卫生总费用快速增长:政府职能缺失与百姓负担增加

26年中我国卫生总费用增速极快,政府承诺了卫生总费用占GDP5%左右,但没有承担额外费用支出的责任,其中所形成的费用负担都由需方个人承担了,因此,社会指责看病贵等情在理中。在解决看病贵等问题,调整卫生费用中需方、政府财政以及社会三方各自的支出责任时,需要深层次关注医院的净收入和业务收入之间大致是1∶5～7的关系,所以,对医院的任何投入需要引入“净投入”概念,只有“净投入”有着重要的控费作用。如果不考虑这种关系,任何的补需方还是补供方的争议都毫无意义,均属于部门利益之争。     

Bond volume rises 19.3%

Tax-exempt healthcare bond volume climbed 19.3% in the first six months of 1991 compared with the same period last year. Hospitals sold 227 separate issues worth a total of $6.5 billion during the period, compared with 195 issues worth $5.4 billion in 1990. The increase was accelerated in part by anticipation of an Internal Revenue Service rule change expected to take effect in September. The change in "reimbursement bond" guidelines could restrict some hospital financings.     

The risk of preeclampsia rises with increasing prepregnancy body mass index

PURPOSE: To explore the dose-dependent relation between prepregnancy body mass index (BMI) and the risk of preeclampsia after adjusting for measured confounders. METHODS: We studied 1179 primiparous women who enrolled at < 16 weeks' gestation into a prospective cohort study of the pathogenesis of preeclampsia. Multivariable logistic regression was used to quantify the independent effect of prepregnancy BMI on the risk of preeclampsia after adjusting for race and smoking status. BMI was specified as a restricted quadratic spline. RESULTS: Preeclampsia risk rose strikingly from a BMI of 15 to 30 kg/m(2). Compared with women with a BMI of 21, the adjusted risk of preeclampsia doubled at a BMI of 26 (odds ratio 2.1 [95% confidence interval, 1.4, 3.4]), and nearly tripled at a BMI of 30 (2.9 [1.6, 5.3]). Women with a BMI of 17 had a 57% reduction in preeclampsia risk compared with women with a BMI of 21 (0.43 [0.25, 0.76]), and a BMI of 19 was associated with a 33% reduction in risk (0.66 [0.50, 0.87]). CONCLUSIONS: These results indicate that preeclampsia risk rises through most of the BMI distribution. The dramatic elevation in overweight prevalence in the United States may increase preeclampsia incidence in the future.     

Fourth-quarter bond volume rises 27.6%

As capital markets showed signs of coping with the war threat in the Persian Gulf, tax-exempt bond volume for the fourth quarter of 1990 rose 27.6% from the previous three months.     

Execs' compensation rises 5.5% in 1993

Propelled by soaring bonuses, compensation for healthcare executives rose 5.5% last year, according to MODERN HEALTHCARE'S annual compensation survey. The survey also showed a growing reliance on variable pay and incentive programs as demands on executives increase.     

Hepatitis E now also in The Netherlands]

A case report of a male aged 31 who, after a journey to Bangladesh, returned with a disease resembling acute hepatitis A. Closer study revealed a hepatitis E infection. He recovered in slightly over two weeks.