accreditation
828:International Organization for Standardization
766:International Organization for Standardization
658:to create confidence in a potential consumer.
1396:
139:The examples and perspective in this article
631:standards operating within the organization
546:(a) healthcare may be too expensive at home
53:Learn how and when to remove these messages
1403:
1389:
1238:"Roayal College of General Practitioners"
707:
687:
589:The following quote, from the website of
257:Learn how and when to remove this message
239:Learn how and when to remove this message
177:Learn how and when to remove this message
114:Learn how and when to remove this message
743:
445:Accreditation Commission for Health Care
1410:
1370:"Role of WHO in hospital accreditation"
1336:"JCI How much do they charge hospitals"
423:A number of larger countries engage in
1583:
1503:International healthcare accreditation
965:"Aged Care Accreditation in Australia"
914:Center on Budget and Policy Priorities
851:
591:Partners Harvard Medical International
437:Community Health Accreditation Program
275:international healthcare accreditation
75:contains content that is written like
1384:
1046:"Making Quality the Competitive Edge"
534:Reasons why patients are seeking out
431:, doing business internationally as "
338:Healthcare and hospital accreditation
1565:Incremental cost-effectiveness ratio
1524:Incremental cost-effectiveness ratio
1093:"United Kingdom Accreditation Forum"
962:
354:accreditation ascends as far as the
188:
125:
59:
18:
1482:Routine health outcomes measurement
944:from the original on 3 October 2009
733:QHA Trent out of the United Kingdom
607:Recent News and blogs | MedTripInfo
13:
1555:Clinical Quality Management System
833:United Kingdom Accreditation Forum
698:United Kingdom Accreditation Forum
669:(JCI) (based in the United States)
14:
1622:
1362:
1026:from the original on 14 July 2014
549:(b) waiting lists may be too long
273:, there is a growing interest in
34:This article has multiple issues.
1346:from the original on 8 July 2011
1122:"Joint Commission International"
193:
130:
64:
23:
1328:
1310:
1288:
1277:from the original on 2016-11-23
1259:
1248:from the original on 2006-04-27
1230:
1219:from the original on 1998-12-03
1201:
1190:from the original on 2016-10-23
1172:
1161:from the original on 2017-03-29
1143:
1132:from the original on 2024-05-01
1114:
1103:from the original on 2007-11-17
1074:from the original on 2009-06-20
1048:. 29 March 2010. Archived from
854:"Accreditation gains attention"
42:or discuss these issues on the
1085:
1056:
1038:
979:
956:
926:
901:
884:
845:
667:Joint Commission International
1:
1560:Disability-adjusted life year
963:Raik, Eva (7 November 2001).
934:"Health care: Bill of Health"
838:
418:
342:Fundamentally healthcare and
1318:"India Accreditation a Must"
1296:"India Accreditation a Must"
611:
7:
1601:Accreditation in healthcare
1529:Cost-effectiveness analysis
813:Patient safety organization
771:
219:the claims made and adding
153:, discuss the issue on the
10:
1627:
1570:Quality-adjusted life year
1534:Cost-minimization analysis
1462:Independent medical review
673:Trent Accreditation Scheme
334:, or "global healthcare".
323:socialised medical systems
1547:
1516:
1490:
1444:
1418:
1004:10.1136/bmjqs-2012-000852
852:Lovern, E. (2000-11-13).
356:World Health Organization
1477:Health services research
1472:Health impact assessment
325:exist, primarily in the
1445:Health care evaluations
1426:Evidence-based medicine
788:Health tourism provider
783:Evidence-based medicine
1498:Hospital accreditation
1151:"Accreditation Canada"
992:BMJ Quality and Safety
778:Hospital accreditation
749:
708:Accreditation services
688:Umbrella organizations
542:options are manifold;
425:hospital accreditation
344:hospital accreditation
747:
574:Clostridium difficile
512:. The importance of
467:form of advertising.
96:neutral point of view
1596:Health care industry
1457:Clinical peer review
1342:. 10 February 2008.
1155:Accreditation Canada
730:Accreditation Canada
159:create a new article
151:improve this article
141:may not represent a
1467:Health care ratings
1419:Concepts of quality
1412:Health care quality
449:The Compliance Team
376:clinical governance
88:promotional content
1539:Cost per procedure
1517:Costs and benefits
750:
204:possibly contains
90:and inappropriate
1591:Quality assurance
1578:
1577:
1436:Medical guideline
1431:Medical consensus
858:Modern Healthcare
823:International SOS
599:global healthcare
576:, ESBL-producing
540:Global Healthcare
529:Global Healthcare
518:Global Healthcare
489:Global Healthcare
481:Global Healthcare
332:"medical tourism"
267:
266:
259:
249:
248:
241:
206:original research
187:
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161:, as appropriate.
124:
123:
116:
57:
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1405:
1398:
1391:
1382:
1381:
1377:
1376:on May 17, 2006.
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1355:
1353:
1351:
1340:Joint Commission
1332:
1326:
1325:
1320:. Archived from
1314:
1308:
1307:
1302:. Archived from
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983:
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971:. Archived from
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940:. 26 June 2009.
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905:
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793:Health insurance
441:Joint Commission
433:Acreditas Global
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77:an advertisement
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1606:Medical tourism
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1052:on 14 May 2010.
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803:Medical tourism
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760:For hospitals,
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629:medical ethical
614:
603:medical tourism
595:medical tourism
582:Chaga's disease
572:, VRSA, VRE>
536:medical tourism
525:medical tourism
514:medical tourism
485:Medical tourism
477:medical tourism
421:
403:extended role.
397:standardization
340:
327:European Union.
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1452:Clinical audit
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1363:External links
1361:
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1327:
1324:on 2013-01-26.
1309:
1306:on 2013-01-26.
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998:(12): 979–91.
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409:medical ethics
389:evidence-based
360:patient safety
339:
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315:private sector
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145:of the subject
143:worldwide view
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92:external links
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1300:IMTJ Online
1180:"QHA Trent"
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561:infertility
559:treatment,
510:Philippines
399:" process.
1585:Categories
1281:2016-12-21
1252:2016-12-20
1223:2007-09-02
1194:2016-12-20
1165:2017-04-03
1136:2016-12-21
1107:2007-09-02
1078:2009-01-12
919:2024-08-14
864:(47): 46.
839:References
461:governance
419:Background
313:or by the
271:healthcare
213:improve it
84:improve it
39:improve it
1030:8 October
870:0160-7480
612:Consumers
502:Hong Kong
500:, India,
494:Singapore
307:financial
295:political
285:. It has
283:societies
217:verifying
155:talk page
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1344:Archived
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557:HIV/AIDS
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508:and the
506:Malaysia
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465:de facto
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384:research
352:hospital
303:business
279:standard
167:May 2022
149:You may
578:E. coli
443:, TJC,
299:ethical
287:medical
211:Please
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