农村生育卫生健康教育现状及需求调查

在福特基金会的资助下,国家卫生部在贵州,山西,河南,青海４省开展改善生育卫生服务项目研究,以促进当地的生育卫生水平提高。研究发现目前贫困农村地区健康教育活动开展较少,很难看到宣传材料,加上封建迷信旧风俗的影响,群众健康意识差,非住院消毒接生率和住院分娩率均很低,其原因不仅是经济落后,没有进行健康教育也是主要原因之一。农民对健康教育需求较高,如能实施有利于健康教育的政策,使农村健康教育顺利开展,对改     

卫生健康规划的内涵和现状研究

通过梳理我国“十三五”以来印发的卫生健康规划,分析卫生健康规划的发展现状及存在的主要问题。在此基础上,提出对新时期卫生健康规划的建议:构建卫生健康规划体系,明确各级各类卫生健康规划功能定位,保障卫生健康事业的顺利发展。     

卫生需求在社区卫生服务定位中的义理之辩

以居民卫生需求为导向是社区卫生服务的定位．但卫生需求存在概念的多义和模糊，以卫生需求为导向的定位实质上隐含市场机制含义。在澄清卫生需求概念的情况下，对医疗卫生需求和供给的经济特征进行充分的分析，推论出以卫生需求为导向的社区卫生服务不能推动医疗卫生活动向全民健康保障的目标前进。社区卫生服务的定位应该是为全民健康保障服务。     

世界发达国家和地区应对突发公共卫生危机措施及卫生检疫网络建设概况(连载一)

本文简要介绍了世界发达国家和地区应对突发公共卫生危机措施及卫生检疫网络建设情况，其中有些经验值得我们学习和探讨。     

社区卫生服务需要量及需求量测算方法研究

运用健康需要法、需求法、工时测算法对社区卫生服务需要及需求量进行了研究，为探索合理的社区卫生服务需要量及需求量测算方法，制定城市社区卫生人力规划提供依据。     

论农村卫生事业的发展与卫生政治学

卫生工作具有政治性,发展卫生事业必须讲政治。一个国家整个人群的健康不是取决于单个的公民或医生,而是取决于社会制度和社会关系。只有通过政治才能改变社会制度和社会关系。解放后我国农村卫生事业取得了令国际社会赞赏的辉煌成就,根本原因在于中国共产党注重从政治的高度认识并开展农村卫生工作。市场经济条件下,我国农村卫生事业发展遇到了挫折,需要我们重新审视农村卫生与政治的关系,探索建立卫生政治学新学科,为农村卫生工作提供理论指导。     

Factors that enable and hinder the implementation of projects in the alcohol and other drug field

Objective: Few studies systematically explore elements of successful project implementation across a range of alcohol and other drug (AOD) activities. This paper provides an evidence base to inform project implementation in the AOD field. Approach: We accessed records for 127 completed projects funded by the Alcohol, Education and Rehabilitation Foundation from 2002 to 2008. An adapted realist synthesis methodology enabled us to develop categories of enablers and barriers to successful project implementation, and to identify factors statistically associated with successful project implementation, defined as meeting all funding objectives. Thematic analysis of eight case study projects allowed detailed exploration of findings. Results: Nine enabler and 10 barrier categories were identified. Those most frequently reported as both barriers and enablers concerned partnerships with external agencies and communities, staffing and project design. Conclusion: Achieving supportive relationships with partner agencies and communities, employing skilled staff and implementing consumer or participant input mechanisms were statistically associated with successful project implementation. Implications: The framework described here will support development of evidence‐based project funding guidelines and project performance indicators. The study provides evidence that investing project hours and resources to develop robust relationships with project partners and communities, implementing mechanisms for consumer or participant input and attracting skilled staff are legitimate and important activities, not just in themselves but because they potentially influence achievement of project funding objectives.     

中国贫困农村生育健康服务的经费、服务提供与利用研究的背景、问题及研究框架

生育健康(reproductive health)是一个内涵深刻且涉及面广的新概念,近年不断得到深化和完善。针对贫困农村生育健康服务的几个基本问题,包括妇女生育健康服务的需要、需求及利用,生育健康服务的经费,以及生育健康服务的提供和效果,设计并实施了一个为期3年的项目。本文回顾了生育健康概念,在简述了生育健康服务的几个基本问题后提出了基本生育健康服务的概念,并给出了本研究的背景及框架。     

卫生经济学视阈中卫生服务公平与效率的关系研究

卫生服务的公平与效率是卫生事业发展的核心问题。卫生服务公平是机会公平、过程公平和质量公平的有机统一;卫生服务效率包括制度效率、经济效率两个方面。基于卫生经济学的视阈,卫生服务中应该坚持"公平优先,兼顾效率"的原则。在宏观上政府要合理的配置卫生资源,积极推进区域卫生计划,提供公平、有效和经济的卫生服务;在微观上加强对医疗机构的经济管理。进而实现公平与效率的和谐统一。     

