Patient satisfaction with health care providers in South Africa: the influences of race and socioeconomic status.

OBJECTIVE: The first democratic government elected in South Africa in 1994 inherited huge inequalities in health status and health provision across all sections of the population. This study set out to assess, 4 years later, the influence of race and socioeconomic status (SES) on perceived quality of care from health care providers. DESIGN: A 1998 countrywide survey of 3820 households assessed many aspects of health care delivery, including levels of satisfaction with health care providers among different segments of South African society. RESULTS: Fifty-one percent (n = 1953) of the respondents had attended a primary care facility in the year preceding the interview and were retained in the analysis. Both race and SES were significant predictors of levels of satisfaction with the services of the health care provider, after adjusting for gender, age, and type of facility visited. White and high SES respondents were about 1.5 times more likely to report excellent service compared with Black and low SES respondents, respectively. CONCLUSION: In South Africa, race and SES are not synonymous and can no longer be considered reliable proxy indicators of one another. Each has distinct and significant but different degrees of association with client satisfaction. Any assessment of equity-driven health policy in South Africa should consider the impacts of both race and SES on client satisfaction as one of the indicators of success.     

Smoking practices in New York City: The use of a population-based survey to guide policy-making and programming

To inform New York City’s (NYC’s) tobacco control program, we identified the neighborhoods with the highest smoking rates, estimated the burden of second-band smoke exposure, assessed the early response to state taxation, and examined cessation practices. We used a stratified random design to conduct a digit-dialed telephone survey in 2002 among 9,674 New York City adults. Our main outcome measures included prevalence of cigarette smoking, exposure to second-hand smoke, the response of smokers to state tax increases, and cessation practices. Even after controlling for sociodemographic factors (age, racelethnicity, income, education, marital status, employment status, and foreign-born status) smoking rates were highest in Central Harlem and in the South Bronx. Sixteen percent of nonsmokers reported frequent exposure to second-hand smoke at home or in a workplace. Among smokers with a child with asthma, only 33% reported having a no-smoking policy in their homes. More than one fifth of smokers reported reducing the number of cigarettes they smoked in response to the state tax increase. Of current smokers who tried to quit, 65% used no cessation aid. These data were used to inform New York City’s smoke-free legislation, taxation, public education, and a free nicotine patch give-away program. In conclusion, large, local surveys can provide essential data to effectively advocate for, plan, implement, and evaluate a comprehensive tobacco control program. Dr. Mostashari (the guarantor) made substantial contributions to the conception, design, and supervision of this paper, the analysis and interpretation of data, the drafting of the paper, critical revisions of the paper for important intellectual content, and the acquisition of data and funding for this research. Dr. Kerker made substantial contributions to the analysis and interpretation of data, the drafting of the paper and critical revisions of the paper for important intellectual content. Ms. Hajat made substantial contributions to the acquisition of data and critical revisions of the paper for important intellectual content. Dr. Miller made substantial contributions to the conception of this paper and critical revisions of the paper for important intellectual content. Dr. Frieden made substantial contributions to the conception, design, and supervision of this paper and critical revisions of the paper for important intellectual content.     

我国内地医疗服务市场对外开放的政策回顾及走势

回顾了我国内地医疗服务市场对外开放的政策历程 ,并探讨了其发展趋势 :营利性和非营利性医疗机构公平竞争的局面将形成、非内地资金开办的大型非营利性医疗机构打响医疗市场争夺战、与国际接轨 ,最终形成以人为本、以市场为导向的医疗服务模式和理念     

ABC分类法在医疗用品库存管理中的应用

结合医院库存用品的特点和特殊的经营性质,在阐述重点库存控制-ABC分类法的思想和操作步骤的基础上,提出了该方法在医院实际应用中应该注意的问题.     

中国民营医疗机构的现状与发展前景

作为新生事物的民营医疗机构，在我国医疗卫生服务体系中有着特殊的地位，在医疗卫生改革中也发挥着重要作用和积极效应，但由于多种因素并不能形成期望的竞争局面。要在我国医疗市场打破公立非营利性医院的垄断地位，发展多样化、多种形式办医模式，形成公平、有序的竞争，卫生行政部门要充分认识到民营医院的社会功能，在政策上积极扶持，引导其健康发展。     

Complexity of Family Life Among the Low‐Income and Working Poor: Introduction to the Special Issue

Like all families, low‐income and working‐poor families need economic stability, safety, good health, and engagement in the larger community. However, the complexity of their lives is greatly impacted by limited economic resources. Three primary themes are explored by the 12 articles in this special issue: competing stressors and tensions, effective parenting, and economic stability and financial decision making. Key findings and program and policy implications identified by each set of authors are discussed. This body of work provides research‐based practice and policy suggestions to guide future efforts in partnering with families to strengthen their families and communities for successful enhancement of child well‐being.     

陕西省农村医疗机构现状研究

本研究采用定性与定量方法分析陕西省农村医疗卫生机构现状。研究表明，陕西省农村卫生组织仍不能适应农村经济发展和群众医疗保健需要，与全面实现小康和基本实现现代化的目标还有相当大的差距。一是农村卫生经济政策贯彻不力。二是农村卫生人员素质不高，学历结构不合理。高学历比例太低，无学历占18．36％。三是农村医疗保障制度改革滞后。四是管理体制和运行机制改革亟待深化。     

关于构建小康社会医疗保障体系的政策建议

根据党的十六大提出的“全面建设小康社会”的宏伟目标，提出构建小康社会医疗保障体制的政策建议：从单一的医疗保障向健康保障拓展；从单一人群向整体人群拓展。同时认为要树立协作观、处理好乡镇企业职工参保、基层操作层面的利用、药品目录的重新制定等问题。     

一种上下文集成的冲突处理方法

为了实现服务组合对环境的适应性,设计了能满足上下文动态集成的模型,并使用CC/PP的RDF创建P rofiles描述上下文。详细分析上下文集成中出现的冲突情况,定义优先级和效用因子,解决上下文集成中的冲突问题。结合原型系统进行测试,并给出了实验结果。研究结果表明:在不同的冲突策略情况下,该方法能在可接受的时间内解决冲突。     

社会医疗改革:我国药品集中招标采购的公共政策分析

药品集中招标采购作为我国从计划经济向市场经济转轨过程中对药品流通体制推出的一项重大改革,改变了过去几十年来业已形成的药品产、供、销等各方面的利益分配格局,关系到医疗卫生事业、医药经济发展和社会医疗保障管理体制的大局。目前,该项政策在实施过程中暴露出药品零售价格中医疗机构利润虚高不下,招标成本转嫁等种种缺陷。基于这样的背景,本文运用公共选择理论中特殊利益集团和政府失灵理论分析问题产生的成因,评价这项政府政策行为的实施效果,力求从建立合理的分配机制、调动和保护各方面积极性的角度,提出合理的改进建议。