我国公共卫生财政投入现状的时空分析

目的:从时间和空间的角度对我国公共卫生投入现状和投入结构进行分析。方法:综合运用卫生统计年鉴和财政决算报表,对我国公共卫生财政投入进行描述性分析、比较研究、空间描述分析、空间自相关分析及局部热点分析。结果:我国当前公共卫生投入整体偏低,增长缓慢,远低于GDP增长水平,且占政府卫生支出、卫生总费用比例较低,投入结构不合理,"重医轻防"矛盾依然突出。结论:政府应增加公共卫生财政投入,探索建立更加合理的投资机制;调整投资结构,尝试改变"重医轻防"的现状;保证公共卫生财政投入公平性,缩小地区差异;针对性增加公共卫生机构经费投入,解决以疾控为主的公共卫生机构当前面临的困境。     

城市社区公共卫生服务投入模式探讨

通过探讨城市社区公共卫生服务投入主体、投入主体与服务提供机构之间以及机构提供的公共卫生服务与基本医疗服务之间的关系,提出如何实施"政府购买服务"以进一步完善公共卫生服务投入模式的建议.     

农村公共卫生项目投入标准测算的思路与方法

借鉴成本核算思路与方法,研制了我国农村公共卫生项目投入标准的测算思路和方法及其所需要的资料来源途径,为进一步科学、合理地测算我国农村公共卫生项目投入标准提供了方法学依据。研究结果显示,农村公共卫生项目投入标准的测算思路包括界定公共卫生项目提供的"农村"范围、界定农村公共卫生服务项目、样本地区服务项目实际成本的测算、样本地区单位服务项目实际成本的测算、样本地区项目任务全部完成所需要标准成本和全国农村公共卫生项目投入标准测算等6步骤,资料来源途径和方法包括文献归纳分析、专家咨询论证、机构调查和常规报表资料的利用等。     

预防公共卫生突发事件的原因探析及措施

近年来,我国公共卫生突发事件层出不穷,社会危害性极大,究其深层次的原因主要有:生存问题与发展问题的背离,经济增长与经济发展的背离,缺乏公共卫生专业人员.因此,从加强对贫困地区的支援和"三网"建设,加大相关教育投入是最好的解决途径.     

我国公共卫生服务均等化评价指标体系及实证研究

目的:评价我国近年来公共卫生服务均等化发展现状.方法:选取可以反映我国公共卫生服务均等化现状的代表性指标,用层次分析法确定权重,建立我国公共卫生服务均等化指标体系.使用2007～2010年我国东部、中部和西部三个地区的数据,并用模糊隶属度函数法对各数据进行标准化分析评价我国公共卫生服务均等化现状.结果:我国公共卫生服务均等化水平逐年提高,但地区之间仍有差异,东西部地区间差异显著.结论:缩小地区间经济发展差距、增加中西部地区的公共卫生服务投入以及完善法律法规以缩小区域均等化差距.     

我国公共卫生信息系统发展的回顾及展望

我国的公共卫生信息化是卫生信息化的重要组成部分,它是与国家信息化密切关联的,正是国家信息化的飞速发展极大地推动了公共卫生的信息化和公共卫生信息系统的建设,促进了公共卫生事业的大发展.20年来,我国公共卫生信息化经历了一个认识不断提高、深化,指导思想不断明确,从以早期的"抓应用、促发展",逐渐转变到需求主导、以人为本、以用为本的过程.     

四川省基层医疗机构基本公共卫生服务人力投入现状分析

目的了解四川省基层医疗机构基本公共卫生服务人力投入情况。方法采用"基本公共卫生服务人力投入"问卷对450名基层医疗机构开展公共卫生服务的人员进行问卷调查。结论 (1)基层医疗机构公共卫生服务人员的人力资源结构不合理,兼职公卫人员和非公卫科室承担了大半基本公共卫生服务。(2)基层医疗机构在居民健康档案、预防接种和慢性病管理等方面投入较多的人力资源。(3)孕产妇健康管理、儿童健康管理等服务的公卫人员不足。     

西部农村区域公共卫生绩效现状评价与改进对策研究

通过对我国西部某省3个县的现场调查,从投入、产出、结果3个维度比较分析了样本地区的公共卫生绩效,计算得到了样本地区公共卫生绩效综合评价指数:公共卫生投入水平普遍偏低;不同公共卫生项目的产出绩效参差不齐;结果绩效整体水平较高.提出了健全农村公共卫生筹资机制、建立以绩效为基础的投入机制、均衡提供基本公共卫生服务项目、加强社会各界的支持等发展农村公共卫生的策略建议.     

