政府支出对医疗服务健康公平影响的比较和启示

医疗服务公平和人民的健康是各国卫生系统向其国家居民提供医疗服务所应实现的两个重要目标。但以英美日为例的发达国家根据世界卫生统计年鉴中的医疗服务公平性排名确有明显差距，因此，高收入和高政府医疗卫生支出与医疗卫生服务公平和健康公平性并没有必然关系。本文通过比较分析美日英国的政府间医疗卫生支出责任划分的结构发现高政府医疗卫生支出比例是提高医疗服务筹资公平性的前提，中央承担社会医疗保险责任是实现医疗服务筹资公平性的保证，政府特别是中央政府出资的长期护理有助于提高国民健康水平，地方政府的参与更有助于提高一国医疗系统机构数量特别是医院的数量。     

The Association Between the New Rural Cooperative Medical System and Health Care Seeking Behavior Among Middle-Aged and Older Chinese

The new rural cooperative medical system (NCMS) is the primary form of social insurance in rural China. This study aims to explore how the NCMS influences the health care seeking behaviors of middle-aged and older Chinese, considering the family and community contexts. A series of multi-level (three-level) models using data from the first wave of the China Health and Retirement Longitudinal Study (CHARLS) are used. We find that the presence of NCMS coverage has a statistically significant association with seeking inpatient and outpatient care but not physical checkups among middle-aged and older rural Chinese: Rural residents insured by NCMS were more likely to seek inpatient and outpatient care than people who were not insured. Other factors at the individual level (such as self-perceived health and number of doctor-diagnosed chronic diseases), the family level (such as living arrangements and household expenditures), and the community level (such as the presence of township hospitals within the community) are also significant predictors of health care seeking behaviors.     

发达国家对华输出电子废弃物的环境影响与对策

近年来,发达国家电子废弃物的流入给发展中国家的环境和民众健康带来了严重的危害。我国在阻止电子废弃物流入的相关法律规制与监管上存在漏洞,且经济发展战略不合理,发展水平相对落后。法律和经济方面的双重落差导致发达国家电子废弃物流入屡禁不止,迫切需要采取有效措施加以应对。分析国外电子废弃物涌入我国之现状与原因,并从法律制度建设、经济发展思路、经济发展战略、国内管理和国际合作5方面提出应对策略。     

Healthy Barbs: Activism Confronts Mortality

Barbara Brenner, JD, was the Executive Director of Breast Cancer Action (BCA) from 1995–2010. Before that, she was a longtime activist in the anti-war movement and an attorney who, for most of her career, practiced public policy law. After she was diagnosed with breast cancer in 1993 at the age of 41, she took the helm of BCA. Under her leadership, the organization moved into a position of national advocacy—demanding research on the causes and prevention of breast cancer, including the role of industrial pollutants. Barbara started the “Think Before You Pink” campaign, encouraging people to question whether companies that display pink ribbons actually produce products that harm women's health or generate any funds to fight breast cancer. Her blog, “Healthy Barbs,” challenged readers to critique routine healthcare practices and policies. Barbara received numerous awards, including a Jefferson Award for Public Service in 2007, the Smith College Medal in 2012, and the ACLU-Northern California's Lola Hanzel Courageous Advocacy Award in 2012. Barbara had a recurrence of breast cancer in 1996. She died of complications associated with amyotrophic lateral sclerosis, ALS, on May 10, 2013.     

Understanding end-user perspectives to enhance perceived value uptake of harm-minimization tools: considering gambler’s views of a pre-commitment system

Harm-minimization strategies reduce the experience of gambling-related harms for individuals and those close to them. Most policies and particularly discussions of tool design and implementation fail to involve end users and consider their concerns and needs. This study aimed to investigate the best way to introduce a harm-minimization tool for electronic gaming machines (EGMs) that will maximize the perceived value and subsequent uptake by the intended audience of gamblers. Focus groups were conducted with 31 Australian regular EGM gamblers experiencing a range of gambling problems. Participants were asked their perspectives of a pre-commitment system (features including accessing activity statements, setting limits, viewing dynamic messages, taking breaks), including concerns, and how to enhance perceived value and usefulness. Positive attitudes about the system were expressed; however, many gamblers saw the tool as relevant only for problem gamblers. Participants indicated that value could be enhanced by making the system flexible and customizable, but still easy to use. Design and implementation strategies such as incorporating flexibility in features, ease of use, appropriate terminology, and educational efforts may address gamblers’ concerns, particularly regarding privacy and potential stigma. This would enhance user perception of harm-minimization tools as relevant and may subsequently enhance effectiveness.     

医学专业毕业生择业观影响因素分析及其对策研究——以内蒙古民族大学医学院为例

通过对临床医学、护理学专业2010届120名本科毕业生的书面问卷调查,对少数民族高等院校医学毕业生的择业观影响因素、择业期望值、求职成功制约要素等进行分析,发现了少数民族高等院校医学毕业生的择业观呈现多元化;择业期望值脱离现实需要;择业心理复杂多样;就业心态存在城市情结;偏执心理、攀比心理、自卑心理等负面心理因素影响择业成功的事实,研究并提出了应对上述问题的对策。     

医学院校“思想道德修养与法律基础”课堂教学改革探索

医学人文教育应该贯穿于医学院校的全部教学环节当中,其教育目标和内容适宜融入"思想道德修养与法律基础"课程。在体现"基础"课教学大纲的基础上,依章节添加医学人文教育内容;并根据学科特点采用医学特色教学方法。新教学班级与传统教学班级的对比研究表明,新教学班级在课堂教学效果与期末考试成绩方面成效显著。     

Examining Outpatient Health Care Utilization Among Adults with Severe or Profound Intellectual Disabilities Living in an Urban Setting

Abstract

The present study examined the health status and outpatient health care utilization among 52 adults with severe or profound intellectual disabilities (IDs) living with their families or in group homes in New York City. Bivariate and regression analyses among demographic variables, medical conditions, health care utilization, and type of living situation were conducted. Findings indicate that demographic factors andhealth statuses were similar regardless of living situation, except for ageand the presence of Down Syndrome, that is, younger people and people with Down Syndrome were more likely to live with family than in group homes. The results indicated that regardless of where they lived, individuals had high rates (70%) of overweight/obesity. The mean number of internal medicine, specialty medicine, nursing, and total clinic visits were significantly higher for those living in group homes compared to those living with their families. The findings and their implications are discussed with respect to social work policy and practice.     

医疗技术管理的伦理建制

医疗技术的快速发展在促进人类健康的同时，也带来了许多道德风险，产生许多负面的社会问题。为了实现医疗技术的科技价值、经济价值与社会价值的平衡，应该建立和完善医疗技术的伦理评估制度，恢复医疗技术活动的人文关怀，加强医疗技术人员的责任伦理建设，建立和完善医疗技术的临床准入制度。     

Introducing a Phobia Program into a Community Mental Health Center

No abstract available for this article.