新型农村合作医疗不同个人筹资方式农民意向调查

农民个人筹资只有充分考虑农民的需求才能顺利进行。比较分析上门收取、协议委托和滚存式筹资3种不同个人筹资方式下的参加新型农村合作医疗农民对筹资方式以及参合的意愿,提出了农民参合的几点影响因素。     

提高新型农村合作医疗农民个人筹资绩效的研究进展

农民个人筹资困难是新型农村合作医疗运行中普遍存在的问题.不少试点地区和研究学者就如何提高农民个人筹资绩效进行了一些实践与探索,如滚动式、协议委托式、集约化方式、依托农民经合组织、市场营销方式、缴费年限累积制、非货币型等多种筹资.现将近年来新型农村合作医疗农民个人筹资方式研究做一综合分析.     

新型农村合作医疗农民个人筹资方式现况研究

对全国新型农村合作医疗第一批试点县农民个人筹资方式进行了问卷调查,发现在151个试点县(市)中,典型的个人筹资方式有上门收取、滚存式筹资和委托代收。其中,以上门收取筹资方式为主的个人筹资方式和筹资体制呈多元化趋势发展的现状。并对此提出了有益建议,为探索适宜的个人筹资方式提供依据。     

新型农村合作医疗"滚动式"筹资的实践与成效

赣榆县是江苏省新型农村合作医疗试点县。试点期间，在广泛调研的基础上，我们积极探索新的筹资方式，即委托镇合管办在农民报销受益的时候，在农民自愿知情的情况下，代扣代缴该农户次年参合资金，达到滚筹资金、滚动发展的目的。这种滚动式筹资方式，在建立稳定的低成本的可持续的筹资机制方面走出了一条新路子。     

卫生部政法司举办第二期卫生筹资与健康公平研讨会

为引导卫生政策制定者、执行者和研究者重视关于卫生筹资与健康公平问题，理解中国卫生改革及筹资现状，加强卫生相关部门对贫困人口卫生筹资问题的理解与交流，卫生部卫生政策法规司委托卫生部人才交流服务中心于2008年5月28-30日在北京举办了“中国卫生政策支持项目（HPSP）第二期卫生筹资与健康公平研讨会”。     

贫困地区农户应对疾病的筹资及效果：基于四川省阆中市的农户调查

通过对四川省阆中市农户大病筹资行为的调查统计,分析了农户几种常见的筹资方式,对家庭经济状况不同的农户进行对比,发现各类农户中采用最频繁的两种筹资方式是亲友的赠予及亲友和金融机构的借贷.而对医疗费用贡献率最大的筹资方式是亲友和金融机构的借贷.文章对各种筹资方式进行了评价,发现当前实施的新型农村合作医疗制度和贫困医疗救助制度对大病农户的医疗费用资助明显不足.     

医院如何降低筹资成本

在市场经济条件下,筹集和使用资金必须支付筹资成本,因此如何选择最佳的筹资渠道和筹资方式、统筹安排资金、降低资金成本成了医院融资管理的重点。以下从目前非营利性医疗机构使用的几种筹资方式入手,对如何降低资金成本提出几点粗浅的看法。     

六合区新农合“三定”筹资基本做法与筹资效果评价

南京市六合区自2003年实施新农合制度以来,筹资标准逐年增加,一直采用村干部上门收缴、村集体经济代缴等传统方式筹集农民新农合参保资金,造成筹资时间长、成本投入大、农民依赖性强。2012年我们对农民个人筹资机制进行了创新改革,探索实施定筹资时间、定送缴地点、定缴费金额的“三定”筹资方式,建立起了“区统筹、镇负责、村为主、组配合、户自愿”的新农合筹资工作新格局,取得了一定成效和经验。     

新型农村合作医疗上门收取个人筹资方式研究

上门收取是目前新型农村合作医疗农民个人筹资的主导方式。通过对上门收取个人筹资方式的产生背景、操作过程和存在问题等进行分析与评价,提出在现阶段上门收取个人筹资方式具有一定的可持续性。     

我国部分地区卫生筹资负担公平性研究

借鉴国际研究方法与成果,利用家庭卫生服务调查数据,对我国部分地区卫生筹资负担公平性进行了定量测量.结果显示,社会保险和直接现金卫生支出筹资方式累进程度较高.文章结合各种筹资政策对我国卫生筹资公平性方面存在的问题进行讨论,如税收筹资的作用、社会保险覆盖面对测算结果的影响等.     

