国外医疗旅游研究现状及启示

文章通过对近年来医疗旅游的外文期刊文献进行归纳和整理,从医疗旅游定义、医疗旅游者决策影响因素、医疗旅游者面临的风险、医疗旅游的影响四个方面综合分析了国外医疗旅游研究现状。在此基础上,文章从医疗旅游者、医疗旅游陪同者、医疗旅游中介机构三个方面对我国医疗旅游研究进行了展望,建议通过构建医疗旅游发展模式、提供国际化的医疗服务、完善医疗旅游政策法规、培养和吸引医疗旅游人才等措施促进我国医疗旅游业发展。     

基于利益相关者理论的农村县乡两级医疗服务整合作用机制分析

目的:分析利益相关者的利益诉求对农村县乡两级医疗服务纵向整合的影响机制。方法:通过对黔江、黄陂、扬中三地区的利益相关者访谈资料进行词频分析,确定各地区利益相关者的利益诉求;通过利益诉求调查问卷了解各地区利益相关者对各类诉求的重视程度和利益得失情况;借鉴综合评价和博弈论的理论方法分析各地区利益相关者的诉求得益情况对其行为反应的影响。结果:各地区的整合政策均在不同程度上反映了利益相关者的利益诉求;利益诉求效益评分越高的地区,其利益相关者对整合政策的行为配合意愿越强。结论:农村医疗服务整合的改革政策应综合考虑各利益相关者的利益诉求;利益相关者的利益诉求满足情况越好,其配合整合改革的动力越强,从而可在一定程度上影响当地整合改革的实施效果。     

山东发展医疗旅游产业的SWOT分析

医疗旅游是医疗和旅游相结合的产业新形式,已成为泰国、印度等亚洲国家的主要经济增长点。本文对山东发展医疗旅游进行了利益相关者分析和SWOT分析。     

医疗服务支付方式改革利益相关者分析

医疗服务支付方式改革是医药卫生体制改革核心问题之一.支付方式能够影响医疗服务利益相关者的行为,从而对医疗费用、医疗质量、医疗服务效率和医疗保险资金使用的效益产生影响.通过对利益相关者在按服务项目支付、按诊断相关组定额预付、总额预付3种支付方式中的行为分析发现,按诊断相关组定额预付既能够切实控制费用增长,使医疗质量得到保障,又能够较好地满足支付方式改革中各利益相关者的诉求.但是,各利益相关者在按诊断相关组定额预付支付中,需要不断完善病案首页数据填报、临床路径使用、信息系统建设、成本核算、费用结构调整等方面.     

儿科医疗联合体利益相关者分析

儿科医疗联合体涉及到不同部门及群体之间的利益关系,各利益相关者的态度和行为直接影响联合体的运行。作者通过对江苏省某儿科医疗联合体的利益相关者访谈,发现各利益主体在联合体具有不同的利益诉求,政府部门期望较大,支持力度和拥有资源最大;患者、成员单位医务人员对联合体的影响力相对较低,核心医院及其医务人员拥有资源较大,但对医联体的支持力度较低。应综合考虑不同利益相关者诉求,构建儿科医联体利益平衡机制,推动儿科医联体平稳有序发展。     

医联体建设中的利益协调困境及协同治理机制研究

医联体利益相关者的利益协调存在价值理念缺失、制度设计缺陷和适宜治理机制缺乏等困境,其根源在于利益相关者系统的复杂性和系统性,协同治理强调治理主体的多元协同并组成利益共同体,各利益相关者互相配合和协调,共同进步以达到协同治理优势。研究建立了医联体利益相关者协同治理综合分析理论框架,并提出了协同治理的价值认同机制、行为合作机制和利益共享机制,达到医联体组织建设公共价值增溢效应的目的。     

利益相关者视角下的远程医疗发展策略研究

远程医疗是一个多维的、复杂的系统,它涉及众多不同利益主体,包括政府、各级卫生行政部门、医院、医生、患者和软硬件企业等。结合远程医疗的特点,依据利益相关者理论,首先将远程医疗利益相关者进行分类,然后分析他们的利益诉求,最后提出促进远程医疗发展的有效策略。     

