公共产品属性视角下基本医疗卫生服务制度构建的政府责任分析

基本医疗卫生服务的公共产品属性,决定了在构建这一制度时必须考虑政府责任的保障。通过对基本医疗卫生服务具有的共享性、非排他性、无选择性和非竞争性等公共产品属性的分析,对于政府责任的工作理念、政府责任的实现形式和政府责任的工作目标等进行探讨,以寻求在政府责任下实现基本医疗卫生服务公平、公益的性质,让人人都能平等的享有基本医疗卫生服务。     

从基本药物的混合产品属性分析基本药物的供给

世界卫生组织(WHO)于20世纪70年代提出基本药物的概念,2002年,WHO将基本药物定义为:满足人们基本的健康需要,根据公共卫生的现状,经有效性、安全性及成本-效果比的论证后遴选的药品.这些药品在任何时候均应保证有足够的数量、适宜的剂型及个人和社区能承受的价格[1].从这一定义可以看出,基本药物必须满足有效性、安全性、相对成本效益和可获得性.本文从公共经济学视角出发,以基本药物的产品属性为切入点,分析基本药物的供给问题.     

论民营医院参与医疗卫生服务供给的公平性

随着社会经济发展和医药卫生体制改革的深化,我国全民医保这一目标已基本实现。新形势下,人民群众的医疗卫生服务需求增长迅速,在大型公立医院“空间失配”的情况下,“看病难”的问题依然十分严重。该文试图以公共治理为出发点,从提高医疗卫生服务的供给能力和效率的角度来讨论民营医院参与医疗卫生服务供给的公平性。     

从公共物品视角看政府在基本医疗卫生制度中的作用

文章从公共物品的-般概述着手,对基本医疗卫生制度的属性进行了剖析,进而说明该制度是一种公共物品,表达了公众的需求.通过对公共物品的特性阐述说明了由政府提供该物品的必要陛并对政府如何实现其主导作用提出了一些见解.     

公共产品理论对我国医疗卫生体制改革的启示

从公共经济学的视角,分析我国现行医疗体制改革中存在的问题,根据公共产品理论指出我国医疗体制改革中存在的市场失灵现象,并以此提出完善我国医疗体制改革的几点启示.     

基本医疗卫生制度的产品选择和实践模型设计

在界定基本医疗卫生制度基础构架的基础上,论述了基本医疗卫生制度建设的产品选择路径和实践模型选择。即:"四梁八柱"是建立基本医疗卫生制度的基础构架,以政府为主导,向居民提供"小病社区低收费以补供方为主,大病住院有保险以补需方为主,公共卫生政府管以财政投入为主"的"三大服务"产品,是适合我国国情的基本医疗卫生制度的产品选择和实践模型。     

城市住宅新区医疗卫生服务供给与需求的现状研究

当前，随着旧城的不断改造，各城市面积的逐渐扩大，陆续出现了许多住宅新区，对住宅新区医疗卫生服务供给与需求的现状，未曾见报道，为了解浙江省城市住宅新区卫生服务状况，为决策部门合理分配卫生资源提供参考依据，我们于１９９８年７月－１０月对浙江省不同地区住宅...     

加快补齐医疗卫生供给短板

2019年广西壮族自治区卫生健康系统以维护人民健康为中心,以扎实推进健康广西建设为主线,以深化医改为动力,以打好基本医疗保障战役为抓手,继续做好“抓两头”工程提高基层、高端医疗卫生机构能力建设,从“调结构、保供给、减负担”的路径,加快补齐医疗卫生供给短板、持续优化医疗卫生供给结构、不断降低人民群众医疗负担,逐步解决群众看病贵、看病难问题。     

宿迁市医疗卫生资源供给现状分析与建议

目的:调查宿迁市医疗卫生资源的配置和供给现状,分析以民营医疗机构为主体的宿迁市医疗卫生服务市场在供给和配置上存在的问题,并提出相应的对策,为宿迁市医疗卫生资源的发展以及优化供给提供参考意见.方法:以宿迁市卫生资源数据为基础,对宿迁市卫生机构数、床位数、医院数量和等级分布、医疗卫生人力资源配置情况以及医疗资源分布情况进行...     

