与时俱进的公共健康促进与法制建设

1．1 从健康教育到健康促进再到公共健康促进需要法律支撑已是一个迫切的问题，在SARS的防制中已凸显出来。事实上健康教育的发展也正在向公共健康促进发展，健康促进扩展到公共健康促进，这不是一个名词的“改革”，而是把健康促进从卫生的范畴中拓宽了。健康教育不能代替公共健康促进，这是健康教育与公共健康促进有着本质的区别。健康教育涵盖     

我国疾控机构公共卫生技术支持工作现状分析

目的简要概括我国疾控机构公共卫生技术支持工作中的矛盾,分析这些矛盾并提出对策、建议。方法总结近年来国家疾控中心的公共卫生技术支持工作和对全国省级疾控机构公共卫生工作调研的信息。结果在健康危害因素监测、健康危害因素风险评估、检验出证、技术仲裁、技术咨询以及参与法规标准的制定和宣传等领域,各级疾控机构做了大量的公共卫生技术支持工作,但在职能定位、经费保障、能力建设以及部门工作协调等方面仍存在着突出问题。结论进一步明确职责和定位,规范疾控机构的公共卫生技术支持工作,建立专门的经费保障机制和工作沟通机制,不断地提高疾控机构的公共卫生技术支持能力。     

基于公共选择理论的医疗保障机制优化

现行医疗保障机制存在许多冲突面，暴露出很多问题。本文运用公共选择理论，分析医 疗保障机制中存在的政府与市场双重失灵现象，诠定政府与市场在医疗保障机制中的定位与协作 关系，优化医疗保障机制。     

宁波市建设新农村健康素质评价研究

目的：探讨宁波市建设新农村健康素质实现状况及其对策。方法：以线性综合加权法对建设新农村健康素质进行评价,并以宁波市2003-2007年新农村健康素质进行验证。结果：设计出以健康素质效果、健康投入与可持续发展支撑、健康公平与效率为＂度＂,包含22个基本指标为＂级＂的三度二级指标体系,实评结果表明宁波市2003-2007年建设新农村健康素质呈现出不均衡性,与实际情况基本相符。结论：文章提出的建设新农村健康素质评价体系是一种实用、有效的评价方法,并认为构建新农村公共健康保障机制,应具体问题具体分析,强化＂公共医疗卫生＂理念,加大政府卫生投入,预防控制影响农民健康的重大疾病,提高农民健康水平。     

卫生机构公共职能与政府卫生投入责任：以浙江省卫生投入测算与分析为例

从卫生机构公共职能的角度出发,探讨政府卫生投入的规模.认为卫生机构的不同公共职能应与政府投入责任以及预算安排直接联系.通过测算和分析浙江省政府卫生投入.提出为完善政府卫生投入保障机制.卫生机构的公共职能应与财政补助科目相对应,并根据不同的公共职能完善政府卫生投入的绩效评估机制.     

公共健康教育对流动老人健康的影响——基于农村老年流动人口视角

目的 基于农村流动人口的视角分析公共健康教育对我国农村流动老人健康的影响。方法 基于全国流动人口动态监测调查2015年调查数据，运用Probit模型以及倾向得分匹配方法分析公共健康教育对农村流动老人健康的影响。结果 接受公共健康教育使农村老年流动人口的自评健康状况向好的概率增加2.4%（0.5%～4.3%,P＜0.05）。纠正变量间的内生性后，公共健康教育使农村流动老人自评健康向好的概率增加2.5%～2.9%（P＜0.01）。异质性分析发现公共健康教育对高龄、高文化水平、东部地区的农村流动老人健康的影响更大。结论 公共健康教育对农村老年流动人口的健康状况有显著的正面影响。应充分考虑老年流动人口的特征，关注不同类别、不同文化水平农村流动老人的偏好，提供契合流动老年人的合理教育方式。     

