疾病经济风险与疾病经济负担分析

新型农村合作医疗的根本目标是通过建立大病统筹方案,重点解决或缓解农民因病致贫与因病返贫的问题。基于云南省禄丰县新型农村合作医疗调查数据,运用风险测量技术测算该人群的疾病经济风险程度,以及疾病的经济负担状况,从而更进一步明确新型农村合作医疗抗风险的重点,为更加科学合理的完善新型农村合作医疗的补偿机制提供决策依据。     

疾病经济风险与疾病经济负担分析

新型农村合作医疗的根本目标是通过建立大病统筹方案,重点解决或缓解农民因病致贫与因病返贫的问题.基于云南省禄丰县新型农村合作医疗调查数据,运用风险测量技术测算该人群的疾病经济风险程度,以及疾病的经济负担状况,从而更进一步明确新型农村合作医疗抗风险的重点,为更加科学合理的完善新型农村合作医疗的补偿机制提供决策依据.     

山西省新型农村合作医疗试点县农村疾病经济风险初步研究

目的：通过对农民疾病经济风险的分析,明确农民疾病经济风险水平和新型农村合作医疗抗疾病风险的重点.方法：采用疾病家庭经济风险度（FR）和特定人群疾病风险采用相对风险度（RR）两个指标来研究试点县农民痰病经济风险.结论：低收入家庭疾病风险强度较大,高疾病轻经济风险集中在少数家庭,不同医疗机构的疾病家庭住院经济风险差别较大,在设计合作医疗补偿方案时,使合作医疗的补偿重点向风险较大的疾病家庭转移,提高新型农村合作医疗抗疾病经济风险能力.     

妊娠期垂体疾病及其临床处理策略研究现状

对于处于妊娠期的孕妇而言,其机体将会产生某些特殊的生理变化,导致妊娠期垂体疾病的诊断与治疗变得复杂.目前临床医生主要依据非孕期垂体疾病的诊治方式对妊娠期垂体疾病进行处理.目前通过规范的管理虽然能够使诸多患垂体疾病的孕期女性成功受孕、正常妊娠,但仍然未具有丰富的诊治经验.本文将对妊娠期垂体疾病及其临床处理策略研究现状进行...     

医疗风险的成因和处理策略

医疗风险具有不确定性、不可预见性和危害性.因此更早、更准确的预测可能发生的医疗风险,制定完善的医疗风险规避制度,对医疗行为进行认真有效的监督,尽可能减少不必要的医疗风险是当今医院管理的重点之一.该文就我国医疗风险的特征、防范和处理进行讨论,希望对降低医疗机构医疗风险的发生和提高处理能力有所借鉴.     

贫困地区农户应对疾病的筹资及效果：基于四川省阆中市的农户调查

通过对四川省阆中市农户大病筹资行为的调查统计,分析了农户几种常见的筹资方式,对家庭经济状况不同的农户进行对比,发现各类农户中采用最频繁的两种筹资方式是亲友的赠予及亲友和金融机构的借贷.而对医疗费用贡献率最大的筹资方式是亲友和金融机构的借贷.文章对各种筹资方式进行了评价,发现当前实施的新型农村合作医疗制度和贫困医疗救助制度对大病农户的医疗费用资助明显不足.     

疾病经济风险的内涵及评价综述

通过对国内外相关研究的系统回顾和总结,在明确相关基本概念的基础上,对疾病经济风险的内涵界定进行了梳理;同时,对相关研究中广泛采用的疾病经济风险评价指标进行了归纳,为更加全面准确地评价疾病经济风险明确了方向。     

农村居民疾病经济风险与灾难性卫生支出关联性研究

综合运用疾病经济风险度和灾难性卫生支出分析农村居民疾病经济风险,结果表明,总体疾病家庭经济风险度较低,但是仍有9.49%的家庭处于高度疾病风险之中;贫困人群疾病经济风险度是非贫困人群的6.63倍;家庭疾病经济风险度与灾难性卫生支出发生率之间有相关关系,贫困人群的灾难性家庭卫生支出发生率大于非贫困人群。对此,提出了建立重大疾病补助基金、实行累进缴费制度、优化调整统筹补偿方案等建议。     

罗平县农村居民糖尿病的疾病经济风险及影响因素研究

目的 了解云南省罗平县农村居民糖尿病疾病经济风险及相关影响因素。方法 于 2021 年 7月在云南省罗平县采用多阶段分层随机抽样方法抽取年龄≥35 岁的 998 名村民进行面访调查及体检。结果 云南省罗平县农村居民糖尿病的患病率为 15. 3% ,且随着年龄增长呈现上升趋势( 趋势 χ²= 10. 776,P = 0. 001) 。患有肥胖( χ²= 4. 749,P = 0. 029) 、高血压( χ²= 5. 732,P = 0. 017) 以及有糖尿病家族史( χ²=13. 064,P < 0. 001) 的农村居民糖尿病患病率均高于未患肥胖、高血压以及没有糖尿病家族史者。糖尿病患者的人均直接、间接和疾病经济负担分别为 4 763. 46 元、177. 78 元和 4 941. 24 元,其中,男性人均直接疾病经济负担高于女性( t = 2. 124,P = 0. 034) ; 云南省罗平县农村糖尿病患者家庭灾难性卫生支出和因病致贫发生率分别为 8. 1% 和 2. 7% ; 糖尿病患者...     

