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Liu Y Berman P Yip W Liang H Meng Q Qu J Li Z 《Health policy (Amsterdam, Netherlands)》2006,77(2):212-220
While China's health services are primarily financed by out-of-pocket spending (private financing), health care providers, especially the hospital industry, are still dominated by state ownership and government control (public provision). Even though the private sector plays an increasing role in the ambulatory sector, private services are not included in the social insurance benefit package, and thus, it primarily serves self-paying patients. The ambiguity of the government policy toward private provision stems from concerns that an increasing private sector would drive up costs and its services may be of questionable quality. This paper tries to gather evidence on the relative performance of private and public sector in China. Neither literature review nor our primary data analysis provides any support for the notion that the private sector charges a higher price and they serve primarily the better-off people. Quite on the contrary, available data seem to suggest that not only the private sector tends to serve disproportionately the low-middle income groups (this may well be due to its relative lower direct and indirect costs), consumer satisfaction also seems to be higher with regards to certain dimensions of the private than public sector. 相似文献
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Chamberlain MA 《Journal of health communication》1996,1(1):43-50
Not since the hundred years following Gutenberg's invention of the printing press in c. 1450 has there been such a tidal wave of change in the way humans communicate. We are moving from the Age of Mass Communication into the Age of Interactive Communication, in which many of the old communication models will be insufficient or redundant. The rate of diffusion of these new media technologies almost defies comprehension. The convergence of computer, telecommunication, and televisual technologies is presenting the consumer with a myriad of choices. The challenge for the communicator is to find a way through this maze and to ensure that the message is received. For the health communication professional, the urgency of the message often adds further difficulty to the task. Differing rates of diffusion internationally and a confusion of technologies do not make the problem any easier. 相似文献
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Forde C 《The Health service journal》2012,122(6291):30-31
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Zimring SD 《Journal of the American Medical Directors Association》2006,7(5):322-326
While federal law establishes guidelines that designated facilities must follow in providing information about a patient's rights regarding self-determination in the health care decision-making process, state law determines the decision-making process and the legal requirements pertaining thereto. A person's capacity to make health care decisions or to have the authority and capacity to delegate the right to make such decisions is a legal conclusion based on statutory and common law principles. This article discusses the legal perspective of capacity in health care decision making and the legal framework of the question of whether or not a person has the capacity to make health care decisions. Western civilization's concepts of personal autonomy and self-determination are at the core of health care decision making, but health care providers must be aware that other cultures do not always share that value system. Sensitivity to multicultural diversity in this context is imperative to maintain individual self-esteem and respect, both for the patient and the patient's family. 相似文献
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Evaluation of fitness for work (FW) is the final task of both health surveillance and risk evaluation. It's aim is to protect the physical and psychological health of workers and respect their professional skills. The Occupational Physician faces several difficulties in the evaluation of FW. Moreover, Italian legislation on this topic can be variously interpreted and this can cause conflicting evaluations. In this session, the most challenging situations in FW evaluation will be taken into consideration. 相似文献
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Canales M 《Health care for women international》2004,25(5):411-435
In this article, I report a component of a qualitative grounded theory study on health care decision making of American Indian women (AIW) residing in the Northeastern United States. Analysis was based upon data collected from 20 women who self-identified as American Indian. Taking care of self was a primary factor influencing health care decisions among this sample of AIW. As women moved between their Native, traditional health practices and conventional Western health practices, efforts toward taking care of self were especially salient. The properties of taking care of self include knowing family history; balancing mind, body, and spirit; understanding the body; and integrating natural practices. I also address some implications of the study findings for practitioners working with Native women. 相似文献
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Stephen B. Thacker M. D. Carolee Osborne Eva J. Salber M.D. D.P.H. 《Journal of community health》1978,3(4):347-356
We combine two standard approaches to analyze power and influence in health policy formulation within a moderately large county in the south. Intrinsic methodologic weaknesses are discussed and several conclusions are drawn regarding power in the health care sector of that community. The most significant finding is the shift in power over time, away from the individuals to committees and health care organizations. The ignorance of most physicians about the broader health care issues that affect the community was reflected in their lack of recognition by others in the community as influential decision makers. The insular relationship of the university to the rest of the community was also noted. Past racial politics had a continuing effect on later health policy formulation. These findings are discussed in light of current and past issues. Because we had promised confidentiality to the persons we interviewed, fictitious names were given to the county, the institutions, and the interviewees. 相似文献
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Teasdale E 《Journal of the Royal Society of Medicine》2000,93(5):234-237
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Weinberg C 《American journal of epidemiology》2003,158(11):1033-5; discussion 1035-8
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OBJECTIVE: To identify factors related to consistency between women's "most important" reason for using contraception and their current contraceptive method. METHODS: A sample of 433 women completed a written questionnaire on demographics, contraceptive use history and the "most important" reason for using contraception. Women were grouped by whether their current contraceptive method "agreed" or "disagreed" with their "most important" reason for contracepting. Multivariable regression was used to identify factors associated with consistency between stated "most important" reason and current method used ("agreed"). RESULTS: Current contraceptive method was inconsistent with the "most important" reason for using a method in 25% of women. Demographic characteristics and knowledge of contraceptive effectiveness did not differ between the "agreed" and "disagreed" groups. Women using a method consistent with their reason were more likely to have discussed contraception with a health care provider (RR=1.59, 95% CI 1.13-2.25) even after adjusting for source of contraceptive method or source of contraceptive information (RR=1.57, 95% CI 1.10-2.23). CONCLUSION: Contact with a health care provider was the only factor associated with consistency between birth control method and reasons for initiating contraception. This association appears to be independent of knowledge about contraceptive effectiveness. 相似文献