社区卫生服务定价研究

社区卫生服务是面向社区所有居民的，开展医疗、预防、保健、康复、健康教育、计划生育六位一体的，具有社会公益性质的卫生服务，是实现“人人享有卫生保健”的一种理想方式。社区卫生服务的性质决定了社区卫生服务机构的任务是提供最基本的、人人都能得到、体现社会平等权利、人民群众和政府都能负担得起的公共卫生和基本医疗服务。为此，国家必须制定合理的社区卫生服务价格，完善社区卫生服务的筹资机制，以充分发挥社区卫生服务机构作为公共卫生服务主力军和医疗服务“守门人”的作用。     

西部Y市社区卫生服务机构服务利用与满意度评价

目的对Y市2015年社区卫生服务机构服务情况进行实地调查,观测居民卫生服务利用、健康档案真实性和规范性及对基本公共卫生项目和基本医疗服务的满意度。方法将Y市69家社区卫生服务站(中心)纳入样本框。对健康档案进行简单随机抽样,并电话核实其真实性;按照国家规范要求核查建档的规范性;满意度调查采用方便抽样和入户调查方法。结果 Y市社区卫生服务利用有所提升;社区卫生服务机构健康档案建立真实性较高,规范性也较好,个别社区需要整改;基本公共卫生服务满意度很高,基本医疗服务中设备齐全度和基本药物的配备情况满意度较低。结论社区卫生服务机构更应该注意重点人群家庭随访、健康教育等工作的提升;持续性的对基层卫生服务机构居民卫生服务利用和满意度的监测有利于对分级诊疗等医改政策效果的判断。     

家庭医生式服务居民健康的“守门人”(一)

<正>《健康北京"十二五"发展建设规划》指出:着力完善社区卫生服务网络,强化社区卫生服务机构的基本医疗和公共卫生职能,推行家庭医生式服务,到2015年,城乡居民健康档案建档率达到85%以上家庭医生式服务是指借鉴先进的家庭医生服务理念,开展以社区卫生服务团队为核心,以居民健康管理为主要内容,在充分告知、自愿签约、自由选择、规范服务的原则下,社区卫生服务团队与服务家庭签订协议并通过与居民建立相对稳定的服务关系,为居民提供主动、连续、综合的健康责任制管理服务。家庭医生式服务是一种医疗服务模式的转变,通过深入居民家庭的访视,主动了解这个     

“片医”：努力走进家庭

2008年,郑州市为了使社区卫生服务工作充分发挥其便民、利民、惠民的优势,做好社区居民健康的“守门人”,学习英国家庭医生的经验,借鉴“片警”做法,结合社区居民的公共卫生和基本医疗的需求,率先推出了“片医负责制”这一新的社区卫生服务模式,在如何更好地完成公共卫生服务项目,更好地服务社区居民方面,     

基于危机管理的社区卫生服务风险防范

社区卫生服务是我国新型城市卫生服务体系的基础,处于医疗服务的最前沿,发挥着居民健康“守门人”的作用,是促进基本卫生服务公平性,实现人人享有基本医疗服务、构建和谐社会的重要环节。社区卫生服务作为公共服务,存在着因医源性、社会性等因素导致的医疗差错、医疗事故、医疗纠纷等风险。本文在借鉴国外危机管理理论研究和最新实践经验的基础上,探讨对社区卫生服务风险的系统防范。     

普陀区社区卫生服务综合改革的实践与思考

社区卫生服务中心是国家基本公共卫生服务和基本医疗服务的网底,为社区居民提供“医疗、预防、保健、康复、健康教育和计划生育技术指导”六位一体服务,使居民得到有效、经济、方便、综合、连续的基本卫生服务。普陀区的社区卫生综合改革,紧紧围绕“保基本、强基层、建机制”的要求,稳步推进社区卫生综合改革,取得显著成果,但是在实践中也遇到一些实际困难。     

宜兴市社区卫生服务机构的现状与对策

城市社区卫生服务机构担负着为居民提供公共卫生服务和基本医疗服务的职能,但目前宜兴市社区卫生服务机构各项功能还不完善,还需要从转变服务理念、注重素质提高、完善设施、明确管理制度等方面开展工作。     

