从医疗保险制度考察城市居民医疗服务的不平等问题

文章通过对城市医疗保险制度的考察,分析过去20年城市实行医疗保险方案改革的经验,以及城市医疗保险制度在医保筹资和获取的公平性、服务提供的有效性方面的影响,探讨了新医疗保险政策的公平和效率含义及提高城市居民医疗服务公平性的挑战与机会。     

老年人社会照料和医疗服务使用的不均等性分析

文章利用集中指数(CI)及其分解方法衡量了中国老年人在社会照料和医疗服务使用中的不均等性,以及各因素对不均等的贡献率。结果表明,相对于医疗服务,老年社会照料使用中存在明显的由非需要类变量引起的亲富人不均等,各因素对二者不均等性的影响方向基本一致,其中收入和城乡分布是不均等的主要根源,社区服务和保险等因素也都表现出了不同的影响和变化趋势。作者建议按照老年人的实际需要分配照料服务资源,并将老年服务纳入城乡和地区均衡发展战略。     

Measuring Disparities in Access to Health Care: A Proposal Based on an Ex-ante Perspective

Social Indicators Research - We provide a novel approach to evaluate access to health care based on the monetization of access barriers individuals face. This approach allows to distinguish the...     

医疗体制改革与社会医疗保险基金合理利用原则的研究

中国医疗体制改革是社会主义经济体制改革的重要部分。中国的公费和劳保医疗制度为保障人民健康 ,做出了巨大的贡献。然而 ,4 0多年的实践证明 ,这种公费医疗体制不适合社会主义市场经济体制改革的趋势 ,所以导致了一系列的问题 ,如 :医疗费用激增 ,医疗服务质量下降 ,医疗机构配置不合理 ,以及医疗资源的浪费等。本文在医疗保险基金的筹资—利用系统中 ,分析了改革试点各种统账方式的利弊。在了解了医疗基金的性质、特征及支付管理内容的基础上 ,探讨了中国医疗保险基金支付方式的原则 ,分析了总额预付制在现阶段实施的可行性 ,为合理利用医疗保险基金的原则提出了较基础的评价     

中国老年人社会养老服务利用的影响因素

社会养老服务供需失衡问题日益受到关注,以往学者大多从供给侧或界面障碍的角度进行研究,在此从需求侧角度关注社会养老服务利用的规律性.文章基于“生物人—经济人—社会人”的多元人性假设理论提出研究思路和假设,并使用2014年“中国老年社会追踪调查”(CLASS)数据,应用多元线性回归方法对1568位具有社会养老服务利用行为的老年人数据进行分析.研究发现:老年人的生理属性、经济属性和社会属性对其社会养老服务利用具有显著影响,社会养老服务利用呈现出“亲知识分子”、“亲中高收入群体”和“亲社会资本”的倾向;城乡老年人社会养老服务利用的影响因素存在显著差异,农村老年入主由其生理属性驱动,城市老年人则主由其经济属性和社会属性驱动.     

From Casual Work to Economic Security: The Case of British Columbia

Analysis of casual work in British Columbia is an important issue given that the increase in casual work has been greater in this province than in other provinces in Canada and given that the labour market has been substantially deregulated since 2001. In this paper, we analyse how individuals’ casual employment status affects their economic security based on a specially designed survey undertaken by the authors. We follow the ILO’s classification of the dimensions of economic security but, based on our findings, add a further dimension—Time security—As being of particular importance to casual workers. On the basis of these results, we analyse the policy interventions that might be necessary to increase the economic security of casual workers, policies which we suggest can best be conceptualized as providing a “security quilt”.

Responding to Social Service and Health Care Needs of Aging Women Veterans

ABSTRACT

This is a study about aging women veterans who served in the military during the 1940s, 1950s and 1960s. The Veterans Administration (VA) represents a formal network of health and support services that offers a wide range of benefits for veterans. However, older women veterans may not be aware of, or benefit from, all that may be available to them. The purpose of this study was to learn about aging women veterans' knowledge and utilization of services and benefits available through the VA. Telephone interviews were conducted in April 1998 with 220 women veterans in Massachusetts who were age 60 + years.

There was generally strong identification with veterans' organizations among the women surveyed. These women veterans were likely to receive medical care—a major benefit available through the VA. The benefits veterans were least likely to know about included services that may be particularly relevant and helpful to an aging veteran, such as long-term care and home adaptation services. Strategies are suggested to enhance outreach efforts to aging veterans.     

