待孕夫妇优生优育综合性教育效果的评价

目的探讨依靠基层计划生育网络,对待孕夫妇进行优生优育综合性教育的干预效果。方法对随机抽取的辖区1 035对已婚待孕夫妇(研究组)进行为期3年的优生优育综合性教育,分析连续3年来该组成员优生优育知识知晓率和计划生育服务满意度的变化,并将第三年的调查结果与同期未参加研究的1 000对已婚未孕夫妇(对照组)进行比较。结果研究组优生优育知识和国家优生政策知晓率逐年提高,3年的结果分别为43.87%、58.84%和74.20%(P<0.05);第三年度研究组与对照组比较,研究组优生优育知识和国家优生政策知晓率显著高于对照组(P<0.05)。结论依托计划生育网络综合性教育的模式可有效提高待孕夫妇优生优育知识和国家优生政策的知晓率,提高其对计划生育服务的满意度。     

Public hospitals and substance abuse services for pregnant women and mothers: Implications for managed-care programs and medicaid

Although an increasing proportion of the US population receives health services through managed care, pregnant women and mothers eligible for Medicaid who are involved with alcohol or other drugs are often excluded from these programs due in large part to lack of information on costs, service needs, and service use. To develop such information policy, service settings, and managed-care plans, the project conducted a national survey using a provider group with experience in caring for this population, the member universe of the National Association of Public Hospitals and Health Systems. The survey requested detailed information on hospital system information, current managed-care arrangements, outcome measurements, financing, service priorities, and service availability. The 81% response rate (n = 95) identified 35 hospital systems providing services to an average of 998 women in 1997. The majority of these systems (69%) reported coordinating care for these patients, but only 26% reported they computerize patient charts. Most use at least one indicator to measure effectiveness, and 50% use at least four. Counseling/education and transportation were seen as key support services, but many acknowledge they are not reimbursed for critical services such as nutrition education. The discussion highlights the need to provide formal support for core support services, to assist in care coordination and provide incentives for developing more sophisticated information, and to specify related services in the state Medicaid contract language. This report was supported by the Substance Abuse Policy Research Program, a national program of the Robert Wood Johnson Foundation.     

Telephone services. Wired for sound

There is some evidence that the British public would like to see an expansion of telephone advice lines. Exact demand is difficult to predict, but some research suggests that 500-1,000 nurses will be needed to staff a national service. The government's timetable for establishing a national service by 2000 is unrealistic.     

我国农村卫生工作现状与对策

农村卫生工作是整个卫生事业的薄弱环节。农民的健康保障水平低,整个农村卫生事业与国民经济发展的比例失调,城乡医疗卫生资源的配置倒置,农村卫生事业滞后影响了全面建设小康社会的进程。文章就我国农村卫生工作的状况作一分析,并提出对策。     

某校学生ABO血型分布的调查分析

利用实验课,统计我校学生的ABO血型的分布情况,以及与全国普通人血型分布状况相比较,有助于本地区采供血部门对我校学生义务献血制定合理的采供计划,更好地为临床、为患者服务,具有重要的作用。     

我国社区卫生服务政策的效果分析

利用现有的文献资料分析了我国社区卫生服务政策的效果。结果表明 ,我国的社区卫生服务政策覆盖面广、连续性强 ,与过去制定的卫生政策相比 ,强度更大、作用更广 ,对我国政府、医疗卫生机构、居民在降低费用支出、提高健康水平、提高整体服务效率等方面做出了较大贡献。     

