洪雅县新型农村合作医疗基金运行状况分析

[目的]本次研究的目的在于分析四川省洪雅县新型农村合作医疗(以下简称"新农合")的基金运行状况,总结目前取得的成果和存在的问题,为新农合的发展提出建议。[方法]本研究通过分析四川省洪雅县实施新农合以来的筹资数据和门诊、住院的就诊人次及费用补偿汇总表,总结资金的筹集和使用状况。[结果]①各级政府的筹资比例不断增加;②存在资金不到位的现象;③基金使用率不高;④基金使用效果状况良好。[结论]根据洪雅县目前存在的问题,提出以下建议:①保证合作医疗基金的到位率;②适时调整补偿方案,减少基金沉淀;③进一步提高筹资比率。     

2003～2008年龙岩市实施全球基金结核病项目效果分析

[目的]按照全球基金结核病项目实施计划,评价项目实施效果。[方法]2008年4月,对龙岩市4个项目县进行项目终期效果评估。[结果]2003年4月至2008年3月,累计接诊可疑肺结核症状者21100例,就诊率2.53‰,查痰19756例,查痰率93.63%,检出涂阳病人3489例,涂阳检出率17.66%。治疗新涂阳病人2664例,治愈2433例,治愈率91.33%。网络报告肺结核病人3495例,转诊率93.25%,转诊到位率52.13%,追踪率91.34%。[结论]龙岩市项目实施取得显著成绩,肺结核病人发现和治疗管理水平得到提高。     

How do HTA agencies perceive conditional approval of medicines? Evidence from England,Scotland, France and Canada

There is a growing disconnect between regulatory agencies that are promoting expedited approval to medicines based on early phase clinical evidence and health technology assessment (HTA) agencies that require robust clinical evidence to inform coverage decisions. This paper provides an assessment of the evidence gap between regulatory and HTA agencies on medicines receiving conditional marketing authorisation (CMA) and examines how HTA agencies in France, England, Scotland, and Canada interpret and appraise evidence for these medicines. A mixed methods research design was used to identify the types and frequency of parameters raised in the context of HTA decision-making for all conditional approvals in Europe and Canada between 2010 and 2017. Significant heterogeneity was found across the HTA agencies in England, Scotland, France, and Canada in the assessment of medicines receiving CMA, with the highest likelihood of rejection present in Quebec (50%) and Scotland (25%). Rejected medicines were more likely to have unresolved uncertainties related to the magnitude of clinical benefit, study design, and issues in economic modelling. More systematic use of joint early dialogue and conditional reimbursement pathways would help clarify evidence requirements and avoid delays in patient access to innovative medicines.     

Global Vaccine Action Plan lessons learned III: Monitoring and evaluation/accountability framework

IntroductionThe Monitoring & Evaluation/Accountability (M&E/A) framework of the Global Vaccine Action Plan (GVAP) was used to report progress annually to the World Health Assembly (WHA).MethodsStakeholder feedback was obtained through five reviews consisting of surveys and semi-structured interviews conducted from 2017 to 2019. Participants consisted of individuals involved in the development and implementation of GVAP or its M&E/A process, national immunization managers, academics, representatives of non-governmental organizations, and civil society organizations.ResultsThe feedback was mixed and contradictory for some components, though most participants reported that the M&E/A process was a highlight of GVAP and a step in the right direction. Several of the goals and targets were considered aspirational and unrealistic for many countries. There were mixed responses on whether it promoted accountability, especially at the country level.DiscussionThe mixed and contradictory views on the M&E/A processes and its impact suggested a failure of communication about its scope and intent. Though the process, especially the annual reporting to the WHA, kept immunization high on the global agenda, it failed to fully meet the expectations in promoting accountability. Engaging with countries to capture the local context in setting global goals and targets and promoting local M&E/A processes will be important to achieve accountability in the next decade.     

海南省第一轮全球基金结核病项目结果分析

目的对海南省第一轮全球基金结核病项目结果进行分析,为今后项目实施提供经验。方法根据项目期间各市县项目实施工作季报表和财务报表,进行统计分析和评价。结果新涂阳发现率为73.8％,其中贫困县发现率为80.7％、非贫困县发现率仅为68.7％（X^2=548 P=0.000）。新涂肺阳结核病人治愈率达93.2％。乡村医生培训仅完成75.2％。督导乡镇仅完成72.4％,其中贫困县完成75.9％、非贫困县完成69.1％（X^2=104 P=0.000）;项目投入经费435万元,项目应配套354万元、实际配套235万元,配套到位率为66％。结论项目实施成效显著。进一步加强政府承诺,落实配套经费,加强对乡村医生进行培训和督导,提高乡村医生结核病防治工作能力,充分发挥三级防痨网的作用,是今后做好结核病项目工作的重要保证。     

2011年广西全球基金疟疾项目县疟疾监测结果分析

目的 分析2011年广西壮族自治区（广西）全球基金疟疾项目县疟疾疫情监测结果及流行动态,为制订防治措施提供参考依据。方法 收集2011年广西7个全球基金疟疾项目县疟疾年报表、工作简报及网络直报等监测数据进行统计分析。结果 2011年广西全球基金疟疾项目县共报告疟疾病例8例,占全区病例总数的7.14%（8/112）;平均年发病率为0.04/万,较2010年上升100%。全年血检常住人口中发热病人42 064人次,未检出疟原虫阳性者;血检流动人口3 867人次,检出疟原虫阳性8例,阳性率为0.21%。8例疟疾病例中,间日疟5例,恶性疟3例;病例分布于隆林县、天峨县、南丹县、右江区,均为到非洲、东南亚等地区务工感染后返乡人员。全年无输入性疟疾继发病例及死亡病例发生。结论 广西壮族自治区全球基金疟疾项目县防治措施有效,疟疾疫情稳定。加强对境外非洲、东南亚等地区务工返乡流动人员疟疾监测是巩固防治成果的关键。     

分析国家自然科学基金申请落选原因提升申报质量

为了提升国家自然科学基金的申报质量,提高获资助率,通过回顾北京市神经外科研究所近5年（2004-2008年）申请国家自然科学基金落选项目反馈评定意见,从45项落选项目的反馈意见中找出落选的主要原因集中在：工作基础薄弱,创新性差、项目可行性差及立论依据不够充分、研究目标不明确,人员配置不合理或者没有完成项目时间保证等方面。根据落选原因制定有助于提高基金资助率的相应改善对策。     

海南南桥试点60年抗疟进程及全球基金项目实施抗疟进展

目的剖析南桥试点半个世纪的抗疟进程,探讨高疟区消除疟疾的规律和经验,为海南消除疟疾提供参考。方法采用描述流行病学方法对试点的抗疟措施及其成果进行回顾和分析。结果杀虫剂滞留喷洒后,主要媒介微小按蚊迅速被消灭,致使疟疾大幅度下降;由于仍存在重要媒介大劣按蚊,致使疟疾下降缓慢,长期徘徊;由于土地和森林不断开垦,大劣按蚊密度下降,加之增加了蚊帐使用,减少了人蚊接触,使疟疾得以持续稳定下降,但偶尔出现小幅波动。表明控制蚊媒是控制疟疾的关键,继续减少人蚊接触和降低媒介能量是巩固抗疟成果,成功消除疟疾的关键。近10年全球基金疟疾项目实施期间抗疟成果得到巩固和发展。结论南桥试点60年的抗疟成绩巨大,现正进入消除疟疾阶段,全球基金疟疾项目实施抗疟成果得到巩固和发展。