国际医疗保险经验的借鉴

从1883年德国通过第一部《疾病社会保险法案》算起,医疗保险已有115年的历史了,近30年来,世界各国都在积极探索适合自己国情的医疗保险模式,并且都在不断地改革和完善。(1)是否提高了本国人民的健康水平;(2)是否使卫生服务具有公平性与效率;控制了卫生费用的不合理增长;(3)是否提高了卫生服务的质量和满意度已成为评价各国医疗保险是否成功的主要指标。 在未来的15年中,中国要健全卫生服务、医疗保障和卫生执法的三大体系。医疗保障是社会保障体系中不可缺少的一部分。中国现有的医疗保障制度与世界各国相比,无论在模式的多样化、覆盖率、筹资、支付及管理方式方面还有很大的     

推进医改五项重点工作中的难点问题——部分地市卫生主管领导调查

目的:通过调查分析部分地市级卫生主管领导在推进医改五项重点工作中存在的困难和问题,及时总结经验,为进一步推进医改工作提供借鉴。方法:对34名地市级卫生主管领导进行问卷调查和访谈,并将所收集的信息进行统计分析和综合归纳。结果和讨论:通过对地方推进五项重点改革工作面临的困难和问题进行重要性排序,可以发现:(1)基本医疗保障制度推进迅速,但存在后续资金不足和资金管理方面的问题;(2)基层医疗卫生服务体系建设成效显著,但人才匮乏成为主要问题;(3)基本公共卫生服务均等化需要进一步制度化、规范化;(4)基本药物制度大有可为,但需集中攻破难点问题;(5)公立医院改革的方向和路径尚不清晰。政策建议:(1)持续、稳定、合理的投入机制是进一步推进改革的基本保证;(2)鼓励地方积极探索,自下而上地探索转化机制的适宜方式;(3)基本药物制度基本确立了综合改革、统筹推进的思路;(4)公立医院改革实践要从统一基本认识出发;(5)重点领域的医改政策解读和研究应更深入和有针对性。     

医疗保障制度改革与老年人保健

目前 ,人口的老龄化日益加剧 ,老年人的卫生保健问题是人口老龄化进程中最为突出的问题之一。近几年 ,世界各国纷纷对医疗保障制度进行一系列改革 ,老年人的医疗保健问题成为改革的重点 ,本文试就中国医疗保障制度改革对老年人保健的影响作一初步探讨。一、中国医疗保障制度改革进展及其与老年人保健的关系中国医疗保障制度的改革可分为以下两个阶段 :(１)１９９４年以前 ,改革的主要目标是控制医疗费用的过快增长。采取的措施包括对需方实行费用分担和对医院加强医疗服务供方费用约束两方面。 (２)１９９４年初 ,国家体改委、财政部、劳动…     

某部做好军事训练伤防护的做法与思考

目的 总结某部军事训练伤防护工作经验做法,为部队做好军事训练伤防护工作提供借鉴.方法 对近几年发生军事训练伤的类型、原因进行回顾分析,坚持边保障、边实践、边总结军事训练伤防护的一些做法和体会.结果 针对基层部队特点,总结出做好军事训练伤防护工作的做法与体会:(1)加强健康教育,增强官兵自我防护意识;(2)注重工作协调,制定科学合理的训练计划;(3)把握关键环节,做好新兵和重点科目防护;(4)加强卫生监督,做好现场医疗保障.同时取得4点体会:(1)领导重视,教育先行是重要基础;(2)部门协同,齐抓共防是关键;(3)严密组训,科学防护是有效手段;(4)身心并重,靠前保障是重要途径.结论 实践中总结出来的做法与体会,对指导部队做好军事训练伤防护,降低部队军事训练伤发生率具有积极的参考意义.     

