辽宁省城乡医疗保障一体化发展路径与策略

城乡医疗保障一体化是推进城乡经济社会发展一体化新格局的重要内容之一.文章提出了辽宁省实现城乡医疗保障一体化的路径与策略,要以健康公平为出发点,保降人人享有基本医疗卫生服务为目标,形成共享、公平、和谐的城乡医疗保阵一体化的发展理念,实现城乡医疗保障三元制向二元制的整合,最终实现全民共享、城乡一体的医疗保障体制.     

Immigrants and health system challenges to TB control in Oman

Background  

During the past three decades, Oman has made significant progress in controlling TB within it's borders. However, the national TB control program elimination target has yet to be reached. This study aims to explore the perceived roles played by the immigrant population and the private health sector in relation to TB control in Oman.     

Integration of health systems and priority health interventions: a case study of the integration of HIV and TB control programmes into the general health system in Vietnam

This case study on Vietnam aims to generate empirical evidence on the relative merits of integration of two priority health interventions, HIV/AIDS and tuberculosis (TB), into six functions of the wider health system: stewardship and governance, service delivery, demand generation, monitoring and evaluation, planning, and financing. Selective documentary reviews and 25 qualitative, semi-structured interviews were conducted in early 2009 in Hanoi, Hai Duong province, Chih Linh district and Hoang Tien commune with informants from international, national and sub-national agencies steering or managing the HIV/AIDS and TB programmes and from health facilities providing HIV/AIDS and TB services. Data collected were collated and evaluated against 25 elements of integration. Each element of integration was ultimately classified as being 'fully/predominantly integrated', 'partially integrated', 'not or predominantly not integrated'. The results showed that none of the six programme functions was fully integrated into the general health care system as a whole. They were established either in parallel, notably at higher administrative levels, or were partially integrated. The study findings also revealed that little integration across all functional levels has occurred between the two programmes. Generally international agencies and sub-national domestic stakeholders supported more integration between vertical programmes (HIV and TB) and the general health systems, while national bodies responsible for HIV and TB favoured reinforcing a more vertical and thus less integrated approach. In the absence of shared assumptions and goals, this polarization of views may result in sub-optimal effectiveness and efficiency of each of the disease programmes as well as of HIV/TB interventions.     

儿童时期健康问题与成年期冠心病的关联性研究进展

高血压、高胆固醇血症是冠心病的主要危险因素,此外肥胖、吸烟、缺乏体力活动等也是冠心病的危险因素。儿童时所出现的肥胖、不良的血脂水平、血压偏高、高胰岛素血症等因素常聚集出现,     

The relationship between age of mother and child health and development.

This study investigates the relationship between age of mother and children's health and development at birth and at approximately three years of age. The sample is composed of Black and Hispanic women and their firstborn children who were delivered on the wards of a large New York City hospital in 1975. There were no differences between children of teenage and older mothers in terms of prematurity or birthweight, but the children of younger mothers had higher Apgar scores than those of older mothers. Age of mother was not significantly related to hospitalizations, the need to see a physician regularly, or abnormal weight. Although the number of injurious conditions and the incidence of burns were higher among the children of adolescent mothers, the effect of age of mother was not independent of other factors. The children of teenage mothers scored better than those of older mothers on the total Denver Developmental Screening Test, as well as on the Fine Motor sector. These findings thus suggest that when relevant background characteristics are controlled, children of teenage mothers are as healthy and develop as well as children of older mothers.     

Benign and malignant breast disease: the relationship between women's health status and health values

The study purpose was to determine whether differences in the weights assigned to various dimensions of health by 90 women in three subgroups (benign breast disease, breast cancer receiving chemotherapy, and breast cancer receiving other therapies) were associated with differences in self-reported health status in these dimensions. Two methods, one direct and the other indirect, were used to elicit values for mobility, depression, and social support. Two different scales also provided self-reports of health status in each of these dimensions. These measures, in conjunction with sociodemographic variables, were used to test for status-value relationships. No statistically significant association between health values and health status was observed. The absence of any detectable association may have been a result of methodologic difficulties in assessing broadly defined dimensions of health. A possible solution would be to use "individualized" dimensions that are uniquely important to the individual, and to take into account such factors as possible influences of past health status and values, and possible gaps between expected health status and health status actually experienced.     

卫生筹资与卫生系统绩效之间的关系及对中国的启示研究

目的:探索卫生筹资对卫生系统绩效的影响,为筹资模式的设计提供依据.方法:以经济合作发展组织(OECD)29个国家为研究样本,将其筹资模式分为税收与社会保险筹资两种方式,采用多元线性回归模型,构建卫生筹资模式及有关变量与卫生系统绩效间的回归模型.结果:税收筹资模式国家的卫生系统绩效总体优于社会保险模式的国家.政府卫生投入、卫生支出、GDP等筹资指标与卫生系统绩效正向相关.结论:税收筹资模式能更好地改善卫生系统绩效.中国卫生筹资应优先考虑税收筹资制度.     

The changing rural environment and the relationship between health services and rural development.

Author summarizes today's changing rural America and the challenges that health services researchers and policymakers face in relating the rural environment to the problems and possibilities of rural health services delivery.     

