以村为单位疫情零报告制度初探

要控制传染病首要的工作就是作好传染病报告。我县从1994年推行以村为单位作为报告传染病的基本单位，如果一句中“本旬无传染病”即零病例报告。以村为单位的传染病零报告制度，使传染病报告更加及时、准确、快捷，使我县传染病防治工作上了新台阶。回零报告制度构想的形成过程80年代初农村实行家庭联产责任制后，过去的合作医疗站多数解体。90年代初恢复和重建的村卫生站中集体办的只占到40％；村卫生站的补偿由过去集体补助工分或开工资变为以个人医疗创收为主。所以预防保健工作为代表的社会性卫生服务工作弱化，传染病管理、报告率明显…     

持续改进新农合制度设计

中国的农村合作医疗制度起始于20世纪50年代，蓬勃发展在60-70年代。当时它是一种梃民互助合作的基本医疗制度，主要由农民自筹资金，没有政府的资助，在一些发达地区有乡村企业的资助。在80年代初期，农村实行家庭联产承包制度以后，大部分地区的合作医疗制度失去了乡、村集体的经济支持，开始瓦解，到90年代，全国大约只有15％的村还维持着低水平的合作医疗制度。     

农村新型合作医疗制度与传统合作医疗的比较

农村合作医疗制度是一种以互助共济为基础,依靠集体经济和群众集资举办的以解决农民基本医疗保健问题为目的的医疗保健制度。80年代初,世界银行和世界卫生组织都曾派专家组来我国考察农村卫生。考察组的报告特别强调指出,“中国农村实行的合作医疗制度是发展中国家群     

农村合作医疗保健制度改革的探索

一、合作医疗发展概况 我省农村合作医疗保健制度的发展经历了一个曲折的过程。合作医疗起源于50年代末,1968年,毛泽东同志对我省长阳县“乐国经验”给予肯定和赞扬。70年代初,全省实现了统一模式的合作医疗,到1978年,农村合作医疗的覆盖率达98％。但80年代初期,随着农村家庭联产承包责任制的推行,大部分地区的合作医疗相继解体,到1989年,全省合作医疗覆盖率只有5％左右。进入90年代,随着农村经济的迅速发展,生活水平逐步提高,农民医疗保障问题也日益突出。为了完善农村卫生网络,解决广大农民看病难问题,省政府     

山东省农村医疗保健制度改革的设想

一、山东省农村医疗保健制度概况现阶段我们实行的医疗保健制度,是筹集、分配和使用医疗基金的一种方式,主要是指居民医疗费用的负担方式。对农村医疗保健制度的研究,也主要是对农村居民医疗费用负担方式的研究。目前农村医疗保健费用的负担方式不外乎2类,一类是集体和个人共同负担的合作医疗、医疗卫生保险(包括单项保健医疗和综合医疗保健)等集资医疗保健制度;另一类是完全由个人负担的自费医疗制度。我省农村医疗保健制度是在农业合作化初期实行的统筹医疗、合作保健的基础上,推广河南省正阳县的合作医疗制度,逐步建立起的。60年代末～70年代     

对农村卫生经济政策的思考

1当前农村卫生经济政策面临的主要问题80年代以前，我国对农村卫生事业实行国家办，农村医疗卫生单位作为社会福利事业免除一切税费负担，国家按计划以平价供给各种医用材料和物资，以村为单位普遍实行合作医疗。随着改革开放和经济体制改革的逐步深化，实行分级办医、分级负责，强调地方政府办卫生职责；提倡以集体办为主多种形式办医模式；拓宽了卫生筹资渠道，实行国家、集体和个人多渠道增加卫生投入。这些卫生经济政策，在农村经济体制改革过程中，为保护农村人口的身体健康发挥了积极的作用。但是，随着社会主义市场经济体制的建立和…     

完善中国农村合作医疗制度的若干建议

合作医疗制度是合作化运动基础上，依靠集体经济。按照互济互助原则建立起来的一种集资医疗制度，就其实质来说是一项低补偿的农村集体福利事业。该制度自50年代开始实施，曾起过良好作用。但自80年代初农村经济体制改革后，集体的公益金积累明显减少，由此也使以公益金为一部分资金来源的合作医疗制度受到严重影响。加上政府没有及时给予引导和支持，     

苏南农村集资一适度风险保障医疗制度的哲学思考

近几年来,苏南农村在完善集资医疗制度的基础上,产生出多种形式的集资一适度风险保障医疗制度。这不是偶然的,它是农村经济由自给型经济向商品型经济发展的一种反映,符合生产关系的调整会促使上层建筑发生变化的客观规律。这一变革适合苏南农村的经济与发展水平和农民的思想觉悟,因而极大地调动了广大农民主动参与的积极性,促进了农村卫生事业的蓬勃发展,使苏南农村卫生事业发生了历史性的变化。 1979年以前,苏南农村普遍实行合作医疗制度。这种以“公社化”为经济基础的医疗制度,随着农村逐步推行家庭联产承包责任制而自行解体。与此同时,适应于家庭联产承包责任制这一经济基础的农     

扬弃—在农村医疗保健制度发展中的实践

以合作医疗制度为代表的我国农村医疗保健制度起源于50年代,60年代、70年代发展得较快,到80年代巩固下来的很少。当历史迈进90年代,经历了10年的改革,各地对农村医疗保健制度不断探索,扬弃,终于认识到当前仍然必须积极引导农民走互助合作的健康保障之路,稳步推行包括合作医疗在内的多种形式的集资医疗制度。10年实践得     

