新农合视角下完善基层医疗卫生服务体系中的政府责任

基层医疗卫生服务体系承担着向基层群众提供基本医疗卫生服务的重要职责。新农合制度运行激发了农民医疗服务需求,我国最近几年也开始重视基层医疗机构的建设。我国的基层医疗卫生服务体系在政府的重视下得到了一定的发展,但是仍然存在着一些问题。文章从加大财政投入、与基本医疗保障制度相结合、优化运行机制等路径提出了完善基层医疗卫生服务体系的政府责任.     

声音

“基层医疗卫生服务机构既是提供基本医疗卫生服务的重要载体。又是整个医疗卫生服务体系中的最薄弱环节。基层医改,通过推进综合改革,实现新旧机制转换,把基本医倮、基层服务体系建设、基本公共卫生服务、基本药物制度四项重点改革任务紧密结合起来,相互作用,形成政策叠加效应。重新塑造了一个新的符合老百姓需求的基层医疗卫生服务体系,这个新体系的能量正在逐步释放出来,效果会越来越明显。”     

潍坊市基本医疗卫生服务可得性建设的主要做法

建立健全基本医疗卫生服务体系是＂人人享有基本医疗卫生服务＂的前提与保障。本文通过分析总结潍坊市在基层卫生机构建设管理方面的经验,提出了整合资源发展基层卫生机构、调整结构建设达标服务体系、加强培训提升人员服务能力、制定惠民利民政策和提高卫生服务可得性的讨论与参考。     

强化基层机构能力建设的几点思考

正健全基层医疗服务体系是医改的重点内容之一,随着医改的纵深推进,加快建立覆盖城乡、布局合理、功能完善的基层医疗服务体系是各级政府义不容辞的职责。近年来,湖南省祁阳县紧紧围绕实现"人人享有基本医疗卫生服务"这一目标,先后出台一系列发展政策和保障措施,积极推进基层医疗卫生机构能力建设,取得了一定的成效。为全面了解我县基层医疗卫生机构服务能力情况,明确下阶段基层医疗卫生服务体系建设的     

健康中国视域下辽宁省基层医疗卫生健康服务提升策略研究*

目的：基层医疗卫生服务是“健康中国2030”国家战略下辽宁省基层医疗卫生服务改革的重要发力点。深入探讨辽宁省基层医疗卫生健康服务的发展现状与挑战,为“十四五”期间应对辽宁省人口的深度老龄化,构建高质量发展的辽宁省医疗卫生健康服务体系,实现辽宁全面振兴、全方位振兴贡献方案。方法：采用文献分析法和调研访谈法,探求健康中国视域下辽宁省基层医疗卫生健康服务提升策略。结论：积极推行慢性病患者“长处方”医疗服务政策;建立健全“互联网+医疗健康”的基层医疗卫生“数字化”服务体系;加强基层医疗卫生机构突发公共卫生事件的应急管理处置能力;健全基层医疗卫生机构服务人才的激励机制;建立多元筹资机制,鼓励社会资本参与基层办医;基层中医药特色诊疗服务能力等策略。     

新医改背景下基层卫生人才队伍发展的实践与探索

基层卫生人才队伍是提供基本医疗卫生服务的主导力量,承担着基本医疗服务和公共卫生双层网底的作用,其人员专业素质的高低不仅直接影响卫生服务的可及性与公平性,也关系基层医疗卫生服务体系的建设与可持续发展。本文以地处我国中部的湖北省孝感市为案例,分析基层卫生人才队伍的现状、问题和对策,以期能为提高中西部地区基层医疗卫生服务水平提供参考。     

成绩可观 未来可期

“人人享有基本医疗卫生服务”是党的十七大确立的奋斗目标之一。记者从卫生部了解到。“十一五”时期,特别是2009年实施新医改以来,中央提出医改的总方针,即“保基本、强基层、建机制,重点完善城乡基层医疗服务体系建设”,使城乡基层医疗卫生服务体系建设速度加快,全国医疗资源总量持续增加,基层医疗服务能力不断增强,医疗服务体系不断完善。     

加强基层医疗服务体系建设的实践及思考

新医改要求用三年时间建成比较完善的基层医疗服务体系,而积极推进基层医疗卫生机构基础设施和能力建设是其中的关键环节。辽宁省从2009年开始大力发展基层医疗服务体系,重点对基层医疗卫生机构的房屋进行全面改造,有力改善了基层基础设施条件,提高了服务能力。     

基层医疗卫生服务体系卫生资源配置的若干思考

在发展基层医疗卫生服务体系的过程中,不能仅着眼于该体系自身,必须处理好其与医院系统间的关系,认识到医院系统已有强大的自我配置优势,避免出现对基层医疗卫生服务体系不断加大投入,但其在整个医务服务体系资源的比重却不断下降的局面。建议以基层医疗卫生服体系为医疗服务体系改革的切入点,处理好基层医疗卫生服务体系和医院系统间的关系,重视提高基层医疗卫生服务体系在医疗服务体系中的比重,提高卫生资源增量的利用率和优化卫生资源存量。     

