政策工具视角下我国中医药基本医疗保险政策文本量化研究

目的：总结分析我国各省份中医药基本医疗保险政策的构成特点与问题,为中医药基本医疗保险政策的完善和优化提供参考。方法：从政策工具视角出发,结合政策工具—政策发展过程两个维度,采用内容分析法对2011—2023年省级中医药基本医疗保险政策文本进行量化研究。结果：纳入93份政策文件,累计编码487条。从政策工具维度来看,内部子工具涵盖主题丰富,但对其关注程度存在差异;从政策发展过程维度来看,各环节也呈现出离散态势,显示出以政策规划和政策实施占主导的特征。结论：优化政策工具运用组合,构建协调平衡的政策工具架构;统筹规划中医药医保政策发展过程,彰显中医药特色优势;重视维度间政策协同性,强化中医药医保政策执行力度。     

政策工具视角下我国基本公共卫生服务均等化政策研究

目的：通过对基本公共卫生服务均等化政策的量化分析,全面了解其总体特征、政策工具组合运用情况,为促进我国基本公共卫生服务均等化政策完善提供建议。方法：以2009—2022年中央政府发布的促进基本公共卫生服务均等化的政策为研究对象,构建“政策工具(X维度)—利益相关方(Y维度)—政策过程(Z维度)”三维政策分析框架,开展政策内容分析。结果：供给型政策工具比例合理、政策重点立足于政府部门和政策执行阶段;主要运用公共卫生项目推进,重视基层医疗机构能力提升,并给予资金、人才支持。但存在总体结构失调、利益主体政策格局失衡和政策阶段关注不均等问题。建议：优化政策工具内部结构、对利益相关方投入多元化政策关注及合理布局政策阶段。     

健康中国行动的政策逻辑与适配：基于“目标—工具”框架的分析(2019—2023)

本文应用 “目标—工具”分析框架,对中央层面2019—2023年颁布的“健康中国行动年度工作要点”文件进行系统分析。研究发现,近年来“健康中国行动”的政策工具选择、运用逻辑及其与实践目标耦合和适配的特征如下： (1)构成型政策为基础政策工具,选用比例高;(2)分配型政策与规制型政策作为常用匹配工具能够实现“健康中国行动”指引与调控的双重任务目标;(3)再分配型政策工具使用率相对较低。未来健康中国行动开展需要进一步着眼于政策工具与行动目标的适配性,加强多种政策工具多位一体和联动运用,动态优化工具匹配秩序,同时注重实质性工具与程序性工具相协同。     

生命早期卫生健康政策内容研究——基于北京市政策文本分析

目的：以北京市为例,探讨以孕产妇、婴幼儿为主体的生命早期卫生健康政策,为政策制定和优化提供依据。方法：运用内容分析法,将149条政策文本分为政策目标和政策工具两大维度,通过人工编码,对结果进行描述性统计、交叉分析和趋势分析。结果：在政策目标维度中,提升妇幼卫生服务水平占比最多(61.7%),提升科研水平占比最少(8.1%)。在政策工具的四个维度中,强制性、自发性、能力建设性、激励性工具分别占比90%、55%、48%和42%。在趋势分析中,政策体系完整度不断加强,婴幼儿照护比例提高。交叉分析与趋势分析均显示出相关政策对强制性和激励性工具的高强度使用;自发性工具与能力建设性工具使用率占比偏少,且使用率随时间推移呈下降趋势。结论：提升妇幼卫生服务水平是政策目标的核心关照,但对家庭、婴幼儿照护和科研建设的关注相对较少。在工具层面,强制性工具普遍应用;激励性工具和自发性工具多用于福祉关怀和软性引导;能力建设性工具使用不足。建议：应进一步完善政策体系,既要有的放矢也要补齐短板,加大对家庭系统的资源支持、更多关注生命早期弱势群体、强化妇幼健康科研实力。     

Understanding Physicians’ and Nurses’ Adaption of National-Leading Patient Safety Culture Policy: A Qualitative Study in Tertiary and General Hospitals in Korea