合作医疗:农民的呼唤

农村合作医疗制度的实行,曾较好地解决了枝江县40多万农民缺医少药和看不起病的问题,使危害农民最严重的血吸虫等传染病和一些地方病得到了有效控制或消灭。到70年代中期,全县实行合作医疗制度的村达357个,普及率达到100％,乡村医生和赤脚医生达741人,95％以上的农民享受到了初级卫生保健服务。随着80年代农村经济体制改革     

Unmet health care and health care utilization

The objective of this study is to examine the causal effect of health care utilization on unmet health care needs. An IV approach deals with the endogeneity between the use of health care services and unmet health care, using the presence of drug insurance and the number of physicians by health region as instruments. We employ three cycles of the Canadian Community Health Survey confidential master files (2003, 2005, and 2014). We find a robustly negative relationship between health care use and unmet health care needs. One more visit to a medical doctor on average decreases the probability of reporting unmet health care needs by 0.014 points. The effect is negative for the women‐only group whereas it is statistically insignificant for men; similarly, the effect is negative for urban dwellers but insignificant for rural ones. Health care use reduces the likelihood of reporting unmet health care. Policies that encourage the use of health care services, like increasing the coverage of public drug insurance and increasing after hours accessibility of physicians, can help reduce the likelihood of unmet health care.     

Systemization of leadership for the systemization health care of health care: the unaddressed issue in health care reform

The case literature strongly suggests that both in England and in Australia health care reforms have had very little impact in terms of "improved performance". It is in the context of a perceived failure in the implementation of the reforms that an interest has arisen in leadership at the level of individual clinical units (e.g an orthopaedics unit or birth unit), as the possible "fix" for bridging the promise-performance gap. Drawing upon extensive case studies that highlight the problem and context for appropriate forms of leadership, this paper argues that the appropriate discourse, in terms of leadership in health reform, needs to focus upon the issue of authorization. In making this argument, addresses the current conceptions of leadership that have been advanced in the discourse before offering some case study material that is suggestive of why attention should be focused on the issue of authorization. Illustrates how and why the processes of leading, central to implementing reform, cannot be construed as socially disembodied processes. Rather, leading and following are partial and partisan processes whose potential is circumscribed by participants' position-takings and what is authorized in the institutional settings in which they are located Argues that the "following" that clinical unit managers could command was shaped by the sub-cultures and "regulatory ideals" with which staff of each profession are involved In the interests of reform, policy players in health should not be focusing attention solely upon the performative qualities and potential leadership abilities of middle level management, but also on their own performance. They should consider how their actions affect what is authorized institutionally and which sets the scope and limits of the leadership-followership dialectic in clinical settings.     

Reforming the health care system: implications for health care marketers

Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.     

Maori health and the health care reforms

Maori participation in the 1991 health care reforms is considered against the background of their involvement in health reforms since the turn of the century. Throughout this period Maori have consistently sought autonomous health care. Traditional indigenous healers have provided healing for Maori as they have for other indigenous people, such as Aborigines, Pacific Islands people and Canadian Indians. Maori, including western health care professionals, submitted that healers should be included among the health care services personnel providing core health services. They argued this on the basis of their health status and of their rights with respect to the Treaty of Waitangi. The influence of the 1977 WHO resolution, concerning the role of traditional healers in attaining 'Health for All by the Year 2000', is considered in relationship to Maori health initiatives and how the 1991 health care reforms may impact upon them, and the bicultural policy that has guided Maori health developments over the last decade. Evaluating Maori health and the health care reforms in terms of Maori participation, the status of traditional indigenous healers and the future of Maori health initiatives leaves Maori in no doubt that they have some hard work ahead to maintain the position they held prior to the reforms.     

Long-term care in the Danish health care system

Because of a declining birth rate and increased life expectancy, emphasis in the Danish health care system has shifted from child care to care of the elderly. The author examines the social, medical, governmental, and financial implications of this shift, focusing on an experimental scheme in the rural community of Skaevinge. By shifting from institutional to community-based services, the Skaevinge project created a new interdisciplinary structure that turned a nursing home into apartments and introduced 24-hour services for the entire community.     

Contraceptive care in the VA health care system

BackgroundLittle is known about contraceptive care within the Veterans Affairs (VA) health care system. This study was conducted to assess the prevalence of documented contraception by race/ethnicity within the VA and to examine the association between receiving primary care in women's health clinics (WHCs) and having a documented contraceptive method.Study DesignWe examined national VA administrative and pharmacy data for 103,950 female veterans aged 18–45 years who made at least one primary care clinic visit in 2008. Multivariable regression models were used to examine the associations between race/ethnicity and receipt of care in a WHC with having a method of contraception while controlling for confounders.ResultsOnly 22% of women veterans had a documented method of contraception during 2008. After adjusting for potential confounders, Hispanic and African–American women were significantly less likely to have a method compared to whites [odds ratio (OR): 0.82; 95% confidence interval (CI): 0.76–0.88 and OR: 0.85; 95% CI: 0.81–0.89, respectively]. Women who went to WHCs were significantly more likely to have a method of contraception compared to women who went to traditional primary care clinics (OR: 2.05; 95% CI: 1.97–2.14).ConclusionsOverall contraceptive prevalence in the VA is low, but receiving care in a WHC is associated with a significantly higher likelihood of having a contraceptive method.