公立医院改革与社会功能关系的探讨

该文研究了公立医院的宏观管理体制和微观组织改革对于转轨时期公立医院社会功能的影响，进行了公立医院社会功能的利益相关者分析，并据此提出了保证公立医院社会功能的政策建议。     

对构建公立医院社会评价体系的思考

文章通过对新时期公立医院的社会功能、社会责任，以及不同时期公立医院社会政策的解读．提出在对新时期公立医院社会功能与社会责任科学界定的基础上，从社会的视角探索构建公立医院社会评价体系的必要性，并针对社会评价的目的和原则、评价主体、评价方法及评价指标体系等阐述了思考建议。     

新时期构建公立医院社会评价体系的思考

在社会主义市场经济环境下，如何引导和规范公立医院较好地履行其社会功能，树立起良好的社会责任，促进解决当前群众看病难、看病贵问题，实现医院与社会的和谐发展，已是各级政府、社会各界及广大群众共同关注的话题。文章通过时新时期公立医院的社会功能、社会责任，以及不同经济时期公立医院社套政策的解读，提出在对新时期公立医院社会功能与社会责任科学界定的基础上，从社会的视角探索构建公立医院社会评价体系的必要性，并针对社会评价的目的和原则、评价主体、评价方法及评价指标体系等阐述了思考建议。     

中国公立医院社会功能相关政策的演变

该文回顾了建国以来中国公立医院社会功能及相关政策的演变 ,分析了各个阶段公立医院社会功能的政策依据和特点 ,提出了转轨时期公立医院改革必须坚持和强化社会功能的观点 ,该结论对我国医院分类管理具有政策启示。     

公立医院社会公益职能弱化的原因及其治理对策

我国公立医院提供了大量具有社会功能性质的任务,但在运行中也出现一些问题,如应有的功能和责任履行不到位,布局、规模和结构不尽合理,职工收入与经济效益挂钩等.政府为公立医院提供良好的政治、经济、政策环境,是促使公立医院体现公益性、履行社会责任的重要保证.公立医院要加强行业自律,提高运营绩效.     

从新医改方案解析社会资本发展公立医院的政策环境

社会资本进入公立医院是一个发展趋势.新医改方案的出台明确了社会资本发展公立医院的宏现政策,但是在中观和微观层面暂时还缺乏国家指导性政策.本研究在论证社会资本进入公立医院必要性前提下,从政策制定的宏观、中观、微观三个层面解析社会资本发展公立医院的政策环境,并针对公立医院吸收社会资本提出一些思考.     

财政对公立医院补助政策的演变及评价

我国卫生事业是政府实行一定福利政策的社会公益事业。卫生事业公益性体现了发展卫生事业是广大人民和社会的共同利益、共同需要、共同收益的本质特性。公益事业多由政府举办，或通过政府的社会政策予以支持。卫生事业的性质，决定了政府对公立医院实施一定的补助政策。由于各历史时期医院预算管理方法不同，对医院发展的影响程度也有很大区别，因此有必要对公立医院财政补助政策的历史演变过程作一回顾和分析，为进一步完善财政补助政策提供思路。     

中国经济转型时期公立医院社会功能评估的研究框架(1)

随着中国社会与宏观经济环境的改变，公立医院的社会功能在医院实行自主化经营过程中发生了变化。该提出了公立医院社会功能的理论依据。改革中社会功能的演变及其定量研究与定性研究的思路以推进我国公立医院改革的不断深化。     

公立医院社会功能的定量评价

该文对不同级别公立医院的社会功能指标及其在1985－2000年之间的变化情况进行了测算，讨论、分析了这些指标的影响因素，发现基层医院比三级医院具有较强的社会功能，在转轨时期公立医院社会功能有下降趋势。     

我国公立医院的目标分析

文章分析了公立医院社会政策目标和实际行为目标之间的差距,揭示了产生这种差距的原因是公立医院社会政策目标不易量化、市场化的推动、医疗服务行业改革不恰当地运用了企业理论为指导、政府对公立医院的控制能力减弱、外部监督力量缺失导致不能形成有效的行业自律等.指出不能将卫生部门的目标等同于公立医院的目标,政府应该为实现卫生部门的目标承担筹资责任.最终提出了公立医院应该具有的社会政策目标和实现这种目标的条件.     

Hospital nurses' perception of public health

The objective of this work was to study hospital nurses' perceptions of public health based on a pedagogical exercise. A qualitative study, lead by students of a training institute for nursing care (IFSI), was conducted using semi-directed interviews of hospital nurses from different departments of a provincial hospital. The main results show that for one-third of the nurses interviewed, the hospital is not a setting for public health practice. In terms of their definition of public health, it is closely linked to the concept of prevention, with primarily individual approaches. This definition is very close to the public health activities that they conduct at the hospital and which are centred on information and disease prevention, on education related to pathologies and the relationship between the provision of care and listening to the patients and their families. Few nurses place their public health activities within the scope of the areas of hospital cleanliness, the welcoming of the patients, the organisation of services, and the improvement of the quality of care. The potential tracks which have emerged from this work lead to the need for the strengthening of training in patient education, in the hospital's work networking with external partners, and in better development of public health activities undertaken in the hospital setting.     

