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Weisman CS 《Maternal and child health journal》1997,1(3):179-189
Objectives: To present an overview of how and why normative conceptions of women's health are changing and to discuss some implications of definitional shifts in the context of the changing U.S. health care system. Method: The paper describes the historical development of views of women's health and health care, contrasts the biomedical and biopsychosocial perspectives on women's health, and presents some evidence of challenges and opportunities for change in health care and policy. Results: While women's health has generally been equated with reproductive functions, expanded definitions focus on health through the life span and in the context of women's multiple roles and diverse social circumstances. This expanded view highlights the limitations of health services and policy based on narrower conceptions and program mandates and the need for strategies for integrated, continuous care. There is evidence of change in women's health care, including in Title V programs. Conclusions: New understandings of women's health are particularly relevant to maternal and child health programs, which are positioned to provide model approaches for improving women's health care. 相似文献
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陈颖青 《中国初级卫生保健》2007,21(4):1-3
卫生保健服务公平性是指无论社会成员的社会地位、收入等因素如何,都应该以需求为导向获得卫生保健服务。通过卫生保健服务公平性评价体系,分析目前在我国卫生保健服务的公平性方面存在着卫生保障覆盖面小、卫生资源配置不平衡及卫生服务费用分担不合理等问题。要改变这一状况,就应该从增加卫生资源的投入、优化卫生资源配置结构、健全和完善医疗保障制度方面着手,推进卫生保健服务的公平,使每一个社会成员都能得到基本的、公平的卫生保健服务,最终实现人人享有卫生保健的目标。 相似文献
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初级卫生保健是构建和谐社会的卫生公平底线 总被引:4,自引:3,他引:4
郭清 《中国初级卫生保健》2006,20(1):1-3
中国曾经是国际初级卫生保健的典范,各国都把“人人享有初级卫生保健”作为人人享有健康权的底线,实现卫生公平是政府的公共职能,农村是初级卫生保健的重点,社区卫生服务是初级卫生保健的载体。 相似文献
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Equity in health and health care is animportant issue. It has been proposed that thepursuit of equity in health care is beinghampered by the dominance of individualism inhealth care practices. This paper explores theway in which communitarian ideals and practicesmight lend themselves to the pursuit of equity.Communitarians acknowledge, respect and fosterthe bonds that unite and identify communities.The paper argues that, to achieve equity inhealth care, these bonds need to be recognisedand harnessed rather than ignored. The notionof individual autonomy in the context of thecommunity is examined. Alternative concepts ofautonomy – social autonomy and communityautonomy – are seen to be more respectful andnurturing of both the individual and thecommunity. Moreover, these concepts appeardesirable for the pursuit of health care equitygoals. The paper concludes with some thoughtsabout how equity in Australia's health caresystem can reasonably progress within acommunitarian vision. Disadvantaged communitiesare discussed throughout, in particular,Australian Aboriginal communities. 相似文献
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Larry R. Churchill 《Health care analysis》1999,7(4):393-411
Describing the U.S. health care system meansdescribing managed care under commercial forces.Managed care creates new moral tension forpractitioners, but more importantly, in its currentform it intensifies the commercialization of healthexpectations and interactions. The largely unregulatedmarketing of health services under managed care hasbeen a major factor in the increasing number ofuninsured citizens, while claims for cost reductionthrough managed care are equivocal. Risk-ratingpractices integral to the current medical marketplacethwart concerns for justice in allocation and createvulnerabilities for almost everyone. Thepolitical-moral concern of the early 1990s for a rightto health care is nowhere in sight. 相似文献
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P. P. M. Harteloh 《Health care analysis》2003,11(3):259-267
During the past three decades, there has been an ongoing debate on the quality of health care. Defining quality is an important part of it. This paper offers a review of definitions and a conceptual analysis in order to understand and explain the differences between them. The analysis results in a semantic rule, expressing the meaning of quality as an optimal balance between possibilities realised and a framework of norms and values. This rule is postulated as a formal criterion of meaning, e.g. when (correctly) applied people understand each other. The rule suits the abstract nature of the term "quality." Quality doesn't exist as such. It is constructed in an interaction between people. This interaction is guided by rules in order to transfer information, e.g. communicate on quality. The rule improves our ability to discuss the debate on quality and to develop a theory grounding actions such as quality assurance or quality improvement. 相似文献
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王亦冬 《中国初级卫生保健》2012,26(6):11-12
概括介绍了新加坡的医疗保健制度、4种医疗保险基金的筹集与支付、医疗服务体系和卫生人力资源的现状,阐述了新加坡医疗保障制度改革和发展经验对我国深化医药卫生体制改革的启示。 相似文献
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Gavin Mooney 《Health care analysis》2000,8(3):203-215
This paper introduces this mini-series on verticalequity in health care. It reflects on the fact that byand large equity policies in health care have failedand that there is a need for positive discriminationto promote equity better in future. This positivediscrimination is examined under the heading of`vertical equity'.The paper considers Varian's notion of `envy' as abasis for equity in health care but concludes thatthis is not a helpful route to go down. Better itwould seem to pursue the idea from Sen of `freedoms'and `communitarian claims' (as raised previously bythis author). While it is argued that proceduraljustice is to be preferred in the longer run as abasis for equity there are gains in adopting a shortrun goal of promoting distributive justice. Somepreliminary evidence is presented on the weighting ofhealth gains to reflect such vertical equityconcerns. 相似文献
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和谐社会构建中的医疗卫生公平性研究 总被引:1,自引:0,他引:1
从和谐社会构建中医疗卫生公平的重要性入手,分析了我国医疗卫生不公平的主要表现及深层次的原因,并对改革当前医疗卫生不公平的对策加以探讨,以期获得在我国和谐社会构建中医疗卫生公平性改革的清晰视角。 相似文献
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The Patterns of Health Care Utilization by Elderly Europeans: Frailty and Its Implications for Health Systems 下载免费PDF全文
Objective
To examine the patterns of health care utilization by the elderly and test the influence of functional decline.Data Source and Study Design
We used the three regular waves of the SHARE survey to estimate the influence of frailty on health care utilization in 10 European countries. We controlled for the main correlates of frailty and unobserved individual effects.Results
The frail elderly increase their primary and hospital care utilization before the onset of disability. Multimorbidity moderates the effect of frailty on care utilization.Conclusions
The prevalence of frailty is high in most countries and is expected to increase. This renders frailty prevention and remediation efforts imperative for two complementary reasons: to promote healthier aging and to reduce the burden on health systems. 相似文献14.
