乡防保科医生结核病防治激励政策认知调查

目的 了解山东省乡镇卫生院防保科医生对结核病防治激励政策的认知状况,探讨有效的结核病防治激励政策,从而提高防保科医生对结核病人的发现与病例督导管理作用.方法 采用自制调查问卷对山东省6个县区36个乡镇卫生院防保科医生进行问卷调查.结果 调查的129名防保科医生中,88.4%的医生熟悉国家对肺结核病人的免费政策,82.1%的医生熟悉国家对肺结核病人发现、管理督导等方面的经济激励政策;69.8%的医生对目前现行的激励政策感到满意;78.3%的医生认为经济激励和非经济激励一样重要.结论 应将规定的激励措施落实到实处,适当提高医生在结核病防治工作中的待遇,同时非经济激励措施也可有效提高医生对结核病防治工作的积极性.     

结核病控制中的医务人员激励机制探索

为全面贯彻执行DOTS策略,提高结核病人的发现率和治愈率,我国在结核病控制中实施了激励政策,文章从利益相关者对现行激励政策的评价及预期激励入手,分析现行激励机制存在的问题.为建立和完善结核病控制中的激励机制提供建议.     

甘肃、河南和浙江三省肺结核患者/可疑患者的激励政策及效果评价

目的 了解甘肃、河南和浙江三省针对肺结核患者/可疑患者的激励政策,评价其效果.方法 通过问卷调查、个人访谈和小组访谈收集信息并进行描述.结果 (1)三省的激励措施主要是提供交通补助,但其起止时间、补助额度各不相同.(2)激励措施在一定程度上可以提高患者治疗依从性.结论 结核病防治工作中的激励措施应该形式多样化,并注重实...     

激励措施在结核病控制中的政策取向初探

在结核病控制工作中，激励的观念和实践渗透于各个环节，激励措施发挥着重要作用。但由于结核病控制工作是一项综合的系统工程，很难直接将结核病控制工作的全部成效都归功于激励机制。因此，对激励措施的应用状况和效果的评价，就成为一个需要探讨的课题。本文从了解激励措施的利益相关者对激励措施的看法入手，尝试对激励措施的执行过程进行评价，以提出激励措施在结核病控制中的政策取向。     

山东省农村肺结核病人对结核激励政策的评价研究

目的:了解山东省农村肺结核病人对结核激励政策的评价情况,分析其存在的问题.方法:采用分层整群随机抽样方法.使用自制调查问卷进行调查.结果:84.4%(416/493)的病人对结核激励政策满意,85.8%(562/655)的病人认为激励政策有激励作用,不满意、不能被激励的主要原因均是免费项目少和辅助药物费用高;17.2%的病人希望抗结核药物免费的同时,能报销一定的辅助药物费用和辅助检查费用.结论:激励政策得到了多数农村病人的认可,但仍需进一步加大力度.     

地方政府层面的医药研发激励政策扩散研究

本文收集整理了2009—2019年我国中央政府颁布的医药研发激励政策和在地方政府扩散的相应政策,运用政策扩散分析方法和网络分析方法,从扩散力度、速度、广度等指标出发,对我国医药研发激励政策在地方政府的扩散情况进行分析,探究我国地方政府落实和推动中央医药研发激励政策的整体情况.研究结果发现,2016年后我国医药研发激励政...     

我国结核病防治法规政策评述和主要问题分析

总结了我国目前在结核病控制方面的主要法规和政策，描述了结核病控制工作中存在的主要问题．并针对现存问题提出了相应对策。     

我国人体捐献器官获取收费政策及相关财务政策评价研究

目的:对我国人体捐献器官获取收费政策及相关财务政策文本进行评价,为进一步优化人体捐献器官获取收费政策及相关财务政策提供理论支撑和决策依据。方法:基于文本挖掘与统计分析法构建政策一致性指数模型,对2021—2022年海南省、浙江省、山东省、内蒙古自治区和广东省制定的5项人体捐献器官获取收费政策及相关财务政策进行量化评价。结果:5项政策均为优秀型政策,海南省政策文本挖掘和政策一致性指数模型指数最高,达8.666。结论:我国人体捐献器官获取收费政策及相关财务政策总体上优秀且科学合理,后续各省份在制定政策时,应进一步科学合理测算器官获取各项成本,确定收付费标准和项目目录,针对不同政策受体,制定相应规范要求,重视政策激励,做好绩效管理工作,逐步建立省级统一的人体器官获取组织银行账户。     

肺结核病人转诊和追踪及医务人员奖励政策的定性研究

目的:探讨肺结核病人转诊追踪及相关奖励政策在实施过程中的问题及影响病人发现的因素。方法选取中国不同地区、不同工作层面的结核病防治人员开展焦点组访谈。结果:理解误区、转诊不到位、利益冲突、宣传力度不足等因素制约着病人的发现,偏低的奖励额度在一定程度上影响了医务人员的热情和积极性。结论:需要充分考虑医防结合模式下各级结防人员的投入与需求,针对不同地区的实际情况采取合适的激励措施,以促进结核病人的发现。     