Planning and management of public health in the federal republic of germany

In the Federal Republic of Germany, the debate on public health is dominated by the question as to the cost and the financing of good health care. Indeed, expenditure planning has now become the main area of planning in the public health sector. By contrast, the plans to improve health standards and to intensify health protection as well as to improve the quality and efficacy of health provision are somewhat neglected. This is probably due, in the main, to the strong position held by the providers of medicines and medical services and thus, by the same token, to the weak position of the consumers.Although there exists a well known set of statistics and indicators to describe the state of public health in this country, there is an almost complete absence of any attempt to evaluate them for planning purposes. The scope of intervening in the sphere of health care is thus left to a large number of protagonists characterized by completely heterogeneous interests. What we lack is a system of target-oriented plans and concrete measures. In the field of providing health care and combating disease, the only available systematic planning concerns the provision of in-patient and out-patient medical services: there is no planning for the quality of such facilities or for the range and quality of psychosocial and nursing services. As regards health-expenditure planning - which has made the biggest advances - the participants enjoy a great deal of independence: the volume of spending and increases in expenditure are thus the outcome of a process of negotiation. Under the current planning philosophy, consensual decision-making enjoys a high status.     

Healthcare financing in Syria: satisfaction with the current system and the role of national health insurance--a qualitative study of householders' views

This study aims to identify the satisfaction with the current public health system and health benefit schemes, examine willingness to participate in national health insurance and review expectations and preferences of national health insurance. To this end, qualitative semi-structured interviews were carried out with 19 Syrian householders. Our results show that a need for health reform exists and that Syrian people are willing to support a national health insurance scheme if some key issues are properly addressed. Funding of the scheme is a major concern and should take into account the ability to pay and help the poor. In addition, waiting times should be shortened and sufficient coverage guaranteed. On the whole, the people would support a national health insurance with national pooling and purchasing under a public set-up, but important concerns of such a system regarding corruption and inefficiency were voiced too. Installing a quasi non-governmental organisation as manager of the insurance system under the stewardship of the Ministry of Health could provide a compromise acceptable to the people.     

海南省政府卫生项目支出与基本支出的现状与对策研究

目的:研究海南省政府卫生投入资金流向分配,项目资金分配占比是否符合当年各区域实时所需,分析评价政府卫生财政资金投入现状,为政府提供基于数据分析和实时分析的卫生财政投入策略。方法:根据政府卫生投入监测系统数据对海南省2017年政府卫生投入进行分析。结果:2017年卫生投入总费用为330929.59万元,项目支出多来源于中央专项资金,卫生行政单位支出在财政性卫生支出中占据较高比例,中央专项资金分配到位所需时间较长。结论:海南省政府在卫生投入项目支出里主要依赖于中央财政的分配,卫生费用主要用于卫生行政机构,应优化转移支付制度,推进政府机构改革,完善资金运行模式,提高资源效率配置。     

我国部分地区社区卫生信息化建设状况的调查与思考

目的基于当前我国一些城市社区卫生服务信息化建设的发展情况,提出社区卫生服务信息化建设中的一些建设性观点与改进措施。方法采用查阅文献和实地采访的方式进行资料收集,对收集的资料进行进一步整理和分析,及时了解当前国内各城市社区卫生服务信息化建设的动态。结果调查地区社区利用信息化手段实现了居民健康档案的建立和更新,基本上实现了"六位一体"的全方位社区卫生服务;但由于社区卫生服务信息化开展程度不均衡,一些地区社区居民电子健康档案发展缓慢,缺少区域性的综合信息交互共享平台,这些地区社区卫生服务信息化建设急需得到进一步改善,以便社区卫生服务朝着"高效率,高质量"的方向发展。结论我国社区卫生服务信息化建设已取得了一定的成效,但社区信息系统还需进一步改善和加强,争取早日实现"记录一生,管理一生,服务一生,受益一生"的终极目标。     

Regional variation in the survival and health of older Australian women: a prospective cohort study

Objective: Older people may act as sensitive indicators of the effectiveness of health systems. Our objective is to distinguish between the effects of socio-economic and behavioural factors and use of health services on urban-rural differences in mortality and health of elderly women.
Methods: Baseline and longitudinal analysis of data from a prospective cohort study. Participants were a community-based random sample of women (n=12778) aged 70-75 years when recruited in 1996 to the Australian Longitudinal Study on Women's Health. Measures used were: urban or rural residence in Australian States and Territories, socio-demographic characteristics, health related behaviour, survival up to 1 October 2006, physical and mental health scores and use of medical services.
Results: Mortality was higher in rural than in urban women (hazard ratio, HR 1.14; 95% CI, 1.03,-1.26) but there were no differences between States and Territories. There were no consistent baseline or longitudinal differences between women for physical or mental health, with or without adjustment for socio-demographic and behavioural factors. Rural women had fewer visits to general practitioners (odds ratio, OR=0.54; 95% CI, 0.48-0.61) and medical specialists (OR=0.60; 95% CI, 0.55-0.65).
Conclusions: Differences in use of health services are a more plausible explanation for higher mortality in rural than urban areas than differences in other factors.
Implications: Older people may be the 'grey canaries' of the health system and may thus provide an 'early warning system' to policy makers and governments.