医院视角下对医师多点执业制度的思考

当前我国面临着医疗资源特别是优质医疗人才资源分配失衡的现状,优质医疗人才资源的失衡造成了医疗市场中患者流向的失衡,大医院人满为患,即“看病难”,而社区医院却门可罗雀的现状.本文结合医师多点执业现状,对医师多点执业制度的落实等相关问题进行具体分析与阐述.     

多源流理论视角下医师多点执业政策研究

随着医疗卫生事业迅速发展,原有的医师定点执业方式已难以适应广大人民群众对医疗卫生服务资源的新需求,我国亟待制定出新的医师多点执业政策应对新形势。笔者采用多源流理论模型,解释医师多点执业的政策过程,对政策过程中的问题源流、政策源流、政治源流分别进行梳理,对政策之窗开启及三个源流的耦合进行分析,指出三条源流未能汇合、政策之窗并未开启是政策推行受阻的主要原因,并浅析多源流理论在我国政策过程中的适用性与局限性。     

对新医改医师多点执业试点政策的思考

医师多点执业由于管理、制度和医师因素的原因,政策优势还无法真正显现。结合云南、广东等地试点的开展情况,分析现有法律法规体系对政策实施的影响,提出稳步推动医务人员的合理流动,需要正确引导与加强监管并举,把多点执业关注点向提升基层医疗机构医疗水平的方向倾斜,并积极探索团队多点执业。     

我国实施医师多点执业的政策分析与思考

医师多点执业试点工作正在各地逐步推开.文章依据国家新医改政策,以医师多点执业为基点,对医师多点执业现状和对医疗卫生系统的运行管理可能带来的影响进行综合分析,结合医疗单位的实际,提出意见建议.     

大型公立医院高级职称医师流动视角下的医师多点执业政策分析

医师多点执业作为医疗体制改革的一个着力点,有助于解决"看病难"问题。但医师多点执业政策落实效果并不理想,笔者试图从大型公立医院高级职称医师流动的视角,以广东某大型公立医院为例,针对属于优质医疗资源的高级职称医师执业选择进行分析,探讨医师多点执业难以推行的原因,进一步提出对策和建议。     

制度变迁视角下完善医师多点执业的思考

作为促进医师流动、优化卫生资源配置的重要举措,多点执业被寄予厚望,但实践中多点执业却遭受冷遇。从制度变迁视角来看,遇冷的根本原因在于既有制度和思维中存在的路径依赖：首先,政府管制体制具有强大的制度惯性将医师锁定在医院中,医师多点执业的合法性与合理性并不统一。其次,医院之间竞争的白热化,多点执业对于医院和医师责权利分配格局统一性的挑战使医院对多点执业冷淡。再次,思维观念中的求稳倾向与追求利益的欲求,使医师对多点执业采取观望态度。因此,多点执业的制度变迁需要加快政府制度创新,为多点执业解锁,实现合法性与合理性的统一;转变医院运行逻辑,扼制逐利动机,推行多点执业契约管理;转变医师思维模式,正视医师利益需求,构建多点执业激励机制。     

博弈论视角下的医师多点执业制度

医师多点执业制度是在新医改的不断推进中,国家为了配置优质的医疗资源的重要举措,这一利民政策能否顺利实行也是维护社会稳定的一个重要因素.笔者从博弈论的角度,分析了政府、医疗机构和医师之间的利益关系,并从政府加大财政投入、完善双向转诊制度、明确医疗机构之间责任及配套制度的改革等方面对医师多点执业制度的推进与发展进行了分析与探索.     

我国医师多点执业的现状及政策问题确认

目的明确我国医师多点执业的现状,并进行政策问题确认。方珐定性研究与定量研究相结合。结果当前我国医师多点执业政策尚处于试点推行阶段,各方反响不一：政策的推行面临一系列诸如人事制度、医疗质量保障和医疗争议追究等体制、机制上的政策问题。结论推行医师多点执业政策是优化资源配置、调动医务人员的积极性、推动公立医院改革的重要举措．但需夯实基础、合理规划、加强监督,逐步深化人事制度改革,促进政策的稳步推行。     