普惠保参与罕见病保障的利益相关者分析与政策建议

目的：基于利益相关者视角,对普惠保参与罕见病保障的利益相关者进行识别,对存在的问题予以分析。方法：使用文献综述法和米切尔评分法进行利益相关者的识别、分型和关系分析,对已明确的主要利益相关者进行定性访谈,探究其在参与普惠保过程中的诉求、定位与阻碍因素。结果：医疗保障局、银保监会与主承保公司为“确定型利益相关者”,对普惠保发展影响最大。编码最终形成了63条概念,并从利益诉求、角色、优势、难点和行为策略5大范畴对各利益相关者进行分析和阐述。结论：各利益相关者之间诉求存在差异,职责不够明晰,有效协同程度不够。     

双向转诊制度下的日间手术利益相关者研究

为解决当前医疗需求与有限医疗资源之间的矛盾,开展日间手术成为了一种必要的手段。合理利用双向转诊进一步优化日间手术的管理模式,有利于提高医疗资源的利用效率,实现医疗全覆盖。采用文献分析、专家咨询等方法,深入探讨日间手术双向转诊过程中涉及的核心利益相关者,并分析核心利益相关者的角色作用、承担责任、利益得失等,最终根据分析结果提出针对性的建议和对策,以促进日间手术双向转诊的顺利实施,为双向转诊与日间手术的研究发展提供新视角。     

公立医院经济运行博弈分析和机制选择

公立医院经济运行是一个复杂适应系统,多方不完全信息下的动态博弈格局是公立医院在市场经济环境下资源优化配置不可或缺的经济过程,各方博弈的动态均衡是医院经济和谐运行的基础。在公立医院经济运行中,利益相关者的不当行为异化了公立医院经济运行主体的博弈行为,如政府的双重目标,使得医院注重医疗服务收入;医药市场无序竞争,医院进行成本转移;医疗保险效用不强,医患控费意识薄弱;患者盲目就医和监督不力,医师诱导医疗需求;医院考虑自身经济利益,默许过度医疗行为等。本文在分析公立医院经济运行的博弈特征和利益相关者的博弈行为的基础上,提出了促使公立医院经济活动达到相对均衡稳定的运行机制：利益关联机制、信息显示机制和激励约束机制。     

Tourist health as a new branch of public health

Tourism has been steadily expanding in recent years and continues to do so, with the result that the health and social problems related to this new mass phenomenon are growing likewise. Urgent and serious attention to the various implications is now required on the part of relevant national and international bodies and of all sectors interested in the health and wellbeing of tourists, both in their place of origin and at their destination. Tourist health is a new branch of public health concerned with the protection and promotion of the health of tourists. The traditional role of medicine has always been to deal with the health aspects of the most important of life's activities, such as work and sport. The medical profession cannot therefore neglect a leisure-time pursuit such as tourism, in view of its wide-ranging health implications. The Italian Association for Tourist Medicine (IATM) and the Tourist Health Centre, with headquarters in Rimini, were founded in 1983 to assist in the creation of tourist health as a discipline and to promote its development. An international meeting on Prevention and control of infections in tourists in the Mediterranean area, organized in close collaboration with the World Health Organization (WHO) and the World Tourism Organization (WTO) was held in Rimini on 8-11 February 1988. The meeting recommended that the IATM act as focal point in the promotion of tourist health and tourist medicine, especially for countries in the Mediterranean area. In December 1988, the Tourist Health Centre, Rimini was designated as a WHO collaborating centre for tourist health and tourist medicine.(ABSTRACT TRUNCATED AT 250 WORDS)     

Government use licenses in Thailand: an assessment of the health and economic impacts

Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism's growth for health systems, drawing on the cases of Thailand, Singapore and Malaysia, three regional hubs for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growth of the medical tourist industry. This article calls for a universal definition of medical tourism and medical tourists to be enunciated, as well as concerted data collection efforts, to be undertaken prior to any meaningful empirical analysis of medical tourism's impact on health systems.     

Medical tourism in Thailand: a cross-sectional study

ObjectiveTo investigate the magnitude and characteristics of medical tourism in Thailand and the impact of such tourism on the Thai health system and economy.MethodsIn 2010, we checked the records of all visits to five private hospitals that are estimated to cover 63% of all foreign patients. We reviewed hospital records of foreign patients and obtained data on their countries of origin, diagnoses and interventions. We surveyed 293 medical tourists to collect demographic characteristics and information on their expenditure and travelling companions. To help understand the impact of medical tourism on the Thai health system, we also interviewed 15 hospital executives and 28 service providers from the private hospitals.FindingsWe obtained 911 913 records of hospital visits, of which 324 906 came from 104 830 medical tourists. We estimated that there were 167 000 medical tourists in Thailand in 2010. Of the medical tourists who attended our study hospitals, 67 987 (64.8%) came from the eastern Mediterranean region or Asia and 109 509 (34%) of them were treated for simple and uncomplicated conditions – i.e. general check-ups and medical consultations. The mean self-reported non-medical expenditure was 2750 United States dollars. According to the hospital staff interviewed, medical tourism in 2010 brought benefits to – and apparently had no negative impacts on – the Thai health system and economy.ConclusionWe estimate that the total number of medical tourists visiting Thailand is about 10% of previous national government estimates of 1.2 million. Such tourists appear to bring economic benefits to Thailand and to have negligible effects on the health system.     

