医学生英语合作学习研究

合作意识与合作能力是现代社会和医学生未来工作的需要。通过对某医学院320名医学生的问卷调查,发现绝大部分被调查医学生能够清楚地意识到英语合作学习的重要性和作用,但缺少英语合作学习行为。对影响医学生合作学习的原因进行分析,并建议开展医学生英语合作学习,有助于提高医学生的合作意识、合作能力和专业英语水平。     

我国医疗体制改革对医疗机构的挑战及对策

本文讨论了我国医疗体制改革给医疗机构带来的挑战,分析了医疗服务及其营销组合的特点.在此基础上,从实施差异化战略和改进医疗服务质量管理的角度,提出了迎接挑战的几个对策性建议.     

Differences in Facilities' Acceptance of Patients Under Long-Term Care Insurance in Japan

Abstract

Objectives. In April 2000, Japan launched a public, long-term care insurance (LTCI) plan for elderly people who need support. This study describes how medical support for the elderly is delivered at LTCI care facilities in Japan now and gaps between system goals and current activity. Recommendations are made for enhancing the implementation of LTCI.

Methods. We mailed questionnaires to all health service facilities for the elderly (HSF) and special nursing homes for the elderly (SNH) located in the Kyushu area of Japan, asking whether they would accept patients with nine specific conditions.

Results. We found that HSFs, which are required to employ a full-time doctor and are reimbursed at a higher rate, accept significantly fewer patients with four conditions that need medical support than are accepted by SNHs, which are not required to employ a full-time doctor.

Discussion. In this study, we find discrepancies between system goals and current activities at LTCI care facilities. For the Japanese LTCI system to work well in the limitation of medical resources, we must understand how it really works and to reform the system continuously.     

医患冲突群体性事件中政府的角色失当及纠正--以“南平医闹事件”的解决过程为例

医惠冲突引发的群体性事件是社会转型时期社会矛盾在医疗领域的具体体现。政府作为社会公共秩序的维护者,在协调解决医患冲突中应发挥主导作用,但在现实生活中,面对医患冲突群体性事件,政府行为不尽如人意。以“南平医闹事件”为例,分析事件发生过程中政府的态度和行为,指出政府在解决医患;中突事件中存在角色失当行为,建议政府通过依法行政维护医疗秩序,促进医患关系和谐发展。     

Student Projects in Medicine: A Lesson in Science and Ethics

Regulation of biomedical research is the subject of considerable debate in the bioethics and health policy worlds. The ethics and governance of medical student projects is becoming an increasingly important topic in its own right, especially in the U.K., where there are periodic calls to change it. My main claim is that there seems to be no good reason for treating student projects differently from projects led by qualified and more experienced scientists and hence no good grounds for changing the current system of ethics review. I first suggest that the educational objectives cannot be met without laying down standards of good science, whatever they may be. Weak science is unnecessary for educational purposes, and it is, in any case, unlikely to produce good researchers in the future. Furthermore, it is curious to want to change the system of ethics review specifically for students when it is the science that is at stake, and when the science now falls largely outside the ethics remit. I further show that ethics review is nevertheless important since students carry a new potential conflict of interests that warrants independent oversight which supervisory support does not offer. This potential conflict may become more morally troublesome the greater the risks to the subjects of the research, and students may impose greater risks on their subjects (relative to professional researchers) by virtue of being inexperienced, whatever the nature of the project. Pragmatic concerns may finally be allayed by organizing the current system more efficiently at critical times of the university calendar.     

完善民族地区农村医疗保险制度的探讨

农村医疗保险制度对于改善民生,促进民族地区的和谐稳定起着有力的保障作用。但是当前我国民族地区农村医疗保险制度存在以下突出问题：特殊的自然条件和社会环境,导致较高的就医成本和风险;受传统文化和保健风险意识的影响,农村居民参合积极性不高;经费投入不足,医疗卫生资源和服务供给能力短缺;农村医疗保险保障水平低,运行监督不规范;民族地区农村居民的语言障碍造成了就医困难。文章针对这些问题提出了七个方面的对策。     

新农合“乡镇住院全报销模式”效果评估——基于桑植县的调查数据

基于桑植县的调研数据,以该县新农合参合人员报销案例最多的3种典型病例及其代表群体“医疗成本”作为依据,对参合农民乡镇住院全报销的免费医疗模式效果开展评价。在进行改制前后患者“医疗成本”比较,以及患者群体“医疗成本”的比较后发现：改革对农村小儿患者群体住院的医疗费用控制效果较差;对成人患者群体而言,虽报销费用明显增加,但受益被增加的自费开支项目抵消;农村老年患者医疗费用因报销费用提高而受益。     

当代中国农村合作医疗制度起源探论

合作医疗是我国农村广泛实行的一项医疗制度,自20世纪二三十年代产生,历经变革,至今仍在沿用.关于它的起源,多数学者认为是源自陕甘宁边区的医药卫生合作社,也有学者提出是形成于民国时期的农村卫生实验区.然而考察民国时期卫生实验区的发展以及国外的研究成果,可知合作医疗在中国的发展实际上有着更为复杂的背景.中国卫生医疗制度近代以来基本上是受到西方国家的影响,合作医疗制度也不例外,其中受东欧国家农村合作医疗制度的影响较大,同时其话语建构也蕴含了社会及文化的变迁.     

陕西省新农合保障能力综合评价——来自陕西省687户微观数据的调研

近年来,随着新农合制度的普及和国家对农村医疗事业投入的加大,农村医疗卫生保障能力有了显著的提高;通过对陕西省687户参合农民的调研表明,农民对新农合制度的保障能力整体评价较高,总体评价为具有“较强”和“很强”的就医保障能力的合计达65.37%。基于利益相关者理论,构建新农合医疗保障能力评价体系,结合熵值法和层次分析法进行指标权重的确定,利用模糊评价法对陕西地区新农合保障能力进行评价。结果显示该地区参合农民对新农合制度的就医保障能力整体评价为较强水平,定点医疗机构的保障能力评价为“较差”,地方政府机构和新农合经办机构的保障状况分别评价为“一般”、“较强”水平。结论认为,陕西地区要进一步提高新农合对农民的就医保障能力,应提高定点医疗机构的就医保障,健全医疗基础设施,提高医护人员的技术与服务水平,加强政府的监管力度。     

国外研究生教育模式对我国研究生培养的启示

总结发达国家研究生教育的模式和特点,分析影响我国研究生培养质量的主要因素,提出国外研究生教育模式对我国研究生教育的启示。