中国中老年人失能状况公平性与影响因素

目的 分析中国50岁及以上中老年人失能状况和失能状况公平性,并探究中老年人失能状况不公平的主要影响因素。方法 利用全球老龄化与成人健康研究(Study on Global Ageing and Adult Health,SAGE)中国2007—2010年第一轮调查数据,计算集中指数和集中曲线,并对集中指数进行分解。结果 中国中老年人失能评估量表平均分为7.32,中老年男性平均分为6.37,女性平均分为8.21。中老年人失能状况集中指数为-0.190 9,中老年男性为-0.184 4,中老年女性为-0.196 1。对集中指数进行分解后,社会经济地位对中老年人失能状况不公平的贡献较高,包括经济水平、受教育程度和工作类型,贡献率分别为66.41%、16.45%和13.10%。与社会结构因素相比,中老年人吸烟、饮酒和身体活动情况等个人生活方式因素的贡献率较低。结论 中国存在中老年人失能状况不公平,较好的健康状况集中在经济水平较好的中老年人群中。中老年男性失能状况较女性更轻,且失能状况不公平程度更小。经济水平、受教育程度和工作类型是对中国中老年人失能状况不公平贡献率较高的主要因素,提示仅通过促进中老年人健康生活方式不能够有效减少失能状况在经济水平较好和较差的中老年人群中的差异。政府需要在重视促进中老年人健康的基础上,进一步加强和完善适宜的社会和医疗保障措施,将减少中老年人健康不公平作为政策重点,尤其应该向发展相对滞后、中老年人相对聚集的地区重点分配医疗卫生和其他相关社会资源,同时应该加大对中老年人健康和健康公平相关研究的支持,为积极应对人口老龄化和制定政策收集证据。     

Mental health: market power and governance

This paper is concerned with the pricing behaviour of providers of residential care for people with mental health problems. Two aspects of pricing were considered. First, are there differences between providers' market power and their actual mark-up rates (e.g. due to differences in motivation)? Second, do the different governance arrangements used in sectors of the industry, such as unified public and non-profit organisation and private bilateral contracting, affect pricing behaviour? A theoretical model was developed to underpin the empirical analysis of 496 residents in 112 mental health care facilities. Private, bilateral organisation was found to be associated with comparatively lower potential price-cost mark-up but a greater propensity to use this power to make profits/surpluses.     

Pay equity and nursing in Ontario: ten years later

Abstract
'Nurses have never been compensated in accordance with their central role in health care' ( Schreiber 1994 ), reflecting the generalized and well-documented under-valuing of the work of women ( Schreiber 1993 ). Pay equity legislation, passed in Ontario, Canada in 1987, designed to correct gender wage discrimination, created great optimism that the under-valuing of nurses' work might be ending. Nonetheless, this has not been the case, as the social, political, and economic climate has not kept pace with the speed and enormity of social change necessary to enact the intent of the legislation. Indeed, gains in nurses' wages have been directly offset by significant lay-offs. In this paper, we examine the issues surrounding the implementation of pay equity legislation in Ontario, Canada, along with analysis and implications of these issues, drawn from 10 years of experience. In addition, we highlight lessons that can be learned from the Ontario experience.     

关于中国建立特困人口医疗救助制度的必要性探讨

通过对贫困人口的健康状况,健康公平状况,健康制度享有情况以及其对实现卫生目标的作用和意义等方面的分析讨论,并在与国外有关情况的对比分析的基础上,提出了在中国建立特困人口医疗救助制度的建议。认为建立这样一种制度将有助于我国社会经济的健康发展,并进一步推动扶贫工作的开展,更为重要的是,它对于改善我国人口的健康状况,改善卫生公平性以及提高卫生部门的效率具有十分重要的意义。它是确保我国实现其卫生目标的最佳策略选择之一。     

关于改善我国卫生服务公平性的思考

卫生服务公平性问题是我国深化卫生改革中关注的焦点问题之一.该文从卫生服务公平性的概念及衡量出发,探讨目前我国卫生服务公平性低下的现状及其主要原因,并提出了相应的对策与建议.     

