Cloud edge integrated security architecture of new cloud manufacturing system

With the rapid development of cloud manufacturing technology and the new generation of artificial intelligence technology,the new cloud manufacturing system(NCMS)built on the connotation of cloud manufacturing 3.0 presents a new business model of“Internet of everything,intelligent leading,data driving,shared services,cross-border integration,and universal innovation”.The network boundaries are becoming increasingly blurred,NCMS is facing security risks such as equipment unauthorized use,account theft,static and extensive access control policies,unauthorized access,supply chain attacks,sensitive data leaks,and industrial control vulnerability attacks.Traditional security architectures mainly use information security technology,which cannot meet the active security protection requirements of NCMS.In order to solve the above problems,this paper proposes an integrated cloud-edge-terminal security system architecture of NCMS.It adopts the zero trust concept and effectively integrates multiple security capabilities such as network,equipment,cloud computing environment,application,identity,and data.It adopts a new access control mode of“continuous verification+dynamic authorization”,classified access control mechanisms such as attribute-based access control,rolebased access control,policy-based access control,and a new data security protection system based on blockchain,achieving“trustworthy subject identity,controllable access behavior,and effective protection of subject and object resources”.This architecture provides an active security protection method for NCMS in the digital transformation of large enterprises,and can effectively enhance network security protection capabilities and cope with increasingly severe network security situations.

新农合网络即时结报的实践与思考

通过建立健全组织机构、实现网络信息对接、抓好全员培训及宣传、优化结报程序、提高结报质量、加强检查督导等方法,持续改进网络即时结报质量。新农合网络即时结报在为参合农民提供方便医疗服务的同时,也为医院带来了良好的社会效益和经济效益。新农合网络即时结报在试运行过程中取得了较好成绩,但目前面临的问题是扩面"瓶颈"难以突破,主要原因是统筹层次低、网络平台多等。

南宁市原新农合参合人员对城乡居民合作医疗满意度调查研究

目的:了解南宁市原新型农村合作医疗参合人员对于新实施的城乡居民合作医疗的满意度,为推进城乡居民基本医疗保险整合的进程和解决尚存在的一些问题提供参考。方法:通过满意度调查问卷的方式,在南宁市内区级和市级三甲医院的门诊部对原新农合参合人员进行满意度调查。结果:对于城乡居民基本医疗保险的总体情况,82.25%的原新农合参合人员感觉非常满意,14.39%的觉得基本满意,3.36%的觉得不满意;不同文化程度和不同职业对于城乡居民医疗保险的满意度有影响(P<0.05)。结论:南宁市原新型农村合作医疗参合人员对城乡居民医疗保险满意度较高,但还需加强城乡居民医保新政策的引导和宣传。

Identification of Factors Influencing Out-of-county Hospitalizations in the New Cooperative Medical Scheme

Summary:Throughout the duration of the New Cooperative Medical Scheme(NCMS),it was found that an increasing number of rural patients were seeking out-of^county medical treatment,which posed a great burden on the NCMS fund.Our study was conducted to examine the prevalence of out-of^county hospitalizations and its related factors,and to provide a scientific basis for follow?up health insurance policies.A total of 215 counties in central and western China from 2008 to 2016 were selected.The total out-of-county hospitalization rate in nine years was 16.95%,which increased from 12.37%in 2008 to 19.21%in 2016 with an average annual growth rate of 5.66%.Its related expenses and compensations were shown to increase each year,with those in the central region being higher than those in the western region.Stepwise logistic regression reveals that the increase in out-of-county hospitalization rate was associated with region(XI),rural population(X2),per capita per year net income(X3),per capita gross domestic product(GDP)(X4),per capita funding amount of NCMS(X5),compensation ratio of out-of^county hospitalization cost(X6),per time average in-county(X7)and out-of-county hospitalization cost(X8).According to Bayesian network(BN),the marginal probability of high out-of^county hospitalization rate was as high as 81.7%.Out-of^county hospitalizations were directly related to X8,X3,X4 and X6.The probability of high out-of-county hospitalization obtained based on hospitalization expenses factors,economy factors,regional characteristics and NCMS policy factors was 95.7%,91.1%,93.0% and 88.8%,respectively.And how these factors affect out-of-county hospitalization and their interrelationships were found out.Our findings suggest that more attention should be paid to the influence mechanism of these factors on out-of-county hospitalizations,and the increase of hospitalizations outside the county should be reasonably supervised and controlled and our results will be used to help guide the formulation of proper intervention policies.

社会医疗保险财政补贴增长及可持续性研究——以医保制度整合为背景

随着医保制度城乡统筹的推进,以财政补贴为主要筹资来源的新农合和居民医保两大制度筹资水平的增长将对财政形成持续的压力。本文基于医保制度整合的背景,综合人口结构转变等方面的动态变化因素,运用保险精算方法对未来三十六年的人均筹资和财政补贴增长进行了测算,并对财政补贴可持续性进行了评估。研究发现,两项制度的未来人均筹资和财政补贴总额都将持续增长,尤其在制度整合完成之前增长更快。尽管如此,现有的财政补贴政策依然是长期可持续的。本文的研究结论为推进社会医疗保险改革、建立公平和可持续的财政补贴机制有着重要的启示意义,未来财政补贴标准应当体现城乡差异和进一步突出年龄差异,补贴总量需要实现从新农合向居民医保的重心转移。同时,为提高政策的可持续性,各级政府的财政补贴责任应当制度化,并进一步强化中央和省级财政的出资责任。本文在某种程度上弥补了现有相关研究以定性分析为主的不足,所采用的研究方法和视角也具有一定的创新价值。

用SPSS实现二次补偿额与原补偿额合并的方法初探

[目的]实现新型农村合作医疗(新农合)的住院病例2次补偿额与原补偿额合并,为有关指标统计分析奠定基础。[方法]用SPSS 11.5软件包,以"复制编程法"或"点窗计算法"均可实现。[结果]两法相比,前者更简便、易掌握。[结论]用SPSS的"复制编程法"或"点窗计算法",实现住院病例2次补偿额与原补偿额的合并,可提高数据分析的严谨性和准确性,对已开展了2次补偿的县市有很大的推广应用价值。

晋江市2009-2013年住院疾病谱分析

目的掌握晋江市新型农村合作医疗（新农合）住院患者疾病构成,为指导防治管理工作提供依据。方法对晋江市2009—2013年住院疾病以国际疾病编码（ICD-10）进行分类,用SPSS 21和Excel 2007软件统计分析。结果5年来年均参合95.43万人次,平均参合率98.4%;平均住院率7.78%,住院人次年均增长5.76%;各年龄组住院率呈儿童和老人高、青年人低趋势;男女病例占比类似。住院＂人口金字塔＂呈＂缩腰＂型,女性25~29岁组最多（11.5%）;男性以〈5岁最多（13.2%）,5~19岁组最少;住院者以呼吸系统疾病最多（23.4%）,其次是循环系统12.5%、消化系统11.4%、肿瘤10.9%、妊娠分娩和产褥期9.2%、损伤中毒4.8%。除呼吸系统、传染病和寄生虫病外,总体上各系统疾病住院人次呈上升趋势。结论通过新农合数据库疾病构成分析,可了解各系统疾病住院规律与特征,为有效开展疾病研究和防治工作提供依据。