中央财政拨付第三笔医改资金

新华社 为支持深化医药卫生体制改革,健全基层医疗卫生服务体系,加强基层医疗卫生服务能力建设,中央财政近日拨付第三笔医改资金17．26亿元,用于补助中西部地区城市社区卫生机构、乡镇卫生院、村卫生室等基层医疗卫生机构设备购置。     

健康公平性概述

健康公平性在国际上得到广泛关注,各国把消除健康不公平作为卫生改革与发展的主要目标。本文就健康公平性的内涵进行梳理,为我国健康公平性内涵和测量研究提供参考。     

The Impact of Medical Home on Selected Children's Health Outcome

Medical Home practice has been shown to deliver effective health care to children. This practice model calls for providing patient-centered care that is compassionate, culturally effective, coordinated, integrated, safe, of high quality, and accessible. This study shows that children in the states with a higher amount of Medical Home received childhood vaccinations at a higher rate than others. However, Medical Home had a limited effect on the rate of children receiving dental/medical services, mental health services, or number of overweight children.     

The Communication Infrastructure as a Social Determinant of Health: Implications for Health Policymaking and Practice

Policy Points

• Persistent communication inequalities limit racial/ethnic minority access to life‐saving health information and make them more vulnerable to the effects of misinformation.
•  Establishing data collection systems that detect and track acute gaps in the supply and/or access of racial/ethnic minority groups to credible health information is long overdue.
• Public investments and support for minority‐serving media and community outlets are needed to close persistent gaps in access to credible health information.

     

Policy Commercializing Nonprofits in Health: The History of a Paradox From the 19th Century to the ACA

Policy Points:

• Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector.
• This policy paradox persists during the implementation of the Affordable Care Act of 2010.

Context

For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization. The implementation of the Affordable Care Act of 2010 (ACA) began yet another chapter in the history of this policy paradox.

Methods

This article explores the origin and persistence of the paradox using what many scholars call “interpretive social science.” This methodology prioritizes history and contingency over formal theory and methods in order to present coherent and plausible narratives of events and explanations for them. These narratives are grounded in documents generated by participants in particular events, as well as conversations with them, observing them in action, and analysis of pertinent secondary sources. The methodology achieves validity and reliability by gathering information from multiple sources and making disciplined judgments about its coherence and correspondence with reality.

Findings

A paradox with deep historical roots persists as a result of consensus about its value for both population health and the revenue of individuals and organizations in the health sector. Participants in this consensus include leaders of governance who have disagreed about many other issues. The paradox persists because of assumptions about the burden of disease and how to address it, as well as about the effects of biomedical science that is translated into professional education, practice, and the organization of services for the prevention, diagnosis, treatment, and management of illness.

Conclusions

The policy paradox that has incentivized the growth and commercialization of nonprofits in the health sector since the late 19th century remains influential in health policy, especially for the allocation of resources. However, aspects of the implementation of the ACA may constrain some of the effects of the paradox.     

Understanding population health terminology

Population health is a relatively new term, with no agreement about whether it refers to a concept of health or a field of study of health determinants. There is debate, sometimes heated, about whether population health and public health are identical or different. Discussions of population health involve many terms, such as outcomes, disparities, determinants, and risk factors, which may be used imprecisely, particularly across different disciplines, such as medicine, epidemiology, economics, and sociology. Nonetheless, thinking and communicating clearly about population health concepts are essential for public and private policymakers to improve the population's health and reduce disparities. This article defines and discusses many of the terms and concepts characterizing this emerging field.     

1994年全国学校卫生现状抽样调查──2000年学校卫生发展战略目标与对策研究之一

全国抽样调查561所城乡中小学校的学校卫生现状。结果表明,我国城乡中小学校的学校卫生现状具有两大特点:其一,学校卫生发展呈现出以经济发达地区城市中学领先、经济欠发达地区乡村小学明显滞后的总态势。其二,学校卫生三个维度发展不平衡,健康环境明显落后于健康服务和健康教育。     

Health education–the case for rehabilitation

The emergence of health promotion in the 1980s was a direct response to critiques of health education which centred on its victim-blaming orientation and a growing appreciation of the need to address the wider determinants of health and health-related behaviour. This paper argues a priori that such critiques centre on a preventive model of health education and overlook its broader potential. It reviews a number of alternative models of health education and locates these within the core values of equity and empowerment which underpin the Ottawa Charter and subsequent WHO documents. It suggests that, despite the rhetoric of health promotion, practice frequently remained focused on individual behaviour change and the use of persuasive health education. The move to health promotion effectively stifled further debate about the broader role of health education in achieving individual empowerment and social change. This paper calls for a broader conceptualisation of health education–the New Health Education–and concludes that this should be the driving force behind health promotion.