国内外医务人员职业满意度比较

目的 对国内外医务人员职业满意度进行比较分析,以期了解国内外差异,及时发现不足之处,为提高医务人员职业满意度提供理论依据.方法 以文献研究、小组讨论为主要研究方法,从定义、理论基础、测评量表、满意现状等方面对国内外医务人员职业满意度进行比较研究.结果 国内外医务人员职业满意度在定义、理论基础、测评量表和满意度现状等方面存在一定差异.结论 我国应借鉴国外的先进经验,去粗取精,有效提高医务人员的职业满意度.     

工作负荷与期望收入指数对医务人员薪酬满意度的影响

目的:探讨工作负荷、期望收入指数对公立医院医务人员的薪酬满意度的影响。方法:2020年10月15日至11月10日,采用国家卫生健康委卫生发展研究中心制定的薪酬制度改革监测公立医院医务人员调查表,就工作负荷、实际收入、期望收入及薪酬满意度等对四川省21个地市(州)120家薪酬改革试点公立医院的8 651名医务人员进行问卷...     

医务人员收入分配不公的问题与对策

收入分配上不等量劳动平均分配和等量劳动不等量分配都同属于分配不公问题。本文仅就医院奖励基金的分配相差悬殊,造成分配不公的问题探讨如下。一当前医疗机构内部的不同科室、不同医务劳动者之间,等量劳动而奖金收入相差悬殊是普遍存在的现象,尤其是市级以上医院     

医务人员薪酬制度主要问题与对策

本文对我国医院医务人员薪酬制度现状进行分析,提出整体水平低、薪酬差距大、标准太陈旧和结构不合理等问题,并提出了相应的解决办法,以期对健全和规范医务人员薪酬管理,提高医院运行效率和经济效益提供借鉴。     

江苏省医务人员收入现状调查分析与建议

通过调查与分析江苏省医务人员的平均月收入水平、医务人员对自己收入的评价与看法等方面的情况,建议政府关注医务人员队伍的稳定性,加大政府投入,适当提高医疗服务价格;建议医疗卫生机构完善岗位绩效工资分配办法,提高医务人员的满意度。     

公立医院医务人员薪酬外部公平的宏观困境

目的 了解制约公立医院医务人员薪酬外部公平实现的宏观必要因素现状,探讨卫生改革者可改善之处。方法 通过比较分析,对劳动力市场成熟度、岗位薪酬落实度、薪酬调查制度透明度、信息系统完善度、社会氛围诚信度、资金投入充沛度等必要宏观条件发展现状及不足进行剖析。结果 现具备高成熟度劳动力市场及其薪酬调查制度,但在岗位薪酬落实程度、信息系统完善程度、社会氛围诚信程度、资金投入充沛程度方面存在不足。结论 公立医院医务人员岗位薪酬的落实,特别是薪酬内部公平与个人公平的实现,是卫生改革者可改善之处,其余问题还需政府、社会的多方协作解决。     

西部地区乡镇卫生院医务人员薪酬满意度及其影响因素

目的 :通过对乡镇卫生院医务人员薪酬满意度及其影响因素的分析,提出符合我国西部农村基层卫生特点的相关薪酬建议。方法 :选取青海和广西4个县的34所乡镇卫生院及其中213名医务人员进行调查,并采用描述、单因素分析、多元回归等统计方法对调查结果进行分析。结果 :西部调查地区乡镇卫生院医务人员2012年的年均薪酬水平为36 483.13元、年平均薪酬从2008年到2012年增加了12 730.43元。薪酬整体满意度为(2.83±0.59)分,薪酬满意度4个维度间存在显著差异(P0.001),其中薪酬水平满意度最低(2.79±0.51)分,薪酬结构/管理满意度最高(3.11±0.65)分,薪酬提升满意度(2.96±0.55)分和福利满意度居中(2.98±0.59)分。多元回归分析结果显示,"编制床位数"是薪酬满意度的负向影响因素,"乡镇卫生院人员核定编制数"及"月均出院人数"为正向影响因素,以上几项因素在西部地区特定条件下分别对不同薪酬满意度维度产生了显著影响。结论 :需要进一步加大针对西部地区基层农村卫生人员的财政支付力度,以提升现况低下的薪酬满意度水平,使卫生人才能够留用在基层。     

上海市医务人员薪酬制度的现状、问题及改革建议

建立科学规范的薪酬制度,是健全激励约束机制、调整优化生产关系、产生改革"红利"的关键措施,也是当前医改的一项重要内容。为建立适应卫生行业特点的医务人员薪酬制度,本文对2010—2012年上海市卫生事业单位薪酬水平进行调查,分析了现行绩效工资政策存在的主要问题。在此基础上,从适应卫生行业特点角度出发,通过建立医务人员薪酬水平与社会平均工资的联动机制,初步构建了包括全面预算管理、理论工作量核定、人员核定、绩效考核分配、行业内结构比例、分配资金管理等的医务人员薪酬制度框架,形成了上海市医务人员薪酬制度的理论框架。     