上海市杨浦区公共浴室卫生现状调查

为了加强公共浴室的卫生管理，保障沐浴者的健康，预防传染病的传播，2008年我们对辖区公共浴室进行了卫生学调查，并对部分公共浴室内公共用品进行采样检测。     

当代中国公共健康伦理研究

我国对公共健康伦理的研究尚处于起步阶段。目前公共健康伦理的研究主要涉及公共健康伦理的定义,公共健康伦理与医学伦理、生命伦理的联系与区别,公共健康伦理研究的内容和目的,公共健康伦理的原则等等。但是,我国公共健康伦理研究尚未形成完整的学科体系,没有自己独特的理论视角和宏观的价值目标。     

广州地区公共健康投入的问题与策略分析

指出广州地区公共健康投入主要存在的问题是:公共健康投入增长滞后于经济增长;城乡拥有卫生资源不均衡,城乡健康投入差距拉大;政府对公共健康投入的力度不够。并提出调整公共健康投入战略的建议:转变公共健康投入观念;加大地方政府对公共健康投入的力度;调整健康投入的结构,提高宏观投资效率。     

走向完善的公共卫生--中国直面SARS触发的公共危机

公共卫生是社会抵御疾病风险，保障公众生命健康的重要组成部分。公共卫生功能弱化则必然成为公共卫生突发性事件和灾难发生的直接原因。当中国直面SARS触发的公共危机时，即充分暴露了我们公共卫生存在的缺陷与危机，又极大地激发、催化公共卫生快速进行一系列的重大改变，促使公共卫生从社会发展的“边缘”转位为“中心”；迅速建立公共卫生突发事件应急处理机制，为公众健康设定了安全警戒线；有效整合了社会公共伦理资源，培育了公众的公共道德和公共观念，重构了中华人民共和国现代公共伦理的强实基础。文章着重分析了我国公共卫生在SARS触发的公共危机中显露出来的缺陷，以及其带来的警示和机遇，提出我国公共卫生逐步走向完善是必然趋势。     

美国公共医疗保险的影响效应分析

作为美国医疗保险市场的重要组成部分,公共医疗保险近年来在市场上占据了相当可观的份额,并显现出强劲增长的态势。文章通过相关文献厘清目前美国公共医疗保险所产生的一系列影响,进而关注美国公共医疗保险的影响情况和溢出效应,并提出在未来研究公共医疗保险时应当着重考虑的方向和突破的重点难点问题,以及由此对我国医疗保险改革的经验借鉴。     

School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance

BACKGROUND: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. METHODS: This study assessed public school nurses' knowledge and beliefs of the impact of health insurance on students' health and academic success. The study also determined whether public school nurses or their schools were involved in helping students obtain public health insurance, and if so, how they did so. Additionally, the study assessed the public school nurses' perceived benefits of and barriers to helping students obtain public health insurance. A paper-and-pencil survey was sent to a national random sample of 750 public school nurses. The response rate was 56%. RESULTS: Nearly 60% of respondents had helped students enroll in public health insurance. The majority perceived that helping students obtain public health insurance would reduce school absenteeism (90%), improve attention during school (84%), reduce the number of students held back (80%), reduce school dropouts (72%), and increase academic test scores (69%). Although the majority (53%) of nurses thought schools should assist students' parents with filling out public health insurance enrollment forms, some expressed reservations about the process. CONCLUSION: School nurses indicated health insurance is important for the health and academic success of students. These beliefs are congruent with state Child Health Insurance Program (CHIP) directors' perceptions, yet few schools have taken on the role of facilitating student enrollment in public health insurance programs.     

School superintendents' perceptions of schools assisting students in obtaining public health insurance

Background: Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between health and learning, and specific school system practices for assisting students were also examined. Methods: A 4‐page questionnaire was sent to a national random sample of public school superintendents using a 4‐wave postal mailing. Results: Only 19% of school districts assessed the health insurance status of students. School districts' assistance in helping enroll students in health insurance was assessed using Stages of Change theory; 36% of superintendents' school districts were in the action or maintenance stages. The schools most often made health insurance materials available to parents (53%). The perceived benefits identified by more than 80% of superintendents were to keep students healthier, reduce the number of students with untreated health problems, reduce school absenteeism, and improvement of students' attention/concentration during school. The 2 most common perceived barriers identified by at least 50% of superintendents were not having enough staff or financial resources. Conclusions: Most superintendents believed schools should play a role in helping students obtain health insurance, but the specific role was unclear. Three fourths of superintendents indicated overwhelmingly positive beliefs regarding the effects of health insurance status on students' health and academic outcomes. School personnel and public policy makers can use the results to support collaboration in getting students enrolled in health insurance.     

