How do policy levers shape the quality of a national health system?

Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.     

The relationship between lifetime health trajectories and socioeconomic attainment in middle age

A large literature demonstrates the direct and indirect influence of health on socioeconomic attainment, and reveals the ways in which health and socioeconomic background simultaneously and dynamically affect opportunities for attainment and mobility. Despite an increasing understanding of the effects of health on social processes, research to date remains limited in its conceptualization and measurement of the temporal dimensions of health, especially in the presence of socioeconomic circumstances that covary with health over time. Guided by life course theory, we use data from the British National Child Development Study, an ongoing panel study of a cohort born in 1958, to examine the association between lifetime health trajectories and socioeconomic attainment in middle age. We apply finite mixture modeling to identify distinct trajectories of health that simultaneously account for timing, duration and stability. Moreover, we employ propensity score weighting models to account for the presence of time-varying socioeconomic factors in estimating the impact of health trajectories. We find that, when poor health is limited to the childhood years, the disadvantage in socioeconomic attainment relative to being continuously healthy is either insignificant or largely explained by time-varying socioeconomic confounders. The socioeconomic impact of continuously deteriorating health over the life course is more persistent, however. Our results suggest that accounting for the timing, duration and stability of poor health throughout both childhood and adulthood is important for understanding how health works to produce social stratification. In addition, the findings highlight the importance of distinguishing between confounding and mediating effects of time-varying socioeconomic circumstances.     

制约学校体育实施健康教育的诸因素分析

本文主要对影响学校体育实施健康教育的因素进行了分类研究 ,为学校体育实施健康教育提供科学的参考依据。     

试论心理健康教育是思想政治教育的重要组成部分

心理健康教育定位不当是思想政治教育长期效果较差的重要原因之一.文章分析了心理健康教育和思想政治教育的关系,认为现代思想政治教育应包括思想教育、政治教育、道德教育和心理教育四个方面,其中,心理教育是基础.心理健康教育是最初级、最低起点的教育,同时又是最深层次的教育.因此,心理健康教育是思想政治教育的重要组成部分.     

高等教育制度改革后贫困大学生心理健康问题浅析

本文阐述了高等教育制度改革后贫困大学生的心理健康问题,分析了贫困大学生心理健康问题的原因,并提出了化解贫困大学生心理健康问题的对策。     

高校《体育与健康课程》构建与发展研究

通过对高校学生体质与健康状况资料的分析 ,认为健康教育应作为高校体育教育的首要任务 ,坚持以人为本 ,“健康第一”。并就《体育与健康课程》的内涵、课程体系的构建及发展进行了探讨和研究     

平教会定县实验中的农村卫生工作之考察

中华平民教育促进会定县实验区在二十世纪三十年代创立了一套由村保健员、乡保健所、县保健院组成的三级卫生保健网,并在学校卫生、妇婴保健、传染病预防和疾病治疗等方面做出了显著的成绩,在当时产生了广泛的影响,对我们今天来说仍值得借鉴。     

Pathways between education and health: a causal modelling approach

Summary.  The association of poor education and poor health has been consistently observed in many studies and in various countries. Thus far, studies examining the mechanisms underlying this association have looked at only a limited set of potential pathways. This study simultaneously examines six distinctive pathways, which have been hypothesized to link education and health and found support from previous studies. A causal analysis of education and health was performed using structural equation models. Data were used from six phases of the National Child Development Study, which is based on following up an initial sample of 17416 children who were born in 1958. The association between education and health appears to be explained by a combination of mechanisms: adolescent health and adult health behaviours for men and women, adult social class among men and parental social class among women. We conclude that improvements in population educational attainment may not automatically lead to improvements in population health, and that health policies for improving health and reducing health inequalities need to target specific causal pathways.     

“健康丝绸之路”构建的“政府—社会”复合路径

借鉴社会运动理论,可探索一种融合了政府自上而下和社会自下而上进程的“政府—社会”复合路径,以构建“健康丝绸之路”。社会运动理论的三种视角可为这种复合路径的具体实施与需要关注的环节带来重要启发：首先,当前新冠肺炎疫情的跨国传播暴露了全球公共卫生治理体系存在的严重不足,凸显出构建补充型国际卫生合作模式的必要性与紧迫性;其次,推进“健康丝绸之路”的构建,需要政府和社会层面的协作,将“一带一路”沿线国家的资源充分调动起来,形成优势互补与资源共享。与此同时,要推进健康话语体系的完善,如倡导和促进“人类卫生健康共同体”理念的传播,通过话语和心理共鸣等民心相通的途径,促使国际社会采取联合行动以共同应对全球公共卫生危机。     

Physician perceptions of medical malpractice and defensive medicine

Using judgments obtained in interviews with 33 Massachusetts physicians, the annual statewide volume of expenditures incurred for defensive medical reasons in 1982 was estimated to be $1.0 billion, 12% of all medical care expenditures. Estimates for the nation were $37 billion, 14% of expenditures. Nationally, 180,000 cesarean deliveries were thought to be performed for defensive motives. In their own institutions, respondents judged 43% of all skull x-rays following injury to be medically justified, 30% to be defensive medicine, 16% to be placebos, and 11% to be physician misjudgments. In considering the economic and noneconomic costs of medical malpractice procedures, the dollar costs of insurance were considered most serious, followed closely by defensive medicine, unfairness, and poorer relations with patients. Thirty-two percent of the responsibility for the negative aspects of malpractice processes was assigned to lawyers, 21% to physicians, 18% to legislatures and courts, 16% to patients, and 13% to insurance companies.