医务人员职业安全经济学研究进展与启示

目的 分析医务人员职业安全经济学在国内外的研究和发展现状,对我国医务人员职业安全经济学发展提出建议。方法 检索中英文数据库关于医务人员职业安全相关文献,并对检索文献进行筛选、分析和总结。结果 国外文献主要关注职业伤害的成本测算和预防措施的成本效益分析;国内文献聚焦于医务人员职业暴露因素分析及防护对策,而对经济学原理和方法视角下的医务人员职业伤害研究关注不足。结论 建议我国重视医务人员职业伤害以及因医务人员职业伤害产生的成本损失,从经济学角度积极开展研究,采用成本效益分析法为临床医疗提供最佳策略选择。     

汉川市不同特征医务人员幸福感调查

目的关注医务人员幸福感水平,为提高医务人员积极情感和工作效率,保证医疗服务质量和队伍稳定性提供参考。方法便利选取汉川市9所乡镇卫生院和市内3所二甲卫生院,应用问卷调查法对332名医务人员进行工作幸福感调查。结果医务人员幸福感9因子由高到低排序依次为：负性情感、健康关注、友好关系、自我价值、利他行为、生命活力、人格成长、正性情感、生活满意。结论为提高医务人员幸福感,建议从医务人员的待遇、排班安排、自身素质培养和医患关系等方面进行改善。     

Occupational Health and Economic Development in African Countries

Although industrialization has resulted in diseases associated with exposures to various substances, it has also produced enormous benefits. It should be possible in underdeveloped countries to plan a program of technological development that would insure maximum health benefits with minimum injurious consequences. Several examples of first-phase industrialization that would meet these criteria are furnished.     

Income Inequality, Trust, and Population Health in 33 Countries

Objectives. I examined the association between income inequality and population health and tested whether this association was mediated by interpersonal trust or public expenditures on health.Methods. Individual data on trust were collected from 48 641 adults in 33 countries. These data were linked to country data on income inequality, public health expenditures, healthy life expectancy, and adult mortality. Regression analyses tested for statistical mediation of the association between income inequality and population health outcomes by country differences in trust and health expenditures.Results. Income inequality correlated with country differences in trust (r = −0.51), health expenditures (r = −0.45), life expectancy (r = −0.74), and mortality (r = 0.55). Trust correlated with life expectancy (r = 0.48) and mortality (r = −0.47) and partly mediated their relations to income inequality. Health expenditures did not correlate with life expectancy and mortality, and health expenditures did not mediate links between inequality and health.Conclusions. Income inequality might contribute to short life expectancy and adult mortality in part because of societal differences in trust. Societies with low levels of trust may lack the capacity to create the kind of social supports and connections that promote health and successful aging.Social inequalities in health are closely aligned with individual differences in income. At every level of socioeconomic status, health tends to be better on the level above and poorer on the level below, even among those who are not poor and enjoy equal access to health services.^1,2 Research also shows that health problems that are associated with socioeconomic status are more common in societies that have wider distributions of personal income.³ It is well-documented that international differences in income inequality (i.e., size of the gap between rich and poor) are associated with rates of mortality⁴ and with various mental and physical health problems.^5–8Opinions are divided regarding the contextual mechanisms that might account for the association between income inequality and health. One line of research focuses on the psychosocial impact of inequality and the breakdown of “social capital,” which is defined as features of social organization—such as networks, norms, and interpersonal trust—that facilitate coordination and cooperation for mutual benefit.^2,9 Wilkinson, Kawachi, and others have suggested that large income differences intensify social hierarchies and increase class conflict and feelings of relative deprivation while simultaneously reducing levels of interpersonal trust, social cohesion, and other dimensions of social capital that promote health.^3,10–12 The alternative “neomaterialist” hypothesis suggests that income inequality inhibits public expenditures on important services and infrastructure that promote health.^13–17 In the United States, for instance, state expenditures on public health and education negatively correlate with income inequality and adult mortality.^13,16 It remains undetermined whether international differences in public expenditures account for the association between income inequality and health.The neomaterialist and social capital hypotheses are not mutually exclusive. Kawachi and Kennedy observed that US state populations with low levels of trust are also characterized by values that support a minimal role for government in reducing health inequalities.¹⁸ Putnam''s index of health and health care in the United States (which included expenditures on health care) was highly correlated with an index of social capital.⁹ Therefore, it could be the case that more equal, more trusting societies are also more willing to support government spending on goods and services that advance the common good, compared with less equal, less trusting societies.It is important to understand which factors account for the association between income inequality and population health. A piecemeal evidence base shows inconsistent findings for mediation by psychosocial and neomaterial paths. Inconsistencies among studies with regard to sample selection criteria, tests of mediated effects, and measures of income inequality have made it difficult to weigh the evidence in favor of either hypothesis.^11,19–21 As a result, previous claims that the relationship between income inequality and poor health is mediated by trust, social capital, or public expenditures²²—or that the relation is simply a statistical artifact caused by confounding effects of individual income,²³ race,²⁴ or education²⁵—have not all been based on rigorous tests of statistical mediation.One issue in particular muddies the water when testing mediated effects: small changes in a regression slope or correlation coefficient that occur when a third variable is controlled can easily cause the statistic to change from significance (P < .05) to nonsignificance (P > .05), even when the third variable does not account for a significant proportion of shared variance. Negligible change from significance to nonsignificance does not, in itself, establish mediation.²⁶ Kawachi et al. addressed this issue by using path analysis to show significant mediated effects of income inequality (via social capital) on mortality¹¹ and births to adolescents.²⁰ However, these studies did not include similar mediation analyses of public expenditures.There has not been a direct comparison of psychosocial and neomaterial paths in accounting for the association between income inequality and health. Therefore, my aim in the current study was to test the association between income inequality and 2 indicators of population health—healthy life expectancy and adult mortality—and then test how much this association was mediated by differences in a proxy indicator of social capital (interpersonal trust) and by public expenditures on health. Of course, trust is just a single aspect of social capital that could mediate links between inequality and health, and expenditures on services other than health might also relate to health. But by using a consistent set of data on income inequality and population health, I explored whether their association (if significant) was better explained by a psychosocial path or a neomaterial path. In disadvantaged populations, healthy life expectancy (also referred to as “disability-free life expectancy”) represents the burden of ill health better than total life expectancy does, according to the World Health Organization,²⁷ so I used healthy life expectancy as an indicator of population health. Adult mortality was used as a general indicator of population health.     

