城市贫困人口医疗救助调查研究

[目的]对上海、广州、武汉、长沙、重庆和大连共6个试点城市1 116户城市贫困家庭的健康状况、医疗救助情况及其影响因素等进行调查研究,从而为完善城市贫困人口医疗救助机制提供科学依据.[方法]采用分层抽样的方法,对6个试点城市贫困人口的健康状况、经济来源、医疗救助利用情况及其影响因素等进行问卷调查.[结果]贫困人口文化程度较低,初中及以下的占65%.城市贫困人口身体状况差,59%的人长期患病或经常得病,仅有5.3%的人很少得病.45%的贫困人口患病后自费医疗,只有29.2%的人得到过医疗救助,影响医疗救助可及性的因素主要有救助病种范围小、补偿额度低、医疗救助程序复杂、起伏线高、定点不方便等,其在6个城市的分布不同(X2=355.950,P＜0.001).[结论]城市贫困人口文化程度低,经济来源少,身体状况差,而目前城市医疗救助覆盖面窄,救助病种的范围小、补偿额度低、起伏线高等,严重阻碍城市的反贫困行动,因而根据各个地区的特征,深入探讨公平有效的城市医疗救助体制显得尤为重要.     

我国城市贫困人口医疗救助现状分析

随着我国经济体制的转轨和产业结构不断调整，社会经济结构正处于转型时期，城市相对贫困人口日益增加。对城市贫困人口进行医疗救助，已经成为稳定社会、防止因病致贫和返贫的重要措施之一。本文利用现有资料对我国医疗救助的现状进行评价和分析。     

对城市贫困人口医疗救助的理论探讨

经济体制改革促进了人民生活水平的提高,但同时也拉大了城市居民的贫富差距。本文从卫生服务的三个性质(功德产品、正的外延性、信息不对称)出发从理论上探讨了政府在卫生服务中应承担的责任,尤其是对城市贫困人口。但目前政府对医疗机构的投入尚不能有效地解决贫困人口的卫生服务,因此,建议政府可通过建立平(贫)民医院或对贫困人口的医疗保险给予补贴等渠道来从体制上解决城市贫困人口的医疗救助问题。     

浅析我国城市贫困人口社区医疗救助模式

1我国城市贫困人口社区医疗救助探索的背景1.1城市贫困人口医疗现状堪忧世界银行在《2000/2001年世界发展报告:与贫困作斗争》中指出,贫困的含义不仅指低收入和低消费,还指在教育、医疗卫生、营养以及人类发展的其他领域取得的成就较少。     

对城市贫困人口医疗救助管理机制的思考

城市贫困问题在我国日益突出.对贫困人口实施医疗救助,已引起社会各界的关注.而科学的管理机制是医疗救助制度能够顺利实施的重要因素,也是医疗救助效果得到巩固的前提条件.文章就我国城市贫困人口医疗救助管理机制的现况、存在的问题进行分析和思考,并提出建议.     

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。     

关于城市贫困人口医疗救助的思考

随着中国社会结构的变化，贫困人口的医疗救助问题已成为社会关注的热点。作者分析了我国贫困人口医疗救助的现状，阐述了目前医疗救助的难点，提出通过确定救助资金、多方筹集资金、建立基金会、采用多样化的救助方式、取得当地医院的积极配合和协调救助组织等进行医疗救助工作的基本思路。     

对我国城市贫困人口医疗救助制度的思考

我国城市贫困人口“因病致贫、因病返贫和因贫致病”已经成为整个社会的严重问题。政府应该在完善城市贫困人口医疗救助制度中发挥主体作用．为全社会每一位成员提供最基本的健康保障。对贫困人群的医疗救助,是新时期建设社会主义和谐社会的重要保障。     

我国城市贫困人口医疗救助现状及政策建议

医疗救助作为医疗保障体系的最后一道防线,对保障贫困线上人口的基本就医权利起到了不容忽视的作用.然而我国的医疗救助制度起步较晚,正在实行医疗救助的城市,其政策均各成体系,目前尚缺乏统一的、制度化的医疗救助体系.通过对我国6个城市(北京、上海、广州、青岛、西安、武汉)现行的医疗救助制度进行分析,为建立符合我国国情的医疗救助模式提供参考.     

中国城市贫困医疗救助的理念与制度设计

关于完善中国城市贫困医疗救助制度,方案设计的目标是一方面要提高贫困人口医疗服务的公平性和可及性,保障贫困人口享受基本医疗服务的权利,改善贫困人群的健康状况;另一方面是建立以社区卫生服务为基础的、多部门协调配合、全社会参与、具有可持续发展的贫困医疗救助制度。为实现上述目标,提出以社区卫生服务中心为运行平台,兼顾基本门诊和基本住院服务的救助方式,以财政救助资金为支柱,以社会筹集资金为补充的总体思路。     

