新疆城市贫困人口医疗救助制度实施现状分析

阐述了新疆城市贫困人口医疗救助制度试点现状,得出当前新疆各试点城市贫困医疗救助筹资完全依赖政府财政投入,筹资水平较低;医疗救助以大病救助为主,门诊救助为辅,救助病种范围小;救助方式属于传统的"事后救助",医疗救助程序复杂等结论。提出继续加大政府筹资力度,拓展社会筹资渠道;调整救助方案,提高救助效率;加大城市医疗救助宣传力度;加强对医疗救助管理的人力投入和经费投入等建议。     

2015年上海市医疗救助制度研究

目的：对上海市医疗救助制度进行总结分析,归纳上海市医疗救助体系发展的成效与不足,为进一步完善上海市医疗救助制度设计提供建议。方法：检索国内外文献,并梳理上海市及其他省市相关政策文件,建立上海市医疗救助制度理论分析框架。结果：上海市已基本建立了较为完善的医疗救助制度,但在资金筹集、救助对象、救助内容和组织方式上仍然存在欠缺。结论：建议上海市医疗救助体系从拓宽筹资渠道、扩大救助范围、协调部门关系、完善医保衔接、发展信息系统等方面予以完善,进一步加大对重点人群的精准救助力度。     

新疆农村贫困人口卫生服务利用与医疗救助现状分析

目的:了解新疆农村贫困人口健康状况,分析新疆农村医疗救助制度试点现状,为完善新疆农村贫困医疗救助制度提供客观依据.方法:利用2008年新疆第四次卫生服务调查数据,运用访谈法收集有关农村贫困医疗救助的统计资料.结果:因病致贫是新疆农村贫困的重要原因之一,新疆农村贫困人口以少数民族为主占97.2％.贫困人口卫生服务需求量和利用量低于全国农村居民;农村医疗救助资金持续增长,主要依赖中央政府财政投入;以资助参合为基础,以住院救助为重点;人均救助水平不断提高,筹资水平偏低,资金的供给不能满足实际需求,但同时出现救助资金沉淀现象.结论:新疆农村医疗救助制度在改善贫困人口健康方面发挥着积极的作用,需要继续完善新疆农村医疗救助制度,加强医疗救助制度与新农合的衔接,逐步解决贫困人口的基本医疗问题.     

我国城乡医疗救助筹资机制研究

构建稳定、可持续、制度化的筹资机制是建立和完善医疗救助制度的核心问题。本文基于相关数据资料,从结构、规模、筹集方式三个方面对我国医疗救助筹资现状及存在问题进行剖析,并提出完善我国医疗救助资金筹集机制的具体改进建议,以期促进城乡医疗救助筹资的规范化、制度化和可持续性。     

对完善社会医疗救助制度的探讨

《中共中央国务院关于深化医药卫生体制改革的意见》指出,完善城乡医疗救助制度,对困难人群参保及其难以负担的医疗费用提供补助,筑牢医疗保障底线。随后,民政、财政、卫生和劳动保障四个部门联合下发的《关于进一步完善城乡医疗救助制度的意见》指出,用三年左右时间,在全国基本建立起资金来源稳定,管理运行规范,救助效果明显,能够为困难群众提供方便、快捷服务的医疗救助制度。本文就如何建立医疗保险、医疗救助、慈善救助有机结合的城乡一体社会医疗救助制度进行探索。     

有限资源约束下农村医疗救助的两难选择

在有限的筹资水平下,农村医疗救助制度的救助水平亟待提高。解决办法面临两重两难选择,第一重选择：要么放松资源约束：增加医疗救助财政投入;要么调整医疗救助制度的内容。而选择后者又面临第二重选择：救助重点是选择大病还是小病。文章从公平与效率原则的要求、医疗救助的内在规定性等角度进行了分析,认为有限资源约束是必然的,应该对医疗救助制度进行内部调整,将医疗救助的重点放在小病而非大病上,并提出了相关的政策建议。     

福州市区贫困人口医疗救助实施情况调查研究

目的：为了了解福州市区贫困人口医疗救助制度具体实施情况，从中发现问题，为医疗救助政策的进一步完善提供参考。方法：采取问卷与访谈相结合的方法，对医疗救助相关负责人及医疗救助对象进行访谈调查，并对调查结果进行分析。结果：福州市4个区都已建立了贫困人口医疗救助的相关政策，并具备了实施医疗救助的一定资源，在医疗救助对象的确定、医疗救助资金来源、实施医疗救助措旌等方面也有了具体的规定，但医疗救助程度还很有限。结论：福州市区医疗救助政策与具体实施措施还不够完善．如何建立适应福州市区实际情况的医疗救助制度还有待进一步探讨和研究。     

农村医疗救助的功能、存在的问题及对策探讨

分析了农村医疗救助的实施现状及存在的一些问题:制度运行"准保险化"、救助范围有限等,并提出了相应的解决对策,如明确农村医疗救助的定位、减轻贫困人口的疾病负担等,以真正完善农村医疗救助制度的功能,解决"因病致贫"的恶性循环,提高农村人口的健康水平.     

