四川省民族地区精神卫生防治体系现状调查与对策研究

目的:了解四川省民族地区精神卫生防治机构的资源配置、能力建设与工作开展情况,为推进该体系的建设与发展提供参考依据.方法:文献法、访谈法、问卷调查法.结果:各级政府对民族地区精神卫生防治工作投入不足,且存在机构布局不合理,服务体系不健全,基础设施薄弱,人力资源不足等问题.建议应强化政府领导职责,构建精神卫生防治三级网络,加强房屋设施及基本设备建设,提高对重性精神疾病的防治与管理.     

四川省少数民族地区乡镇卫生院服务能力现状研究

目的:了解四川省民族地区乡镇卫生院数量、设备拥有情况、人员及卫生服务能力等情况。方法:采用自制调查问卷对2008年四川省60个民族及民族待遇县乡镇卫生院进行调查。结果:收回数据的52个民族及民族待遇县共有乡镇卫生院1180.00所,其中,中心卫生院208.00所,一般乡镇卫生院972.00所,卫生技术人员职称以初级为主占56.69%,卫生院设备短缺,业务开展情况不理想,手术类的医疗服务项目开展情况最差,各地区机构业务收入均低于业务支出,收不抵支。结论:政府加大对乡镇卫生院的投入,同时注意投入结构和投入方向的调整;建立稳定的双向流动对口支援机制,提高卫生技术人员业务素质;建立"县医院—乡镇卫生院"服务延伸网络,提高乡镇卫生院的技术水平和服务能力。     

四川省少数民族地区医疗保健机构产科服务能力现状分析

目的:了解四川省民族地区医疗保健机构产科服务能力情况,发现问题和探讨对策。方法:在全省60个民族县中按经济发展水平高、中、低选取9个少数民族县开展问卷调查,共调查31个县/乡级医疗保健机构及197名医护人员,内容涉及机构等级、产科病床编制、分娩量及助产机构医务人员情况,对数据进行分析。结果:产科医生大专及以上学历占70.87%、中高级职称达39.81%;产科护士大专及以上学历占44.67%、初级及以上职称比例为79.33%,医护比1∶1.46;医院、卫生院年均助产611例和52例;医院、卫生院每位产科医生年均助产127例和31例。结论:产科队伍素质整体偏低,产科医生工作量不饱和,产科服务能力不足,可及性差。应通过加强产科后备队伍建设、待产点建设、提供主动服务,加强对口支援,提高县乡级医疗保健机构技术水平,将农村孕产妇孕期检查、交通费、产后访视等相关费用列入新农合报销或补助等措施,有利于提高民族地区产科服务可及性和产科服务利用。     

四川省少数民族地区县乡村一体化实施效果评价研究

目的探讨四川省少数民族地区县乡村一体化医疗模式的实施效果,为进一步的卫生决策提供参考。方法查阅相关文件和问卷调查搜集县乡村一体化实施前后县乡村三级医疗机构相关资料,采用倍差法对各级医疗机构卫生人员、设备设施和医疗服务等方面的变化情况进行评价。结果县乡村一体化实施初期,实施组在妇幼健康状况(新生儿死亡率下降了1.82‰,孕产妇死亡率下降了65.47/10万)、医疗卫生人员、设备设施、基本医疗卫生和基本公共卫生服务有所改善,但存在以下问题:民族地区医疗卫生技术人员相对缺乏(每千人口执业(助理)医师数和每千人口注册护士数均小于1)、基本医疗卫生服务地区间差异大、双向转诊存在挑战以及公共卫生基础薄弱和发展不均衡。结论县乡村一体化的实施一定程度上促进了县乡村三级医疗机构综合服务能力的提升,但三级医疗网络仍需进一步完善。     

四川省急救医疗服务空间可及性研究

目的了解急救医疗服务的空间可及性特征,为有限急救医疗资源的优化配置等提供依据。方法纳入四川省内2017年所有提供急救医疗服务的医疗卫生机构为供方,四川省内所有人口为需方。采用最短路径法计算所有需求点到最近急救医疗服务设施点的最短就医时间。结果总体而言,四川省的急救医疗服务的空间可及性较好,但四川省内急救医疗服务可及性也存在着较大的差异。与四川省东部地区相比,位于川西地区的阿坝藏族羌族自治州、甘孜藏族自治州和凉山彝族自治州的急救医疗服务可及性稍差。结论医疗资源多较集中地分布在人口密度较大、经济发展较好、自然条件等较优越的地方。通过最短就医时间分析,可以较全面地了解医疗资源的空间配置状况。对于急救医疗资源空间可及性较差的地区,除了新建/增设急救医疗机构外,可以通过增强居民自救技能等综合的策略改善急救医疗服务可及性,弥补由于有限条件导致的急救医疗服务空间可及性差的情况,有助于维护和促进人民健康。     