The relationship between qualified and unqualified workers in health care: the case of the remedial therapy professions

Summary The role of knowledge has traditionally been studied in terms of education and training, not in terms of job practice and the division of labour. This article examines the meaning of knowledge in the work context and its role in legitimating the division of labour between qualified and unqualified remedial therapy workers. The main analytic framework is derived from the work of Schutz.     

The relationship between literacy and health

In non-industrialized countries, populations with the lowest literacy rates have the poorest health status. In the United States, however, there is no published research on whether illiteracy, independently of other sociodemographic factors, is related to health status. There are numerous plausible mechanisms by which such a relationship could occur. For example, published reports indicate that most information handouts, consent forms, and other materials for patients are written at reading levels too difficult for most American adults. These and other findings may have important implications in the health care of underserved populations. Research is needed to determine the health effects of impaired literacy skills among Americans, and to develop non-literacy-dependent methods for providing patient education, obtaining informed consent, and administering diagnostic tests.     

适应中国疾病控制体系发展的口岸卫生检疫监管体系框架研究

在分析国际传染病应对以及中国疾病控制体系建设发展趋势的基础上,提出适应这一变化趋势的口岸卫生检疫监管体系的组织和业务框架,即由现在的按职能划分为检疫查验、传染病监测、卫生监督、卫生处理以及后来增加的口岸反恐等,调整为按突发公共卫生事件的应对过程划分为信息监测预警、传染病监测、应急处置和卫生监督等。     

The health workforce crisis in TB control: a report from high-burden countries

Background  

Human resources (HR) constraints have been reported as one of the main barriers to achieving the 2005 global tuberculosis (TB) control targets in 18 of the 22 TB high-burden countries (HBCs); consequently we try to assess the current HR available for TB control in HBCs.     

中国农村医疗保障制度的现状与对策

稳定的筹资渠道是农村合作医疗可持续发展的关键．亟待建立与完善。文章通过分析当前中国农村医疗保障政策中存在的主要问题、机遇和挑战，提出政府要借助重建合作医疗这一契机，制定和稳定符合农民根本利益的相关政策-建立和完善可持续的筹资体系。通过重建农村合作医疗制度．构建农村多层次的医疗保障体系．尤其是对贫困农民实行医疗救助。逐步缩小城乡差别，最终实现将农村合作医疗与城镇职工医疗保险对接整合的战略发展目标。     

Decentralisation and TB control in Nepal: understanding the views of TB control staff

Experience shows that planners need to consider the effect of the process of decentralisation on national health programmes. The aim of this article is to explore the relationship between decentralisation and a national disease control programme by seeking to understand the views and attitudes of staff working in a national TB control programme on the process of change and their involvement in that change. The study to which this paper refers was performed in Nepal, where, in common with several low- and middle-income countries, a Local Self Governance Act has been passed and decentralisation is in the process of being introduced in the health sector. The aim of the study was to develop a process of initial dialogue among programme staff with a view to exemplifying those enabling and disabling factors which could influence the process and content of health systems development and its impact on health and health care. The study used individual interviews and group discussions to increase our understanding of the experience of different stakeholders at both national and district levels. Important problems identified include: confused lines of authority, difficulties of integrated supervision, poor career paths and promotion possibilities, unclear performance management, lack of priority to be given to health and TB control, lack of local accountability, lack of capacity and the risk to the drug supply. The study highlights the need to (a) develop consensus techniques, achieve a balanced appreciation and include all stakeholders in the process of change and (b) define central and local responsibilities, limiting political bias, maintaining quality control, organising different lines of authority, maintaining priorities and programme integration.     

The health workforce crisis in TB control: a report from high-burden countries

Human resources are the most important assets of any health system, and health workforce problems have for decades limited the efficiency and quality of Latin America health systems. World Bank-led reforms aimed at increasing equity, efficiency, quality of care and user satisfaction did not attempt to resolve the human resources problems that had been identified in multiple health sector assessments. However, the two most important reform policies – decentralization and privatization – have had a negative impact on the conditions of employment and prompted opposition from organized professionals and unions. In several countries of the region, the workforce became the most important obstacle to successful reform.     

论健康城市与社会经济发展

城市化,尤其是发展中国家,作为社会经济发展的基本战略,是实现社会经济跨越式发展和现代化的重要手段。城市化浪潮已经席卷世界。我国也已处于城市化进程的快速发展阶段。预计到2015年,世界城市人口的比重将达到54.5%,发达国家中城市人口的比重将达到81.6%。但城市化在推动社会经济发展的同时也带来了一系列的问题。为此,世界卫生组织(WHO)提出健康城市理念,掀起了一场全球性的健康战略运动。一、健康城市定义及其内涵根据WHO的定义,一个健康城市应该是由健康的人群、健康的环境和健康的社会有机结合的整体,这个整体应该能不断地改善环境…     

社区卫生服务中影响医患关系的心理因素及对策

医患关系是指以医生为中心的群体与以患者为中心的群体之间为维护和促进健康而建立起来的一种人际关系。医患关系是人际关系在社区卫生服务活动中的一种具体化形式。良好的医患关系是全科医生深入社区、走进家庭最重要的工作基础。医患关系是医学伦理学最基本和最核心的问题，整个关于医德医风问题的讨论都是以它为轴心而开展的。医患关系作为一个历史范畴，决定于社会生产力和医学科学技术的发展水平，受社会、经济、文化、伦理道德等因素的制约，