新农合对四川藏区的减贫效应分析

The New Rural Cooperative Medi-cal System ( hereafter NRCMS) in Tibetan areas of Sichuan was started in Wenchuan in 2005 , and by 2008 covered all of the province’s Tibetan areas. This paper studies the effects of the NRCMS on im-proving the health of and alleviating poverty for farmers and herdsmen in Tibetan area of Sichuan. Most parts of the Tibetan areas of Sichuan are located in high altitude districts. Thirty two coun-ties of these areas are classified as “National Pov-erty Counties”. Poverty and disease go hand in hand in these regions. Kashin-Beck disease and hydatid disease are the major endemics in the pas-toral and agro-pastoral areas of Sichuan. Endemic, infectious and chronic diseases are widespread in Sichuan’s Tibetan areas. More than 70% of pa-tients are workers from 20 to 60 years old. Disea-ses are more prevalent in women than in men. Kashin-Beck disease and hydatid disease are cur-rently incurable. Patients suffer from health prob-lems, which leads to a decrease in their income and the heavy burden of medical expenses. The new rural cooperative medical system alleviates the negative effects of farmers’ falling into, or back in-to poverty due to disease. However, the existing medical compensation mechanism is not sufficient to solve the problem. The greatest impact of NRCMS on the farmers and herdsmen in Sichuan’s Tibetan areas is that the system has gradually changed local people’s medi-cal behavior, as well as their underlying ideas a-bout medicine: they begin to believe in hospitals. In particular, more pregnant women are choosing to give birth in hospitals, which reduces the rate of infant mortality and postpartum diseases, and im-proves the health of women. Since the full coverage of the NRCMS in 2008 , the number of people participating in the system has reached the overall average level of Si-chuan province. By analyzing the data before and after the implementation of this system, and meas-uring the impact of the system on people’s health, it can be found that the NRCMS’s role in serving the vulnerable population, such as the elderly and infant children, is more marked. Since the implementation of the NRCMS, all administrative villages in Sichuan Tibetan areas have established village clinics, which solved the problem of a shortage of medicines and doctors in those areas. Farmers and herdsmen have conven-ient access to medical treatment, enhancing the ac-cessibility of medical service. After the implemen-tation of the NRCMS, the health of the elderly population in rural areas has improved. Infant mor-tality rates have dramatically fallen. The implementation of the NRCMS improved the medical service capacity of township hospitals and village clinics. And the NRCMS has brought the township hospitals and village clinics into its scope of compensation, which greatly promotes the utilization of primary medical services in Tibetan areas. The poverty reduction effect of the NRCMS can be analyzed from two aspects:Firstly, the im-
provement in health leads to increased income, be-cause good health can promote labor productivity. Meanwhile, the increase in income will in turn im-prove the overall level of health. Secondly, the in-patient and outpatient compensation rate is raised year by year, which reduces the medical fees of farmers, and prevents them from falling back into poverty.     

独立院校医学生人文素质教育分析与对策研究

人文素质教育对于医学生的培养不容忽视。由于我国现行医学生选拔和培养模式、独立院校校园文化薄弱和“三本”学生自身特点等因素影响,独立院校医学生人文素质教育有待加强。独立医学院校应从深化教学改革、提高师资力量、建设校园文化、增强临床教学等四方面入手,努力提高医学生人文素养,不仅有利于医学生的成长成才,也有利于缓和当前的医患矛盾,更有助于推动医疗卫生事业的和谐发展。     

新医改背景下医科大学生价值取向变化趋势及教育引导研究

新医改的价值目标是公益性,对于当前医科大学生价值取向的产生、形成具有重要导向作用。当前医科大学生价值取向出现了价值目标趋于功利化、迷失医学真正目的;医学技术至上、自身技术能力下滑;科研作风不够严谨,人文素质滑坡等趋势。因此,应从树立崇高职业理想,提升使命感和责任感;创新医德教育体系,强化思想政治教育育人功能;关注物质精神需求,提高从医幸福感等方面教育引导医科大学生树立正确价值取向。     

浅议医学院校化学教学改革的必要性

为了提高高等医学院校学生学习化学的兴趣,培养学生宽厚的知识面。笔者以医学院校的特点及化学教学中普遍存在的问题为出发点,讨论了如何通过教学改革的方法在基础教学中缩短教与学、理论与实践的距离感,激发学生学习化学的积极性、主动性,并结合自身教学经验对医学院校化学教学改革的必要性进行详细论证。     

论《侵权责任法》规定的医疗产品损害责任

《侵权责任法》规定的医疗产品损害责任,从性质上来说,既是医疗损害责任的一个特殊类型,也属于产品责任的范畴,适用无过错责任原则。其中第59条规制的适用范围包括有缺陷的药品、消毒药剂和医疗器械以及不合格的血液,但此适用范围应予以界定。在此界定内,导致患者损害的医疗机构、生产者所承担的赔偿责任才是《侵权责任法》第59条规定的医疗产品损害责任。     

医学生医德教育的困境及对策

医德是保证社会医疗卫生事业健康发展的一个重要因素,而关于医德方面的教育也是医学教育中的重要组成部分之一。可以说,医德教育的好坏直接关系到社会医德风尚,但是从目前的形势上来看,在我国现行的医学生医德教育中实际上是存在着许多问题的,医德教育很多时候都是在困境中前行的。因此在本文中作者在对医德教育其重要意义进行了阐释的基础上就医学生医学教育中存在的诸多问题进行了剖析,并就这些问题提出了相应的解决方案和应对策略,旨在以此为提高医学生医德教育的质量提供一定的参照和指导。     

城乡差异、就医惯性与老年人卫生服务利用

现有对城乡老年人卫生服务利用不公平的研究多忽略了长期的城乡差异所导致的隐性的农村老年人就医惯性的存在。本研究在控制了收入、医疗保障和就医可及性等因素的条件下,发现就医惯性的存在;并运用集中指数分解法发现,卫生服务的利用存在不公平,偏向于富人,而就医惯性在两种卫生服务利用中的贡献度分别为12%和5%。这种城乡固定差异造成了农村老年人在身体健康、心理健康和自我照料能力上都显著地低于城市老年人。     

知识经济与教育改革

本文通过对知识经济及其概念特征的剖析,揭示了知识经济时代对人的素质的基本要求。并由此提出了若干教育改革的方略和教育创新的要求     

我国目前医疗纠纷的赔偿现状及完善

《医疗事故处理条例》在解决医疗纠纷赔偿的司法审判实践的过程中,与民事法律、法规及司法解释存在着冲突。国际上关于医疗纠纷赔偿责任的性质的两种观点中,对患者的保护都不充分。应将未纳入医疗事故的部分医疗差错也纳入进来并给予赔偿,建立和完善专家库,允许并采纳司法鉴定机构对医疗纠纷进行过错责任鉴定。医疗纠纷绝大多数属于民事纠纷,对此我国已有完备的解决途径,如调解、仲裁、民事诉讼等,因此,作为行政法规的《医疗事故处理条例》没有必要再对这一民事纠纷加以规范,以免与现行的诉讼制度相矛盾。     

市场经济条件下医德建设的主要问题

我国社会主义市场经济的改革不断深入,市场经济的观念深入人心,并逐渐渗透到社会的各个领域,医疗卫生行业也不例外。在新的经济形势下,医疗行业中医德医风的建设也迎来了新的挑战,并暴露出很多问题。本文将以社会主义市场经济对医德建设提出的新要求为出发点,探讨我国在医德建设过程中出现的与市场经济的发展相关的主要问题。