卫生政事分开：政府“只掌舵，不划桨”

在卫生领域政事分开的中国式探索中，政府职能与角色定位应强调“只掌舵，不划桨”。即收缩自身职能范围，解除不适当的政府干预，充分发挥市场力量和社会资本的优势与能力，来参与和提供医疗卫生服务，从而最终建立起政府公共部门和非国有组织共同负担医疗卫生服务供给，双方既竞争又合作的全新制度。     

医疗服务市场化的动力与阻力分析

借鉴公共服务市场化的理论,对医疗服务市场化的内涵、动力及其阻力进行分析,并指出医疗体制改革的方向取决于动力与阻力两种力量的权衡博弈,现在得出“市场化非医改方向”的结论为时过早。     

娱乐场所100%安全套使用项目评估指标设计

开展娱乐场所100％安全套使用项目的目的是遏制艾滋病经性途径传播。该项目要求，100％的性娱乐场所，100％的性服务人员在100％的服务时间里正确使用安全套。针对高危人群大力宣传并推广正确使用安全套，对性服务从业者进行健康教育和行为干预，是降低其高危行为发生率，预防和控制艾滋病经性途径传播的一项有效措施，也是一种低投入、高效益的干预手段。泰国和柬埔寨经过10多年项目实施，得出的结论是，项目的开展在阻断艾滋病经性途径传播上有十分明显的作用，并已得到世界卫生组织的认可。本文分析了项目评估中的几个值得注意的方面，报告如下。     

中国西部地区农村居民卫生服务不平等与潜在的可及性状况分析与对策探讨

卫生服务可及性是评价居民卫生服务利用的重要指标之一.中国西部地区同于特殊的地理、经济、民族等特点,使得这些地区广大的农村居民存在卫生服务不平等与潜在可及性差的问题.在对国家第三次卫生服务调查数据再分析的基础上,结合各地区的特点,提出加强农村新型合作医疗的推进速度和覆盖率、因地制宜,科学合理利用民族医学等措施和建议.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

"无红包"医院能走多远

今年3月，无锡市卫生局和无锡市医院管理中心对全市医疗单位提出了创建“无红包医院”的目标、任务和要求，要求各家医院今年上半年要积极参与创建“无红包医院”活动，向社会做出公开承诺，并且明确规定，如果在“无红包医院“创建活动中未达标或者违反了相关规定，将实行一票否决制。 无锡卫生局此举是否可取？能否从根本上解决医务人员收受红包的问题？是否有可持续性？还需要哪些配套措施？本刊特约业内专家进行探讨。[编者按]     

农村孕产妇急危重症的家庭因素及管理对策研究

目的 :本文采取 1∶ 2病例对照的方法 ,通过对影响我国农村地区孕产妇急危重症发病的家庭因素进行调查研究 ,采用条件 logistic回归的统计方法进行分析 ,得出影响我国农村地区孕产妇急危重症发生的家庭因素主要为家庭性质、家庭经济状况、丈夫的年龄、文化程度和抽烟嗜好。在此基础上 ,从家庭因素和管理对策两个层面提出减少农村孕产妇急危重症发生几率的措施     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

医护人员职业耗竭现状及其与人格特质的关系

目的:调查医护人员职业耗竭的现状,分析职业耗竭的影响因素,探讨耗竭与人格特质的关系。方法:采用Mɑslɑch耗竭量表和艾森克人格问卷,对武汉市2家医院175名医护人员进行调查。结果:分别有65.5%和75.7%的人有中度及以上情绪衰竭和缺乏人情味,43.8%的人成就感低;职业耗竭不存在性别、医护、年龄的差异,但婚姻状况、文化程度、医院类型会影响个体的耗竭;人格特质各维度(内外向性、神经质性和精神质性)与职业耗竭各维度(情绪衰竭、缺乏人情味和成就感低落)的相关均具有显著性的意义;回归分析显示,情感衰竭的预测源有文化程度、神经质性、内外向性,医院情感衰竭的预测源是精神质性,成就感低落的预测源是内外向性和精神质性。结论:医护人员有一定程度的职业耗竭现象,应从组织、个体等层面预防和缓解耗竭。     

医疗卫生改革的价值取向与战略选择

结合现阶段中国基本国情和医疗卫生改革的发展状况．提出我国医疗卫生改革政策的实质是政策主体如何在社会主义市场经济的宏观政治经济环境下有效弥补市场缺陷的向度安排的决策过程。就政策的价值取向而言，应尽可能实现保持社会均衡状态的目标，也就是说政策主体应努力协调公平与效率的经济均衡和不同主体之间的利益均衡。