健康保障托底:医疗救助制度建设的地方实践及未来展望

本文结合某县的实际情况,从政策托底、城乡统筹、分类实施三个方面总结了医疗救助制度的发展特点。并从四个方面分析了医疗救助制度面临的现实挑战:政策实施偏差,政策制定与实际情况矛盾重重;救助比例偏低,贫困程度及贫困脆弱性难以缓解;筹资渠道较窄,制度运行经济基础有待夯实;事后救助效率低,医疗救助内卷化问题依然严峻。并在此基础上,提出了进一步完善医疗救助制度的对策思考。     

加大保障力度,改善医疗服务公平性——新农合与医疗救助制度的衔接机制及成效分析

提高低收入人群医疗服务公平性和可及性,是中国医疗保障制度的重要目标,经过10多年的实践,该领域取得了举世瞩目的成绩,为广大人民群众所称道。世行贷款/英国赠款中国农村卫生发展项目(简称"卫十一项目"),利用资金、管理和人力优势,以新农合与医疗救助制度有效衔接、探索重大疾病救助制度为主题开展了一系列项目活动,部分地区在医疗救助对象确认、优化管理实现新农合与医疗救助制度"无缝衔接"、探索重大疾病救助制度尤其是增加筹资渠道建立"重大疾病救助基金"、强化配套监管等方面进行了一系列探索实践。结果表明,项目地区医疗救助对象服务利用情况明显改善,医疗保障水平大幅度提高,群众满意度明显提升。     

The President's Commission on AIDS: what did it do?

A member of the President's Commission on the Human Immunodeficiency Virus Epidemic reviews the Commission's work. Gebbie, who represented the public health community, briefly summarizes what the Commission did and did not accomplish in attempting to carry out its charge to "advise the President and Secretary of Health and Human Service and other relevant cabinet heads on public health dangers including medical, legal, ethical, social and economic impact, from the spread of the HIV and resulting illnesses." She concludes with an argument for increased funding for state public health departments which have a major role to play in controlling the HIV/AIDS epidemic.     

城市医疗救助费用控制适宜模式的路径设计与优化

对城市医疗救助费用控制适宜模式的有效实施进行相应的路径设计,概括为"一个中心、两大主体、两种手段",阐明了实现此路径良性运作所需具备的支撑条件。并从宏观和微观两个层面提出了优化路径的相关政策建议,如加大反贫困及医疗卫生体制改革力度、促进医疗救助制度与整个社会医疗保障体系同行、准确定位目标人群、合理确定医疗救助保障水平和保证双向转诊渠道通畅等,以保证各路径环节的顺利运转,达到费用控制既定效果。     

浅析新型农村合作医疗制度公共产品特征

新型农村合作医疗制度运行八年来对于缓解农村居民"看病难、看病贵"、提高参合农民健康水平发挥了重要作用,但仍然存在着筹资不足、基金风险池小等问题。文章以公共产品理论为基础分析了新农合非竞争性、非排他性、积极外部性、公平性特征,并从与医疗救助制度衔接、克服"拥挤"现象、加大财政补贴、支持基层医疗机构建设等角度提出了新农合制度进一步发展的路径选择。     

Social health assistance schemes: the case of Medical Financial Assistance for the rural poor in four counties of China

Background  

Economic transition which took place in China over the last three decades, has led to a rapid marketization of the health care sector. Today inequity in health and poverty resulting from major illness has become a serious problem in rural areas of China. Medical Financial Assistance (MFA) is a health assistance scheme that helps rural poor people cope with major illness and alleviate their financial burden from major illness, which will definitely play a significant role in the process of rebuilding Chinese new rural health system. It mainly provides assistance to cover medical expenditure for inpatient services or the treatment of major illnesses, with joint funding from the central and local government. The purpose of this paper is to review the design, funding, implementation and to explore the preliminary effects of four counties' MFA in Hubei and Sichuan province of China.     