中高级干部长途见习活动医疗保障的做法与体会

目的探讨做好中高级干部长途见习活动医疗保障的做法与体会,为类似重大活动医疗保障提供科学依据。方法对中高级干部长途见习活动医疗保障特点及做法进行回顾性分析。结果总结出中高级干部长途见习活动医疗保障的做法:(1)精心准备,建立各种医疗保障预案;(2)随队保障,提供及时有效的医疗处置;(3)预防为主,严防传染病发生。取得的体会:(1)提高保障人员的综合素质、全面科学地制订各种保障预案是做好医疗保障工作的基础;(2)开展对外医疗合作是做好医疗保障工作的必要补充;(3)贯彻"预防为主、防治结合"的方针是做好医疗保障工作的关键。结论总结出的中高级干部长途见习活动医疗保障的做法和体会对类似活动的医疗保障有参考意义。     

老年医疗保障体系研究与构建江苏省社科

借鉴国外在实施老年医疗保障方面的经验,剖析我国老年医疗保障存在的问题与面临的挑战: (1) 老龄化带来的巨大医疗需求和医疗费用的上涨;(2) 老年医疗保障制度不健全;(3) 老年医疗服务机构数量少、服务质量差.分析从宏观、中观、微观三个层面提出老年医疗保障体系框架性设计,提出强调政府的责任与制度的完善,建立和完善以社区为中心的老年医疗卫生服务体系的,家庭护理体系的构建和完善等一系列措施.并展望老年医疗保障制度的未来.     

全球结核病现状与我国控制措施

目前世界上有1/3的人口感染了结核杆菌,其中大约有5000万人感染了抗药性结核病。全世界75％的结核病人集中在13个国家,我国结核病疫情在全球仍属高流行区。因此,我国采取了防治结核病的相关措施:(1)制定了《1991～2000年全国结核病防治规划》,颁布了《结核病防治管理办法》等法规和诊断、治疗标准;(2)设立了卫生部结核病控制中心、分中心,建立了全国结核病防治网;(3)增加财政投入,1992年起投入1.13亿美元和150万元人民币对涂阳病人实行免费诊断治疗;(4)控制外来开放性肺结核病例的投入。     

中国农村合作医疗最佳实践模式的研究

1 课题内容 “中国农村合作医疗最佳实践模式”研究课题是由世界卫生组织、联合国计划开发署和中国卫生部规划财务司、基层卫生与妇幼保健司在2001—2002年共同合作研究的项目。1.1 研究目的 该项目研究的目的是回顾20世纪60年代以来中国不同经济发展地区推行农村合作医疗制度和开展试点研究的成功经验和失败教训,从中找到适合不同经济发展水平地区农村健康保障制度的最佳实践模式。1.2 研究内容 研究内容重点:(1)政策定位;(2)动员各种资源的方式,包括筹资、组织结构和人力资源;(3)发展多种形式的农村医疗保障制度;(4)农村合作医疗的有效管理;(5)总     

水和世界人口增长

在过去的 2 0年中 ,令人担心的水问题已扩展到世界各国 ,许多地方淡水短缺越来越严重 ,成为农业生产、人类健康、环境质量和地区和平与稳定的主要障碍。 2 1世纪初 ,各国政府为满足全球人口增长对水需要的同时 ,提出应保护水环境 ,防止由水引起冲突。1　水是特殊和有限的资源(1 )水对生命是必不可少的 ,它是所有动、植物包括人类赖以生存的物质 ;(2 )水与大多数其它资源不同 ,它没有替代物 ;(3)水虽可再使用 ,但却很有限。随着全球人口增长 ,每年人均可再使用的水不断减少。从 1 95 0年以来 ,世界人口从2 5亿迅速增至 6 0亿 ,全球人均可使用…     

