初级卫生保健试点县妇幼保健投入产出分析

对我国１５５个初级卫生保健试点县卫生事业拨款与妇幼保健经费进行了分析。结果表明，妇幼保健经费总额、人均妇幼保健经费与当地经济水平呈正相关。但小康地区的妇幼保健经费占卫生事业费的比例最低，表明妇幼保健经费的增长滞后于卫生事业费的增长，当妇幼保健经费由低投入提高到中等投入时，其产出明显提高。     

初级卫生保健试点县妇保健投入产出分析

对我国１５５个初级卫生保健试点县卫生事业拨款与妇幼保健经费进行了分析。结果表明，妇幼保健经费总额、人均妇幼保健经费与当地经济水平呈正相关。但小康地区的妇幼保健经费占卫生事业费的比例最低，表明妇幼保健经费的增长滞后于卫生事业费的增长，当妇幼保健经费由低投入提高到中等投入时，其产出明显提高。     

镇、村级肺结核病防治的措施与效果

目的：探索镇、村两级卫生机构在结核病防治工作中的作用，寻求有效结核病防治措施。方法：自2006年起，从完善肺结核病组织管理人手．实行明确责任与奖惩相结合的措施，以加强肺结核病健康教育宣传为抓手．不断强化对肺结核病人的管理．规范防治肺结核病经费的发放。结果：通过2年的观察实践，本地区结防工作各指标比前两年有较大提高。结论：采取新措施对促进结核病防治工作有重要作用。     

江苏省县级卫生防疫经费投入情况分析

分析了1990－1994年江苏省县级卫生防疫经费投入状况，并与全国水平比较，表明江苏省卫生防疫经费投入不足。为使卫生防疫事业与社会经济同步发展，建议在拓宽卫生防疫有偿服务渠道的同时，应提高卫生防疫经费的财政投入。     

浅谈市场经济条件下的食品卫生监督

随着市场经济的发展，人民生活水平和消费水准的提高，食品卫生问题越来越被人们重视，卫生监督已成为社会主义法制的重要组成部分。食品卫生监督工作不但通过保护公众的健康而促进生产力的发展，间接为经济建设贡献力量，还直接对建设市场经济体制的形成起到了规范、促进的作用。例如：通过严格发放卫生许可证加强食品生产经营单位对基础卫生     

关于乡镇卫生院建设的若干举措

近几年来，自治区党委和政府对卫生工作高度重视，下发了《广西关于加快我区卫生改革与发展的决定》、《关于加强初级卫生保健工作通知》等文件，出台了一系列农村卫生政策。如自治区财政每年拨出2000万元用于乡镇卫生院危房抢修，乡镇卫生院预防保健人员经费和业务经费由财政预算安排，县、乡两级政府每年拨出一定经费补助乡村医生报酬，使其收入不低于当地村干部水平，促进了农村卫生事业的发展。     

挪威以病例为依据向医院发放经费评析

挪威有１９个州，其经费分别由各州根据其人口数发放固定的补助金，实践下来并非十全十美，遂于１９９１年起选择四家医院作为试点，经费一部分由补助金补给，另一部分则根据疾病类别和例数领取补贴，试行二年，和原法比较，仍存在一些问题与不足。     

妇女保健经费管理模式的探讨

妇女保健服务是公共卫生服务的重要组成部分。三门县加大经费投入用于提高妇女健康生育水平。本文旨在探讨如何在新的形势下,在有限的经费投入与提高妇女健康生育水平之间找到最佳契合点,提高公共卫生经费的使用效率。目前三门县有     

盐城市县级妇幼保健机构现状调查

掌握妇幼保健机构现状，探讨加强县级妇幼保健院机构建设的措施。方法：发放调查表，现场核对．查阅资料。结果：县级妇幼保健机构技术服务水平等方面有了极大提高，与系统内医疗、防疫等行业相比存有差距，人员配备、技术装备、妇幼经费、技术工作还较薄弱。讨论：县级妇幼保健机构需重点搞好特色服务，加强队伍建设，依靠科技进步，求得突破。     

