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本文从婚前保健服务的属性入手,探讨其筹资机制,为完善我国婚检制度提供科学依据。采用文献调研和现场调研相结合的方法,梳理国内外婚检筹资现状,收集福建、广西、江苏等8个调研地区婚检筹资相关数据,并对政府有关部门、婚检机构相关人员进行访谈。婚前保健服务属于准公共产品的范畴,本文从筹资水平、资金渠道、资金分配、资金支付和资金监管等方面对其筹资机制进行探讨,提出应明确婚检服务性质、建立财政专项投入机制,进行科学论证、统一婚检服务基本筹资标准,及时足额拨付婚检专项经费、加强经费监管等政策建议。 相似文献
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《Vaccine》2016,34(35):4213-4220
BackgroundIntroduction of new vaccines in low- and lower middle-income countries has accelerated since Gavi, the Vaccine Alliance was established in 2000. This study sought to (i) estimate the costs of introducing pneumococcal conjugate vaccine, rotavirus vaccine and a second dose of measles vaccine in Zambia; and (ii) assess affordability of the new vaccines in relation to Gavi’s co-financing and eligibility policies.MethodsData on ‘one-time’ costs of cold storage expansions, training and social mobilisation were collected from the government and development partners. A detailed economic cost study of routine immunisation based on a representative sample of 51 health facilities provided information on labour and vaccine transport costs. Gavi co-financing payments and immunisation programme costs were projected until 2022 when Zambia is expected to transition from Gavi support. The ability of Zambia to self-finance both new and traditional vaccines was assessed by comparing these with projected government health expenditures.Results‘One-time’ costs of introducing the three vaccines amounted to US$ 0.28 per capita. The new vaccines increased annual immunisation programme costs by 38%, resulting in economic cost per fully immunised child of US$ 102. Co-financing payments on average increased by 10% during 2008–2017, but must increase 49% annually between 2017 and 2022. In 2014, the government spent approximately 6% of its health expenditures on immunisation. Assuming no real budget increases, immunisation would account for around 10% in 2022. Vaccines represented 1% of government, non-personnel expenditures for health in 2014, and would be 6% in 2022, assuming no real budget increases.ConclusionWhile the introduction of new vaccines is justified by expected positive health impacts, long-term affordability will be challenging in light of the current economic climate in Zambia. The government needs to both allocate more resources to the health sector and seek efficiency gains within service provision. 相似文献
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Lunan Li Jiyong Jing Huiqin Gao Chenjing Zhang Haifang Lou Wensheng Pan 《Gastroenterologia y hepatologia》2021,44(4):286-292
Background and aimsThe regular arrangement of collecting venules (RAC) refers to the appearance of multiple regular tiny veins in the body of the stomach and is considered to be very effective for identifying gastric mucosa with non-Helicobacter pylori infection. This meta-analysis was conducted to systematically evaluate the value of the sign in predicting a Helicobacter pylori-negative stomach and the relevant factors that may affect the performance of this prediction.MethodsTwo biomedical databases (PubMed and EMBASE) were systematically searched through April 20, 2020. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the SROC curve (AUC) were calculated.ResultsFourteen articles with 4070 patients were included. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for the RAC in predicting non-Hp infection were 0.80 (0.67–0.89), 0.97 (0.93–0.98), 24.8 (12.2–50.8), 0.21 (0.12–0.36), 120 (47–301) and 0.97 (0.19–1.00), respectively.ConclusionsThe RAC is a valuable endoscopic feature for the prediction of patients without Hp infection. 相似文献
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Hiroki Tanaka Ayana Kanatome Shin Takagi 《Genes to cells : devoted to molecular & cellular mechanisms》2020,25(6):391-401
Vesicular transport serves as an important mechanism for cell shape regulation during development. Although the semaphorin signaling molecule, a well‐known regulator of axon guidance, induces endocytosis in the growth cone and the axonal transport of vertebrate neurons, the underlying molecular mechanisms remain largely unclear. Here, we show that the Caenorhabditis elegans SNT‐1/synaptotagmin‐UNC‐41/stonin2 system, whose role in synaptic vesicle recycling in neurons has been studied extensively, is involved in semaphorin‐regulated vesicular transport in larval epidermal cells. Mutations in the snt‐1/unc‐41 genes strongly suppressed the cell shape defects of semaphorin mutants. The null mutation in the semaphorin receptor gene, plx‐1, altered the expression and localization pattern of endocytic and exocytic markers in the epidermal cells while repressing the transport of SNT‐1‐containing vesicles toward late endosome/lysosome pathways. Our findings suggest that the nematode semaphorins regulate the vesicular transport in epidermal cells in a manner distinct from that of vertebrate semaphorins in neurons. 相似文献
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"The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital''s facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.
