医疗卫生领域政府主导的形式

政府主导作用的有效发挥是医疗卫生体制改革成败的关键。政府主导存在3个层次的含义和两个方面的形式。以卫生体系的分析框架来分析说明政府主导的形式在供给、筹资、制度建设中的分类、分层运用。     

医疗卫生领域政府主导的内容

政府主导作用的有效发挥是医疗卫生事业健康发展的关键。从为什么要政府主导、什么是政府主导、政府主导为了什么、政府主导什么以及政府如何主导5个方面全方位解析政府主导的内涵。     

后SARS时代医疗卫生中的政府作用

2003年非典疫情的蔓延,集中暴露了我们国家医疗卫生发展滞后的问题。这些问题必须高度重视,并逐步加以解决。决不能任其发展下去,否则必将由局部性问题,演变为全局性的问题,阻碍经济持续快速协调健康发展。     

医疗卫生领域政府主导的多学科透视

政府主导作用的有效发挥是实现医疗卫生事业健康发展的关键。政府主导是一个涵盖根源、对象、内容、形式的复杂概念,需要多学科解析才能揭示问题本质。     

刘学:医疗监管呼唤服务型政府

今年两会期间,温家宝总理在《政府工作报告》中首次提出的“建设服务型政府”目标,成为各界共同关注的焦点话题之一。舆论认为,这是中国政府改革走向“深水区”的重要标志。在经济转型期,作为政府主管部门的各级医疗卫生行政机构在监管职能层面将会面临哪些课题?本刊记者就此采访了北京大学光华管理学院卫生经济与管理系副教授刘学。     

对政府在医疗卫生事业发展中作用的探讨

深化城市医疗卫生体制改革，是2004年我国卫生工作的重点之一，医疗卫生行业担负着为广大群众提供医疗服务的任务，它的生存和发展以及提供医疗服务的质量，直接影响着整个社会、经济的统筹、协调发展。医疗卫生体制改革，必须在实现“三赢”的基础上推进：既要为医疗卫生机构找到生存和发展的出路，特别是使医疗卫生机构建立“自体造血”机制，     

服务型政府拉开新医改大幕——2008两会卫生版

盼望着、盼望着，东风来了，春天的脚步近了。又是一年春风暖，又是一年两会开。从3月3日至3月18日，备受全世界瞩目的十一届全国人大一次会议和全国政协十一届一次会议在北京召开。此时，距中国共产党第十七次全国代表大会胜利闭幕，刚刚过去4个多月。     

医疗卫生事业发展中政府与市场机制的定位分析

该文从卫生服务分类、公平与效率的关系和目前卫生改革目标三个角度分析了政府和市场机制主导地位选择的问题，认为发展我国医疗卫生事业应以政府主导为基础并引入市场机制。     

美国的医疗卫生改革

由500人组成的白宫工作小组,经过9个月的努力工作,终于完成了长达24万字的美国总统克林顿“卫生改革法案”,并于1993年10月上旬由克林顿总统提交国会审议,使美国的卫生改革从设计阶段走向了论证与修改完善阶段。 究竟是什么原因迫使美国政府改革他们一直引以为自豪的“世界上质量最好的”卫生服务系统?美     

政府建设农村医疗卫生的依据和职责定位

大量存在的农民因病致贫和因病返贫是农村医疗卫生体系不健全、保障制度缺失的表现。农村医疗服务的特点、医改过度市场化和政府干预不力导致农村医疗网络破损；保障制度建设尚处于起步阶段，由于制度环境、监管等原因导致制度实际效力低下。因此政府一方面要完善和维护好农村医疗卫生网络，发挥网络的整体功能，另一方面应在制度建设的全过程——目标规划、制度设计、实施和监管中承担起责任。全面落实政府的责任还应建立起政府和农民之间的信任关系。适时推进政策的法制化。     

Indicators of sustainable capacity building for health research: analysis of four African case studies

Background  

Despite substantial investment in health capacity building in developing countries, evaluations of capacity building effectiveness are scarce. By analysing projects in Africa that had successfully built sustainable capacity, we aimed to identify evidence that could indicate that capacity building was likely to be sustainable.     

政府卫生补助受益归属分析

综合国内外文献介绍在卫生领域实施受益归属分析的原理、步骤、评价方法和指标，以及国际和国内进行政府卫生补助受益归属分析研究的进展，并讨论了该方法在我国卫生政策研究中的应用前景。     

政府卫生支出健康效率测算及分析

目的：测算和分析中国1990年、2000年和2010年政府卫生支出的健康效率及其影响因素。方法：运用DEA和Tobit测算政府卫生支出的健康效率,评估效率值的影响因素。结果：政府卫生支出的健康生产效率在波动中有所提高,不同年度处于前沿面的省份基本一致,远离前沿面的省份存在较大差别;该效率在各区域间的差异较显著,东部地区政府卫生支出的健康生产效率高于中、西部地区;财政分权与政府卫生支出健康效率存在显著负相关关系。结论：财政分权制度的改革与完善是提高政府卫生支出健康效率的重要途径。     