上海市区(县)慢性病防治人力资源现况和公平性研究

目的：了解上海市区(县)慢性病防治人力资源的现状以及人口分布和地理分布配置的公平性。方法：采用问卷调查方法，收集区(县)疾病预防控制中心慢性病防治科人员的年龄、性别、学历、职称等信息，同时，收集各区(县)2003年的人口数和地理面积，并利用洛伦茨曲线和基尼系数测算公平性。结论：目前，上海市区(县)疾病预防控制机构慢性病防治人员以大专以上学历的中青年女性为多，市郊和郊区的人员中以初级职称者为主。公平性分析结果提示慢性病防治人员在地理分布上不公平，郊区的服务半径最大，市区最小。     

基于医护协作的信息化管理模式在胸外科手术计价耗材管理中的应用及效果评价

目的：探讨基于医护协作的信息化管理模式在胸外科手术计价耗材管理的应用效果。方法：2021年6月胸外科手术计价耗材的管理开始实施医护协作的信息化管理模式,2021年3月-2021年5月为实施前,2021年6月-2021年8月为实施后,比较实施前后的首台开台延迟率、巡回护士术中在位率等。结果：实施基于医护合作的信息化管理模式后,首台开台延迟率明显降低,植入物耗材临时配送率明显降低,巡回护士术中在位率显著提高（P< 0.05)。结论：基于医护合作的信息化管理模式可有效提高胸外科手术计价耗材管理的效率,提升精细化管理水平,促进手术室整体管理水平的提高。     

An examination of technologies in complementary medicine education and practice: The perceptions and experiences of naturopathy students,faculty and educational leaders

ObjectivesLittle is known about the education of future CM practitioners. The objective is to explore the perceptions and experiences of students, faculty and professional leaders toward technologies in complementary medicine education and practice.Design and settingQualitative focus groups and one-on-one semi-structured interviews were conducted in CM educational organizations and institutions in North America (United States / Canada) and Australia involving seven focus groups (29 naturopathic students), and 30 one-on-one interviews (faculty, educational and professional leaders of the naturopathic profession).ResultsData analysis identified five issues reported. These related to perceptions of; the shortfalls of CM classroom technology, the value of technology within CM clinical practice, learning technologies in the classroom, addressing equity concerns as a consequence of learning technology use, and the need to develop technology literacy skills amongst students and faculty.ConclusionThis is the first study to examine the perceptions of students, faculty and professional leaders toward technologies in CM education and practice within an education setting. CM students exhibited complex attitudes and adoption patterns to technology. CM students were critical of faculty who have perceived low levels of digital literacy. The technology issue that students in our study found most challenging was PowerPoint use in the classroom. There is an urgent need to establish a strategic research agenda and modelling around this important area of health care education in order to ensure a well-educated, effective workforce able to deliver the best outcomes for the patients and communities they serve.     

我国卫生人力资源配置的公平性分析

借助Lorenz曲线和Gini系数,对我国卫生资源配置的公平性进行测量和评价,结果：显示卫生人力资源按人口的配置处于较均衡的状态且逐年优化,但按面积配置不公平性显著,且一直未得到改善。东、中、西部地区资源配置不公平性显著,但差距逐年减小。需要建立一套科学合理的卫生人才配置标准;重视护理人才的培养,开拓卫生人才职业教育途径;加快医疗保障制度的建立和完善。     

Why stents are expensive: Drivers of high prices in emerging markets

Pricing of stents is being questioned by healthcare stakeholders due to large differences in price of its product types and its variation across different markets. The stent pricing literature published during 1997–2017 were reviewed besides inputs from industry experts to identify initial key pricing drivers. Interpretive structural modeling was used to build priority for checking the price rise in emerging markets like India. Lack of regulation besides other drivers like R&D cost and price of substitute was found to be important drivers of high prices. The findings would help policy makers to take steps to make stent pricing affordable.