苏州市社会医疗保险在社区卫生服务中的影响分析

目的:了解苏州市社区卫生服务机构的业务收入与社会医疗保险情况及两者之间的关系。方法:对苏州市三个老城区所属的37家社区卫生服务机构的业务收入进行问卷调查及定性访谈。结果:在2006年度苏州市社区卫生服务的业务收入中,基本医疗收入所占的比重最大,在90%左右。而在基本医疗收入中,比例最高的依旧是药品收入,占业务总收入的80%左右。社会医疗保险对社区卫生服务机构的覆盖率是91.7%,对其业务收入的补偿在60%左右。苏州市三个老城区在社区卫生服务业务总收入和社会医疗保险的补偿方面均无统计学差异。结论:药品收入是社区卫生服务业务总收入的主要来源,社会医疗保险在社区卫生服务机构中的覆盖面较广、补偿程度较高。     

我国卫生监督机构财政收支状况分析

研究采用分层整群抽样的方法选取样本,通过对我国东、中、西部11省共209个样本卫生监督机构的调查,分析我国卫生监督机构财政收入、财政支出水平。结果显示:2005年,样本卫生监督机构总收入平均为302.2万元,总支出平均为314.3万元,政府投入占卫生监督机构支出比例的平均水平为73.0%,县级政府这一比例仅为55.8%。而大多数"全额拨款"机构与其单位性质不相符,真正实现全额拨款的也只有20.4%的机构,甚至有0.5%的机构政府投入为0。提示政府尚未真正承担其卫生监督机构的筹资职能。     

2001～2006年我国卫生监督机构不同渠道经费来源分析

目的评价2001～2006年我国卫生监督机构不同渠道经费来源的变化趋势及其构成比例的变化情况。方法通过全国系统抽样,获取2001—2006年卫生监督机构政府财政拨款、服务收入、上级补助和其他投入等不同渠道的经费情况。结果：（1）从绝对数看,与体系3年建设前相比,服务收入下降了6．4％,上级补助收入增加了7．3％,其他收入增加了23．0％;（2）从构成情况看,财政拨款所占比重从2001年的62．1％上升到2006年的74．4％,而服务收入所占比重从2001年的32．9％逐年下降到2006年的21．2％,已经表现出了政府对财政投入逐步重视、机构对服务收入依赖性有所下降的良好趋势。     

完善社区卫生机构筹资机制

城市社区卫生服务中心筹资现状 从我们调查的社区卫生服务中心筹资来源来看,全额预算管理社区卫生机构的政府财政补助占总收入的比例是22．8％,差额预算管理的社区卫生机构的政府财政补助占总收入的比例是12．2％。业务收入的主要来源依然是药品的收入,大概占66％。     

免疫接种筹资政策的变化及存在的问题

我国公共卫生服务机构的收入主要来自政府投入、业务收入和其他收入三个方面。政府投入主要包括政府预算拨款和专项经费投入；业务收入主要包括体检收入、有偿服务收入和监督监测收入。近年来，我国公共卫生服务系统的筹资机制经历了很大的变化。由于政府财政支付能力的限制和卫生服务成本的增加，公共卫生服务机构对政府投入的依赖性下降，     

内蒙古实施乡村卫生服务一体化管理的乡村两级医疗机构经济运行试点研究

目的:分析乡村卫生服务一体化管理对乡村两级医疗机构运行的影响,并提出相应的政策建议。方法:收集样本地区卫生统计年报和卫生财务年报数据,采用描述性统计方法分析内蒙古巴彦淖尔市两试点旗县乡村两级医疗机构2010—2013年的经济运行情况。结果:乡村卫生服务一体化管理实施后,乡村两级医疗机构总收入、财政收入增加明显,药品收入占总收入的比重呈下降趋势;总支出整体呈上升趋势,药品支出占总支出比重逐年下降;乡镇卫生院总收支结余率增加,村卫生室总收支结余率下降,药品收支结余率逐年下降,并伴随基本药物零差率制度的实施而为零。结论:乡村卫生服务一体化管理实施之后,乡村两级医疗机构筹资来源得到改善,逐步破除"以药养医"的事实,但由于该制度的实施对两级机构经济运行冲击较大,在提高自身服务能力和水平的同时,需要继续加大财政投入,尤其是对村卫生室的投入。     

试论医院药品收支两条线的管理与思路

为贯彻《医院药品收支两条线管理暂行办法》 (以下简称《办法》) ,２０００年９月 ,由温州市体改委牵头会同市卫生局、财政局、物价局等部门组成调研组 ,对温州市８所各类公立非营利性医院进行调研 ,现分析如下 :一、八所医院近三年的财务状况１．业务收入。近三年来 ,八所医院药品收入占业务总收入的比重都在５０%以上 ,其中中医院该比重超过６０% ,反映了医院特别是中医院难以摆脱“以药养医”的困境 (详见表１)。业务总收入 医疗收入（占总收入 %）药品收入（占总收入 %）１９９７２１５６８．５９０１２．６６（４１．７９）１１６７９…     