不同国家和地区学校卫生工作模式比较和借鉴

通过比较不同国家和地区学校卫生工作的建设和发展状况,运用归纳法和比较分析法总结各国学校卫生工作模式,分析各模式的特点和发展趋势。在此基础上,结合我国学校卫生工作的实际,借鉴国外理念和方法,提出相关建议。     

卫生事业发展状况的国际比较分析

依据世界银行和世界卫生组织的有关统计资料,对中国与世界其他人均收入水平相近的19个国家有关数据以及不同收入组国家平均数据进行了国际间横向比较分析,并针对其存在的主要问题,提出了优化中国卫生资源配置、促进卫生事业科学发展的政策建议。     

基于实证分析的我国经济收入与卫生费用关系的地区差异比较

目的:明确中国经济收入与卫生费用的关系,为提高卫生服务公平性提出建议。方法:以居民经济收入、卫生总费用与人均卫生费用为指标,对31省市进行聚类分析。结果:卫生总费用、人均卫生费用与地区经济收入不完全一致,政府卫生政策、卫生资源配置都会对卫生费用产生影响,经济收入并非卫生费用的唯一决定因素。结论:为提高卫生服务的公平性,提出如下建议:优化卫生资源配置,完善政府卫生财政转移支付制度,各类社会医疗保障制度,积极筹措社会资金等。     

典型国家生活垃圾分类的立法与启示

垃圾分类是对垃圾收集处置传统方式的改革,是生活垃圾资源化利用和处理处置的重要前置条件.20世纪70年代以来,国外许多国家已经逐步建立了一套完整的从国家到省市层面的立法、实施细则和技术指南体系,成为生活垃圾分类投放、收集和处理的有力保障.以欧盟、德国、新加坡和日本等典型国家(地区)为例,剖析了垃圾分类管理的法律法规及其实...     

Procedures, Treatments and Staff Roles in Occupational Health

This study examines certain aspects of the treatment componentof occupational health services in 20 organizations in Nottingham.The study has identified several factors which contribute tothe variation in the type of care given by occupational healthservices. The type of care provided by the occupational healthservice appears to be valued by management and employees andis characterized by easy access, continuity of care and rapidreturn to work. Simple effective care combined with reassuranceis provided for everyday problems. Issues of staff trainingand the role of the first aider are discussed. Accepted        1 November 1981 Dr J. Pearson, Department of Community Health, University of Nottingham, Queen's Medical Centre, Clifton Boulevard, Nottingham, NG7 2UH     

铁路系统不同岗位职工健康状况分析

目的掌握铁路系统职工高血压、血脂异常和脂肪肝的发病情况与岗位的关系。方法采用健康检查、血液生化检查、腹部B超检查的方法，对铁路系统从事站车工作、火车司机、火车乘警和机关工作者共5163人进行健康检查，统计高血压、血脂异常、脂肪肝的检出率，并分析高发病的影响因素。结果从事站车工作者和火车司机高血压的检出率为34．1％（1012／2970），高于火车乘警和机关工作者的24％（526／2193），P〈0．05。以上4种岗位职工，血脂异常和脂肪肝的总发病率为36．3％（1875／5163）和33．5％（1730／5163），发病率与岗位无关（P〉0．05）。但是火车乘警的血脂异常和脂肪肝的发病率为47％（564／1154）和46．5％（540／1154），明显高于其他3种岗位者（P〈n01）。结论铁路职工高血压的发病率高与长期精神高度紧张、大脑高度集中的工作岗位有密切关系；血脂异常和脂肪肝发病率升高与岗位关系不大。3种疾病均与不良的饮食、习惯有关。