上海市贫困人口就医问题及对策研究

城市新贫困不仅构筑了社会经济发展的"陷阱",而且明显地损害了社会公正,影响了社会的发展,并对社会稳定构成了直接的冲击.目前,城市贫困家庭就医问题业已成为中国城市普遍面临的一项挑战.本文通过对上海市贫困家庭人口就医问题的调查,分析贫困人口就医问题现状与就医障碍,探讨了贫困人口就医问题的社会危害,提出了解决贫困人口就医的对策.     

Arts and the Perceived Quality of Life in British Columbia

The aims of this investigation were (1) to measure the impact of arts-related activities on the perceived quality of life of a representative sample of British Columbians aged 18 years or more in the spring of 2007, and (2) to compare the findings of this study with those of a sample of 1,027 adults drawn from five B.C. communities (Comox Valley, Kamloops, Nanaimo, Port Moody and Prince George) in the fall of 2006. Seven hundred and eight British Columbians responded to a mailed out questionnaire, and the working data set was weighted by age and education to match the 2006 census statistics for the province, yielding a fairly representative sample. Speaking quite generally, about 62.0% of the results for the two samples are very similar. In particular, in both surveys we found that (a) among arts-related activities in which people participate relatively infrequently (i.e., participation is counted in times per year rather than in hours per week), live theatre is supreme in the strength of its positive correlation with respondents’ perceived quality of life measured in 7 different ways, and (b) compared to 4 demographic variables (age, education, household income and body mass index), household income had the highest average, positive correlation with 7 different measures of respondents’ overall life assessments, namely, self-assessed general health, satisfaction with life as a whole (single item), happiness, satisfaction with the quality of life, satisfaction with life as a whole (5-item index), contentment with life (5-item index) and subjective wellbeing (4-item index). Different results were found in the province-wide versus the five-communities survey for the following, among other things, (a) compared to all 7 life assessment measures, for the province, satisfaction with the quality of life and happiness had the largest number of significant correlations with arts-related activities measured in hours per week engaged, while for the five communities, the single measure of satisfaction with the quality of life had the largest number of significant correlations, and (b) For the province, compared to all 7 life assessment measures, satisfaction with the quality of life had the largest number of significant correlations with arts-related activities measured in times per year engaged; for the five communities, compared to all 7 life assessment measures, self-assessed general health had the largest number of significant correlations with arts-related activities measured in times per year engaged.     

Exploring the Complex Associations Among Social Determinants of Health in Andalusia After the 2008 Financial Crisis

Social Indicators Research - In this study, we disentangle the complex relationship between structural and intermediary social determinants of health in Andalusia (Spain) after the period of...     

Alternative technology and quality of life: An exploratory survey of British Columbia smallholders

During the last decade there has occurred a significant demographic shift in North American society as rural areas become repopulated by urban-to-rural migration. Part of this migratory flow is the smallholding movement, families and individuals practicing near subsistence agriculture on small parcels of land. Central to the ideology of smallholding are the notions of simple living and technological self-reliance through the use of alternative technology (solar water heaters, windmills, greenhouses, etc.). In order to gain insight into the actual practice of smallholding, interviews with a small population of smallholders in southeastern British Columbia and southern Alberta were conducted. The data from the interviews are presented in terms of the correlations of a selected number of quality of life indicators with technical skill, technological use, attitudinal and demographic/structural factors. In general, commitment to the ideals of the smallholding movement were found to be positively correlated with quality of life and use of alternative technology, indicating that the smallholders may be a group where ideological commitment has a more consistent positive correlation with behavior and sentiments than have structural or material factors.     

The Determinants of Child Health in Pakistan: An Economic Analysis

This paper estimates linear structural models using LISREL and employs MIMIC models to find out factors determining child health in Pakistan. A distinction has been made in permanent and transitory health states that lend support to Grossman’s (1972) stock and flow concepts of health. The paper addresses the issue of health unobservability and finds out that latent variables using MIMIC models best represent underlying child health states. To overcome problems of poor income data, factor analysis is applied to extract measures of housing and durables as indicators of socio-economic well-being of children in Pakistan. The results of the study show that child health states, both permanent and transitory, are affected significantly by factors such as parental education, socio-economic conditions, and health care variables.     

