中国人寿承办安阳市新农合大病补充医疗保险的效果分析

自2003年新型农村合作医疗制度在全国试点以来,商业保险参与新农合也同时开始试点。发展新农合大病保险不仅对建立多层次医疗保障体系十分必要,而且对新农合制度的实施也很重要。河南省2014年开展了大病医疗互助补充保险的试点工作,并要求采用保险合同模式委托商业保险公司经办。笔者通过对安阳地区中国人寿承办新农合大病医保的效果进行了分析,得出商业保险机构参与新农合管理可以更好地达到多方共赢局面的结论。     

龙游县新农合实行“政保合作”服务管理的实践与成效

文章介绍龙游县引进太平洋保险公司参与新农合经办和管理,建立＂征、管、办＂相分离的合作医疗管理运行模式的主要做法,探讨分析商业保险机构参与合作医疗管理服务在降低运行成本、完善农村医疗保险服务体系、提高合作医疗监管效能等方面发挥的作用,并提出可能存在工作风险及对策建议。     

新型农村合作医疗不宜商业运作

新型农村合作医疗运作模式多样,其中一种模式就是管办分离,引入商业保险公司,由其具体经办。笔者认为:新型农村合作医疗采用商业运作,存在诸多隐患。首先,新型农村合作医疗是党中央、国务院的一项惠农政策,目的在于解决群众“看病难、看病贵”问题。但是,一旦采用商业运作,由于其机构的营利性质,容易产生挤占、挪用新型农村合作医疗基金的现象,削弱新型农村合作医疗“惠农”效果。同时,商业保险公司以前在农村开展的养老保险,最后不了了之,挫伤了农民对商业保险的信心,从而在很大程度上影响了农民参合的积极性。其次,商业保险公司管理的真正目就是以新型农村合作医疗为平台,拓展保险业务。因此,每次培训基本以保险业务为主,新型农村合作医疗的知识所讲甚少,并且强行要求专管员参加保险任职资格考试。同时,商业保险公司把专管员纳入其中进行管理,将政府给予的部分工资与专管员完成保险业务挂钩,专管员在做好新型农村合作医疗工作的同时还要做好保险业务,大大影响了专管员的积极性,对新型农村合作医疗造成了不良影响。新型农村合作医疗是一项农民期盼已久的惠农政策,万万不可因商业运作而丧失民心!Health Economics Research,2008.6新型农村合...     

新型农村合作医疗经办模式研究综述

在我国新型农村合作医疗的运行过程中存在卫生部门、社保中心及商业保险公司3种经办模式。从经办机构的管理模式、成本管理模式、基金管理模式等方面论述我国新型农村合作医疗不同经办模式的特点。     

新型农村合作医疗经办模式研究综述

在我国新型农村合作医疗的运行过程中存在卫生部门、社保中心及商业保险公司3种经办模式.从经办机构的管理模式、成本管理模式、基金管理模式等方面论述我国新型农村合作医疗不同经办模式的特点.     

新型农村合作医疗试行商业保险模式的构建与推广途径

为探索新型农村合作医疗商业保险模式的构建与推广途径,文章根据国家有关鼓励保险业参与新型农村合作医疗业务的政策,通过对新型农村合作医疗现行两种运行模式的优劣对比,剖析其各自运行过程中出现的问题与不足,认为管办分离的新型农村合作医疗商业保险模式具有更强的竞争力,并就新型农村合作医疗商业保险模式的构建与推广提出政策建议。     

政府和商业保险公司经办新农合的运行机制比较

商业保险公司经营新农合业务是卫生改革中的新现象,存在一定的矛盾与困惑.通过对政府和商业保险公司经办新农合模式的运行机制即结算流程、投诉反应性、对医疗机构的监管和基金流向的管理方面的比较,归纳出政府和保险公司运行的不同模式及之间的差异.商业保险公司参与新农合经办,微观上提高新农合服务质量和对医疗机构的监管,但也增加了新农合运行的社会成本;从理论和机制上看,商业保险公司参与新农合并非必需.     

商业保险公司参与新农合业务的原因分析：基于6区县的案例研究

商业保险公司参与新型农村合作医疗业务动机包括:延续政企合作、加强与政府联系、构建政企合作新平台、社会医疗保险对商业健康保险的互补性、市场竞争的需求、拓展新市场的需求、广告效应、公司文化和企业发展战略的需求等.政府将新型农村合作医疗委托给商业保险公司,有预算不足、编制缺乏、缺少经验、职能转变、政府公信力、业务能力以及保险公司积极性等原因.随着新型农村合作医疗信息系统和支付方式的迅速改进,新型农村合作医疗经办效率大大提高,商业保险公司参与新型农村合作医疗业务的必要性在逐渐丧失.建议政府在与商业保险公司合作中,要防止商业公司的“逐利性”可能造成的公共利益损失.     

商业保险参与新型农村合作医疗经办服务中的政府职能定位

商业保险参与新型农村合作医疗（简称新农合）经办服务是在我国政府转型的背景下提出来的,对这一新型公共服务提供方式,不管在理论上还是实践上都不成熟也不完善。因此,探讨政府在向商业保险机构购买新农合经办服务过程中可能存在的问题,对于转变政府的角色和职能.     

保险公司不应介入新型农村合作医疗的运作

近年来有保险公司希望能参与新型农村合作医疗试点，也有部分人大代表建议建立“中国农村保险公司”，用保险的市场运作方式来解决农民的医疗和养老问题。将农民逐步纳入社会保障制度的范畴是社会发展的必然趋势，在经济较发达的地区，选择1～2个市开展农民商业性医疗保险试点工作，探讨其可行性和运作模式是可以考虑的。但笔者认为，目前我国大多数农村地区特别是中西部农村地区经济水平十分有限，现阶段将农民的健康保障纳入商业保险的条件尚不成熟，     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.