医务社会工作者如何介入临终关怀

随着社会的不断进步,越来越多的人开始意识到医务社会工作在医院工作中的重要性。医务社会工作者从专业角度和人文关怀的角度介入临终关怀,在很大程度上提高了临终病人的生命质量。     

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ilitary Medical UniversityJournal of the Fourth Military Medical UniversityJournal of the Fourth Military Medical UniversityJournal of the Fourth Military Medical UniversityJournal of the Fourth Military Medical UniversityJournal of the Fourth     

“Trying to give birth naturally was out of the question”: Accounting for intervention in childbirth

Problem

Studies of women’s childbirth preferences repeatedly show that natural birth remains highly valued, yet the majority of births involve some form of medical intervention. Reasons for this lack of correspondence have typically been investigated through interviews and focus-groups with women. Relatively little research explores the ways in which women describe their experiences of childbirth outside of such research settings.

社会性别视角下医务工作者择偶观差异及其出路思考

性别平等政策自新中国成立以来已推行落实70载春秋,社会性别文化在逐渐嬗变,80、90后医务工作者的择偶观也随之发生变化。调查显示他们的择偶观存在性别差异,重感情、自主择偶成为主流,但女性示爱相对被动；重内在、平等式选择凸显,但斜坡式选择仍然存在；择偶范围差异不大,但两性受欢迎度和职业偏好显著。女性医务工作者做为健康中国的建设主体,经济独立自主,仍需平等的性别制度安排和社会性别文化的嬗变,消解其追求事业发展和家庭幸福的矛盾。     

我国医疗保障事业发展的历程和经验

我国医疗保障事业建立、改革、发展经过了计划经济体制下的单位保障、市场化改革背景下的医疗保险、全面建设小康社会目标中的全民医疗保障。发展我国的医疗保障事业必须以科学发展观为指导,将保障人民健康作为根本宗旨;医疗保障事业建设必须立足国情,与经济发展水平相适应;各项医疗保障必须要协调发展,积极推进医疗保障制度一体化;医疗保障与医药卫生服务体系建设必须要全面推进,深化医药卫生体制改革。     

推动医疗保障制度与预防疾病相结合的思考

针对国务院2009年3月在《医药卫生体制改革近期重点实施方案》中提出的＂最大限度地预防疾病＂的要求,分析了医疗保障制度与预防疾病相结合的必要性,认为这是提高医疗保障体系运行效率、提高居民健康水平、实现社会发展目标的需要。当前医疗保障制度与预防疾病相结合面临的主要困难有：政府投入不足、初级卫生服务体系不健全、医疗保障制度设计上有缺陷、人口老龄化及疾病谱的变化等。认为应该最大限度地发挥预防疾病的作用,建构以健康为中心的医疗保障体系。     

建设和完善山西省新农合信息系统的思考

随着新型农村合作医疗工作的不断深入,将管理信息系统引入到新型农村合作医疗的管理中已成为现实的必然要求。在对山西省新型农村合作医疗的现状和必要性进行总结的基础上,分析山西省新农合信息系统建设和完善应遵循的原则、策略规划,并就健全管理机制、建立信息互动、加强人员培训等方面提出建议。     

新型农村合作医疗制度建设绩效评价

文章以分析新农合建设模式与目标为基点,利用2009年中部四省12个县的调查数据,从农民的“主观感受”和制度实施的“客观效果”两个层面,对新农合建设绩效进行了分析和评价。研究发现,新农合的福利性得到了大多数农民的认同,但补偿率较低,农民满意率也较低;新农合的福利效应比较明显,但保障能力有待提高;新农合存在的主要问题,不是宏观制度设计而是微观运行机制的问题。提升新农合建设绩效,应合理调整起付线、封顶线和补偿比例以提高农民的受益率;加强监督管理,重点防止医疗供方道德风险;加大财政投入,在精算的基础上扩大筹资规模,重在基层医疗机构基础设施建设和人才培养等。     

Events,Politics and Patterns of Policy‐Making: Impact of Major Incidents on Health Sector Regulatory Reforms in the UK and Japan

This article examines the major malpractice incidents in the late 1990s through early 2000s in the UK and Japan, comparing how these incidents opened up pathways for a new type of hospital regulation in each case. Applying John Kingdon's three‐stream model of agenda‐setting and policy change, the article argues that governance arrangements as well as the policy instruments that a government has at its disposal determine how an event could be translated into a political agenda by throwing light on the problems within the public domain. The long‐term effect of such adverse events is therefore determined by how open the relevant institutional arrangements are, and is enhanced if actors constantly scrutinize the system by proactively setting the agenda. A higher level of political accountability in the UK led to British politicians taking a greater role in promoting patient‐led reforms than Japanese counterparts. However, a political system with clear accountability is more conscious of its own involvement and any potential blame it might receive for policy failures. Therefore, the political class could become more engaged in continuous reforms and the delegation of tasks rather than a constant search for remedial actions. The article sheds light on the interactive aspects of the particular triggering events discussed through the decade of regulatory developments in the two health‐care systems.     

民国医疗社会工作述评与当代启示

民国时期北平协和医院、南京的鼓楼医院、济南的齐鲁医院等医院相继成立社会服务部开展医疗社会工作。民国医疗社会工作起步不晚,但分布不广;以经济救助为主要内容,以个案工作为主要手段;与学校互动,实践与教学良性循环。民国医疗社会工作的开展凸显了以北平协和医院为代表的相关医院鲜明的人道主义精神和强烈的社会责任感。民国医疗社会工作对当代我国医疗社会工作的复苏与发展有着积极的启示意义。