昭通市农村居民两周患病卫生服务需求与利用现状及影响因素分析

[目的]了解农村居民卫生服务需求与利用现状,并找出相关的影响因素,为卫生政策的制定提供参考依据。[方法]采用分层随机整群抽样方法,对昭通市3个县(区)共3645户10,584个居民进行入户调查。通过两周就诊率、两周就诊次数、两周患病就诊率了解农村居民两周患病卫生服务需求与利用现况,运用二分类Logistic回归、零膨胀泊松模型等方法进行影响因素分析。[结果]昭通市农村居民两周就诊率为4.72%,两周患病就诊率为73.49%。卫生服务需求受年龄、性别、职业、婚姻状况、人均收入的影响;卫生服务利用的影响因素有性别、职业、文化程度,人均收入。[结论]昭通市农村居民卫生服务需求和卫生服务利用均低于国家农村平均水平。农民卫生服务需求高,但卫生服务利用不足;低收入人群和男性就诊可能性低,就诊时疾病严重程度高。应更加关注男性、农民和低收入人群的卫生服务需求和利用情况。     

Health education intervention in the separation and divorce process

This paper argues the case for a full national conciliation service which would include the provision of anticipatory guidance on the health consequences of the divorce process. After a small empirical study on a group of women from York, evidence emerged that no such provision existed. Despite the fact that all the women belonged to, or were associated with, the One-Parent Family group in York, they all felt that some form of support agency and a health adviser would have been invaluable.     

中部四省女性农民工医疗保健服务利用及影响因素分析

目的:分析经济因素对女性农民工医疗保健服务利用的影响作用,为建立女性农民工医疗保健服务对策提供科学依据。方法:采用问卷调查中部4省1 142例女性农民工的人口学特征、医疗保健服务需求和利用情况及影响因素,运用EPI Data 3.0建立数据库,SPSS 17.0进行统计分析。结果:女性农民工最近两周患病率为29.4%,高于2008年第四次国家卫生服务调查;未就诊的女性农民工为38.1%,与第四次国家卫生服务调查接近;慢性病患病率为17.8%,略低于第四次国家卫生服务调查。有22.3%的女性农民工未接受过产前检查,产前检查达到5次的占36.9%。结论:女性农民工的疾病经济风险比较高,经济状况是农村居民卫生服务利用的主要影响因素,建议结合女性农民工的务工特点建立适宜的医疗保险和服务方式。     

知难而进迎接挑战——上海卫生系统贯彻国务院医改决定的配套改革情况

本文就近几年来上海卫生系统配合医改所做的主要工作进行了回顾,并根据上海卫生改革总体部署就进一步贯彻国务院医改决定的配套工作提出初步设想.     

中医医疗服务价格现状及政策建议

通过对中医医疗服务项目的数量及各地价格情况进行对比,发现中医医疗服务项目和价格中存在的突出问题, 深入分析其形成原因,提出在医疗服务项目动态调整中增加中医项目比例、提高中医项目价格、制定全国统一的中医医疗服务项目立项指南、制定中医医疗服务项目全国性指导价格、对重点中医项目加大支持力度等建议。     

Eye health and sight loss: the UK Vision Strategy

The UK Vision Strategy is a Vision 2020 UK initiative, led by the Royal National Institute of Blind People (RNIB), to develop a unified plan for action on all issues relating to eye health and sight loss across the four countries of the UK. The Strategy was developed in response to a World Health Assembly resolution of 2003, which urged the development of national plans to tackle sight loss. Launched in April 2008, the UK Vision Strategy is a bold, ambitious plan to radically improve the eye health of the nation, eliminate avoidable sight loss, improve services to people, including children, with sight loss, and increase inclusion in society for blind and partially sighted people. Health and social care professionals joined the voluntary sector, Government representatives, service users and individuals with experience of sight loss to develop the Strategy. Local groups of health and social service professionals and service users are being formed across the UK to find ways to implement the Strategy. Any health professional with an interest in this work can contribute to their local group either through their professional representative on the group or directly.     

Clinical management. Where medicine meets management. Senior moments

Most general hospital users are older people. Standard 4 of the national service framework for older people aims to transform the whole hospital experience for this group. Trusts have yet to grasp the fundamentals of this approach, despite the fact that it will help them achieve improvements such as access targets. Investment in staff training and education is needed to achieve the necessary cultural change.     