Graphical Abstract
Open in a separate window 相似文献8.
《L'Encéphale》2016,42(4):379-381
For 25 years work has been underway in France for the implementation of an alternative to public financing of health care. In the absence of progress, some regional health agencies are engaged in work related to the reallocation of public finances between psychiatric institutions. We propose a reflection with suggestion on the method proposed by the Provence Alpes Côte d’Azur Regional Health Agency. Without questioning the need for a reallocation of resources between psychiatric institutions, the method proposed here needs to evolve further to be applied in a legitimate and appropriate manner. There is a kind of urgency for a reallocation of resources between psychiatric institutions in France, but it implies a collective thinking and especially the definition of evaluation procedures for the selected models. These conditions are necessary to guarantee the quality of French psychiatry and equity in access to psychiatric care. 相似文献
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The asphalt mastic–aggregate interface plays an essential role in determining the service performance of asphalt mixtures. The objective of this paper was to investigate the adhesion behaviors and mechanism between asphalt mastic and aggregate based on molecular dynamic (MD) simulations. First, the asphalt mastic model considering the actual mass ratio of filler to asphalt (F/A) condition was established and validated in terms of thermodynamic properties. Second, the molecular arrangement characteristics of polar components on the aggregate substrate were analyzed by radial distribution function (RDF), relative concentration (RC), and mean square displacement (MSD). Third, the interfacial adhesion ability between asphalt and aggregate was quantitively evaluated based on the work of adhesion. Finally, the coupling effect of moisture and temperature on interfacial adhesion behaviors was investigated to explore the adhesion failure characteristics of the asphalt–aggregate interface. The results demonstrate that the thermodynamic properties could be employed to validate the reliability of the asphalt mastic model. The self-aggregation degree of polar components in base asphalt could be significantly increased with the addition of silica particles, exhibiting a change of configuration from “parallel arrangement” into “stack distribution” due to the high polarity of silica particles. The polar components in asphalt mastic exhibit a more uniform distribution state and lower mobility capability than base asphalt owing to the adsorption effect of silica particles. Silica particles with amounts of residual charges could significantly increase the electrostatic energy of the asphalt mastic–aggregate interface, contributing to an improvement of the adhesion between asphalt mastic and aggregate. The increase of temperature enhances the work of adhesion of the asphalt mastic–aggregate interface, which is opposite to that of the base asphalt–aggregate interface. The asphalt mastic exhibits a greater sensitivity to interfacial moisture damage than base asphalt. The findings would provide insights into a better understanding on the micro adhesion mechanism of the asphalt mastic–aggregate interface. 相似文献
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目前我国已全面开展长期护理保险制度试点。通过对第一批四个试点城市的长期护理保险筹资方案进行梳理,比较分析各城市保险的筹资性质、筹资来源、筹资水平、筹资公平性,发现长期护理保险筹资来源较单一、缺乏激励措施、筹资总体水平不高、筹资公平性有待改善等问题。为完善长期护理保险筹资方案制度设计,本文提出需要特别注意的几个问题:完善筹资来源,应逐步形成合理稳定的筹资来源,拓宽筹资渠道,提高筹资水平;改善筹资公平性,从完善参保制度、加强宣传等方面提高筹资公平性;理顺保险筹资管理体系。 相似文献