新医改后山东省基层医疗卫生机构收支结构研究

目的 :分析2009—2015年期间山东省基层医疗卫生机构收支结构变化情况,提出相应策略。方法 :资料来源于《2009—2016年的山东省卫生统计年鉴》和《2015年山东省卫生和计划生育事业发展统计公报》等。采用定性分析、描述性分析与对比研究等方法。结果 :山东省基层卫生机构总收入与总支出逐年增加,年均增长率分别为14.47%和14.80%,但收支结余率下降;收支结构变化明显,财政补助收入占比逐年增长,业务收入占比逐年下降,人员支出占比增长且增速较快。结论 :应继续强化政府责任,加大财政补偿力度,进一步增加人员经费和公共卫生事业补助的比重。     

发展特色医疗专科 培植卫生经济亮点

近年来 ,我们通过专科建设打造特色品牌医疗 ,培植卫生经济新的增长点 ,取得了明显成效。 2 0 0 1年全县医疗业务收入 1 .0 5亿元 ,专科收入占医疗总收入的 1 5 %。其中 ,经过县卫生局验收挂牌的 1 1个特色专科的收入达到卫生院医疗业务收入的 2 0 %以上。医疗专科的蓬勃发展 ,     

发展特色医疗专科培植卫生经济亮点

医疗专科建设是卫生经济发展的新亮点,是患者就医的聚焦点,也是医疗单位生存与发展的关键所在.近年来,我们通过专科建设打造特色品牌医疗,培植卫生经济新的增长点,取得了明显成效.2001年全县医疗业务收入1.05亿,专科收入占医疗总收入的15%.其中,经过县卫生局验收挂牌的11个特色专科的收入达到卫生院医疗业务收入的20%以上.医疗专科的蓬勃发展,为全县医疗单位特别是乡镇卫生院提升了卫生经济、增添了发展后劲.我们的做法是:     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

Changes in Fatty Acid Composition in Beef in Italy

Results from a study conducted in Italy concerning the updating of composition data of beef consumed in Italy are reported here. The study required a very wide sampling plan with regard to both animals and cuts to analyse. Data related to lipid composition of the most widely used type of beef consumed in Italy (young bull, 16–22 months old) show a reduction in total lipid content (which, according to the cuts, ranges between 1.8 and 10.2%) and a substantial change in fatty acid composition, with a high % of polyunsaturated fatty acids (mean 20% of total fatty acids). Such data have been confirmed by other studies conducted in Italy, and are in contrast with data reported in the tables of food composition from other countries, reporting a fatty acid composition characterized by a high fatty acid saturation degree. The occurrence of long-chain polyunsaturated fatty acid is probably due to the high ratio of phospholipids: triglycerides, occurring when the content in intramuscular lipid is very low; to the young age of animals; to the reduced activity of the rumen, where saturation of fatty acids occurs. It may be concluded that a fatty acid composition, which is particularly rich in polyunsaturated fatty acids, seems typical for Italian products.     

Changes in immune function in asthma in the elderly

Asthma is an inflammatory disorder of the airway. The airway inflammation of asthma is typically an allergic inflammation characterized by cells and mediators described as a "Th2" inflammatory response. There is a growing body of evidence describing changes in the function of immune cells upon aging, a phenomenon referred to as "immunosenescence". Several studies utilizing animal models and human subjects with asthma have begun to explore age-related effects on the airway inflammation in asthma. This review explores the existing data on the presence and effects of immunosenescence or age-related changes in immune function in asthma.     

Increase in social inequality in health expectancy in Denmark

AIMS: Health expectancy represents the average lifetime in various states of health and differs among social groups. The purpose of the study was to determine trends in social inequality in health expectancy since 1994 between groups with high, medium and low educational levels in Denmark. METHODS: The study was based on data from nationwide registers on educational level and mortality during the period 1994-2005 and data on health status derived from the Danish Health Interview Surveys carried out in 1994, 2000 and 2005. Expected lifetime in self-rated good and poor health, lifetime without and with longstanding illness and expected lifetime without and with long-lasting difficulties or restrictions were estimated by Sullivan's method. RESULTS: Between 1994 and 2005, life expectancy at age 30 years increased by 1.9 years for men and 1.5 years for women with a low educational level. For people with a high educational level, the increase was 2.7 years for men and 2.2 years for women. The difference between people with low and high educational level in expected lifetime in self-rated good health increased by 2.0 and 1.3 years for 30-year-old men and women, respectively. The social gap also increased for other indicators. CONCLUSIONS: During the past 12 years, social inequality in life expectancy and health expectancy has increased in Denmark, but the proportion of the population with a low educational level has decreased.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。