基本医疗卫生服务信息系统的构建

信息化是提高社区卫生服务效率和管理的重要手段,文章叙述了潍坊市社区卫生信息系统建设的项目背景和系统开发构建要点,并对系统的功能成本维护进行了论述,此外还对基层卫生信息化的设计开发经验、难点以及推广进行了讨论。     

Water supply and public health

EU legislative framework on water for human consumption has recently been deeply modified. As from 25 December 2003, the Directive 80/778/EEC has been abrogated by the Directive 98/83/EC, transposed into the Italian legislation with the law 31/2001, which establishes as an inspiring principle the observance of laws common to all Member States while leaving them the discretion to introduce secondary parametric values. The directive provides that the parametric values should be respected until water distribution, by making the final user fall into the sphere of responsibility as a responsible of either a public commercial concern or a privately-run concern. This piece of legislation lays the foundation for an actual cultural revolution and the involvement of all the institutional, political and technical components of the territory, the aim being to safeguard a property that "belongs to future generations" and, thus, to be protected.     

Systemic intervention for public health

Many calls have been made for a systems approach to public health. My response is to offer a methodology for systemic intervention that (1) emphasizes the need to explore stakeholder values and boundaries for analysis, (2) challenges marginalization, and (3) draws upon a wide range of methods (from the systems literature and beyond) to create a flexible and responsive systems practice.I present and discuss several well-tested methods with a view to identifying their potential for supporting systemic intervention for public health.     

Narrative intervention in behavior and public health

Public health interventions using narratives, or stories, as a means for encouraging behavior change are common, especially in the developing world. Entertainment-education (EE) is perhaps the most widely researched form of such "narrative intervention," but many other kinds of interventions, or parts of interventions, rely on stories to convey information about behavior risk and to model risk avoidance. Although narrative interventions are often grounded in social-cognitive theory and in commonsense assumptions about the power of storytelling, they are generally undertaken without much regard for the philosophical and cognitive bases for narrative about which much has been written. Many aspects of narrative intervention in behavior and public health could be better understood in light this literature. These include the 1) challenges inherent in creating and building on a discourse around behavior change in non-Western contexts; 2) current emphasis in public health on production rather than reception and the fundamental problem of interpretation; 3) differences between messaging versus providing an alternative worldview, and finally; 4) issues surrounding the appropriate approach to the evaluation of a narrative intervention.     

卫生领域的政府干预

我国要以世界5·4%的卫生总支出为世界上21%的人口提供基本公共卫生服务,并不断提高13亿人口的健康水平,卫生改革与发展的任务相当艰巨。从政府干预的经济原理出发探讨卫生领域中政府的职责与作用。     

Principles for the justification of public health intervention

OBJECTIVES: The objective of this paper is to discuss principles relevant to ethical deliberation in public health. METHODS: Conceptual analysis and literature review. RESULTS: Four principles are identified: The Harm Principle, The Principle of Least Restrictive Means, The Reciprocity Principle, and The Transparency Principle. Two examples of how the principles are applied in practice are provided. INTERPRETATION: The paper illustrates how clinical ethics is not an appropriate model for public health ethics and argues that the type of reasoning involved in public health ethics may be at potential variance from that of empirical science. Further research and debate on the appropriate ethics for public health are required.     

对政府购买社区公共卫生产品的设想

现在有一种流行的说法，叫做社区卫生服务站办得起，养不起。这是因为非营利性质的功能定位，使社区卫生服务站提供的服务，除了便民性质的基本医疗还有一点收入以外，其他均为无法收费或难以收费的公共卫生或准公共卫生产品，社区卫生服务站能做到经济上收支持平已很不容易，赚钱几乎是不可能的。     

Essential functions of public health: emerging topic in health care reform]

In the Americas, health sector reforms are facing the challenge of strengthening the steering and leadership role of health authorities. An important part of that role consists of fulfilling the essential public health functions (EPHFs) that are incumbent on all levels of government. For that, it's crucial to improve public health practice, as well as the instruments used to assess the current state of public health practice and the areas where it needs to be strengthened. For that purpose, the Pan American Health Organization has started an initiative called "Public Health in the Americas," with the objective of defining and measuring EPHFs, as a way of improving public health practice and strengthening the leadership provided by health authorities at all levels of government. This article summarizes conceptual and methodological aspects of defining and measuring EPHFs. The article also analyzes the implications that measuring performance on these public health roles, responsibilities, and activities would have for improving public health practice in the Americas.