关于医师多点执业的思考

医师多点执业是当前社会热门话题之一,对其利弊的讨论众说纷纭。从医师多点执业的积极意义和可能带来的问题这2个方面进行了分析。     

医师多点执业政策执行的研究

医师多点执业从试行以来,实际效果并不显著,政策经多次修订,正逐步解决试行过程中遇到的瓶颈和阻力。文章通过研究医师多点执业政策在宏观执行与微观执行过程中的问题,剖析了产生问题的原因,并提出了相应的解决对策和出路。     

医师多地点执业现状调查及监管对策

医师多地点执业对促进医疗人才的合理流动和资源共享,缩小城乡差别有着十分重要的作用,随着医改方案的出台,医师多地点执业问题再次成为社会各方关注的焦点。为了解我区医师外出执业的现况,以及医务人员、卫生行政管理人员对医师多地点执业的管理建议,我区于2010年开展了\     

注册医师多点执业政策利益诉求与博弈分析 —基于政府和医院角度

摘要:目的　探究我国医师多点执业政策实施效果不佳的原因和决策建议。方法　利用完全信息动态博弈模型,对政府、第一执业医院和第二（三）执业医院进行博弈分析。结果　博弈最佳策略组合为政府深入实施政策,第一执业医院阻碍医师外院执业,第二（三）执业医院积极表达需求并施加影响,印证我国政策推行的实际情形。结论　政府部门应关注第一执业医院对政策的态度和反应,在横向流动名额配置、首诊转诊制度以及医疗行为保障等方面加以完善。     

Performance of the Dutch health care from an international perspective: background and implications for policy

The 'World Health Report 2000' has stimulated discussions on the Netherlands' performance in health and healthcare from an international perspective. The only concrete result it provided was a world ranking in which the Netherlands stood in 17th place. The comparative data which have appeared in several other recent reports, are more useful to policy makers, a notable example being those from the Organization for Economic Cooperation and Development (OECD). One issue arising from these reports is that the increase in life expectancy in the Netherlands is lagging behind the European Union average. This is particularly the case for women and a major cause of this is smoking. Developments in Dutch perinatal mortality are also unfavourable and are associated with a strong increase in the age at which women bear children. International comparisons of public health data are valuable inputs for health policy development and it is therefore important to invest in the international harmonisation of such data collection.     

转型期公立医院推进医师多点执业的研究和探索

针对新医改方案中提出的优化整合医疗资源,探索注册医师多点执业的要求,通过比较国内外医师执业制度的差别．分析在我国当前政策条件下实施医师多点执业的利弊．结合新华医院在推进医疗资源纵向整合实际工作中遇到的问题．对探索注册医师多点执业提出政策性建议,以期对管理决策提供参考。     

基于SWOT-CLPV模型的我国医师多点执业政策分析

为实现优质医疗人力资源的合理配置,促进医师多点执业有效落实,运用SWOT-CLPV模型对我国医师多点执业的内部优劣势、外部机会、威胁及相互作用产生的杠杆效应、抑制性、脆弱性和问题性进行综合分析,找出关键影响因素,并针对多点执业推行中遇到的主要问题提出对策建议。     

Contraception: an international perspective

Although it is estimated that the population growth rate will decline to a replacement level by 2050, it is also now predicted that the total world population will reach 8.9 billion in that year -- far higher than the 2004 estimate of 6.4 billion. More than 26 billion new couples will need contraceptives in the next half century. Although a steady increase in contraceptive use has been observed in both developed and developing countries, the contraceptive needs of a high percentage of couples have not yet been met and the number of unplanned pregnancies continues to increase. The actual use of contraception differs from region to region. Although no new method has been registered for many years, several new products have been marketed during the last 5. Among these are new implants, medicated intrauterine systems, contraceptive vaginal rings, transdermal patches and several new combined oral contraceptive formulations. New contraceptive methods have been developed to meet the objectives of expanding contraceptive choices for both women and men and answering an unmet need for contraceptives with a long-term action that meet the expectations of consumers. Simplicity, reversibility and effectiveness are the desired features of a male contraceptive, but no new male contraceptive method is yet available. New areas of basic research include studies on genes, proteins and enzymes involved in the reproductive system. The new methods will be targeted to specific interactions within the reproductive system at the level of ovaries and testes, as well as between spermatozoa and ova. This futuristic approach still keeps in mind the need for better access to existing contraceptive methods, as well as the discovery of new contraceptives that are simple to use, safe, reversible and inexpensive. In the future, contraceptives may be combined with other medicinal agents to provide dual protection against both pregnancy and other preventable conditions, such as sexually transmitted infections.