经济欠发达县中心卫生院急救服务状况与对策研究

对浙江省25个经济欠发达县119个乡镇中心卫生院的急救服务需要、供给能力及急救管理工作现状进行调查与分析，表明中心卫生院在常见疾病、外科急腹症的临床急救处理以及开展常见急救手术项目的能力有待提高，急救协调、管理环节薄弱，并针对问题，提出了增强乡镇中心卫生院急救医疗服务能力的对策建议。     

徐州市院前急救医疗体系建设分析

随着医学的不断发展,急救医疗已成为医疗卫生事业的重要组成部分.该文从徐州市院前急救医疗体系机构建设、经费车辆投入、人员配置、运行办公条件的现状分析人手,找到发展中面临的困境以及问题的缘由,并从法律保障、政府责任落实、建立扁平化急救组织、完善运行监督机制、提高服务能力建设等几个方面人手,对徐州市急救医疗下一步发展作出展望.     

上海社区医疗急救现状和展望

根据卫生部相关文件规定,社区卫生服务机构具有提供急救服务的功能,然而目前上海市社区急救能力还相当薄弱,存在一系列问题,如急救人员、急救设备等资源不足,公众缺乏急救意识和急救技能。为此,在借鉴发达国家经验的基础上,结合上海市具体情况,提出提高上海市社区急救能力的措施,主要为：社区急救网络建设;社区急救网络与急救中心及医院的紧密衔接;社区急救设备配置,急救人员培训等。     

急救医疗一体化服务模式的探索

现代急救医疗服务体系要求必须建设一条快速、连续、高效的急救医疗绿色通道,以提高危重症患者的抢救成功率,降低死亡率及病残率.有关专家提出建设具有中国特色的急救医疗服务体系的"三环理论",其基本内涵是急救医疗服务体系包括三个基本环节,即院前急救体系、院内急诊体系、重症监护治疗体系[1-2].三个体系缺一不可,形成一个完整、统一、高效的急救医疗服务体系.     

我国西部地区产科能力建设现状及需求

目的分析西部地区产科能力建设现状及需求,为进一步开展妇幼健康针对性干预和培训提供参考。方法采取先分层再整群抽样的方法,抽取贵州省、广西壮族自治区、云南省、四川省、新疆维吾尔自治区、青海省、陕西省7个省市150家医疗机构为调查对象,收集这些地区产科能力建设现状及存在问题、影响因素及培训需求等资料。结果西部地区各级医疗结构产科床位、助产人数需求大,医务人员学历差距悬殊、高学历者所占比例低,急救物资配备不全、急救及危重症护理能力不足,助产人员外出培训机会少及对专科能力培训需求高。结论西部地区的各级医疗机构更应重视产科能力建设,缓解需求与资源矛盾,不断提高产科健康服务能力,为社会提供高质量的妇幼保健服务。     

基于CiteSpace的我国基层医疗卫生机构服务能力研究热点分析

目的了解基层医疗卫生机构服务能力领域研究热点。方法采用CiteSpace软件对中国学术期刊全文数据库2010年1月1日—2021年3月25日收录的相关文献进行可视化分析。结果共纳入文献814篇。发文量总体呈上升趋势,年均增加13.9篇;尚未形成核心研究团队,研究机构合作不紧密。研究热点可归纳为4方面:基层医疗卫生机构服务能力评价和建设;分级诊疗制度推行及落实;全科医生和家庭医生发展现状及对策;医联体背景下基层医疗卫生机构服务能力。结论国家政策推动是基层医疗卫生机构服务能力建设和提升的关键因素。基层医疗卫生机构服务能力研究内容逐渐丰富。未来应重点关注少数民族地区基层医疗卫生机构服务能力建设与发展。     

Investigating socio-economic explanations for gender and ethnic inequalities in health

This paper examines inequalities in the self-reported health of men and women from white and minority ethnic groups in the UK using representative data from the Health Survey for England, 1993-1996. The results show substantially poorer health among all minority ethnic groups compared to whites of working-age. The absence of gender inequality in health among white adults contrasts with higher morbidity for many minority ethnic women compared to men in the same ethnic group. The analysis addresses whether socio-economic inequality is a potential explanation for this pattern of health inequality using measures of educational level, employment status, occupational social class and material deprivation. There are marked socio-economic differences according to gender and ethnic group: high morbidity is concentrated among adults who are most socio-economically disadvantaged, notably Pakistanis and Bangladeshis. Logistic regression analyses show that socio-economic inequality can account for a sizeable proportion of the health disadvantage experienced by minority ethnic men and women, but gender inequality in minority ethnic health remains after adjusting for socio-economic characteristics.     

The concept of race and health status in America.