北京月坛社区卫生服务中心免费服务量变化的研究

自1997年起社区卫生服务在我国蓬勃发展起来,发展社区卫生服务一方面是改革医疗卫生体系,建立"小病在社区,大病进医院,康复回社区"的就医模式;另一方面是为社区居民,特别是弱势人群提供方便的公共卫生服务(免费卫生服务)。但社区公共卫生服务是否需要政府投入,政府投入后是否能有效促进公共卫生服务量提高是值得我们研究的问题。复兴医院和西城区卫生局从1995年起在国家科委"国家社会发展综合实验区(北京西城区)"     

贫困地区农村基本公共卫生筹资现状

选择了3个样本县,对贫困地区农村基本公共卫生筹资现状进行了调查分析.结果显示:样本县各级财政对农村基本公共卫生的投入比重较高,但投入金额不足.建议:加大对贫困地区基本公共卫生服务专项经费的转移支付力度;规范财务管理,建立独立的基本公共卫生服务经费专户;以提高服务质量为契入点,提高经费的使用效益.     

2016—2020年天津市公共卫生财政投入状况分析*

目的：分析2016—2020年天津市公共卫生领域财政投入状况以及存在的主要问题。方法：运用天津市以及国内其他部分省市财政决算报表数据、年鉴数据，进行描述性分析和比较分析。结果：“十三五”期间天津市政府对于卫生健康事业重视程度较高，但是对于公共卫生领域重视不够，财政拨款支出表现出明显医疗服务系统偏向性，公共卫生机构支出明显偏低，突发公共卫生事件应急处理事先投入严重不足。结论：建议调整优化卫生健康支出结构，加大公共卫生财政投入， 切实落实疾控机构公益一类事业单位财政全额保障政策，建立突发公共卫生事件应急处理储备金制度。     

Advancing a Human Rights-Based Approach to Access to Medicines: Lessons Learned from the Constitutional Court of Peru

Access to medicines and the right to health continues to be widely discussed in academic literature. United Nations human rights bodies have done much work to elaborate on the normative content of the right to health and the obligations of states to uphold this right, although translating this into tangible benefits to the public at national level remains a challenge. This paper explores the case of Peru to evaluate prominent decisions of the Constitutional Court that have been instructive in clarifying the state’s obligations in relation to health. I argue that the court’s rights-based approach offers lessons that other states can draw on to meet their obligations to ensure the right to health by securing access to essential medicines.     

我国公共卫生服务均等化的实证研究：重庆市公共卫生服务券的分析与评价

发放公共卫生服务券是公共卫生服务制度的一种创新,是实现公共卫生服务均等化的手段之一。由原来投入供方的机制,转变为投向需方,确保居民获得基本公共卫生服务机会的公平性和可及性, 促进卫生机构之间的公平竞争。通过现场考察和座谈,本文总结了重庆市公共卫生服务券制度的现状,分析了制度的优点和存在的问题。作者认为对该项制度需要进行长期的实践和对比评价,有很多理论问题值得进一步探讨。     

成都市促进城乡基本公共卫生服务均等化的实施策略研究

分析成都市在推进城乡基本公共卫生服务均等化的实施策略及目前存在的问题和难点,提出进一步有效推进城乡基本公共卫生服务均等化的建议,即制定有财力保障的、体现均等化原则的基本公共卫生服务规划;测算基本公共卫生服务成本,增加公共卫生经费投入;保障流动人口有效地获得公共卫生服务;扩大基层公共卫生服务队伍,引入专业技术人员;进一步做好基层医疗卫生机构的公共卫生职能定位,将基层机构公共卫生考核和专业公卫机构工作结合。     

Tangible evidence, trust and power: public perceptions of community environmental health studies

