菲律宾的卫生改革和国家卫生帐户

本文介绍了1998年菲律宾卫生行政管理改革，根据国家卫生费用核算（ NHA）模型发现的问题，进行公共卫生、公立医院、地方卫生体系、卫生行政管理和社会医疗保险五个方面的改革。并将NHA模型用于规划政策，表达改革议程，设计修正实施计划。     

公立医院产权制度改革应注意的若干问题

公立医院产权制度改革是实现医疗机构贤源重组和卫生资源优化配置、实施区域卫生规划的先决条件，是改变公立医院效率低下、成本上升、经营行为不合理的有效手段，也是中国医疗卫生事业迎对人世挑战的积极对策，其必要性和意义在政府部门和广大卫生工作者中已经形成共识。目前，公立医院产权制度改革已成为许多地区的重要事件。部分已先走一步的地区，公立医院的产权制度改革却出现了一些与改革目的不相协调的情况，如部分市县把所有医院全部转为私营；某些地方低价拍卖医院，导致国有资产流失等。为此，我们提出了公立医院产权制度改革中应该注意的一些问题，希望引起决策者们的重视。     

关于公立医院改革难点问题的对话

近日，在2012年中国卫生论坛“公立医院改革”专题论坛上，专家官员们针对公立医院改革进展情况与现场嘉宾进行了精彩互动。     

公立医院体制改革的模式及其借鉴

公立医院体制改革是当前卫生改革的重点和难点。该分析和各国公立医院体制垢基本模式及对我国公立医院体制改革的借鉴，着重对公司化运作进行了探讨。     

梳理天使之翼——北京市公立医院成本核算与财政补偿机制改革研讨会实录

2010年将是我国卫生体制改革攻坚的一年。卫生体制改革中有一些难点的问题，例如公立医院管理体制改革，运行机制改革，公立医院补偿机制改革等等要在今年得到破解。     

基层公立医院领导班子的协调与沟通

随着卫生改革与发展，作为卫生事业单位的基层公立医院相继实行并完善院长负责制。院长负责制作为卫生改革过程中出现的一种医院领导体制，顺应了组织管理体制理论中对组织领导所提出的要求，较好解决了我国医院作为一个独立经营的实体组织管理所需的一些内在要求。但是我们也看到了实行院长负责制以来，一些基层公立医院领导班子建设中所遇到一些新情况、新问题，亟待通过有效发挥领导班子的协调与沟通作用来解决。     

卫生资源配置与卫生管理体制改革

卫生体制改革包括卫生管理体制、公立医院的运行机制以及药品流通体制等方面。其中 ,与卫生资源配置密切相关的是卫生管理体制的改革 ,而公立医院运行机制的改革则是卫生管理体制改革的必然结果。卫生资源的配置是特定区域内卫生资源配置状况的反映 ,应根据当地经济发展、人口数量与结构、自然环境、居民的主要卫生问题和不同的卫生需求等因素来配置。但长期以来 ,我国卫生资源是按照计划经济的模式由政府统一计划配置的 ,它既使卫生资源的数量依赖于政府的财政投入 ,也使卫生资源的配置格局受制于卫生管理体制。1　卫生资源配置中存在的主…     

华东卫生经济研究协作会召开第29次学术年会

本刊讯华东卫生经济研究协作会第29次学术年会暨浙江省卫生经济学会、温州市卫生经济学会2013年学术年会2013年10月31日在浙江省温州市召开。本次年会围绕医药卫生体制改革，结合华东六省一市卫生改革的实际情况，主要探讨“推进公立医院改革”这一议题。     

澳大利亚卫生体制改革趋势

改善卫生服务的质量、效率和可及性，是世界各国卫生体制改革的核心目标。2007年澳大利亚联邦政府在公立医院、慢性病管理、老年保健以及医疗保险等方面提出了一系列改革举措，如投资6亿澳元用于缩短公立医院择期手术患者候床时间、将慢性痛患者部分牙科服务列入全民医疗保险范畴等，其做法可供我国医疗体制的完善与改革提供借鉴。     

国家不能"大踏步后退"——访卫生部卫生经济研究所卫生发展与战略研究室主任李卫平

刚刚结束的全国卫生工作会议上，对医疗体制的改革提出了很多指导性意见。其中，继续深化城镇医疗卫生体制改革，成为行业内人士关注的焦点。公立医院体制改革，是否可以说国家将“大踏步”后退?政府是否是“一卖了之”?针对这些问题，记者采访了卫生经济专家、卫生部卫生经济研究所卫生发展与战略研究室主任李卫平。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.