公平--创建和谐社会的卫生政策价值取向

在创建社会主义和谐社会的过程中，公平的卫生政策对于确保全国人民的健康具有重大的社会意义，而且公平的卫生政采也是和谐社会的应有之意。通过描述我国卫生政策的不公平现状，进而提出了实现卫生公平，创建和谐社会的公共政策选择。     

Recommendations for responding to changes in reimbursement policy

With profound changes in reimbursement policy on the horizon, organizations are preparing a variety of responses to ensure long-term success. Most are anticipating decreases in reimbursement rates from most payers. Whether due to nonpayment for hospital-acquired complications and infections, reductions due to high readmission rates, or a move toward value-based purchasing and bundled payment models, the impact is predicted to be substantial. Because of these sweeping changes, organizations must quickly prepare a thoughtful, effective response to ensure their financial stability. At the heart of these global changes in reimbursement, including those in the healthcare reform legislation, is a drive toward integration, the formation of integrated delivery systems in response to changing financial incentives. However, the new integrated systems must be not just an assemblage of the required components, but a true functional integration in which patients experience a seamless continuum of care that is highly coordinated, efficient, effective, and accessible. In this article, we'll address changes in reimbursement and recommended responses from three perspectives. First, we offer a three-pronged approach for managing general decreases in reimbursement. Second, we highlight strategies for managing nonpayment for readmissions, focusing on the demonstration project in the state of Michigan, MI STAAR. And finally, we review managing patient care in an environment of bundled payment, including the interventions at the center of the PROMETHEUS demonstration project.     

和谐社会的精神健康及其政策选择

人的身心健康和全面发展是和谐社会的基本特征,只有科学防治精神疾病,有效促进全民精神健康,依法保障病患群体的基本人权,切实维护家庭和谐、社区和谐,才能构建安定有序的和谐社会。作者简述了和谐社会精神健康的内涵,指出精神健康问题首先是一个公共卫生问题,国家和政府应当高度重视精神健康工作,积极创新精神健康政策,努力营造良好的政策环境,科学防治精神疾病,有效促进全民精神健康和共享和谐社会。     

Lowering the barriers to consumer-directed health care: responding to concerns

Consumer-directed health care is a potentially promising tool for moving toward more efficient use of health care resources. Tax policy has long been biased against health plans with significant patient cost sharing. Tax advantages created by health savings accounts (HSAs) began to change that, and proposed tax reforms could go even further. We assess various critiques of these plans, focusing on why they benefit not just the healthy and wealthy. Lower costs and more efficient health spending would help all patients and reduce uninsurance. Potential negative distributional effects are important but can be remedied more efficiently without distorting insurance design.     

The health society: importance of the new policy proposal by the EU Commission on health and consumer affairs

As health expands in modern societies, the role of the citizenin health gains increasing importance. This role has many facets:as an individual who takes care of her own health, as a consumerin the health market place, as a patient in the health caresystem, as a voter on health care issues, and as a social activistor volunteer together with others in Non Governmental Organizationsand social movements. In this context, the access to knowledge and information playsan ever-larger role in managing health and disease. Health systemsand health plans are becoming more complex to navigate, treatmentoptions need to be considered, complex drug regimes need tobe adhered to, living wills need to be drawn up, and healthylifestyles need to be lived. Every visit to the supermarketdemands health choices, every decision to take the car ratherthan     

卫生政策循证方法探讨：如何在特定环境下评价政策干预效果

政策干预主要体现在政策执行过程中,其受外部环境和内部环境的影响.卫生政策实施的外部环境包括自然环境和社会环境,内部条件包括政策本身、政策执行主体、政策执行客体和政策执行资源,对政策效果进行评价时除了要考虑这些环境因素外,还应该考虑科研研究的局限.系统综述评价一个卫生政策干预措施的效果方法:首先,应该判断政策措施有效还是无效;其次,应该判断政策干预措施与什么相比是有效的;第三,应该判断政策干预措施对谁有效;第四,判断政策干预措施效果的大小.     

Ethics in American health 1: ethical approaches to health policy

I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy.     

构建和谐社会视野下的医疗公正与宏观卫生政策

公正是科学发展观的重要内容,是卫生系统的主要价值取向,实现公正是医药卫生界的神圣职责。自从医疗保健政策向"经济导向型"方向转变之后,国家大幅度减少了对卫生事业的投入,医院必须从病人身上取得卫生发展必要的资金,医药费用上涨是必然的,也就失去了公平和公正。在今后的深化改革中,必须强调医学目的,贯彻以人为本的指导思想,加大政府的投入,围绕公正目标,建立覆盖全民的医疗保障体制。     

Role of state health agencies in responding to AIDS

State health agencies have assumed a leadership role in responding to the major public health issues raised by the AIDS epidemic. Directors of State health agencies (State health officers) have asserted their influence at the national level as well as at the State level. The Association of State and Territorial Health Officials (ASTHO), and especially ASTHO'S AIDS Committee, has served as the primary vehicle through which State health officers communicate their views to the Federal Government and vice versa. To date, ASTHO has held four national conferences on AIDS. Each one has brought together Federal, State, and local officials, advocacy groups, and other public health experts, and each has resulted in practical recommendations to public health departments on how to implement their AIDS programs most effectively. Although State health agencies have responded differently to the epidemic, many have adopted innovative, and sometimes unpopular, approaches. State health agencies' responses to the AIDS epidemic are governed partly by environmental factors, including the views of political leaders in the State, the strength of concerned advocacy groups, and the number of AIDS cases in the State. Despite their different approaches, State health officers have agreed that education is the most important tool in their programs to prevent human immunodeficiency virus (HIV) infections. The rapidly changing AIDS epidemic has required State health agencies to be flexible in their approaches to controlling the epidemic. State health officers' evolving views about HIV testing and partner notification are two examples of how new information about the epidemic has affected States' HIV control programs.