重庆市农民工医疗保险现况调查

目的 了解重庆市农民工医疗保险状况,为相关部门完善农民工医保政策提供依据.方法 采用自行设计问卷,抽样调查重庆市6区884名农民工,采用SAS9.1软件进行分析.结果 有45.53%的农民工未参加任何医疗保险,参保者中有95.37%参加的是新型农村合作医疗,未参加新型农村合作医疗的417人中,有48.2%的人没有听说过,有26.38%的人回答在城市务工,不可能享受到;有62.53%的人不愿自行交纳医疗保险.农民工的性别、学历、婚姻状况和进城务工年限对参保态度影响最大.结论 农民工医保政策的落实既有农民工自身原因,更需要社会的关注及政府的支持.     

陕西省新型农村合作医疗缓解“因病致贫”效果研究

目的:对新型农村合作医疗的政策目标进行评估,为完善新型农村合作医疗制度提供政策建议;方法:采用入户询问的方法对样本人口进行调查,分析比较参保人群在医疗费用补偿前后贫困指标的变化;结果:新型农村合作医疗降低参保人群贫困发生广度和深度的效果较好,但对住院人群缓贫效果更好,新型农村合作医疗的补偿资金对缓解住院人群"因病致贫"有较大的贡献.结论:应加大新型农村合作医疗资金筹集力度、提高住院补偿比例、扩大补偿范围、规范医疗服务机构行为,提升新型农村合作医疗政策效果.     

山西省农民参加合作医疗意愿及其影响因素分析

目的 :研究农民参加合作医疗的主要影响因素及其对新型农村合作医疗发展的影响 ;方法 :利用山西省调查资料对农民参保意愿及其影响因素进行单因素和多元 L ogistic回归分析 ;结果 :是否参加过合作医疗、对村医技术的满意度、住院以及户主年龄、文化程度和吸烟是影响农民参保意愿的主要因素。结论 :加强宣传、健康教育和合作医疗的科学管理是增强农民参保积极性的重要途径。     

影响农民参加新型农村合作医疗的因素分析

在自愿参加和筹资水平既定的前提下，农民的参保率是决定新型农村合作医疗制度成败的关键。对于不同地区、不同农民个体，由于社会、经济、心理特征不同，影响每一个农民参加新型农村合作医疗的决定因素会有不同，但对于特定地区，具有基本相同的社会、经济和心理背景的农民群体来说，影响他们参加新型农村合作医疗的一些主要因素是相同的。本文以安徽省滁州市为例，通过对天长市、凤阳县100个参保农户和100个未参保农户的调查，     

对滁州市实施新型农村合作医疗制度的调查与思考

20 0 3年 ,安徽省确定了 10个新型农村合作医疗试点县 (市 ) ,滁州市的天长市和凤阳县名列其中。经过近一年的运行 ,我市的新型农村合作医疗试点工作取得了明显成效 ,但同时也暴露了一些问题。为了摸清我市新型农村合作医疗制度试点工作状况 ,进一步规范和推动新型农村合作医疗制度建设 ,扩大试点和全面推行新型农村合作医疗制度提供决策依据 ,我们精心抽选了 10 0个参加新型农村合作医疗的农户 (以下简称“参保农户”)和 10 0个未参加的农户 (以下简称“未参保农户”) ,以及 10个定点医疗机构 (以下简称“定点机构”)进行问卷调查。1　新型…     

新型农村合作医疗满意度及影响因素分析

目的 了解山东省威海市农民对新型农村合作医疗制度满意度及影响因素,为进一步推行新型农村合作医疗制度提供科学依据.方法 按照分层随机整群抽样的方法抽取威海市4 303名农村居民,用多元Logistic回归分析满意度影响因素.结果 对新型农村合作医疗的满意率为73.2%.满意度主要受是否参加过体检(P=0.024)和是否住院(P=0.002)因素影响.结论 威海市农村居民对新型农村合作医疗制度的满意率较高,扩大体检覆盖率有利于提高新型农村合作医疗制度的满意率.     

新型农村合作医疗改善卫生服务可及性效果评价

利用陕西省国家第四次卫生服务调查数据,采用特征分数配比法对新型农村合作医疗参保和未参保居民进行匹配,进而比较分析了参保和未参保居民卫生服务利用的总体差别以及在不同级别医疗机构就诊的差别,评价了我国新型农村合作医疗制度对于改善农村居民卫生服务可及性的效果.     

江苏省涟水县新型农村合作医疗现状调查

为了解农民对新型农村合作医疗的参保情况、对新型农村合作医疗制度的知晓程度以及对相关的医疗情况满意程度等进行调查,以利于探讨农民对新型农村合作医疗需求及有待解决的问题。     

大邑县农民新型合作医疗的参保能力研究

目的:研究农民对新型合作医疗制度的参保意愿和参保能力,以及影响参保能力的主要因素.方法:通过对四川省大邑县三个乡的89户农民进行入户调查,应用多元线性回归进行分析.结果:92.1%的农民表示愿意参加新型合作医疗,但对合作医疗的参保能力平均为24.49元,占年人均收入不到2%,占年人均医疗费用负担的比例都较低.影响农民参保能力的因素主要是经济方面的因素,包括年人均总收入、全家累计存款和欠款、年人均门诊花费.针对这些因素,采取相应的措施,是能够提高农民的参保能力的.     