Promoting health, building community

As part of its mission to honor human dignity and to care for the poor and vulnerable, Catholic Healthcare Partners (CHP), Cincinnati, has made a systemwide commitment to address housing needs in the communities it serves. A priority for the system is providing safe, affordable housing options for the low-income elderly. CHP's approach goes beyond "bricks and mortar," however. The system aims not only to provide a home for senior adults but also to enrich their lives. Through various activities and support services, CHP's senior living complexes in Kentucky, Ohio, Pennsylvania, and Tennessee offer residents an opportunity to live in a vibrant community. CHP facilities have developed a variety of initiatives to enhance residents' lives. Among these are: spiritual care services, nurses who serve as a resource to low-income elders, a short-stay shelter for seniors in transition, a service referral program, and therapy to help elders remain independent. In order to offer these comprehensive services to senior adults, CHP relies on partnerships with a variety of organizations and on funding from both the federal government and private investors. Especially as the nation's population ages, CHP continues to make its housing ministry a strategic priority.     

Indoor environmental and air quality characteristics,building-related health symptoms,and worker productivity in a federal government building complex

Building Health Sciences, Inc. (BHS), investigated environmental conditions by many modalities in 71 discreet areas of 12 buildings in a government building complex that had experienced persistent occupant complaints despite correction of deficiencies following a prior survey. An online health survey was completed by 7,637 building occupants (49% response rate), a subset of whom voluntarily wore personal sampling apparatus and underwent medical evaluation. Building environmental measures were within current standards and guidelines, with few outliers. Four environmental factors were consistently associated with group-level building-related health complaints: physical comfort/discomfort, odor, job stress, and glare. Several other factors were frequently commented on by participants, including cleanliness, renovation and construction activities, and noise. Low relative humidity was significantly associated with lower respiratory and “sick building syndrome”-type symptoms. No other environmental conditions (including formaldehyde, PM₁₀ [particulate matter with an aerodynamic diameter <10 μm], or mold levels, which were tested by 7 parameters) correlated directly with individual health symptoms. Indicators of atopy or allergy (sinusitis, allergies, and asthma), when present singly, in combinations of 2 conditions, or together, were hierarchically associated with the following: increased absence, increased presenteeism (presence at work but at reduced capacity), and increase in reported symptom-days, including symptoms not related to respiratory disease. We found that in buildings without unusual hazards and with environmental and air quality indicators within the range of acceptable indoor air quality standards, there is an identifiable population of occupants with a high prevalence of asthma and allergic disease who disproportionately report discomfort and lost productivity due to symptoms and that in “normal” buildings these outcome indicators are more closely associated with host factors than with environmental conditions. We concluded from the experience of this study that building-related health complaints should be investigated at the work-area level and not at a building-wide level. An occupant-centric medical evaluation should guide environmental investigations, especially when screening results of building indoor environmental and air quality measurements show that the building and its work areas are within regulatory standards and industry guidelines.     

Global health, national development, and the role of government.

In spite of extreme differences in health status between the more developed and less developed countries, trends of infant mortality and life expectancy show substantial improvements in both types of country between 1950 and 1980. These improvements may be attributed to three types of change: 1) socio-economic development with decolonization, increased industrialization, growth of gross domestic product, urbanization, the gains of women, and enhanced education; 2) cross-national influences due to greater international trade, the spread of technology, and widespread affirmation of human rights; and 3) national health system development through expanded governmental health programs. Further improvements will depend on greater strength in public sector health services rather than private sector services which aggravate inequities.     

卫生改革与发展必须实现市场机制和政府调节的优化组合

该文根据经济学理论,以现代社会存在的市场失灵、政府失灵现象及其在卫生服务领域的表现进行了分析,提出了克服失灵、深化卫生改革的建议。     

社区卫生服务体系建设的典型案例分析

对华北某市社区卫生服务体系建设现状进行调研。结果显示,该市社区卫生服务体系建设已初步形成,但也存在一些问题。建议进一步加强体系建设,短期内可以考虑推行政府购买公共卫生服务项目的方式,并加强监管考核,确保投入成效。     

政府卫生事业投入分析

目的：了解政府对卫生事业财政投入的现状及问题，为提高卫生系统绩效及制定与改革卫生政策提供依据。方法：利用卫生总 和的筹资来源法和机构法计算全国、甘肃省及榆中与和政两县政府卫生投入。采用平减指数法对财政支出与政府卫生投入增长率进行分析。结果：目前我国政府卫生投入量逐年下降，机构分布不合理，城乡差别大，效率低下。结论：政府有关部门应重视对卫生事业的投入并进行相应改革；尤其应调整投入结构，增加投入力度，加强公共卫生投入；提高资金的使用效率，为保障人民健康，提高人民健康水平，发挥政府部门应尽的责任。