地方债券与自治体医院的关系

自治体医院应根据各所在的地区实际情况而开设并遵守地方自治法、财政法、公营企业法等。其经费主要来源于财政部门发放地方债。为了提高地方公共团体的自主性和独立性，激活地域社会经济活力，修改了地方债务制度、改革了财政投融资制度、加强医院预算管理设立了执行经理审批财务制度保证医院（地方公共团体）等正常运营。     

A PICTURE OF LOCATIONAL-OCCUPATIONAL DIVERSITY: AN ANALYSIS OF THE NEEDS OF RURAL AND REMOTE HEALTHCARE WORKERS WHEN WRITING RHSET APPLICATIONS

ABSTRACT: Methods for meeting the research needs of rural/remote health workers have been assessed on the assumption that these workers form a seemingly homogeneous group. This paper provides a picture of locational-occupational diversity not previously considered when addressing the needs of rural health workers writing research and project grant submissions. Rural/remote health workers and researchers were surveyed about their needs when seeking assistance with the development, implementation and evaluation of funded project/program proposals. New South Wales respondents were differentiated according to five geographical locations and 10 occupational categories. The results suggest that geographical location and occupational category are major factors in determining research requirements for rural/remote health workers and researchers, and should be considered when identifying barriers to the development and implementation of research projects in rural/remote health care issues. Those health workers most isolated required access to resource information and research and grant writing skills development, while researchers in metropolitan areas were more inclined to seek funding information and general assistance. Those in occupational categories who do not generally receive research and grant writing skills training are less likely to attract funding than their more 'academic' counterparts.     

The effects of federal funding cuts on family planning services, 1980-1983

According to data from surveys conducted in the past two years, some changes occurred in the provision of family planning services between 1980, the year before the 1981 federal budget cuts, and 1983. Six percent of the family planning agencies that were operating in 1980 had closed or had stopped offering medical family planning services by 1983. The annual income of the family planning agencies that continued to operate, adjusted for inflation, was lower in 1983 than in 1980. While Title X remains the principal source of family planning funding, the proportion of clinics receiving income from Title X declined substantially during the period under study; this drop occurred among all types of providers. There was a slight decline in the proportion receiving funding from the Social Services block grant (formerly Title XX) in 1983, but there was no change in the contribution made by the Maternal and Child Health (MCH) block grant (formerly Title V). The proportion of total clinic income represented by Title XIX (Medicaid) funds rose slightly during this period. Decreases in federal funding appear to have been partly offset by an increase in the proportion of total income contributed by state and local governments and by private sources, particularly patient fees. Indeed, the number of agencies that collected patient fees, the proportion of clinic income derived from such fees and the proportion of patients who paid at least part of the cost of their family planning services all increased between 1980 and 1983. A separate survey of providers shows that fees varied widely, depending on a woman's income and on the type of agency.(ABSTRACT TRUNCATED AT 250 WORDS)     

