首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 124 毫秒
1.
随着新一轮医药卫生体制改革方案的出台,"全民医保",即实现基本医疗卫生服务均等化,成为了这次改革的主要目标和任务.然而,如何实现这个目标却是摆在所有卫生工作者面前的难题,因为这关乎到医疗卫生资源在整个社会层面的重现配置,涉及到卫生利益的再次评估、分配.文章从均等化的视角,结合国内外基本卫生服务包的实践现状,试图探寻推进基本卫生服务包的路径,实现基本卫生服务均等化,从而使更多的人享受得到基本卫生服务,提高全社会健康水平.  相似文献   

2.
在现阶段卫生资源投入水平下,若要逐步实现社区基本公共卫生服务的均等化,首先要根据本地区基本公共卫生服务项目,确定应该和最有条件首先实现均等化的优先项目服务包.研究根据优先项目确定的原则和方法确定上海市社区基本公共卫生服务优先项目服务包,为实现上海市社区基本公共卫生服务逐步均等化提供参考依据.  相似文献   

3.
实现基本医疗卫生服务均等化的条件、问题和建议   总被引:3,自引:2,他引:1  
城乡居民如何在城乡一体化和新医改的背景下实现基本医疗卫生服务均等化,是值得研究的一个问题。通过对"基本医疗卫生服务"、"一体化"和"均等化"等基本概念的辨析和对实现基本医疗卫生服务均等化必要性及有利条件的分析,总结了在认识、内容和路径等几个方面有待解决的问题,提出转变观念,提高认识;明确享有基本医疗服务均等化的对象;合理界定基本医疗服务均等化的内容;全面实施城乡居民统一的基本医疗保险制度;加强农村医疗卫生机构和人才队伍的建设;采取积极稳妥的推进步骤等建议。  相似文献   

4.
中山市根据实际情况,在全市推行镇村卫生服务一体化管理,并统筹城乡发展社区卫生服务,在加强和夯实基层医疗卫生工作上取得了实效,为建立基本医疗制度、基本医疗保障制度和实现公共卫生均等化服务等打下了良好的基础。  相似文献   

5.
目的:了解海南省市县际间基本医疗卫生服务均等化现状,为促进全省基本医疗卫生服务均等化建设提供参考。方法:利用海南省、我国及经合组织国家等卫生统计数据,对海南省市县际间基本医疗卫生服务均等化指标进行分析。结果:资源分布均等化方面,机构地理可及性相差较大,医护比为1∶1.2,资源分布的基尼系数大于0.3;筹资均等化方面,人均医疗保健支出低于全国,人均政府卫生支出额高的市县主要集中在各区域的中心,多数市县新农合住院实际补偿比在50%左右;服务提供均等化方面,多数市县床位使用率低于90%,药费占比在30%~40%,地区之间孕产妇及儿童健康管理差距较小,但管理率普遍低于全国。结论:基本医疗卫生服务资源分布与政治、经济等条件有关,筹资机制不健全、基本医疗和公共卫生服务提供能力低影响了基本医疗卫生服务的质量。建议合理布局基本医疗卫生服务资源,加大卫生筹资力度,提高基本医疗卫生服务提供能力。  相似文献   

6.
实现卫生服务均等化是我国近年的一项重要社会政策,是医药卫生体制改革任务之一。通过比较山西省与陕西省、河南省、浙江省、甘肃省卫生服务资源,评价山西省医疗卫生服务资源均等化状况,为山西省进一步促进基本卫生服务均等化提供理论依据。  相似文献   

7.
基本医疗卫生服务均等化研究进展与路径选择   总被引:1,自引:0,他引:1  
加快推进基本医疗卫生服务均等化,已成为实现新医改提出的建立健全覆盖城乡居民基本医疗卫生制度的重要内容和热点问题。本文从国内外基本医疗卫生服务均等化理论基础、发展内涵、实施策略、筹资与供给机制、测量评价等方面系统阐述其研究进展,并在综合述评的基础上,提出了进一步明确基本医疗卫生服务均等化内涵界定、探索基本医疗卫生服务均等化筹资机制、构建基本医疗卫生服务均等化评价体系以及完善城乡基层基本医疗卫生服务及政策体系等方面的路径选择和思考建议。  相似文献   

8.
以世界卫生组织推荐的主要慢性病干预服务包(WHO PEN)为依托,从人力资源、人员培训、设备配备、基本设施、基本生理生化检查指标和药品情况等方面研究西部农村地区资源配置,以期实现农村基本医疗卫生服务均等化.结果发现,项目县、市村级卫生人力资源缺乏,人员老化,工作满意度低下;卫生院工作人员无有效的激励机制,弱化临床服务,浪费卫生资源;越是在贫困地区,设备虽然配备较齐,但设备闲置和利用率太低;药品缺乏,药品不全是制约卫生院和卫生室发展的重要因素.建议进一步研究基层卫生工作人员激励机制,吸引和保留其在基层工作;平衡基本医疗与基本公共卫生服务的关系,积极开展临床服务,提高设备利用率;扩大基本药品目录,加强招标管理,加强配送管理.  相似文献   