Communities with environmental health concerns in the USA frequently request studies from their local or state departments of public health. This paper presents findings from three focus groups conducted in communities north of Boston that have been the subject of two different environmental health studies. The focus groups were designed to elicit residents' perceptions of environmental health, and of the particular studies conducted in their communities. In all focus groups, participants had difficulty accepting the findings of health studies that contradicted their own experiences of environmental exposures and illness. Our results suggest that lay knowledge, informed in varying degrees by the experience of what we term "tangible evidence," creates a lens through which communities interpret a health study's findings. The differences in reliance on tangible evidence were related to participants' sense of trust in public officials, and the institutions responsible for conducting health studies. Participants from the wealthier, predominantly white communities discussed trust in study design and methodologies used. In contrast, participants from the lower-income, higher-minority communities assessed health studies with reference to their trust (or lack thereof) in study sponsors and public health institutions. Participants' experience of tangible evidence, trust or distrust in health agencies and research institutions, and a sense of relative community power, influence how they assess the findings of environmental health studies and may have implications for pubic health.     

A model approach for developing effective local public health policies: a North Carolina County responds to large-scale hog production.

When intensive livestock operations or other large-scale industrial facilities pose a threat to public health, elected officials have a responsibility to ensure that the public's health is protected. Local policymakers need to guarantee that the process offers ample opportunity for balanced community input, and that the policy base is sound and well reasoned. Government officials need to manage the process so that balanced perspectives are presented and respectfully heard. A model approach, similar to the one described here, will assist local officials in crafting reasonable health rules that protect the public health and that diverse stakeholders can accept.     

Strengthening the public health workforce: An estimation of the long-term requirements for public health specialists in Serbia

At the beginning of the 21st century, planning the public health workforce requirements came into the focus of policy makers. The need for improved provision of essential public health services, driven by a challenging non-communicable disease and causes of death and disability within Serbia, calls for a much needed estimation of the requirements of the public health professionals. Mid and long-term public health specialists’ supply and demand estimations out to 2025were developed based on national staffing standards and regional distribution of the workforce in public health institutes of Serbia. By 2025, the supply of specialists, taking into account attrition rate of −1% reaches the staffing standard. However, a slight increase in attrition rates has the impact of revealing supply shortage risks. Demand side projections show that public health institutes require an annual input of 10 specialists or 2.1% annual growth rate in order for the four public health fields to achieve a headcount of 487 by 2025 as well as counteract workforce attrition rates. Shortage and poor distribution of public health specialists underline the urgent need for workforce recruitment and retention in public health institutes in order to ensure the coordination, management, surveillance and provision of essential public health services over the next decade.     

我国公共卫生投入保障机制研究

目的:系统分析我国公共卫生投入保障现状、存在的困难与问题,提出完善我国公共卫生投入保障机制的建议。方法:采用时间序列分析对财政公共卫生投入水平与结构变化情况进行评价,并结合文献研究、关键知情者访谈及专家咨询等,分析我国公共卫生投入保障方面存在的困难和问题。结果:政府对公共卫生的投入力度不断加大,但仍然存在尚未建立起稳定的公共卫生投入机制、补偿机制不健全、总体水平较发达国家仍有较大差距等困难或挑战。结论:需要构建以政府为主体、社会为补充、个人承担一定责任的筹资策略,并进一步完善我国政府公共卫生投入增长机制,推动并建立起公共卫生服务提供机构的运行新机制。     

对公共卫生投入的逻辑思考

公共卫生是一个相当宽泛的概念，在不同的社会，或同一社会的不同时期，公共卫生的含义都会有所不同。现阶段，我国尚没有学者能够对公共卫生的内涵和外延做出准确的界定。因此，对公共卫生的投入到底应该投入哪些方面，优先投入哪些项目，对公共卫生投入有哪些要求以及对加大公共卫生投入存在的误解，都应该进一步的研究和探讨。     

Transforming a Master of Public Health program to address public health practice needs

The future of the constantly changing public health profession is tied to the development of practice skills through competency-based training. In this article, we describe a program change in the Master of Public Health program at East Stroudsburg University in northeastern Pennsylvania. The first goal of the program transition was to ensure that all program elements included the relevant vision, values, mission, goals, and objectives. The second goal was to use continuous data input and evaluation to incorporate opportunities for flexible assessments. The change process helped the university faculty define the program's vision and fostered an environment of community collaboration that guides training for public health professionals.