Appealing to the ''experience'' of the patient in the care of the dying

The care of dying patients in hospital is characterized by the copresence of four different frames: practical, medical, lay and psychological. Within the psychological frame, the staff define the patient as an experiencing subject, exposed to the staff members' knowledge and involvement. The psychological frame is used in two different circumstances. First, it is used by the staff members when the patient deviates from an expected identity within some other frame. The deviation creates a threat to the working conditions and moral order at the ward. The threat is managed through a shift into the psychological frame. Second, the psychological frame is used spontaneously in the accounts of their work given by staff members to the sociological field researcher. The image of care associated with the field researcher is characterized by a special awareness of the psychological issues. Thus the field researcher is inevitably a part of the functioning of the new kind of surveillance working through the psychological frame.     

病房改造后的效益分析

以病人为中心,实施医院病房改造，将既往8－10人一间的病房改造成中小病房，每个病房有独立卫生间、阳台、空调，满足了病人不同的需求，吸引了更多的患者到院就医，从而使2000年比1999年的同期的门诊人次增加14．4％，出院人次增加16．2％，平均床位开放增加9．0％，床位周转增长6．8％，平均住院日下降7．0％，期内门诊收入增长43．9％，药品收入占业务收入下降10．5％，年业务收入增长18．9％。     

Epidemiologic study of the residents of the southeastern area of the Municipality of La Spieza

We carried out an epidemiologic study to assess the effect on human health of living in an area (Zona D) of La Spezia Municipality (Liguria Region, Italy). Zona D is characterized by the presence of factories, industrial plants, shipyards, a coal-fired power-station, a heavily trafficked thoroughfare and urban waste disposal sites. 230 households for target and control populations were randomly selected from Demographic Department files and surveyed by means of a structured questionnaire administrated by trained interviewers in order to obtain information on adverse health outcome prevalence in 1997 (subjective symptoms and other self-reported conditions) and incidence during 1980-1997 (self-reported diseases diagnosed by general practitioners). In addition, residential, housing, household, and individual characteristics were also gathered. Non-responding households totalled nearly 45%, but were homogeneously distributed by area. After adjustment for several confounders, people living in Zona D showed an increased relative risk (RR) of skin and mucous membrane symptoms (RR = 1.25, 95% CI = 1.02-1.53) attributable to airborne pollutants produced by an incinerator located within a disposal site. A rising RR was also observed for anaemia occurrence in both cross-sectional (RR = 2.44, 95% CI = 1.08-5.48) and longitudinal (RR = 3.21, 95% CI = 1.52-6.72) settings. These last results are consistent with the presence of lead ground pollution due to a heavy metal processing plant located in the same area. Analysis of adverse reproductive effects and cause-specific incidence and mortality revealed no remarkable differences between the study groups.     

院长业务查房的做法及对医疗质量的影响

实行了业务院长带领与医疗有关的职能科室负责人和临床医疗、药学专家进行综合性业务查房。这种具有前馈质控、环节质控的查房模式,强化和完善了院长查房在医疗质量控制中的作用,是全面、及时了解临床科室业务工作,落实三级医师负责制,全面控制医疗质量,培养和考核各级医护人员、进行病历环节质控和医疗安全监控的有效方法。     

The importance of the gastrointestinal microflora to the nutrition of the host

The microflora of the gastrointestinal tract is responsible for considerable metabolic activity which could have beneficial or detrimental effects on the host. In gnotobiotic animals it has been clearly demonstrated that gut microorganisms synthesize vitamin K and the B complex, take part in the degradation and synthesis of proteins and other nitrogenous compounds, hydrogenate polyunsaturated fatty acids and effect extensive transformations of bile acids and sterols. In non-ruminants the greatest microbial activity occurs in the lower gut, distal to the main areas of absorption, so that the end-products are not readily utilized by a non-coprophagous host. Human subjects on a low protein intake may derive some benefit from microbially recycled nitrogen but in subjects on adequate diets the presence of a microflora imposes a small demand on the host's nutrient economy. This is offset by the protection afforded by the “normal” gut microflora which provides an effective barrier against invasion by pathogens.     

