基于医疗质量的公立医院绩效体系构建研究

目的：运用德尔菲法构建一套科学、可操作的公立医院绩效评价体系。方法：采用文献法研究国内外绩效评价理论,结合问卷结果形成初始量表。通过德尔菲法对指标进行两轮筛选及优化。结果：初步形成由“社会效益”、“质量安全”、“运行效益与效率”为基本结构的指标体系,包括3个一级指标、13个二级指标和72个三级指标。结论：该指标体系重点关注医院公益性及内涵质量,对公立医院绩效评价具有一定参考意义。     

江苏省综合性医院临床医生对新医改认知研究

为了解江苏省综合性医院临床医生对新医改现状的看法,评价新医改在江苏省内的实施进展和效果,该研究选取了新医改部分重点问题,采用自设计问卷,调查江苏省内7家三级综合性医院和7家二级综合性医院临床医生,运用描述性分析和卡方检验辅助分析研究结果。发现66.5%的医生更希望政府医改经费投入能侧重于医务人员劳动收入;对家庭医生签约服务的认知度及成效评价低于分级诊疗及医联体建设;认为医患关系和看病难、看病贵问题略有改善的医生分别占20.3%、24.9%、27.9%。需正确认识医务人员认知差异及原因;重视医务人员权益、优化薪酬管理制度;加强家庭医生签约服务的宣传和推广;丰富医联体间活动形式;建立及时有效的临床医生反馈机制。     

农民工养老保险参与决策：一个OLG模型的考察

通过构建一个农民工追求跨期效用最大化的OLG模型,理论分析了均衡条件下农民工收入及风险偏好因素对其养老保险参与决策的影响;基于全国31个省市的调查数据,利用双变量Probit模型实证分析了个人与家庭特征、收入与土地、务工状况与预期等因素对农民工养老保险参与决策的影响。结果表明：务工与务农收入对农民工参与养老保险决策的影响并不显著,而恩格尔系数和非收入性因素却大多显著地影响了农民工的参保决策。为此,一方面,要提高农民工的收入水平、生活宽裕程度和支付能力,使之更有意愿和能力参与养老保险;另一方面,要增强农民工对未来生活确定性的预期和安全感,使之参与养老保险的水平得以提高。     

基于需要层次理论的保险代理人分类激励机制指标体系设计

针对保险代理人的具体情况和实际需求，将马斯洛的需要层次理论灵活地应用到实际当中，设计出一系列量化分类指标，运用数理统计方法，进行加权汇总后得出几个总值，对这几个总值的大小进行排序，根据排序的结果科学理性地将保险代理人分成若干类别，在对保险代理人管理过程中可以针对不同类别的代理人采取不同激励措施，进而有效而又低成本地解决保险业对代理人激励不力的问题。     

Does Iconicity in Pictographs Matter? The Influence of Iconicity and Numeracy on Information Processing,Decision Making,and Liking in an Eye‐Tracking Study

Researchers recommend the use of pictographs in medical risk communication to improve people's risk comprehension and decision making. However, it is not yet clear whether the iconicity used in pictographs to convey risk information influences individuals’ information processing and comprehension. In an eye‐tracking experiment with participants from the general population (N = 188), we examined whether specific types of pictograph icons influence the processing strategy viewers use to extract numerical information. In addition, we examined the effect of iconicity and numeracy on probability estimation, recall, and icon liking. This experiment used a 2 (iconicity: blocks vs. restroom icons) × 2 (scenario: medical vs. nonmedical) between‐subject design. Numeracy had a significant effect on information processing strategy, but we found no effect of iconicity or scenario. Results indicated that both icon types enabled high and low numerates to use their default way of processing and extracting the gist of the message from the pictorial risk communication format: high numerates counted icons, whereas low numerates used large‐area processing. There was no effect of iconicity in the probability estimation. However, people who saw restroom icons had a higher probability of correctly recalling the exact risk level. Iconicity had no effect on icon liking. Although the effects are small, our findings suggest that person‐like restroom icons in pictographs seem to have some advantages for risk communication. Specifically, in nonpersonalized prevention brochures, person‐like restroom icons may maintain reader motivation for processing the risk information.     

从“反”传统到“返”传统——以五四文人的“弃医从文"现象为例

五四的知识分子的经历大都有弃医从文的现象，以此为切入点来探讨这批知识分子在面对现代文明与传统文化时的复杂态度．并试图通过还原历史语境的方式来阐释出他们从反传统到返传统的逻辑理路。     

Constructing ‘disability’ in Myanmar: teachers,community stakeholders,and the complexity of disability models

This article explores Myanmar teachers’ and community stakeholders’ constructions of disability. We examine how various religious perspectives – particularly Buddhism – inform and shape understandings of impairment and how these beliefs intersect with a strongly medicalised construction of disability. However, in our discussion and exploration of the responses, we also found that the notion of two primary disability ‘models’ – namely the medical model and the social model – lack nuance, complexity, and socio-cultural consideration. Through examining teachers’ and community members’ perspectives of disability in Myanmar, we highlight the importance of socio-cultural variance in understanding local constructions of disability.     

The case of vegetovascular dystonia: inventing the most common Soviet disease

ABSTRACT

The paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general.     

医院青年文化品牌塑造的路径探析

青年是医院的未来,引导青年医务人员树立坚定而充沛的文化自信是激发其积极性、主动性和创造性的重要方式。常州市第一人民医院以涵养文化自信为着力点打造青年文化品牌“青之源”,通过营造学习创新氛围、建设团日活动体系、搭建阅读分享平台、探索涵养青年文化自信的品牌塑造路径等方式,动力、活力、能力三源合流,为青年成长提供正向激励和人文滋养。     

逆向选择条件下带奖惩金的两期保险契约模型及其Pareto改进性研究

为了更有效的规避影响保险市场交易效率的逆向选择问题，本文分投保人风险类型为两种和多种情形建立了带奖惩金的两期保险契约模型，首次提出可以用奖励金和惩罚金有效甄别投保人的风险类型。该模型根据投保人第一个保险期内的索赔情况在第二个保险期对其进行奖励或惩罚，高风险类型的投保人如果选择为低风险类型投保人设计的保险契约，则其在第二阶段受到惩罚的概率要远远大于得到奖励的概率，即风险越高的投保人越害怕惩罚金，因此所建模型满足斯彭斯-莫里斯分离条件。带奖惩金的两期保险契约模型中保险公司的期望利润仍然为0，并不会给投保人带来额外的经济负担，却能够实现对传统部分保险契约简单重复两次的严格帕累托改进。最后采用一个算例说明了该模型的有效性。