Adolescent pregnancy program stresses family counseling, educational services

Pathways, and adolescent family life demostration program at St. Ann's Infant and Maternity Home in Hyattsville, Maryland, which initiated activities in March, 1983, served 268 clients in its 1st year. 59% were 17 years of age or under. A 5-year grant from the Department of Health and Human Services Office of Adolescent Pregnancy Programs provided for residential care for pregnant adolescents lacking family to assist them in the last phase of pregnancy; a day program offering accredited educational services and community vocational resources, training in parenting skills, individual and family counseling, and prenatal care for teenagers; an aftercare residence for adolescent mothers and their infants with an intensive program of vocational and parenting education; and a community outreach program offering health care, counseling, family life education, adoption, and other services. The program differs from previous programs at St. Ann's in 5 main ways: 1) substantial care is available to teenage mothers after delivery 2) educational services have been expanded for mothers living at home and attending during the day 3) a more comprehensive counseling program with more intensive family focus in included 4) the program is raching out into the community with a range of services to adolescents seeking assistance, regardless of race, religion, or financial status, and 5) an evluation program has been developed to monitor the operating program, the adolescents receiving services, and their children. The National Center for Family Studies at the Catholic University of America has assisted in staff training and service delivery design. Follow-up studies on clients who have left the program are only beginning. Counseling plans are formulated to fit individual needs, but all residents participate in group therapy sessions led by a psychiatrist and social worker. The infants' fathers and the adolescents' parents recieve services when possible. Although the grant finances the basic program, additional funds are contributed by foundations, United Way, program service fees, and public agencies. Client fees are based on a sliding scale which ranges from 30-100% of the acutal cost of care. Maximum enrollment in the program is 8 mothers and babies in the Aftercare Program, 25 adolescents in the residential program, 10-16 in the day programs, and 40-50 in the coumunity outreach program.     

Access and payment for health care: the poor of Northern Vietnam

In common with many developing countries, Vietnam has begun to introduce user fees at community and district level. This is part response to the transformation of the economy, economic recession, and the growing acceptability of alternative forms of health finance. This article examines the impact of these charges on the rural poor. Results from a 1995 survey in North Vietnam suggest that the poor generally delay treatment, make less use of government health facilities, and pay more for each episode of illness than the rich. There is evidence that the poor are forced to reduce consumption of essential goods or to borrow to meet these charges. A significant minority are deterred from using facilities. The current system of exemptions fails to provide adequate protection to the poor and a completely new system is required. The results suggest that it is the poor in poorer communes that are most affected by high user fees and it is to these areas that any assistance from government or donors should be targeted.     

Building a regional health equity movement: the grantmaking model of a local health department

The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.     

Financing newborn screening: sources, issues, and future considerations.

Newborn screening (NBS) programs are population-based public health programs and are uniquely financed footline compared with many other public health programs. Since they began more than 45 years ago, the financing issues have become more complex for NBS programs. Today, almost all programs have a portion of their costs paid by fees. The fee amounts vary from program to program, with little standardization in the way they are formulated, collected, or used. We previously surveyed 37 of the 51 dried blood spot screening programs throughout the United States, and confirmed an increasing dependence on NBS fees. In this study, we have collected responses from all 51 programs (100%), including updated responses from the original 37, and updated our fee listings. Comments from those surveyed indicated that the lack of a national standardized procedural coding system for NBS contributes to billing complexities. We suggest one coding possibility for discussion and debate for such a system. Differences in Medicaid interpretations may also contribute to financing inequities across NBS programs and there may be benefit from certain clarifications at the national level. Completed survey responses accounted for few changes in the conclusions of our original survey. We confirmed that 90 percent of all NBS programs have a fee paid by parents or a third party payer. Sixty-one percent reported receiving some funds from the Maternal and Child Health Services Title V block grant, 33 percent reported some funding from state general revenue/general public health appropriations; and 24 percent reported obtaining direct reimbursement from Medicaid (without passing through a third party). A majority of programs (63%) reported budget increases between 2002 and 2005, with increases primarily from fees (72%) and to a lesser extent from Medicaid, the Title V block grant, and state general revenues.     

Characteristics of a medical care program for specific diseases in Japan in an era of changing cost-sharing

The Medical Care Program for Specific Diseases (Specific Diseases Program) was initiated in 1972. The Program has two major components; research grant for specific diseases and medical cost subsidy for specific diseases. The research grant component now targets 118 diseases, and the medical cost subsidy component supports all or part of the co-payments of medical expenses for patients of 44 out of the 118 research target diseases. The present study reviewed public assistance programs for the vulnerable population in Japan, particularly those with designated Specific Diseases, in the context of the wider social security system. Existing governmental information were abstracted and analyzed. The results showed that the recent reform of the Specific Disease Program, which requires the patients in this Program to share a small portion of the medical costs, influenced the number of patients and health services utilization. Other health insurance reforms also have significant effects on the number of patients registered in the Specific Diseases Program, reflecting the relative merit/demerit of the Program in comparison with the general health insurance scheme. Therefore, in an environment of social security reform, formulation of health care policies for specific programs should take into account the relative merits and demerits of the Program in question, in comparison with the general health insurance scheme, to avoid misestimating the number of patients covered by the Program and their utilization of health care services.     