The Medicaid cutoff and abortion services for the poor

Since 1977, the Hyde Amendment's restrictions on federal funding of abortions have prevented poor women from obtaining abortions through the federal Medicaid program. This article describes research undertaken to determine the impact of these restrictions on low-income women. Patients who had Medicaid-funded abortions at a clinic in St. Louis, Missouri, in 1977 (when Medicaid funding of abortions was available) were compared with Medicaid-eligible patients who had abortions at the same clinic in 1982 (when public funding of abortions was allowed only if the woman's life would be endangered by continuation of the pregnancy). Their experiences were also compared with those of higher income women attending the same clinic in both years. Finally, some of the 1982 patients were interviewed in 1983 to determine how they went about raising the money that they needed to pay for their abortions. In 1977, Medicaid-eligible patients experienced no delay in obtaining abortions compared with other women, even when demographic differences are considered. However, in 1982, they were significantly delayed; on average, the Medicaid-eligible women who were delayed had abortions 2-3 weeks later than the others. Fifty percent of patients eligible for Medicaid in 1982 had abortions at 10 weeks of gestation or later, compared with 37 percent in 1977. Medicaid-eligible women who were interviewed in depth had abortions about a week later than the other women. Increased delays occurred both between their first suspicion of pregnancy and their pregnancy test and between their decision to have an abortion and the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)     

Social support and living conditions in poor elderly people in urban Mexico

The aim of this paper was to analyze social support and living conditions among poor elderly people in Mexican cities. A qualitative study with eight focus groups was carried out in Guadalajara, Cuernavaca, Chilpancingo, and Culiacan, Mexico, in 2005. Forty men and 63 women participated in the study. The main support for the elderly in daily living came from their immediate family and in some cases from neighbors. Social support was basically material and economic, in addition to providing company and transportation for medical appointments. Daily emotional support, companionship, and social inclusion were minimal or absent. The study identified a significant lack of support from government and religious or civil society organizations. The family is still the main source of support for the elderly. Increased government collaboration is dramatically needed to combat the misconception that the needs of the elderly are the individual family's responsibility rather than a collaborative effort by society.     

城市贫困人群生命质量及其主要影响因素

目的 研究城市贫困人群生命质量及其主要影响因素。方法 用SF-36量表对沈阳市237名贫困人群和261名对照人群的生命质量进行评价。经t检验、Logistic回归分析得出主要影响因素。结果 贫困人群与对照人群的生命质量有显著性差异。年龄、性别、医疗花费、债务、救济渠道、患病对贫困人群的生理健康影响明显；而医疗花费、教育花费、债务、救济渠道则是影响贫困人群心理健康的主要因素。除生理职能(RP)维度以外，其它维度的量化值均随困难年数增加而减少。结论 被调查贫困人群的生命质量低于对照人群，尤以35～50岁年龄段的贫困人群更为明显。贫困人群的生命质量受年龄、性别、医疗花费、债务、救济渠道、患病、教育花费等因素影响。     

Equity of the Medicaid program to the poor versus taxpayers

The last 15 years have witnessed explosive growth in State Medicaid programs. This article demonstrates the equalizing impacts of greater spending and recent Federal mandates on the health care coverage of the poor. Large inequalities in generosity still remain, however. Inequalities in taxpayer burdens are also documented, and simulations of alternative Federal sharing algorithms show significant changes that would be required to achieve a more equitable distribution of the program's financial burden.     

城市贫困人口医疗救助的模式

世界工业化和城市化的发展,促进了经济的繁荣,同时也拉大了贫富差距,发展中国家城市贫困人口逐渐增多,他们收入较低,健康状况相对较差,基本卫生需要得不到完全保障。本文介绍国内外对城市贫困居民的主要医疗救助形式,包括：全民卫生服务体制、对穷人实行补贴的混合体制、专门的穷人保险、社会捐助和国际援助,并对每种模式的优缺点加以评价,为建立符合我国国情的医疗救助模式提供参考。     

Health and the urban poor

Traditionally, cities have benefited from a disproportionateshare of the resources available for health care and, as a result,most developments in primary health care have been in ruralareas. Recently, however, attention has been called to the inequitiesthat exist within cities and to the rapid growth of the urbanpoor. This paper reviews the topic of primary health care andthe urban poor in developing countries. The disease patternsof the urban poor reflect the problems of underdevelopment andindustrialization. The few studies that focus upon the healthproblems of the urban poor demonstrate a prevalence of infectiousdiseases and malnutrition which is comparable to and often greaterthan that observed in rural populations. At the same time, however,the urban poor suffer the typical spectrum of chronic and socialdiseases. The magnitude of the health problems of the urbanpoor rarely emerges in city health statistics. This is eitherbecause the ‘unofficial’ squatters and shanty townor slum inhabitants do not appear in the statistics or becausetheir conditions are obscured by the enormous difference thatexists between their status and that of the urban elite. Atthe community level there is now evidence of relevant, constructiveand hopeful approaches to helping the urban poor through primaryhealth care. Although there are few analytical or evaluativeexaminations of such initiatives, it is possible to identifyemerging trends such as the development of neighbourhood healthprogrammes, the use of community health workers and attemptsto link hospital services with community health action. It remainsto be seen whether the health departments in any cities canbring about the co-ordination and support needed for the improvementof environmental and socio-economic conditions which are fundamentalfor improving health. Also, international agencies need to focusmore attention upon the particular plight of the urban poor.