科研业绩评价政策激励实效分析和思考

目的:通过对安徽医科大学近五年来科研总量及教师科研业绩变化趋势分析.分析激励效果,探讨科研政策调整方向,以期进一步提高激励绩效.方法:收集近5年来该校科技人员的科研业绩数据资料,分析各类业绩年度变化趋势,数据库建立和分析用SPSS10.0和SAS6.12统计软件处理.结果:研究显示,全校科研业绩总量、承担科研项目数、发表科技论文数等均呈上升趋势(Z分别为4.407、7.754和26.884,P＜0.05),无科研业绩的科技人员逐年递减,且对中级及以下职称、具有硕士和博士学位及35岁以下青年科技工作者个人科研业绩总量的增长激励效果明显(Z分别为6.074、2.908、1.929和2.420,P＜0.05).发表的被SCI源收录的科技论文单项指标增势明显,在各职称段、36-55岁年龄段及具有博士学位的科技人员群体激励效果突出(Z分别为3.533、2.045、2.025、1.912、3.039和4.289,P＜0.05).结论:高校科研业绩评价激励政策调整应向着激励全体科技人员的研究热情,鼓励创新性成果、创新团队和优秀拔尖人才产生,兼顾学科均衡发展,科研质与量结合等方向倾斜,进一步完善科研业绩政策体系,提高科研政策激励绩效.     

全国村医结核病防治知识、政策、行为现状调查

目的了解我国农村医生（简称“村医”）结核病防治核心信息、政策知晓率以及结核病相关医疗行为和健康教育与健康促进工作现状,为制定结核病健康教育和健康促进工作计划提供依据。方法多阶段整群抽样,全国共抽取45个县270个村的村医326名。使用统一设计的调查问卷对村医进行面对面询问式调查。结果74.8%的村医知道咳嗽、咳痰3星期以上有可能是肺结核,83.1%的村医知道新发现的肺结核病人必须进行6个月以上的规范治疗。93.9%的村医知道在结核病防治所做痰检免费,53.1%的村医知道在结核病防治所获取治疗肺结核的药物部分免费。62.6%的村医发现过可疑的肺结核病人。发现过可疑肺结核病人的村医中,75.0%村医对病人进行了登记,77.0%的村医将其转诊至结核病防治所,20.5%村医将病人转诊至其他医院,2.5%村医没有将病人转诊。57.7%的村医经常主动向村民讲解防治肺结核病的知识。66.9%的村医经常宣传国家防治肺结核病的免费政策。大多数村医拿到过宣传画和折页等宣传材料。结论村医的肺结核病防治核心信息和政策知晓率总体较好。大多数村医能够将发现的病人进行登记并转诊,村医主动向病人宣传结核病知识与政策的比例还较低。     

Integration of TB into child health policies in Africa’s high-burden countries: a normative analysis

Integration of paediatric TB care into decentralised child health services has the potential to reduce the large proportion of childhood TB that remains undiagnosed. We performed a review of national guidelines and policies for TB and child health to evaluate the normative integration of paediatric TB into existing child health programmes in 15 high TB burden countries in Africa. While integration is addressed in 80% of the national strategic plans for TB, the child health strategies insufficiently address TB in their plans to reduce child mortality. Emphasis needs to be put on multi-sectoral collaboration among national health programmes.     

通过建立激励机制提高肺结核患者发现和治疗效果的研究

目的探讨激励机制对提高肺结核患者发现和治疗效果的作用，为制定结核病控制策略提供科学依据。方法FIDELIS项目于2004年11月至2005年10月在山西省50个县实施，主要措施是向贫困患者和卫生服务人员提供激励机制。结果项目地区新涂阳患者登记数在项目实施前为5105例，项目实施后为7736例，项目实施后患者数是项目前的151．5％（19〈0．01）。项目实施前后，治疗2个月末痰菌阴转率分别为95．5％和96．0％，患者治愈率分别为93．4％和95．2％。结论在山西省的50个县采取的激励机制是十分有效的，符合投入-效益原则。     

长期护理保险制度政策评价:基于PMC指数模型

目的:以首批9个试点城市的长期护理保险政策作为研究对象进行政策分析,探索上海等9个城市的政策特色,为完善长期护理保险政策提供建议。方法:基于PMC指数模型对9个试点城市的政策进行评价,结合气泡图分析政策制定的影响因素。结果:9个城市的PMC得分均值为6.922分,政策制定总体尚可,但政策时效及激励约束方面略显不足;政策制定与千人床位数、人均医疗保健支出构成比成正相关。结论:长期护理保险政策规划有待完善,可从政策体系完善、激励机制建立、医护资源配置等方面着手。     

Coloring the white plague: a syndemic approach to immigrant tuberculosis in Canada