新型农村合作医疗缓解疾病经济风险的效果评估

[目的]对新型农村合作医疗缓解疾病经济风险进行评估.[方法]采用入户询问的方法对样本人口进行调查,分析比较农村居民在新农合实施前后疾病经济风险的变化.[结果]家庭消费支出中医疗费占比重较大;低收入家庭支付能力依然低下;新农合降低了家庭总体疾病经济风险;住院家庭疾病经济风险增加;低年龄组人群疾病经济风险度高.[结论]农村卫生筹资应以政府为主,降低居民个人医疗卫生支出;提高新农合的覆盖率,促使新农合制度持续发展;提高筹资水平,增加对住院病人的补偿;完善医疗教助体系,降低贫困人口疾病经济风险.     

中国人口老龄化社会发展与应对策略

目的探讨我国老龄化社会发展现状与应对策略。方法结合中外文献,分析中国老龄化快速发展的特点与严峻挑战。结果在世界人口老龄化快速发展进程中引发的全球慢性病急剧增加,已成为几乎所有国家成人最主要的死因,中国不仅是当今全球老龄人口数量最多、发展速度最快的国家,也是慢性病的高发国。结论老龄化社会发展现状已成为世界各国所面临的重大公共卫生问题,重视加强应对策略,建立健全养老体系和社区养老机构扶持,深入开展老年病研究,积极防治老年慢性病,提高老年人生活质量,为促进健康老龄化社会发展而努力。     

Mumps vaccine effectiveness and risk factors for disease in households during an outbreak in New York City

Background and objectives

Mumps outbreaks have been reported among vaccinated populations, and declining mumps vaccine effectiveness (VE) has been suggested as one possible cause. During a large mumps outbreak in New York City, we assessed: (1) VE of measles-mumps-rubella vaccine (MMR) against mumps and (2) risk factors for acquiring mumps in households.

Methods

Cases of mumps were investigated using standard methods. Additional information on disease and vaccination status of household contacts was collected. Case households completed follow-up phone interviews 78–198 days after initial investigation to ascertain additional cases. Mumps cases meeting the study case definition were included in the analysis. Risk factors for mumps were assessed, and VE was calculated using secondary household attack rates.

Results

Three hundred and eleven households with 2176 residents were included in the analysis. The median age of residents was 13 years (range <1–85), and 462 (21.2%) residents met the study mumps case definition. Among 7–17 year olds, 89.7% received one or more doses of MMR vaccine, with 76.7% receiving two doses. Young adults aged 10–14 years (OR = 2.4, CI = 1.3–4.7) and 15–19 years (OR = 2.5, CI = 1.3–5.0) were at highest risk of mumps. The overall 2-dose VE for secondary contacts aged five and older was 86.3% (CI 63.3–94.9).

Conclusions

The two-dose effectiveness of MMR vaccine against mumps was 86.3%, consistent with other published mumps VE estimates. Many factors likely contributed to this outbreak. Suboptimal MMR coverage in the affected population combined with VE may not have conferred adequate immunity to prevent transmission and may have contributed to this outbreak. Achieving high MMR coverage remains the best available strategy for prevention of mumps outbreaks.     

卫生计生网络舆情分析及应对策略研究

在信息时代,互联网已成为卫生计生舆情监测的主要渠道。本文概述了2015年卫生计生网络舆情监测分析的总体情况,研究了卫生计生网络舆情的特征规律,并对卫生计生重点舆情进行了分析研判。在此基础上就进一步做好卫生计生宣传工作提出了建议策略。     

手术室专职教师教学压力因素及应对策略

目的探讨专职教师应对教学压力的有效策略,切实提高教学质量。方法在护理部及护士长领导下,手术室专职教师采取分层次针对性教学、强化教学对象的职业安全教育、情景模拟教学、在教学活动中总结经验,教学相长、扎根临床,业精于勤、外出学习开阔视野等策略积极应对。结果专职教师每年高质量完成多层次、多批次的教学任务约400人次。结论手术室教学策略有助于减轻专职教师教学压力及提高教学质量。     