论建立新型农村合作医疗制度的有效筹资机制

建立符合我国农村实际状况的、能够满足广大农民基本医疗需求的医疗保障制度关系到全面建设小康社会的前进步伐,也是党的执政能力在新形势下的新考验。新型农村合作医疗制度的试点和全面铺开则是目前最佳的选择。而这一制度的建立、完善和可持续发展的关键问题就是寻找有别于传统意义的更为稳定有效的筹资机制。而新的筹资机制的建立必须遵守5条原则:(1)政府主导的原则;(2)社会公正的原则;(3)重点倾斜原则;(4)个人自愿交费的原则;(5)向医疗保险制度过渡的原则。新的筹资制度的特点是国家主导投入;社会多元统筹;个人自愿交费。新型农村合作医疗制度也将走向逐步法制化的道路。     

Allergy and occupational exposure to hydroquinone and to methionine

Respiratory manifestations have been reported after exposure to hydroquinone and to methionine. One hundred and three men in the same chemical plant were divided into three groups according to their exposure and compared by questionnaire, respiratory functional tests with methacholine then salbutamol challenges, and measurements of serum immunoglobulins G and E. Group H included 33 workers exposed to hydroquinone, trimethyl-hydroquinone, and retinene-hydroquinone. Group M included 15 workers exposed to methionine. Group C was a control group of 55 workers. The prevalence of respiratory symptoms was higher in the two exposed groups. Before challenges, pulmonary function values were significantly lower in groups H and M than those in group C. The challenges induced significant variations in the three groups but these variations were less pronounced in group M than in the other groups. The level of immunoglobulin G in group H (m +/- SD = 12.5 gram/liter +/- 2.6) was significantly higher than in group C (10.6 gram/liter +/- 2.4; p less than 0.002). The level of immunoglobulin E in group H (m = 140 IU/l) was also higher in group C (109 IU/l) but this difference was not significant. These findings suggest that exposure to methionine and to hydroquinone and its derivatives induce ventilatory impairment, perhaps by an immunological mechanism.     

Allergy and occupational exposure to hydroquinone and to methionine.

Respiratory manifestations have been reported after exposure to hydroquinone and to methionine. One hundred and three men in the same chemical plant were divided into three groups according to their exposure and compared by questionnaire, respiratory functional tests with methacholine then salbutamol challenges, and measurements of serum immunoglobulins G and E. Group H included 33 workers exposed to hydroquinone, trimethyl-hydroquinone, and retinene-hydroquinone. Group M included 15 workers exposed to methionine. Group C was a control group of 55 workers. The prevalence of respiratory symptoms was higher in the two exposed groups. Before challenges, pulmonary function values were significantly lower in groups H and M than those in group C. The challenges induced significant variations in the three groups but these variations were less pronounced in group M than in the other groups. The level of immunoglobulin G in group H (m +/- SD = 12.5 gram/liter +/- 2.6) was significantly higher than in group C (10.6 gram/liter +/- 2.4; p less than 0.002). The level of immunoglobulin E in group H (m = 140 IU/l) was also higher in group C (109 IU/l) but this difference was not significant. These findings suggest that exposure to methionine and to hydroquinone and its derivatives induce ventilatory impairment, perhaps by an immunological mechanism.     

Correlation between susceptibility to malaria and babesia parasites and to endotoxicity

Adult (185g) rats are about twice as sensitive to the harmful effects of injected endotoxin as are younger (65g) rats. This relationship correlates with an earlier report on the densities of Plasmodium berghei at which deaths occur in rats of these two age groups. Similarly lizards, which withstand very high parasitaemias of malaria parasites, are refractory to very large doses of endotoxin. This correlation appears to hold for malaria and babesiosis in all host species for which information is available, with man, for instance, very sensitive to these infections and to injected endotoxin.It is now realized that endotoxicity is not caused by the direct effects of endotoxin, but is the consequence of the release of a range of harmful soluble mediators, mainly from macrophages. Since the susceptibility of a host species to endotoxicity and to malaria and babesiosis correlate, and the illness produced in each case is very similar, these harmful mediators which cause endotoxicity are likely candidates for the origins of much of the pathology of malaria and babesiosis. This concept may also explain the relationship between parasite density and illness in these infections in man.