我国部分地区艾滋病抗病毒治疗服务体系现状及特点分析

目的 了解我国部分地区艾滋病抗病毒治疗服务体系现状,分析其主要模式及特点,明确主要问题。 方法 采用面对面定性访谈方法,调查我国9省份抗病毒治疗工作人员49人,运用主题分析法对资料进行归纳总结。 结果 我国已逐步形成以医疗机构为主承担抗病毒治疗工作的基本模式,但在治疗转介和随访、药品采购管理、医保与救助、异地治疗、社会组织和基层医疗卫生机构参与等工作机制上呈现出地区性特点。抗病毒治疗服务体系在药品采购管理、经费保障、人员稳定、医疗保障、关怀救助、社会组织及基层医疗卫生机构参与方面存在不同程度问题。 结论 需要不断加强艾滋病抗病毒治疗服务体系建设,完善药品采购管理体制,健全经费投入和人员保障机制,改善艾滋病医保及救助政策,促进社会组织及基层医疗卫生机构参与。     

The undue burden of paying for abortion: An exploration of abortion fund cases

The results of a secondary data analysis of 3,999 administrative cases from a national abortion fund, representing patients who received pledges for financial assistance to pay for an abortion from 2010 to 2015, are presented. Case data from the fund’s national call center was analyzed to assess the impact of the fund and examine sample demographics which were compared to the demographics of national abortion patients. Procedure costs, patient resources, funding pledges, additional aid, and changes over time in financial pledges for second-trimester procedures were also examined. Results indicate that the fund sample differed from national abortion patients in that fund patients were primarily single, African American, and seeking funding for second trimester abortions. Patients were also seeking to fund expensive procedures, costing an average of over $2,000; patients were receiving over $1,000 per case in pledges and other aid; and funding pledges for second trimester procedures were increasing over time. Abortion funding assistance is essential for women who are not able to afford abortion costs, and it is particularly beneficial for patients of color and those who are younger and single. Repeal of policy banning public funding of abortion would help to eliminate financial barriers that impede abortion access.     

Venture funding for science-based African health innovation

Background

While venture funding has been applied to biotechnology and health in high-income countries, it is still nascent in these fields in developing countries, and particularly in Africa. Yet the need for implementing innovative solutions to health challenges is greatest in Africa, with its enormous burden of communicable disease. Issues such as risk, investment opportunities, return on investment requirements, and quantifying health impact are critical in assessing venture capital’s potential for supporting health innovation. This paper uses lessons learned from five venture capital firms from Kenya, South Africa, China, India, and the US to suggest design principles for African health venture funds.

Discussion

The case study method was used to explore relevant funds, and lessons for the African context. The health venture funds in this study included publicly-owned organizations, corporations, social enterprises, and subsidiaries of foreign venture firms. The size and type of investments varied widely. The primary investor in four funds was the International Finance Corporation. Three of the funds aimed primarily for financial returns, one aimed primarily for social and health returns, and one had mixed aims. Lessons learned include the importance of measuring and supporting both social and financial returns; the need to engage both upstream capital such as government risk-funding and downstream capital from the private sector; and the existence of many challenges including difficulty of raising capital, low human resource capacity, regulatory barriers, and risky business environments. Based on these lessons, design principles for appropriate venture funding are suggested.

Summary

Based on the cases studied and relevant experiences elsewhere, there is a case for venture funding as one support mechanism for science-based African health innovation, with opportunities for risk-tolerant investors to make financial as well as social returns. Such funds should be structured to overcome the challenges identified, be sustainable in the long run, attract for-profit private sector funds, and have measurable and significant health impact. If this is done, the proposed venture approach may have complementary benefits to existing initiatives and encourage local scientific and economic development while tapping new sources of funding.

     

A Central Supply Technician Training Program: From a Dream to a Reality

Decreased public funding, a competitive healthcare market, and higher patient care costs have been blamed for the present financial challenges that confront academic health centers. The authors examined the costs associated with graduate medical education, particularly, indirect medical education expenses in the operating room. The results indicate that it is more costly for teaching hospitals to provide surgical care to patients in the operating room. The academic health center's indirect graduate medical expenses only covered a portion of the increased costs. If the missions of academic health centers are perceived as a public good, policy makers must design a system that more appropriately compensates academic health centers for the additional costs associated with surgical procedures in graduate medical education.     

新型农村合作医疗定位及其重构理论研究

从新型农村合作医疗的设计思路及政策目标看，该制度的目标定位在认识与实践上都存在着许多问题和缺陷。对此，文章在分析其制度本质属性及运行模式的基础上，提出建立包含农村合作医疗、农村社区卫生服务、农村医疗救助和农村养老保险制度四个模块的新型农村合作医疗体系。     

安徽省深化基层卫生综合改革的进展与挑战

安徽省为深化基层卫生综合改革,于2011年8月颁布了《关于巩固完善基层卫生综合改革的意见》。本文主要分析了该项政策实施以来的主要进展与挑战。政策实施以后,提高了乡镇卫生院服务效率和农村居民就医受益程度,促进了村卫生室落实基本药物制度等;但财政补助政策落实、乡镇卫生院服务提供、卫生技术人才队伍建设和药品配送等方面还存在一些问题。针对这些问题,提出了如下政策建议：落实财政保障制度,建立统分结合的人员聘用制度,完善基本药物采购及配送制度,加强村医及村卫生室管理,建立县域基层卫生服务能力评估制度等。