幼儿教师的心理健康状况和应对方式

目的：探讨幼儿教师的心理健康状况和应对方式及其相互关系。方法：使用症状自评量表（SCL-90）和肖计划编制的应付方式问卷分别测查了幼儿教师的心理健康状况和应对方式,并对其相互关系进行相关和回归分析。结果：幼儿教师的心理问题总检出率为10．38％;相对于40～49岁的幼儿教师,30岁以下和30～39岁的幼儿教师的心理健康状况较差,职称为小学一级的幼儿教师的心理健康水平最低。幼儿教师对各种应对方式的使用频繁程度依次为：解决问题、求助、退避、幻想、合理化和自责。大部分应对方式因子对心理健康各因子有显著的预测作用。结论：部分幼儿教师存在心理健康问题,应对方式是影响幼儿教师心理健康的重要因素。     

Associations Between Academic Stressors,Reaction to Stress,Coping Strategies and Musculoskeletal Disorders Among College Students

Background

The adverse health effects of stress are enormous, and vary among people, probably because of differences in how stress is appraised and the strategies individuals use to cope with it. This study assessed the association between academic stress and musculoskeletal disorders (MSDs) among 1365 undergraduates.

Methods

This was a cross-sectional study conducted in a Nigerian university at the beginning of the 2010/2011 academic session with the same group of participants. The Life Stress Assessment Inventory, Coping Strategies Questionnaire, and Short Musculoskeletal Function Assessment were administered as tools of data gathering.

Results

Students'' stress level and associated MSDs were higher during the examination period than the pre-examination periods. Stressors were significantly associated with increased risk of MSDs in both sexes were those related to changes (odds ratio (OR) = 1.7, p = 0.002) and pressures (OR = 2.09, p = 0.001). Emotional and physiological reactions to stress were significantly associated with MSDs in both sexes, with higher odds for MSDs in females, whereas cognitive and behavioral reactions showed higher odds (though non-significant) in males. The risk of MSDs was higher in respondents who adopted avoidance and religious coping strategies compared with those who adopted active practical and distracting coping strategies.

Conclusions

Stress among students could be significantly associated with MSDs depending on individuals'' demographics, stressors, reactions to stress, and coping methods. Interventions to reduce stress-induced MSDs among students should consider these factors among others.     

浅谈牙科治疗中严重并发症的防范与应对

目的本文将对发生严重并发症的牙科患者给予临床分析,从而探讨牙科治疗中严重并发症的防范措施与应对策略,为提高牙科患者生活质量与生命安全提供可靠依据。方法对2008年1月1日—2012年12月31日五年间来该院就诊并发生严重并发症的12例牙科患者临床资料给予回顾性分析,内容包括患者并发症发生类型、并发症发生原因以及临床有效应对策略,并根据上述内容总结牙科治疗中严重并发症的防范措施。结果 12例牙科治疗中出现严重并发症患者中,发生严重血肿比例最高,为41.67%,其次为晕厥(所占比例为25.00%)以及过敏性休克(所占比例为16.67%)。结论牙科治疗过程中,操作人员应严格掌握操作规程,对可能引起严重并发症的危险因素进行排除,患者发生并发症后应及时对其进行有效抢救措施,从而保障患者生活质量与生命安全。     

The economic cost of measles: Healthcare,public health and societal costs of the 2012–13 outbreak in Merseyside,UK

BackgroundMeasles is a highly contagious vaccine-preventable infection that caused large outbreaks in England in 2012 and 2013 in areas which failed to achieve herd protection levels (95%) consistently. We sought to quantify the economic costs associated with the 2012–13 Merseyside measles outbreak, relative to the cost of extending preventative vaccination to secure herd protection.MethodsA costing model based on a critical literature review was developed. A workshop and interviews were held with key stakeholders in the Merseyside outbreak to understand the pathway of a measles case and then quantify healthcare activity and costs for the main NHS providers and public health team incurred during the initial four month period to May 2012. These data were used to model the total costs of the full outbreak to August 2013, comprising those to healthcare providers for patient treatment, public health and societal productivity losses. The modelled total cost of the full outbreak was compared to the cost of extending the preventative vaccination programme to achieve herd protection.FindingsThe Merseyside outbreak included 2458 reported cases. The estimated cost of the outbreak was £4.4 m (sensitivity analysis £3.9 m to £5.2 m) comprising 15% (£0.7 m) NHS patient treatment costs, 40% (£1.8 m) public health costs and 44% (£2.0 m) for societal productivity losses. In comparison, over the previous five years in Cheshire and Merseyside a further 11,793 MMR vaccinations would have been needed to achieve herd protection at an estimated cost of £182,909 (4% of the total cost of the measles outbreak).InterpretationFailure to consistently reach MMR uptake levels of 95% across all localities and sectors (achieve herd protection) risks comparatively higher economic costs associated with the containment (including healthcare costs) and implementation of effective public health management of outbreaks.FundingCommissioned by the Cheshire and Merseyside Public Health England Centre.