卫生投入机制的核心问题探讨——以浙江省卫生投入改革实践为例

通过分析浙江省卫生投入机制的改革实践，认为完善卫生投入机制的核心问题是，必须明确卫生机构的公共职能与政府的相应投入责任，加强省级政府的转移支付责任以促进区域内基本卫生服务的均等化，通过加强卫生投入绩效评价转换卫生投入机制。     

浅析健康教育与健康投资

本文对于健康教育与健康投资的浅析,使人们对健康教育与健康投资有所了解。健康教育是通过学习、传播和行为干预,帮助个人和群众掌握卫生保健知识和技术,树立健康观念,自愿采纳有利于健康行为和生活方式的教育活动与过程。保持健康就像逆水行舟,不进则退;要健康,就必须下功夫进行健康投资。     

长三角地区外商直接投资的技术外溢与吸收效果——基于长江三角洲16个城市的面板数据分析

在长三角经济增长中，外商直接投资（FDI）起到了显著的推动作用，FDI的溢出效应是存在的。长江三角洲基础设施和科学事业经费的投入能够提高对FDI溢出效应的吸收能力，而人力资本投入对FDI溢出效应的吸收能力作用并不显著。基础设施形成的吸收效果仍然存在边际递增效应，而科学事业经费的投入的吸收效果存在边际递减效应。进一步提高外商直接投资的质量，加快长江三角洲先进制造业基地的建设，大力引进外资研发机构是今后长江三角洲地区利用外资的重点。     

Smoking cessation in a blue-collar population: results from an evidence-based pilot program

BACKGROUND: Taft Hartley Funds provide group health care coverage for 10 million union workers as well as their dependents in industries such as construction and transportation. The adult smoking rate in these populations is estimated at approximately 40%, therefore, these funds include 9 million adult smokers. The absence of evidence demonstrating the effectiveness of smoking cessation programs has kept Taft Hartley Funds from investing in smoking cessation benefits. METHODS: A prototype for Taft Hartley Funds consistent with the Federal Clinical Guidelines for Smoking Cessation was designed and implemented in a pilot demonstration in the Carpenters Health and Security Trust of Western Washington. Participants chose a 1-call or more intensive 5-call smoking cessation counseling plan provided by the Group Health Cooperative's Free and Clear program. Medications were limited to the nicotine patch, nicotine gum, and Bupropion. Assessment of outcomes was performed by Free and Clear through a telephone survey 12 months following the enrollment date. RESULTS: Nine hundred thirty-five smokers participated in the program. This pilot evaluation covers 325 participants with at least 12 months since enrollment; 75% were male, the average age was 41.4 and 63% had smoked at least one pack per day for more than 20 years. Sixty-one percent selected 5-Call Counseling; 39% 1-Call. Seventy-five percent also used smoking cessation medications: gum, 4%; patch, 32%; Bupropion 21.5%; patch plus Bupropion, 15.7%. The point-prevalence-quit rates were: overall, 27.5%; 1-Call, 25.5%; and 5-Call, 28.9%. The cost of the program was $1025.28 per smoker who quit, or $11.78 per full-time equivalent employee covered by the Fund per year. The compounded savings in reduced lifetime tobacco-related medical costs for the participants who quit are estimated to be 15 times the cost of the program, yielding an annual return on investment of 27.6%. CONCLUSIONS: These results strongly suggest that smoking cessation programs can be effective even in such hard-to-reach populations as itinerant building trades workers, provided that the program is designed to their needs and environment. Based on these findings, health plans need to consider whether they are at risk of violating their fiduciary duties if they fail to offer smoking cessation benefits.     

试论"三难"的成因与缓解对策

我国城镇医疗服务体制改革面临"政府投入难、医院发展难、群众就医难"的"三难",凸显改革深层次矛盾.对策:科学发展观是指导,综合治理、配套政策、深化改革、加大投入、发展经济是缓解"三难"的根本途径.     

医疗保险统账结合模式的问题与对策

我国城镇职工基本医疗保险制度采取“统账结合”模式,实现了“横向”社会共济保障和“纵向”个人自我保障的有机结合,但在运行中仍出现了一些新问题。从个人账户的共济性、资金积累、沉淀资金收益及统筹资金筹资的公平性、时效性和统账结合方式等方面进行探讨,总结近年来学者们提出的对策方法,引发人们对我国医保模式的进一步思索与讨论,以促进我国基本医疗保险制度日臻完善。     

论医院治疗服务产出的核算方法

讨论了医院用投入法核算治疗服务产出存在的问题，从完整产品的角度提出改进的方法——医院完整治疗产出的核算方法，并通过模拟数据计算证明该方法能对医院治疗服务产出进行准确的测算。     

乌鲁木齐市某所三级甲等医院1092例高血压病医保患者住院费用的分析

目的:探讨高血压病住院医保患者医疗费用增长情况,为建立合理的医疗费用控制机制提供依据. 方法:对乌鲁木齐市某所三级综合型医院2003年1月～2007年9月收治的1 092例高血压住院医保病例的住院天数、住院费用以及个人支付和统筹支付费用情况进行分析.结果:5年来次均住院天数的平均增长速度为2.86%,次均住院费用的平均增长速度为6.45%,次均床位费用、药品费用、检查费用、诊疗费用的平均增长速度分别为5.22%、-3.92%、11.18%、25.41%,个人支付费用占住院总费用的比例由2003年的54.21%下降至2007年的38.01%,降幅明显.结论:控制药费、检查费用和诊疗费用等费用增长点,继续发挥城镇职工基本医疗保险的作用,倡导慢性疾病的管理以及发挥社区医疗服务机构的功能是控制医疗费用增长的有效途径.     

南京市新型农村合作医疗住院补偿资金使用情况分析

目的了解南京市新型农村合作医疗住院补偿资金使用与分布情况。方法采用分层整群随机抽样方法收集南京市7个区县2005年和2006年新型农村合作医疗统计数据,并对住院补偿相关指标进行可比性分析。结果2005年,南京市住院补偿49923人次,2006年为59968人次,比上年增长了20.0%。两年均是县级医疗机构所占比例最多,县级以上医疗机构次之,乡镇卫生院最少。2006年次均住院费用比2005年增长了14.2%。2005年对各级医疗机构住院费用补偿了4964.37万元,次均住院补偿费用994元,补偿比例为23.8%,2006年达26.7%。结论南京市住院补偿人次和补偿费用在县级和县级以上医疗机构一直维持较高比例,而乡镇卫生院则相对较少。应完善补偿方案,引导患者合理分流,提高新型农村合作医疗住院补偿资金使用效率。     

Effect of casting methods on accuracy of peridental restorations

Abstract – The present study has shown that the accuracy of peridental gold alloy castings depends 1) on the type of casting machine used, 2) on the diameter of the casting sprue, and 3) on the strength properties of the investment material. The dependence between the accuracy and the three factors mentioned is based on erosion of the investment mold by the inflow of the liquid casting alloy. The vacuum casting technique proved to be a more gentle casting method than centrifugal and vacuum/pressure techniques.