法国的补充医疗保险及其借鉴意义

主要研究了补充医疗保险在法国社会保障制度中的作用,强调了其市场结构和业绩方面的主要特征。首先简要回顾了法国医疗保险制度发展的历史以及补充医疗保险与公共医疗保险的关系,接着介绍了公共医疗保险和补充医疗保险的保障范围和程度,考察了法国补充医疗保险的市场结构、监管法规和市场业绩。最后阐述了法国补充医疗保险对我国发展医疗保险的借鉴意义。     

Child health as human capital

Child health is increasingly understood to be a critical form of human capital, but only recently have we begun to understand how valuable it is and how its development could be better supported. This article provides an overview of recent work that demonstrates the key role of public insurance in supporting longer term human capital development and points to improvements in child mental health as an especially important mechanism.     

Healthcare financing in Syria: satisfaction with the current system and the role of national health insurance--a qualitative study of householders' views

This study aims to identify the satisfaction with the current public health system and health benefit schemes, examine willingness to participate in national health insurance and review expectations and preferences of national health insurance. To this end, qualitative semi-structured interviews were carried out with 19 Syrian householders. Our results show that a need for health reform exists and that Syrian people are willing to support a national health insurance scheme if some key issues are properly addressed. Funding of the scheme is a major concern and should take into account the ability to pay and help the poor. In addition, waiting times should be shortened and sufficient coverage guaranteed. On the whole, the people would support a national health insurance with national pooling and purchasing under a public set-up, but important concerns of such a system regarding corruption and inefficiency were voiced too. Installing a quasi non-governmental organisation as manager of the insurance system under the stewardship of the Ministry of Health could provide a compromise acceptable to the people.     

未来可能影响老年人口卫生费用的因素

随着人口的老龄化，老年人口的卫生费用在卫生总费用中的比例将会越来越高，本文对未来可能影响老年人口卫生费用的几个因素进行了分析，主要是医疗保障制度、老年人生活居住方式、医疗技术的发展和传播、疾病模式转变、公共政策的选择等。     

Regulating private health insurance to serve the public interest: policy issues for developing countries

Private health insurance plays a large and increasing role around the world. This paper reviews international experiences and shows that private health insurance is significant in countries with widely different income levels and health system structures. It contrasts trends in private health insurance expansion across regions and highlights countries with particularly important experiences of private coverage. It then discusses the regulatory approaches and policies that can structure private health insurance markets in ways that mobilize resources for health care, promote financial risk protection, protect consumers and reduce inequities. The paper argues that policy makers need to confront the role that private health insurance will play in their health systems and regulate the sector appropriately so that it serves public goals of universal coverage and equity.     

社会医疗保险制度下公立医院财政补助机制

我国医疗卫生体制已从公共融合向公共契约模式转变，社会医疗保险的迅速推进使基本医疗需方投入为主成为实际的政策选择。在社会医疗保险制度框架下，公立医院仍有部分支出不能由社会医疗保险支付，需要财政补助予以保障。政府财政补助应与公立医院绩效评估机制相联系，以对公立医院经营者形成有效的激励约束机制。     

对县域医改有关问题的思考

我国有些县的医疗改革缺乏全面统筹规划,不能有效地协调联动,致使县域卫生事业发展不平衡,卫生资源配置不合理,医疗卫生结构不协调。因此,县域医改一是要全面统筹规划,坚持整体发展,进行整体协调改革;二是要解决基础定位该怎么定的问题,资金从何处筹集、人员往何处去等关键问题;三是要打破以药养医,坚持公益性质,建立医改的保障机制,明确主体责任机制,坚持政策配套,投入常态机制和医技养医机制。