新医改形势下医院优化思想政治工作的路径选择

医药卫生体制改革是国家重点实施的宏大民生工程,触及体制、结构、机制等深层次问题,容易形成公众舆论和社会思潮。新形势下推进公立医院改革试点,必须充分发挥思想政治工作的政治优势,从政策解读、落实服务理念、加强职业道德建设、发挥典型示范作用、优化活动载体等方面优化医院思想政治工作,为新医改的实施提供精神动力和政治保障。     

企业医院的社会责任探讨

医院的社会责任并无明确的概念,通过对萍矿总医院落实医院的社会责任总结与分析,认为医院的社会责任应该是为患者和社会提供优质的医疗服务与公共卫生服务,切实维护好患者与员工的利益,全面保护环境,积极有效地参与公益活动,加强医院治理与医院文化建设。它是医院发展的核心竞争力,与医院的经济效益并无矛盾。建立一个良好的评价指标体系与可持续发展的战略规划尤显重要。     

新时期大型公立医院社会责任价值取向与实现路径

分析了大型公立医院公益性、绩效管理和社会责任等不同价值取向的区别及矛盾冲突,认为社会责任不是对公益性和绩效管理的扬弃,而是兼容并蓄。根据大型公立医院的功能定位及事业单位分类改革等环境的变化,认为大型公立医院与县级及以下公立医疗卫生机构价值取向应该有所区别,应选择社会责任价值取向,并基于社会责任理论提出大型公立医院社会责任的内涵、社会责任的履行和评价机制,实现大型公立医院的社会责任价值。     

The social nature of the definition problem in health.

In this article it is argued that through the adoption of the appropriate theoretical approach and the derivation of suitable analytical categories, the definition problem in health can be seen as operational, nontrivial, and highly problematic to the determination of health care policy. Specifically, an attempt is made to isolate the social basis of the definition of health. Part one develops that theoretical approach to the problem. First, notions of health are traced paradigmatically, then a historical materialist approach is employed to develop the social basis of an operational, contemporary definition of health. This definition is then compared with other existing definitions, and part one concludes with a discussion of the possibilities of a normative definition. Part two applies the new definition by reinterpreting parts of the history of public health and medicine, and concludes with a discussion of how this definition is highly problematic to the major structural reforms currently under way in the American health care system.     

Health disparities and health equity: the issue is justice

Eliminating health disparities is a Healthy People goal. Given the diverse and sometimes broad definitions of health disparities commonly used, a subcommittee convened by the Secretary's Advisory Committee for Healthy People 2020 proposed an operational definition for use in developing objectives and targets, determining resource allocation priorities, and assessing progress. Based on that subcommittee's work, we propose that health disparities are systematic, plausibly avoidable health differences adversely affecting socially disadvantaged groups; they may reflect social disadvantage, but causality need not be established. This definition, grounded in ethical and human rights principles, focuses on the subset of health differences reflecting social injustice, distinguishing health disparities from other health differences also warranting concerted attention, and from health differences in general. We explain the definition, its underlying concepts, the challenges it addresses, and the rationale for applying it to United States public health policy.     

医院档案管理工作基于新形势的开展途径分析

医院是为人类提供公共卫生服务的一个单位,其存在具有至关重要的影响意义,是人们医疗卫生事业的主要承担场所,医院所提供的公共卫生服务水平主要受到两个方面因素的影响,其一是医疗卫生发展水平,其二是人们生活水平;而这两种因素均受到人类社会经济发展水平的影响,由此可见,医院可以直接反映人类社会的发展水平,医院管理治疗会对其实际运行水平产生直接性影响,同时也侧面体现了我国公共卫生服务质量。因此,基于此种社会现实下,结合新形势要求,分析医院档案管理工作存在的弊端,并探讨创新途径具有至关重要的影响意义,这不仅是国家发展、社会发展的要求,同时也是医院实现可持续运行的根本条件,是当前医院刻不容缓需要解决的主要问题。     

Is violence a disease? Situating violence prevention in public health policy and practice

The paper provides a review of some of the thoughts, ideas, and opinions that pervade the public health literature concerning how to classify or conceptualise violence. It is argued that violence transcends classic distinctions between communicable and non-communicable diseases, distinguishes itself from the discipline of injury control, and is influenced by wider, social determinants. Through a discussion of these varied perspectives it is concluded that a fourth revolution in public health is needed – a ‘change in scope’ revolution – that recognizes the influence of social justice, economics, and globalization in the aetiology of premature death and ill health, into which violence fits. However, rather than be shackled by debates of definition or classification, it is important that public health acknowledges the role it can play in preventing violence through policy and practice, and takes unified action.     

Health as a human right: an epidemiologist's perspective on the public health.

The modern idea of health as a human right is examined, as it evolved from the 18th century, in terms of its origins, its essential content, and 20th-century attempts at implementation. Equity for social groups is seen as a guiding principle. Two attempts at implementation, in Britain and in Cuba, are examined for their effects on equity in health service and in health states. The British National Health Service achieved equity between social classes in services but failed to achieve it in health states (as measured by mortality). Deficiencies in commitment to public health services, it is argued, contributed largely to this failure. The Cuban experiment appears to have moved beyond equity solely in services and toward equity in health states. This success reflects an overall Cuban commitment to the public health. Two important elements of that commitment are, first, continuous evaluation with flexible response and, second, community involvement.