ObjectiveWe study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence.ConclusionsOur study findings suggest that recent immigrants could be forgoing essential care, which later translates into higher spending. It portrays the vulnerability of a population that would remain exposed to income shocks, even after the Affordable Care Act (ACA) implementation. 相似文献
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Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the “graying of America” promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education. 相似文献
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Joel C. Cantor Susan Brownlee Cliff Zukin John M. Boyle 《Health services research》2009,44(5P1):1762-1772
Objective. To assess the effect of wireless telephone substitution in a survey of health care reform opinions.
Data Source. Survey of New Jersey adults conducted by landline and wireless telephones from June 1 to July 9, 2007.
Study Design. Eighty-one survey measures are compared by wireless status. Logistic regression is used to confirm landline–wireless gaps in support for coverage reforms, controlling for population differences. Weights adjust for selection probability, complex sample design, and demographic distributions.
Principal Findings. Significant differences by wireless status were found in many survey measures. Wireless users were significantly more likely to favor coverage reforms. Higher support for government-sponsored universal coverage, income-related state coverage subsidies, and an individual mandate remain after adjustment for demographic variables.
Conclusions. Opinion polls excluding wireless users are likely to understate support for coverage reforms. 相似文献
Data Source. Survey of New Jersey adults conducted by landline and wireless telephones from June 1 to July 9, 2007.
Study Design. Eighty-one survey measures are compared by wireless status. Logistic regression is used to confirm landline–wireless gaps in support for coverage reforms, controlling for population differences. Weights adjust for selection probability, complex sample design, and demographic distributions.
Principal Findings. Significant differences by wireless status were found in many survey measures. Wireless users were significantly more likely to favor coverage reforms. Higher support for government-sponsored universal coverage, income-related state coverage subsidies, and an individual mandate remain after adjustment for demographic variables.
Conclusions. Opinion polls excluding wireless users are likely to understate support for coverage reforms. 相似文献
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A Statewide Profile of Frequent Users of School‐Based Health Centers: Implications for Adolescent Health Care 下载免费PDF全文
Kevin T. Koenig MPP Mary M. Ramos MD MPH FAAP Tara T. Fowler PhD MPH CPH Kristin Oreskovich DNP CNP Jane McGrath MD FAAP Gerry Fairbrother PhD 《The Journal of school health》2016,86(4):250-257
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会泽县卫生服务利用的公平性研究 总被引:1,自引:0,他引:1
目的了解会泽县新型农村合作医疗实施中,参合农民卫生服务利用的公平性,为制订合理的补偿方案提供依据。方法采用分层抽样的方法抽取2个乡镇,共调查农户1209户,计4646人。结果调查农民2周患病率为7.1%,2周患病就诊率为8.7%,均低于第三次全国卫生服务调查农村平均水平。2005年住院率为5.6%,高于全国平均水平(3.4%),不同乡镇和不同家庭经济收入农民门诊服务利用的差异不大,但住院服务存在统计学差异。住院率随收入增加而增高,需住院未住院比例随收入增加而降低。住院机构、次均住院费用和次均住院补偿费用在2个乡镇间有较大差异,而在不同经济收入间无明显差异。结论新型农村合作医疗实施中,应该注意提高卫生服务利用的公平性。 相似文献
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Although the fields of urban planning and public health share a common origin in the efforts of reformers to tame the ravages
of early industrialization in the 19th century, the 2 disciplines parted ways in the early 20th century as planners increasingly
focused on the built environment while public health professionals narrowed in on biomedical causes of disease and disability.
Among the unfortunate results of this divergence was a tendency to discount the public health implications of planning decisions.
Given increasingly complex urban environments and grave health disparities in cities worldwide, urban planners and public
health professionals have once again become convinced of the need for inclusive approaches to improve population health and
achieve health equity. To make substantive progress, intersectoral collaboration utilizing ecological and systems science
perspectives will be crucial as the solutions lie well beyond the control of any single authority. Grounded in the social
determinants of health, and with a renewed sense of interconnectedness, dedicated and talented people in government agencies
and communities who recognize that our future depends on cultivating local change and evaluating the results can come to grips
with the enormous challenge that lies ahead to create more equitable, sustainable, and healthier cities worldwide. 相似文献