9.
通过对国内、国外基本医疗卫生服务理论与实践的梳理,认为基本医疗卫生服务应当是最基本、人人能获得、体现社会公平、政府和居民都能负担得起的医疗卫生服务;要基于政府筹资能力、结合疾病发生特点来选择服务内容,可根据服务内容确定不同层级的服务包(一、二、三级包),逐步扩展实施。最后提出未来7年基本医疗卫生服务的实施策略:一是建立以基本医疗保障制度为支付主体的基本医疗卫生服务筹资体系;二是建立以公立医院为主、非公立医院为重要补充的基本医疗卫生服务提供体系;三是建立适应基本医疗卫生服务需求的卫生治理监管体系。  相似文献   

10.
潍坊市普及基本医疗卫生制度实验研究的理论成果   总被引:1,自引:1,他引:0  
本文明确了基本医疗卫生制度的内涵和外延,确立了基本医疗卫生制度的产品选择和实践模型,设计了基本卫生服务包和基本医疗服务包,并建立了基本医疗卫生制度建设程度的评判标准。主要回答了什么是基本医疗卫生制度、建立什么样的基本医疗卫生制度、怎样建立基本医疗卫生制度以及如何评判基本医疗卫生制度建立程度等4个问题。  相似文献   

11.
建立国家基本卫生制度、实现人人享有基本卫生保健是国际社会"全民健康覆盖"目标的具体体现。过去几十年,江苏省农村卫生服务体系得到了较好发展,基本建立具有较高可及性的农村服务组织网络,为实现农村居民人人享有基本卫生保健打下了良好的基础,同时还存在诸多亟待解决的问题。为此提出建议:明确政府健康责任,改革卫生投入机制;优化卫生服务体系布局,提高高质量卫生服务的可及性;加强基层卫生人才队伍建设,提高基本卫生服务质量;完善薪酬分配制度,调动卫生人员积极性。  相似文献   

12.
Objective: To develop a conceptual framework for monitoring the relationship between health services and health outcomes in rural Australia. Design and setting: Development of an evaluation framework for a rural comprehensive primary health service in Victoria. Results: Evidence regarding essential components for successful primary health care, and objective health service and health status measures were combined to develop a conceptual health service evaluation framework. Application of the framework is illustrated using a case study of a rural primary health service in Victoria. Conclusions: Inadequate health services limit access to health care, delay use at times of need and result in poor health outcomes. Currently, there is a lack of evidence from rigorous health service evaluations to indicate which rural health services work well, where and why that could inform rural health policies and funding. Although the nature of health service models will vary across communities in order to meet their differing geographic circumstances, there is considerable scope for the translation and generalisation of evidence gained from health service models that are shown to be sustainable, responsive and able to deliver local quality health care. This framework can guide future health service evaluation research and thereby provide a better understanding of a health service's impact on the health of the community and its residents.  相似文献   

13.
农村公共卫生服务包的构建研究   总被引:3,自引:0,他引:3  
目的:探讨农村公共卫生服务包的构建,为各地区选择与自身社会经济条件相适应的农村公共卫生服务内容提供科学依据。方法:采用经济学分摊的方法对农村县、乡、村三级公共卫生机构进行成本测算,并运用D e lph i专家咨询法,对92项农村公共卫生服务项目进行属性、重要性和必需性的鉴定,构建公共卫生服务包。结果:构建了三个层次的农村公共卫生服务包:基本公共卫生服务包、扩大公共卫生服务包和全面公共卫生服务包,人均成本依次为27.57、52.52和66.21元,项目数分别为30、66、92项。结论:三类农村公共卫生服务包适合不同的经济发展水平的各地区:经济发达地区应充分开展全面公共卫生服务包中的项目;经济较发达地区应选择扩大公共卫生服务包,即在保证基本公共服务的同时,结合地方特点适当选择其他一些公共卫生服务内容;贫困地区应保证基本公共卫生服务包的开展。  相似文献   

14.
调查了云南省三个处于不同经济发展水平的新型农村合作医疗试点县(市)试点一年以来的实施情况,分析了新农合对医疗服务的供给以及乡村一体化管理的影响,提出由新农合而引发的农村公共卫生服务与基层财政困难之间的矛盾,总结了新农合要获得可持续发展所必须要关注的问题.  相似文献   