广西实施国家基本公共卫生服务项目进展、成效与政策建议

文章从基本公共卫生服务规范、项目实施方案、补助资金管理办法、绩效考核等方面系统梳理了2009-2018年广西实施国家基本公共卫生服务项目的进展情况,展示广西实施国家基本公共卫生服务项目取得的成效,并与相关指标的全国平均水平比较,深入探讨作为欠发达地区的广西在实施国家基本公共卫生服务项目存在的一些共性问题以及面临的挑战,在此基础上提出政策建议。     

Re-vitalizing public health care systems: a proposal for public competition in Sweden.

This article examines the health policy opportunities presented by building market-style incentives into the structure of a national public health system. The goal is to develop a service delivery model which can achieve simultaneously high levels of patient service, economic efficiency and social responsibility. The article develops its "public competition" approach implicitly, through a detailed case study of the Swedish health care system. The broad theory appears to hold promise for a variety of existing and emerging national public health systems in Europe.     

安庆市郊区农民医疗需要和卫生服务利用研究

目的 :了解安庆市郊区农民医疗卫生需要量及卫生服务利用的基本情况和特点。方法 :通过分层整群抽样 ,访谈安庆市郊区农民 2 2 6 6人。结果 :慢性病患病率 ,尤其是男性的慢性病患病率高于全国农村平均水平 (P<0 .0 5 ) ,两周患病率与全国农村平均水平相比有很大差距。两周就诊率也高于全国农村平均水平。两周未就诊率、年住院率与全国农村平均水平接近。就诊单位构成比基本与各级医疗机构功能吻合 ,仍有 1/ 5的病人因经济困难而未就诊。医疗服务费用高于全国农村平均水平 ,给农民带来了一定的经济负担。结论 :安庆市郊区农民的健康状况不容乐观 ,与全国农村平均水平相比 ,医疗需要量大 ,医疗费用较高 ,加重了病人的负担 ,因此推行合作医疗势在必行 ,同时要完善健全三级医疗网。     

高原地区军队医院在发挥民族医疗中的作用

军队医院在不同时期、不同历史背景下，采取不同的方式开展民族医疗工作，给军队、社会带来了良好的效益。按照相关规定，指派医务人员深入到民众、尤其偏远少数民族地区巡诊义诊、防病治病，做群众工作，培养技术人才，传播科学文化知识，改善了少数民族地区缺医少药的状况。民族医疗工作无论是过去、现在还是将来，都发挥了并将继续发挥着祖国统一、边防稳定、促进医院发展，构建和谐社会的重要作用。     

Medicaid waiver programs for traumatic brain and spinal cord injury

With policy makers facing the competing challenges of budget crises and pressures to expand Medicaid home and community- based service programs to populations including those with traumatic brain and spinal cord injuries (TBI/SCI), this paper addresses the need for information about the development of waiver programs for this target population. This study draws from the most recent and comprehensive available dataset to present national participation and expenditure trends for all TBI/SCI waivers for the period 1995-2002, it reports findings from a national survey of policies (e.g., eligibility criteria and cost controls) used on these waiver programs in 2002, and compares the Medicaid cost of serving this target group through institutional care and waiver programs.     

National family planning service guidelines. Contraception

This paper examines the role of the Program for International Training in Health (INTRAH) in the development of national family planning service guidelines throughout sub-Saharan Africa. INTRAH noted that the service managers, trainers and service providers lacked a common set of references to guide family planning service development, provision, training and evaluation. This was evident from the great variations in family planning service delivery practices and procedures and working conditions, and considerable confusion about what constituted an acceptable level of family planning service coverage and quality. In response to this problem, INTRAH conducted a series of technical assistance program in Botswana, which resulted in two ministry-sanctioned service and training-directed guidance documents. These documents include a national family planning service policy and a set of standards to accompany the policy statements, and a set of family planning service guideline that operates the policy and standards. These documents are available at all government-sponsored family planning service sites, and service providers are expected to use them as references for service planning, provision and evaluation. In addition, INTRAH assists ministries of health to organize for and prepare drafts of country-appropriate service guides and guidelines with an emphasis on in-country working groups.