Race is an unscientific, societally constructed taxonomy that is based on an ideology that views some human population groups as inherently superior to others on the basis of external physical characteristics or geographic origin. The concept of race is socially meaningful but of limited biological significance. Racial or ethnic variations in health status result primarily from variations among races in exposure or vulnerability to behavioral, psychosocial, material, and environmental risk factors and resources. Additional data that capture the specific factors that contribute to group differences in disease must be collected. However, reductions in racial disparities in health will ultimately require change in the larger societal institutions and structures that determine exposure to pathogenic conditions. More attention needs to be given to the ways that racism, in its multiple forms, affects health status. Socio-economic status is a central determinant of health status, overlaps the concept of race, but is not equivalent to race. Inadequate attention has been given to the range of variation in social, cultural, and health characteristics within and between racial or ethnic minority populations. There is a growing emphasis, both within and without the Federal Government, on the collection of racial or ethnic identifiers in health data systems, but noncoverage of the Asian and Pacific Islander population, Native Americans, and subgroups of the Hispanic population is still a major problem. However, for all racial or ethnic groups, we need not only more data but better data. We must be more active in directly measuring the health-related aspects of belonging to these social categories.     

四川省民族地区疾病预防控制机构基本情况及存在的主要问题

了解四川省民族地区疾病预防控制机构工作条件和基本职能开展情况,分析民族地区疾病预防控制工作存在的主要问题和困难,针对性地提出加强民族地区疾病预防控制工作的三点建议,为制定民族地区卫生事业发展十年行动计划提供客观依据.     

Use and Preference of Advice on Small Children's Food: Differences Between Parents From Ethnic Minority,Ethnic Majority,and Mixed Households

The authors analyzed the influence of acculturation on parental attitudes to, and use of, different sources of health advice about young children's food in Denmark. Using combined ethnic position of the children's parents as a proxy for household acculturation, the authors conducted a postal survey of 2,511 households with young children (6 months to 3.5 years) occupying ethnic minority, ethnic majority, or ethnic mixed position. The analysis showed that the use of advice differed in the 3 groups. Households with ethnic minority status were more likely to use the child's grandparents, general practitioners, and hospital staff as information sources, while households with ethnic majority status were more likely to use mothers’ peer groups and written material. In all types of household municipal public health nurses were relied on as a source of advice on young children's food, but households with ethnic minority status were more likely to find the advice obtained in this way incompatible with their family eating habits. Although existing dietary health communication strategies delivered by public health nurses appear to work well in all household types, parents from minority households seem to experience dilemmas. These may be related to their cultural and generational status at the time of receiving the advice. Adjustments to current communication strategies on young children's food are suggested.     

Racial/ethnic variation in functional and self-reported health

OBJECTIVES: We investigated whether racial/ethnic health disparities exist in Canada and whether socioeconomic or behavioral differences between racial/ ethnic minorities and nonminorities account for such disparities. METHODS: We used data from the National Population Health Survey, conducted by Statistics Canada in 1996 and 1997. We used regression models to examine differences in functional and self-reported health. RESULTS: Our study found no association between socioeconomic or behavioral differences and racial/ethnic health disparities. There was no clear pattern between racial/ethnic minority status and health. CONCLUSIONS: The state can play an important role in health outcomes, and public commitment to accessible health care may explain why socioeconomic status and health behaviors are weak indicators of racial/ethnic health variation in Canada.     

Minority health status in adulthood: the middle years of life

The objective of this article is to describe the racial and ethnic differences in health status during the "middle years" of life. We use data from National Vital Statistics Reports (Hoyert, Kochanek, and Murphy, 1999) to estimate excess mortality among racial and ethnic minority groups for the leading causes of death among adults. Also discussed are the current state of scholarship in minority health and suggestions for future directions for research on racial and ethnic differences in health status.     

墨玉县乡村卫生服务一体化管理模式构建及实现效果研究

目的通过对新疆墨玉县实施乡村一体化进程的跟踪,总结少数民族地区乡村卫生服务一体化的适宜模式。方法采取问卷调查,收集该县实施一体化前后乡村两级医疗机构运行情况及村民就医可及性,采取座谈会及访谈形式掌握该县一体化实施的进程和方法。结果墨玉县自2011年实施乡村卫生服务一体化以后,分4个实施阶段运行,并形成了＂县级卫生行政部门统一部署,县级医疗机构协助乡镇卫生院,乡镇卫生院管理村卫生室,县级医疗机构帮扶村卫生室＂的县乡村一体化新模式,并取得了显著成效。结论该县在硬件设施建设、人员招聘管理和业务制度建设等方面均有值得在西部少数民族地区推广的经验。     

Racial/ethnic variations in women's health: the social embeddedness of health

This article provides an overview of the magnitude of and trends in racial/ethnic disparities in health for women in the United States. It emphasizes the importance of attending to diversity in the health profiles and populations of minority women. Socioeconomic status is a central determinant of racial/ethnic disparities in health, but several other factors, including medical care, geographic location, migration and acculturation, racism, and exposure to stress and resources also play a role. There is a need for renewed attention to monitoring, understanding, and actively seeking to eliminate racial/ethnic disparities in health.