县级公立医院医药分开改革对医院收入和医疗服务的影响——基于广西的实证分析

目的:评价广西县级公立医院医药分开改革对医院收入和医疗服务的影响。方法:采用前后对照设计,2009—2012年为干预前,2013年为干预期,试点县级公立医院为干预组,非试点县级公立医院为对照组;数据来源于2009—2013年医院统计报表和新农合报表、2010—2014年广西统计年鉴;采用基于回归的倍差法进行分析。结果:医药分开改革包括取消药品加成、提高诊查费和护理费项目价格、降低大型设备检查项目价格和增加财政补助;在医院收入方面,相对于非试点医院,试点医院药品收入减少332.6万元、医疗收入增加1 075万元,财政补助没有显著变化;在医疗费用方面,相对于非试点医院,试点医院次均门诊药品费用减少3.51元、次均门诊诊查费用增加2.23元、次均住院药品费用减少133.50元、次均住院诊查费用增加62.01元、次均住院护理费用增加69.72元,门诊和住院人次、平均住院日、次均门诊和住院费用均无显著变化。结论:县级公立医院住院医疗服务价格调整弥补了取消药品加成带来的损失,门诊需通过政策外项目费用调整来弥补损失。医药分开改革没有减少试点医院业务收入,但对医院和医生的激励作用有限。     

Child care in Slovenia: an example of a successful transition

Slovenia is a country which has managed to retain most of its advantages and achievements in preschool child care attained in the socialist period, while, during the transition years, rather successfully reforming services according to principles of the market economy. The female activity rate has been high since the mid 1940s, and female employment has been the main factor influencing the demand for preschool child care services. Slovenian mothers work full-time and after 1 year of paid maternity and parental leave they mostly stay in the labour market. Child care facilities, 70% of them constructed in the period 1971-1985, are sufficient for almost 60% of the preschool population, and just a very small percentage of demand remains unmet. Child care services are traditionally highly subsidised. On average, parents finance up to a quarter of the current costs, so that the average in-kind transfer for a child in child care amounts to about 30% of the average net salary. Social assistance recipients are exempt from paying fees altogether, while the rest of the parents pay from 15% to 80% of the current costs. The highest fee is paid by families with a per capita income > 110% of the average salary in Slovenia. Research into the burden of parental fees for child care in Ljubljana in 1994 has shown that three-quarters of families spent between 5 and 15% of their total net income on child care (for one or more children). For three-quarters of families, the total of fees paid did not exceed 30% of their net income per family member. The lower middle income group was relatively most burdened by child care fees.     

The science of sex research: Some methodological considerations

This paper represents a review of substantive theoretical, methodological, and statistical issues relevant to conducting research on human sexual behavior. Guidelines for maintaining rigor and precision in future investigations are also proposed. So as to be able to address issues that pervade all research on human sexual behavior, six topic areas are discussed: theory-related issues, issues involving research design, issues involving subject selection, measurement issues, data-analytic issues, and issues concerned with human-subject protection. The ultimate objective of this paper is to make suggestions aimed at improving the quality of research on human sexual behavior.Invited paper, Conference on Methodology in Sex Research, Washington, D.C., November 8–19, 1977. This investigation was supported in part by a Research Scientist Development Award (KO2-DA00017), Biomedical Research Support Grant from University of California, Los Angeles, and research grant DA1070 from the U.S. Public Health Service. The assistance of Bonnie Barron is gratefully acknowledged.