15.
我国农村卫生服务需要与需求变化趋势及特点分析   总被引:4,自引:0,他引:4  
根据国家卫生服务调查和现有的有关资料,通过对我国农村卫生服务需求与供给状况分析,总结我国农村卫生服务需要及需求变化情况,目的是了解我国农村卫生服务需要与需求的现状,为决策部门制定农村卫生政策和措施提供依据。  相似文献   

16.
目的:分析江苏省大丰市和浙江省嵊州市乡村医生签约服务实践及其初步成效。方法:采用典型抽样,对江苏省大丰市和浙江省嵊州市卫生局的局长或分管局长、乡镇卫生院的院长、乡村医生进行访谈,对访谈内容和政策文件进行归纳,对签约服务前后的服务量变化进行描述性分析。结果:大丰和嵊州乡村医生签约服务以村卫生室和乡镇卫生院为主体,面向全体居民并侧重重点人群,因地制宜地设计了不同的个性化服务包,并建立了相应的保障措施和激励机制。结论:通过签约服务,满足了群众的个性化需求;乡村医生收入增加,积极性提高,农村卫生服务网底得到巩固;基本公共卫生服务质量有所改善;基层医疗卫生机构基本医疗功能得到进一步强化;乡村医生签约服务助推了农村卫生改革,为地方制定和完善农村卫生改革政策提供了依据,但仍需进一步完善。建议:加强乡村医生队伍建设;完善乡村医生签约服务的激励机制;加强对乡村医生签约服务工作的总结评估,为进一步推广签约服务提供依据。  相似文献   

17.
Objective:  To provide an overview of papers discussing optimal service delivery models for rural and remote Australia.
Design:  A synthesis of overarching considerations guiding rural and remote health service policies.
Setting:  Small rural and remote communities in Australia.
Participants:  Invited delegates attending the Inaugural Rural and Remote Health Scientific Symposium in Brisbane 2008.
Main outcome measures:  Key issues underpinning health service provision for small rural and remote communities.
Results:  The formulation and implementation of effective health service provision policies must be underpinned by overarching health goals, agreed health service requirements, recognition of how rural and remote health contexts impact upon health service provision and the constraints limiting health service responses.
Conclusion:  Systemic change is required in order to ensure equitable access to health care services in small rural and remote communities.  相似文献   

18.
Objective: To highlight how evidence from studies of innovative rural and remote models of service provision can inform global health system reform in order to develop appropriate, accessible and sustainable primary health care (PHC) services to ‘difficult‐to‐service’ communities. Methods: The paper synthesises evidence from remote and rural PHC health service innovations in Australia. Results: There is a strong history of PHC innovation in Australia. Successful health service models are ‘contextualised’ to address diverse conditions. They also require systemic solutions, which address a range of interlinked factors such as governance, leadership and management, adequate funding, infrastructure, service linkages and workforce. An effective systemic approach relies on alignment of changes at the health service level with those in the external policy environment. Ideally, every level of government or health authority needs to agree on policy and funding arrangements for optimal service development. A systematic approach in addressing these health system requirements is also important. Service providers, funders and consumers need to know what type and level of services they can reasonably expect in different community contexts, but there are gaps in agreed indicators and benchmarks for PHC services. In order to be able to comprehensively monitor and evaluate services, as well as benchmarks, we need adequate national information systems. Conclusions: Despite the gaps in our knowledge, we do have a significant amount of information about what works, where and why. At a time of global PHC reform, applying this knowledge will contribute significantly to the development of appropriate, sustainable PHC services and improving access.  相似文献   

19.
This paper describes the older people's mental health workforce development, policy development and implementation process and quantifies the rural service delivery and access impacts over a 15‐year period in New South Wales. It highlights the factors that are considered to be critical to successful rural service development such as commitment to funding parity, investment in strong local service leadership, and development of innovative, locally adapted rural service models. Building on these foundations, the Older People's Mental Health Program in New South Wales was able to address key challenges relating to service access in rural health and develop new, sustainable specialist older people's mental health service networks. A sustained focus on policy and implementation which explicitly supports rural older people's mental health service enhancement, and development of evidence‐based models of care, has significantly improved access to specialist mental health care for older people in rural areas. It has delivered 23 new rural older people's mental health community teams and a 440% increase in the number of people accessing these teams. It has also doubled the number of acute inpatient units and established new specialist mental health‐residential aged care partnership services in rural New South Wales. It has resulted in increased access to services for the “older old,” while not diminishing older people's rates of access to general adult mental health services. It has also supported innovative, sustainable rural service models such as “hub and spoke” models and step‐up step‐down inpatient services that build on existing health and hospital infrastructure and link geographically dispersed specialist clinicians and services together in rural service delivery.  相似文献   

20.
The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号