中国31个省市道路交通事故现状分析及实现SDGs死伤减半目标趋势预测

  目的   分析2010-2017年我国31个省市道路交通事故发生数和死伤情况, 预测到2020年各省市实现可持续发展目标(sustainable development goals, SDGs)中设定的死伤人数较2015年减半的情况。   方法   分析31个省市道路交通事故现状, 利用趋势外推法预测2020年能否实现SDGs目标。   结果   2010-2017年广东、江苏、浙江、山东的交通事故发生数、死伤数呈下降趋势但仍居前列。2017年死亡率前两位是北京和贵州, 受伤率贵州和天津居高。预测显示, 到2020年全国道路交通事故的死亡和受伤人数分别增加了17%和1.3%, 难以实现减半的目标; 预计2020年湖南的死伤人数分别降至2015年的50.7%和65.3%, 能够达到目标; 上海的受伤人数降低83.3%, 但死亡人数只降低34.5%, 与目标有差距; 其余省市难以达到目标。预计到2020年11个省市的死亡人数将增加, 其中北京、吉林、江西、湖北和贵州增长最为明显; 有8个省市的受伤人数呈增长趋势, 其中吉林、江西、湖北和贵州四省增幅明显。   结论   除湖南省外, 全国和各省市均难以达到SDGs目标, 可以根据预测结果和实际现状制定有针对性的科学防控策略。湖南和上海在交通事故防控方面的措施有效, 值得借鉴。     

以“十九大精神”为指导的护理教研工作现状分析

目的了解以十九大精神为指导的护理教学科研开展现状,为进一步在护理队伍中深入贯彻十九大精神,并以十九大精神为指导更好地开展护理教研工作。方法调查云南省第二人民医院护理学教研室2017年1月—2018年12月的护理教研工作现状,并进行整理、分析描述。结果在十九大精神的指导下该院护理实习生总人数增长93人,本科实习生人数占比提高7.6%,针刺伤发生率降低1.7%,课堂教学课时数增加1112学时,护理人员论文发表数量增加79篇,专著发表增加3部,科研立项项目增加3项。结论在该院深入贯彻十九大精神后,护理教研工作百花齐放,护理人员仁心仁术,护理质量显著提升,有利于和谐医院的构建、有助于和谐社会的建设。     

Role of the environment in the occurrence of noninfectious diseases of the digestive tract in the Primorie Territory

The paper presents the results of a hygienic study to identify the leading regional risk factors for noninfectious diseases of the digestive tract (DT) in the Primorye Territory. Data on 55 environmental factors and registered deaths by 5 groups of noninfectious DT diseases over 15 years were collected for the study. The authors used an original scheme for identifying risk factors for DT diseases, by concurrently applying a correlation and regression analysis. The chemical composition of portable water from the water supply system, soil contamination by trace elements, and socioeconomic factors showed 5.6-23.2% responsibility for the geographical distribution of the bulk of DT diseases. At the same time, many years' rises in morbidity rates among children and adolescents by 5.6-18.2% and adults by as high as 50% are attributable to altered daily diets and socioeconomic factors and to reduced access to medical care. The nature of the found risk factors allows one to direct the main ways to prevent non-infectious DT diseases among the region's population.     

空气中流感病毒富集于采样介质中的存活情况与监测应用

目的 建立流感病毒气溶胶富集方法,检测富集病毒气溶胶存活情况并评价空气微生物采样器的采样效率.方法 通过气溶胶发生器模拟空气中流感病毒,使用30μm孔径超细静电纤维膜、0.2μm孔径Teflon静电膜和AGI-30大气采样器分别对流感病毒进行富集监测,运用荧光定量PCR和MDCK细胞培养方法,分析探讨不同采样介质中流感病毒存活情况与采样效率. 结果 在一定的条件下富集空气中的流感病毒,超细静电纤维膜和Teflon膜收集到的病毒存活率低,而使用7％胎牛血清处理过的超细静电纤维膜和Teflon膜采样,则病毒存活率高;使用静电膜富集空气中的流感病毒,疫点和医院发热门诊流感病毒RNA阳性检出率分别为100％和20％,而使用AGI-30采样病毒RNA检测全为阴性. 结论 监测空气中流感病毒的活性是有效预防流感的关键,空气中流感病毒气溶胶的富集,采用较大孔径和小孔径的静电膜都具有较高的富集效能,可应用于空气环境监测.