青岛市公立医院管理体制改革剖析

山东省青岛市在保留原有公立医院管理组织构架的基础上，通过明确政府与公立医院之间的职责安排，推行财务科长和审计科长的委派制，加强对公立医院院长的绩效考核等方式，在确保政府对公立医院宏观指导的同时提高了医院的自治化程度，有效地改进了公立医院的运行效率。     

关于公立医院银行融资问题的思考

从公立医院对外融资的必要性出发，阐述了公立医院银行融资的特点和前景，分析了银行融资种类和方式的选择，提出了公立医院融资需要注意的问题。     

公立医院与社会责任

公立医院作为政府投资设立的非营利组织，应该承担一定的社会责任，但是，如何理解公立医院的社会责任是需要研究的问题。本文通过分析公立医院承担社会责任的现状，探讨公立医院承担社会责任的方式，旨在增强医院的社会责任意识，构建和谐医患关系。     

陕西省县级公立医院改革的做法与启示

通过对陕西省县级公立医院改革的主要成效及面临的问题进行深入分析,探讨了县级公立医院改革进程中公立医院公益性如何界定和体现、怎样实现管办分开等一些难点问题,为促进县级公立医院改革提出如下政策建议：重新界定公立医院公益性的内涵和体现方式,通过建立医院法人治理机构实现管办分开,改革人事分配制度建立激励机制,通过支付方式改革控制医疗费用不合理增长。     

我国公立医院财政长效补偿机制实现方式探讨

通过对公立医院财政补偿方式与发展趋势的阐述,分析了公立医院补偿机制的现状及问题,并提出了完全实现社会功能的公立医院、待实现社会功能的公立医院和待转型的公立医院3种补偿机制,以期对我国公立医院财政长效补偿机制的实现提供参考依据.     

专病运营模式在医院运营中的应用研究

为实现公立医院高质量发展，公立医院应不断提升管理能力，创新管理方式。公立医院采用专病运营模式，有助于医院回归功能定位、提升医疗质量、优化患者就医体验。文章以华中科技大学附属协和医院为例，通过分析专病运营内涵、 管理目标、实施路径、管理成效，总结专病运营的有效模式，为推动公立医院高质量发展提供经验借鉴。     

法国公立医院改革的主要做法与启示

为了应对经济危机和人口老龄化,法国公立医院开始了以成本控制为主要目标的改革。改革的重点在于服务体系、管理体制和补偿机制,具体措施包括成立区域卫生管理局,制定区域卫生规划,为公立医院发展设定目标和明确功能定位;通过构建权责明晰的治理结构和签订绩效管理合同,公立医院院长在政府宏观管理下拥有较大的经营自主权;通过加强预算管理和支付方式改革等多种方式控制医疗服务成本;加强对公立医院的认证和评价。改革主要特点是加强医疗资源规划与整合,促进公立医院与区域卫生管理局的契约化,明确公立医院治理的各方权责,通过控制医疗费用提高资源利用效率,对我国公立医院改革具有一定借鉴。     

“医药收支分开管理”

建立规范的公立医院运行机制……实行医药收支分开管理，探索有效方式逐步改革以药补医机制，通过实行药品购销差别加价、设立药事服务费等多种方式逐步改革或取消药品加成政策，同时采取适当调整医疗服务价格、增加政府投入、改革支付方式等措施完善公立医院补偿机制。     

公立医院医疗体制改革设想

目的 通过分析公立医院医疗体制的一些缺陷和局限，结合国内外资和民营医院的一些做法，提出公立医院医疗体制改革后应建立、符合当代社会发展需要的最佳模式。方法 通过对当前国内公立医院医疗体制进行剖析，发现体制弊端和改进方法，并对改进后的医疗体制模式进行设想。结果 近年来我国大多数公立医院所进行的医疗体制改革，几乎都是在传统医疗体制下修修补补的革新，对几十年来所形成的体制弊端，触动不大。结论 行政体制实行院长总监负责制、临床科室建立责任医疗小组制，是改变目前医疗体制一些缺陷和局限的创新方式，也是新时期国内公立医院所应建立的最佳医疗体制模式。     

鞍山公立医院的“双保”模式

在公立医院改革中，人们最关注补偿如何落实，因为这直接关系到维护公立医院公益性和调动职工积极性的核心问题。全国公立医院改革试点城市之一的辽宁省鞍山市，在破题公立医院补偿机制改革中，明确提出了政府既保综合医院的社会保障费，又保专科医院的收支差额的“双保”模式，这种政府补偿方式的再调整，为鞍山公立医院改革打开了一道“补偿”之门。     

Pharma in the bedroom . . . and the kitchen. . . . The pharmaceuticalisation of daily life

This paper examines the consequences of a new emphasis on lifestyle in the production, marketing and consumption of pharmaceuticals. Over the past decade, a range of medicines have become available that address aspects of lifestyle, while others have been the subject of lifestyle marketing. We argue, with recourse to a broad literature from the social sciences, economics and health services research and from our study of pharmaceutical consumption, that two processes can be discerned. First, there is a domestication of pharmaceutical consumption, with drugs available via home computers, and marketing of pharmaceuticals that focuses upon private or personal conditions and addresses domestic activities such as sex and cooking. Secondly, there is a pharmaceuticalisation of everyday life as the pharmaceutical industry introduces profitable medicines for a range of daily activities and pharmaceuticals come to be seen by consumers as a 'magic bullet' to resolve problems of daily life. We suggest that the pharmaceuticalisation of daily life links the economics and politics of pharmaceutical production to the private lives of citizens.     

Physicians and the state in the U.S.A. and Israel.

The paper focuses on two patterns of policy-making: a professional pattern in which physicians dominate, and a political pattern in which state authorities take the lead. It looks into the causes of the emergence of each of these patterns and their consequences, in terms of the equity of the health services and their efficiency. The U.S.A. and Israel provide examples for the professional and political patterns of health policy making. The causes for the development of the political pattern in the U.S.A. are grounded in the social salience of medical care, in physicians' economic power, and in the individualistic political culture. The politicization of health services in Israel came about owing to the low placement of health on the social agenda, the proletarianization of physicians, and the hierarchical administrative culture. Analysis of the results indicates that Israel portrays more equity in health services. However, in terms of efficiency results are mixed. In both countries, changes are taking place in opposite directions: more politicization in the U.S.A.; less in Israel.     

Nutrition in Space: Evidence from the U.S. and the U.S.S.R.

Space flight exposes humans to a hostile, stressful environment as well as to the weightlessness associated with microgravity. The stresses of space travel affect nutritional balance, as evidenced by interrelated changes in body composition, energy utilization, and endocrine function. The limited data gathered thus far suggest that space flight incurs acute decreases in fluid mass and chronic, ongoing changes in muscle and bone mass. Concurrent with these changes is an increase in energy used per unit body mass. Other preliminary data suggest that bed rest and space flight may incur increased sensitivity to insulin. Further research is needed to determine the human energy and protein requirements for space, as well as a means of quantifying changes in body composition during extended-duration space flight.