BackgroundIn Korea, the safety culture is led by national policy. How the policy ensures a patient safety culture needs to be investigated. This study aimed to examine the way in which physicians and nurses regard, understand, or interpret the patient safety-related policy in the hospital setting.MethodsIn this qualitative study, we conducted four focus group interviews (FGIs) with 25 physicians and nurses from tertiary and general hospitals in South Korea. FGIs data were analyzed using thematic analysis, which was conducted in an inductive and interpretative way.ResultsThree themes were identified. The healthcare providers recognized its benefits in the forms of knowledge, information and training at least although the policy implemented by the law forcibly and temporarily. The second theme was about the interaction of the policy and the Korean context of healthcare, which makes a “turning point” in the safety culture. The final theme was about some strains and conflicts resulting from patient safety policy.ConclusionTo provide a patient safety culture, it is necessary to develop a plan to improve the voluntary participation of healthcare professionals and their commitment to safety. Hospitals should provide more resources and support for healthcare professionals.     

Prevalence and reasons of increased type 2 diabetes in Gulf Cooperation Council Countries

Arab Gulf Cooperation Council countries are considered as one of the most regions exhibiting a high prevalence of diabetes including the kingdom of Saudi Arabia, Bahrain, Qatar, Oman, Kuwait, and United Arab of Emirates, which have similar population characteristics (for example, religion, language, lifestyle, diet, and income). The frequency rate of diabetes in these countries ranged from 8 to 22% according to the last International Diabetes Federation (IDF) report. Many factors impact the prevalence in this region including obesity, unhealthy lifestyle, increased life expectancy, increased healthcare expenditures, increased the incidence of type 2 diabetic mellitus (T2DM) among children and young persons, and genetic susceptibility. This study aims to review the published papers on the incidence of T2DM and explore the most reasons behind elevated incidence of T2DM in these countries.     

The Impact of Underage Drinking Laws on Alcohol-Related Fatal Crashes of Young Drivers

Background: This study used a pre‐ to post‐design to evaluate the influence on drinking‐and‐driving fatal crashes of 6 laws directed at youth aged 20 and younger and 4 laws targeting all drivers. Methods: Data on the laws were drawn from the Alcohol Policy Information System data set (1998 to 2005), the Digests of State Alcohol Highway Safety Related Legislation (1983 to 2006), and the Westlaw database. The Fatality Analysis Reporting System data set (1982 to 2004) was used to assess the ratio of drinking to nondrinking drivers involved in fatal crashes [fatal crash incidence ratio (CIR)]. The data were analyzed using structural equation modeling techniques. Results: Significant decreases in the underage fatal CIR were associated with presence of 4 of the laws targeting youth (possession, purchase, use and lose, and zero tolerance) and 3 of the laws targeting all drivers (0.08 blood alcohol concentration illegal per se law, secondary or upgrade to a primary seat belt law, and an administrative license revocation law). Beer consumption was associated with a significant increase in the underage fatal CIR. The direct effects of laws targeting drivers of all ages on adult drinking drivers aged 26 and older were similar but of a smaller magnitude compared to the findings for those aged 20 and younger. It is estimated that the 2 core underage drinking laws (purchase and possession) and the zero tolerance law are currently saving an estimated 732 lives per year controlling for other exposure factors. If all states adopted use and lose laws, an additional 165 lives could be saved annually. Conclusions: These results provide substantial support for the effectiveness of under age 21 drinking laws with 4 of the 6 laws examined having significant associations with reductions in underage drinking‐and‐driving fatal crashes. These findings point to the importance of key underage drinking and traffic safety laws in efforts to reduce underage drinking‐driver crashes.     

The current global status of chinese materia medica

The Chinese government has recently established a national project to improve the standards of Chinese Materia Medica (CMM) products, particularly regarding their quality control and safety evaluation, in order to promote modernization and increase international trade. In 2006, the global sales value of Chinese medicinal products increased to 20 billion US$, and the export value of CMM was up to more than 1 billion US$. However, the standard of these products still needs to be improved to meet the more stringent requirements of the international markets. Over the past decade we have witnessed the increasing growth in popularity of health foods and herbal medicinal products, especially Chinese Materia Medica products (CMM). Copyright © 2009 John Wiley & Sons, Ltd.     

武汉市社区卫生服务发展概述

本文对武汉市近年来大力发展社区卫生服务工作所取得的成绩和经验进行了总结,对存在的问题进行了分析,对下一步社区卫生服务的发展提出了建议。