我国健康旅游产业发展对策研究

在我国政府大力推进健康服务业发展的政策背景下,我国健康旅游产业正迎来发展的黄金时期。本研究在综合国内外文献的基础上,理清健康旅游的定义和分类,指出了当前我国健康旅游产业重点关注老年人、女性、高端医疗以及国际市场。在此基础上分析了我国健康旅游产业发展存在的问题,主要包括缺乏权威的行业统计标准、资源整合不足、缺乏明确定位、复合型人才缺乏、相关法律法规有待完善。为推动我国健康旅游产业的发展,建议应当制定行业发展规划与统计标准、整合相关资源、明确自身优势、建立信息共享机制、加强自身宣传、人才培养和科学研究。     

旅行医疗的兴起与发展策略探讨

目的 了解国内外旅行医疗的发展状况,提出中国发展旅行医疗的建议.方法 使用文献分析法对国内外近10年的相关文献进行归纳梳理.结果 部分国家由于医疗费用低、等待时间短、技术设备满足需求等已经成为旅行医疗的重要目的地;中国发展旅行医疗具有潜在优势,目前还处于起步阶段.结论 应充分发挥市场机制的决定性作用,利用传统医药和旅游资源以及价格等优势,发展特色旅行医疗项目.     

温州市民营医院发展SWOT分析

目的 综合分析温州市民营医院的内外部环境影响因素,为温州市民营医院的进一步发展提出策略和建议.方法 采用SWOT分析法定性分析民营医院的优势、劣势、机会和威胁.结果 温州市民营医院拥有以社会需求为导向,营销方式多样性等突出优势,社会资本办医试点城市和民众医疗需求多样化趋势为民营医院发展提供机会;同时民营医院的发展也面临一些劣势和挑战:如医务人员离职率高,缺乏高学历人才,民众信任度低,外来务工人员减少等.结论 民营医院要重视人才和医院文化建设,提升技术水平和提高民众信任度.此外,政府部门应落实配套措施,营造公平的竞争环境.     

论新时代医疗保险公法人治理体制的创新——基于多中心治理理论

本文基于多中心治理理论检视发现，现行的医疗保险运行机制存在基本医疗保险基金所有权与管理权分离、医疗保险政策改革只能"做加法"不能"做减法"，其他相关利益主体缺位、改革无法满足多方诉求，医保经办主体动力和能力不足等问题。这些问题不仅导致医疗保险制度的可持续性面临严峻挑战，而且与实现全民统一医疗保险制度的目标渐行渐远。因此，在新时代背景下，为了构建权责清晰、保障适度、可持续发展的医疗保险制度，本文提出创新医疗保险公法人治理体制，完善中国特色医疗保险治理体系，同时推进社会保险公法人治理机制的创新，促进政府、市场与社会之间的协同与配合，最终实现推进国家治理体系和治理能力现代化的伟大目标。     

Health hazards of international travel

The growth of travel and the increasing numbers of those affected by travel-related illnesses, some of a serious nature, will cause this subject to demand the attention of the medical profession, the travel trade, travellers themselves and the health authorities of countries receiving tourists. Provision of appropriate advice for the traveller is a shared responsibility, best channelled mainly through travel agencies; it can moreover be shown to be cost-beneficial. Continued monitoring of illness in travellers and provision of information systems geared to this problem and its prevention are fully justified. They should be based on traditional channels of communication and currently-available modern technology, and be readily accessible to medical and related workers. Increased collaboration between medical workers, health educators and those involved in the travel trade would be a positive and useful contribution towards the reduction of illness and discomfort among travellers and the associated expense incurred by the various national health services concerned. There are clearly economic benefits from the development of international tourism, but these have to be balanced in countries accepting tourists by attention to the prevention of illnesses associated with travel.