Objective. In this article, we adopt a syndemic approach to immigrant tuberculosis (TB) in Canada as a way of challenging contemporary epidemiological models of infectious diseases that tend to racialize and medicalize the risk of infections in socio-economically disadvantage populations and obscure the role of social conditions in sustaining the unequal distribution of diseases in these populations. Design. A syndemic approach unravels social and biological connections which shape the distribution of infections over space and time and is useful in de-racializing and de-medicalizing these epidemiologic models. The socio-historic framework allows us to examine social factors which, refracted through medical science, were central to the development of TB control in Canada at the beginning of twentieth century. Results. We expose the ideological assumptions about race, immigration, and social status which underpin current policies designed to control TB within the immigrant population. We argue that TB control policies which divert the attention from structural health determinants perpetuate health and social inequities of racialized populations in Canada. Medical screening and surveillance is an ineffective control policy because the proportion of TB cases attributed to immigrants increased from 18 to 66% between 1970 and 2007. Conclusion. More effective TB control policies require shifting the focus from the individual disease carriers toward social inequities which underlie the problem of immigrant TB in Canada. In addition, de-racialization and de-medicalization of the contemporary epidemiological models of infectious diseases entail an in-depth exploration of how the categories of ethnicity, culture, and immigration status are played out in everyday health-related experiences of racialized groups.     

Promoting innovation in small markets: Evidence from the market for rare and intractable diseases

In many medical care markets with limited profit potential, firms often have little incentive to innovate. These include the market for rare diseases, “neglected” tropical diseases, and personalized medicine. Governments and not-for-profit organizations promote innovation in such markets but empirical evidence on the policy effect is limited. We study this issue by analyzing the impact of a demand-side policy in Japan, which reduces the cost sharing of patients with some rare and intractable diseases and attempts to establish and promote the treatment of those diseases. Using clinical trials data taken from public registries, we identify the effect of the policy using a difference-in-difference approach. We find that the demand-side policy increased firms’ incentive to innovate: firm-sponsored clinical trials increased 181% (0.16 per disease per year) when covered by the policy. This result indicates that the demand-side policy can be an important part of innovation policies in markets with limited profit potential.     

苏南地区公众肺结核防治知识现状及其影响因素分析

目的 了解苏南地区公众肺结核防治知识现状及其影响因素,为有效开展肺结核健康教育提供依据。方法 采用逐级整群抽样调查,抽取苏南地区2个县、4个乡镇（街道）、12个村（居委会）的1200户,按照制定的调查对象入选标准,使用统一设计的调查问卷,共调查2179人,有效应答率为99.77%。结果 苏南地区公众肺结核防治知识总知晓率为23.03%。58.46%的调查对象知道肺结核一种以上主要症状,仅24.84%和24.56%的公众分别知道肺结核免费检查和免费治疗政策。居住地、户口性质、文化程度、保险形式、婚姻状况、职业、年龄、周围有无肺肺结核人、自身有无患过肺结核病、是否听过广播宣传肺结核、过去一年是否看过电视上肺结核相关知识节目、是否获得过防治结核宣传材料等12项因素对该地区公众知晓肺结核防治知识有影响。结论 苏南地区公众肺结核防治知识知晓率较低,尤其缺乏对肺结核症状知识和对国家相关免费政策的了解,针对该地区公众设计适合的肺结核健康教育方式势在必行。     

Tuberculosis prevention and control in large jails: a challenge to tuberculosis elimination

BACKGROUND: This study assessed the extent to which 20 large jail systems have implemented national recommendations for tuberculosis (TB) prevention and control in correctional facilities. METHODS: Data were collected through questionnaires to jail medical directors and TB control directors, observation at the jails, and abstraction of medical records of inmates with TB disease and latent TB infection. RESULTS: Twenty percent of jail systems (4/20) had conducted an assessment of risk for TB transmission in their facilities, and 55% (11/20) monitored tuberculin skin test conversions of inmates and staff. Sixty-five percent (13/20) of jails had an aggregate record-keeping system for tracking TB status and treatment, which was usually paper based. Forty-five percent of jails (9/20) had policies to offer HIV counseling and testing to tuberculin skin test-positive patients, and 75% (15/20) screen HIV-infected inmates with chest radiographs. Three quarters of jails (15/20) had policies to always isolate patients with suspected or confirmed pulmonary TB in an airborne infection isolation room. Half of jails with airborne infection isolation rooms (6/12) conformed to Centers for Disease Control and Prevention (CDC) guidelines for monitoring negative pressure. CONCLUSIONS: Improvements are needed in conducting TB risk assessments and evaluations to determine priorities and reduce risk of transmission. Inadequate medical information systems are impeding TB control and evaluation efforts. Although HIV infection is the greatest cofactor for development of TB disease, jails have inadequate information on patients' HIV status to make informed decisions in screening and management of TB and latent TB infection. Jails need to improve the use of environmental controls.