Driven to Care: The Car,Automobility and Social Work

Abstract

Welfare practices are invariably represented in static and sedentary ways and their mobilities ignored. This paper corrects for this by examining the car and auto‐mobility in social work. The car is not just a means to reaching vulnerable children and other service users quickly, and a mobile office, but a space where significant casework goes on and deeply meaningful ‘therapeutic journeys’ happen. The car carries similar emotional meanings and possibilities for workers as a space within which to contain the anxieties and emotions they routinely confront in their work. Drawing on mobile social science and psychoanalytic theory, the paper shows how the power and meanings of auto‐mobility in ‘car therapy’ are products of the design of cars and the distinct rhythms and mobilities they produce in themselves. The car in social work is conceptualised as a ‘fluid container’ for the processing of personal troubles, emotion and key life changes. The theoretical implications of this argument for the social science of mobilities are drawn out.     

城乡差分与内外之别:流动人口社会保障研究

流动人口与流入地居民之间最主要的差异集中表现为社会保障福利和其他公共资源的获得。2005年全国1%人口抽样调查数据。分析结果显示,由于户籍类型造成的城乡差分及因户籍地引起的内外之别共同作用于个体社会保障的可获得性,三个人群的社会保障水平呈现出显著的梯级差别,乡-城流动人口处于农村人和外来人的双重弱势;而且,经济越发达,流动人口的社会保障水平越低;而在经济欠发达之地,他们与本地市民的差距较小,呈现出低水平融入的特点。这些发现表明,各级政府改善流动人口社会福利的努力在很大程度上受制于各地区现行的制度安排,而这些制约维系着不同身份人群之间在公共资源可及性和可得性方面的不公。     

High Rates of Access to Health Care,Disclosure of Sexuality and Gender Identity to Providers Among House and Ball Community Members in New York City

The House and Ball community is an important cultural manifestation of resiliency for Black and Latino gay and bisexual men and transgender women. Participants at the August 2013 House of Latex Ball in New York City were surveyed about insurance coverage, health care access, experiences in health care, and housing instability. The sample (n = 367) was 58% Black/African American and 20% Hispanic/Latino, with a mean age of 31. Fifty-five percent were gay and bisexual men. Although only 6% identified as transgender, nearly one half were gender nonconforming. Strong majorities had health insurance, were in regular medical care, and were “out” to their providers. Some were unstably housed and had recently exchanged sex for shelter or money. High rates of health care access and disclosure indicate resiliency and agency. Unstable housing and income insecurity may be structural drivers of vulnerability for this population to HIV infection and other health risks.     

Sexual Orientation and Sexual Health Care Needs: A Comparison of Women Beneficiaries in Outpatient Military Health Care Settings

ABSTRACT

The objectives of this study are to compare the sexual concerns, interest and experiences in discussing these concerns with their doctor for women of “Only Men” and “Some to Only Women” sexual orientation. A survey was mailed to women patients from two military outpatient settings, with 1,196 women responding. Of eligible respondents (N = 1,170), 90% reported “Only Men” and 10% reported “Some to Only Women” sexual orientation. Sexual concerns varied by sexual orientation, while interest and experience in discussing sexual concerns and desire for physicians to initiate the topic differed minimally. Women with “Some to Only Women” sexual orientation have both similar and differing sexual concerns compared to “male-only” oriented women. Larger primary care patient-based studies of sexual health care needs of sexual minorities are needed.     

我国居民初婚前同居状况及影响因素分析

文章分析2014年中国家庭追踪调查数据,考察我国男性与女性初婚前同居的状况及其影响因素.结果表明,我国居民中具有初婚前同居经历的比例约为10%,且这一比例在较年轻的群体中更高.在最近结婚的人群当中,同居比例达到1/3以上.根据发展范式这一理论框架,结合我国的社会情境,文章提出,人们观念的改变与制度的变化是造成我国同居比例上升最主要的推动力.多元回归分析的结果表明,出生世代、教育程度、城市生活经历、流动经历、党员身份和居住地经济发展水平这些因素,对我国居民是否具有初婚前同居的经历均有着显著的影响.文章对同居的分析能够帮助我们更好地理解当前我国初婚年龄的推迟等婚姻与家庭领域中发生的变化.     

Economic and Social Determinants of Human Development: A New Perspective

The aim of this work is to determine the factors affecting development, not only the economic ones, which play a central role in economic literature, but also social. To do so we have used a wide sample of countries and have estimated a panel data for 171 of those that have been members of the United Nations for a period of 16 years (from 1995 to 2010 inclusive). The results obtained allow us to conclude that fight against poverty, provision of basic infrastructure, and investment in greater democracy, greater stability and less corruption, have, in all cases, a positive effect on human development in these countries.