农民参加新型农村合作医疗意愿的影响因素分析

目的了解河南、吉林两省试点地区农村居民对新型农村合作医疗的认知、参保意愿及其影响因素,为增强新型农村合作医疗的可持续发展提供对策和建议。方法自行设计问卷,采用分层整群随机抽样方法,对947名农户进行入户访谈式问卷调查。结果调查对象中,93.5%的农村居民参加了新型农村合作医疗。89.6%的农村居民愿意参加下一年的合作医疗。Logistic回归结果显示:参合报销情况、卫生服务需要利用(过去一年内家人慢性病罹患情况)、新型农村合作医疗相关知识的认知情况(政策知晓、对合作医疗的担心)是影响农村居民参合意愿的主要因素,R2=0.202。结论宣传和健康教育是增强农民参合积极性的重要途径。     

Rural Medicare Beneficiaries''Use of Rural and Urban Hospitals

This report examines the use of rural and urban hospitals by rural Medicare beneficiaries. Many rural Medicare beneficiaries are treated in urban hospitals, primarily for specialized care that is not available locally. This study examines Medicare inpatient hospital discharge data for rural beneficiaries from fiscal year 1990 to fiscal year 1998. Utilization patterns by diagnosis-related group (DRG) are examined for fiscal year (FY) 1997. The percentage of rural beneficiaries treated in urban hospitals ranged from 30 percent to 36 percent during the study period. For the most frequently occurring DRGs among rural beneficiaries, which were those for routine conditions, treatment occurred predominantly in rural hospitals. The conditions most often responsible for rural beneficiaries' use of urban hospitals during this period reflected the need for coronary and other specialized surgical care. The stability of volume and case-mix throughout the study period underscores the viability of rural hospitals during a period of substantial change in the organization of health care provision.     

新型农村卫生体制下的乡村医生

乡村医生是农民基本医疗和预防保健服务的提供者,为农村经济发展与社会和谐提供了有力的健康保障。由于历史的原因．乡村医生这个特殊群体一直被政府和社会忽视。基于乡村医生生存和发展的视角对乡村医生的现状和面临的困难进行考察．发现在已建立的新型农村卫生体制下,乡村医生普遍面临报酬偏低、养老保障缺失、执业考试门槛高等困境。分析以往的研究和目前一些地方的改革实践认为．只有解决了乡村医生的身份定位问题,才能从根本上改善他们的状况。     

Rural Psychiatry

The commonly occurring psychiatric disorders, anxiety and depression, have a combined community prevalence rate of 15–30% and are associated with significant clinical and economic cost. Although a number of effective pharmacological and psychological treatments are available for the management of these disorders, many people do not have access to, or do not receive, these treatments. An important factor associated with the lower rates of use of specialist services is rural, particularly remote, residence.This review discusses the problems of delivery of services to rural areas in countries with formal mental health services, and where the availability of psychiatrists and specialist mental health practitioners approximates that recommended by the World Health Organization. Relevant data were collected via a literature search using Medline and PsychLit and supplemented by material from key textbooks and by articles recommended by local experts in the field.A variety of special issues in rural areas, which make mental health service provision problematic, were identified. These relate to the characteristics of the rural location and community, demands upon and availability of mental health clinicians, and the changing role and focus of mental health services.These features, together with limited access to services by patients, necessitate models of service delivery different from those provided in urban areas. Important features include a shift from the ‘specialist as direct provider of care’ role to one of consultation, education, and indirect service provision and the use of a variety of outreach arrangements to enable patient access to essential specialist services.     

Rural recruitment

Physician and nurse shortages are a fact of life for rural hospitals. This foldout section details the scope of the problem and shows how rural hospitals must increasingly compete with their urban counterparts to attract clinical staff.     

Rural medicine

There is a need for radical restructuring of training of physicians with subsequent post-graduate training every three years and quarterly improvement of self-education of physicians. Head physicians of regional rural hospitals should be released from all administrative and economic functions. This is the responsibility of an administrator with higher technical or economic education. Regional and rural Soviets should provide physicians-graduates with dwelling space or flats at their arrival to the place of work; ensure patronage for all kinds of care at rural regional hospitals, their departments and wards; undertake daily supervision and provision of rural hospitals with food products and in autumn time with firing. Rural physicians should be granted an opportunity each month to order food products for themselves and their families from collective-farms at State and collective-farm prices. The Ministry of Health of the USSR should solve the questions of centralization of supply and standardization of equipment and medical appliances for rural hospitals.