对社区卫生服务机构监督执法的几点思考

社区卫生服务机构是向辖区内的常住居民、暂住居民及其他有关人员提供基础卫生服务的场所,其内容涉及基本医疗服务领域和公共卫生领域两个方面,在我国医药卫生体制改革中占有重要的地位。常州市卫生监督所在对主城区各社区卫生服务机构日常监管、专项督查过程中发现部分社区卫生服务机构在人员配置、经营性质方面存在着一定的问题。针对存在的问题,笔者认为社区卫生服务机构人员应向全科方向培养,经营性质应向政府主导的非营利化方向发展。     

上海财经大学卫生政策与管理研究中心主任、本刊特约编委俞卫：社区卫生服务体系建设新思路

当前,新医改对社区卫生体系有了明确定位：即“把基本医疗卫生制度作为公共产品向全民提供,实现人人享有基本医疗卫生服务。”这是按照大公共卫生概念,除了提供基本医疗服务,社区卫生服务中心的角色也向帮助居民预防疾病转变,将工作重点放在居民建健康档案、慢性病管理、妇女儿童保健、     

家庭医生式服务居民健康的“守门人”(二)

<正>(接上期)家庭医生式服务的服务内容签约居民在享受《北京市社区卫生服务中心(站)服务管理规范》所规定的基本公共卫生和基本医疗服务的基础上,还可享受到以健康管理为主要内容、主动服务为主要形式的5类个性化的服务和优惠措施:(一)"健康状况早了解"——个人健康评估及规划。根据居民个人健康     

Ecosystem health and human health

The study of ecosystem health is a relatively recent discipline that has already provided new insights into numerous aspects of environmental management. One of the most interesting fields of study is the one investigating the relationships between ecosystem and human heath. In this paper some basic terms of reference are given in order to help the understanding of this new approach. One definition of ecosystem health is given, possible causes of degradation are indicated and links with human health are addressed. The ecosystem approach to human health stresses the importance of cultural and social values in shaping the concept of health, both at human and at ecosystem level. Two case-studies showing man-ecosystem interactions are described: mining activities, that provide a suitable field of application of the ecosystem approach, and the case of malaria and DDT, that shows the risks of certain policies neglecting basic human expectations such as health. As a conclusion, some suggestions for possible research activities are given and a few recommendations for sound public health policies are indicated.     

Communicating health through health footprints

The depth and scale of challenges posed by noncommunicable diseases such as diabetes mellitus and cardiovascular disease are now well known and clearly documented. Reducing the 4 key risk factors has been shown to reduce premature mortality and morbidity by 70% globally. The authors consider how affirmative action can be driven to reduce these risk factors through Health Footprints, targeted interventions within specific domains of consumption, on the basis of an assessment of the negative health effect of specific choices, with the goal of driving healthy choices and improving health. In this article, the authors propose a methodology that ties together insight from public health, behavioral economics, marketing, and health communication. They offer 3 specific examples for affirmative action: a Pigovian tax on unhealthy foods, group-level interventions on the basis of sharing key health data, and personalized prevention tailored to specific individuals. In addition, they discuss the approach to implementation, including the role of an apex coordinating organization in setting standards for data and ethics, and evaluation of the effect of interventions to drive continuous improvement.     

Community health and foot health

The limiting factor in health and mobility for many seniors is the state of their feet. The origins of their foot problems can often be traced back to childhood and years of wearing badly fitting or inappropriate footwear. Well-fitting footwear is essential if mobility and independence are to be retained. The chiropodist (or podiatrist) is a health professional specializing in the treatment of conditions of the foot. Some common foot conditions, together with their treatments, are described. Although numbers of chiropodists in Canada are limited, their role is being increasingly recognized in maintaining or restoring mobility, and also their place in the community health team.     

Oral health and systemic health

Certain cancers, hypertension, diabetes, leukemia, gastrointestinal disorders, osteoporosis, and HIV and other infectious diseases can manifest themselves in the oral cavity. In addition, some of these conditions and the therapies for them can affect the teeth and mouth. This article outlines what physicians should know about how certain medical conditions and medications can affect dental health and treatment, how dentists can help detect underlying medical conditions, and how the two professions can better serve patients by working together. placement of implants, periodontal surgery, endodontic treatment, or subgingival manipulation. Physicians should be aware of potential complications from dental treatment, inform patients of the risks, and communicate to the patient's dentist about the patient's physical status, the extent to which his or her condition is under control, and how to prevent complications. The following examples illustrate the need for such interaction between physicians and dentists.