A Cornerstone of Health Reform

In order to ensure fair and affordable health services for all Chinese citizens and to set up a healthcare system that covers both urban and rural residents, the Chinese Government put forward a strategic task of deepening the healthcare system reform. The major objective of this reform is to provide medical service as a public service. In an interview with Beijing-based Guangming Daily, Li Weiping, a fellow researcher at the Institute of Medicine and Economy under the Ministry of Health, says that public hospitals are key to making this reform work and medical workers will need to drive this process forward.

Evaluation of the Effect of China’s Health Care Reform Based on Prospect Theory

Objective To evaluate the effect of health care reform policy in China comprehensively and provide suggestions for its further implementation.Methods Data on the effect of health care reform were obtained from“China Health Statistics Yearbook”and National Bureau of Statistics of China and the indicators were selected by corrected item total correlation(CITC)and Cronbach’sαreliability coefficient.Then,the selected indicators were calculated through the prospect theory model.Meanwhile,the gray relation analysis method was introduced to enlarge the differences between the advantages and disadvantages to make the comprehensive evaluation result more obvious.Results and Conclusion The implementation of China’s health care reform has a significant impact on China’s medical and health system.However,the effect of the policy will become less with the increase of the total amount.An effective management can ensure that the policy continues to play its role.

Health care reform in the USA: Recommendations from USA and non-USA radiologists

AIM: To compare the opinions and recommendations of imaging specialists from United States (USA) and non-USA developed nations for USA health care reform. METHODS: A survey was emailed out to 18 imaging specialists from 17 non-USA developed nation countries and 14 radiologists within the USA regarding health care reform. The questionnaire contained the following ques tions: what are the strengths of your health care system, what problems are present in your nation's health care system, and what recommendations do you have for health care reform in the USA. USA and non-USA radiologists received the same questionnaire. RESULTS: Strengths of the USA health care system include high quality care, autonomy, and access to timely care. Twelve of 14 (86%) USA radiologists identified medicolegal action as a major problem in their health care system and felt that medicolegal reform was a critical aspect of health care reform. None of the non-USA radiologists identified medicolegal aspects as a problem in their own country nor identified it as a subject for USA health care reform. Eleven of 14 (79%) USA radiologists and 16/18 (89%) non-USA radiologists identified universal health care coverage as an important recommendation for reform. CONCLUSION: Without full universal coverage, meaningful health care reform will likely require medicolegal reform as an early and important aspect of improved and efficient health care.

A Better Understanding of Reasons for the Failure of the Healthcare Reform in Colombia

The Colombian healthcare crisis is evidenced by obstacles to health service, diminished working conditions and medical autonomy, financial infeasibility, loss of leadership and legitimacy of the healthcare system. In the year 2013 twelve reform projects were presented to Congress, including a statutory law that defines health as a fundamental right which was approved and another ordinary one which sought a complete reform of the system but was rejected and criticized by different opinion leaders. For this study we have made an adaptation to Q methodology, which assigns quantitative values to the most frequent statement variables obtained from secondary sources (norms, articles, media, forums) giving objective information about the diverse positions in the proposals to healthcare reform. We analyzed from the most objective position and from academic independence the different views of the opinion leaders for a better understanding of the reasons for this failure in healthcare reform. There was a great polarization in the diverse statements which made an agreement with the government unlikely and, when added to a political moment in which the presidential election was being held, made the new reform non-viable. Although there is an agreement about the existence of a crisis, this has not been the case about the analysis of its causes or solutions. At the present time, the government is not presenting a new reform proposal and is focusing on some decree to create a model of healthcare in rural zones, define financial conditions for the EPSes (health providers), update norms for membership in a healthcare system and regulate biotechnological drugs. Even though to date there have been no opinions, plus taking into account the previous analysis, it is very possible there will be much criticism from those who demand a structural change in the system.

New Challenges for Occupational Health Services Facing Economic Reform in China

In China, which is facing economic reform and the rapid development of small-scale industries, various occupational hazards are reappearing. The problems are related to the ignorance of the managers and the workers, a lack of capital, the insufficiency of occupational health services, and the transfer of some hazardous work from large factories in the cities to small plants in the towns and villages. The change in life-style, especially in smoking habits, has aggravated occupational hazards. The problems may be solved by renewing the concept of health among the managers and workers, enforcing legislation related to occupational hazards, strengthening health personnel training, and reinforcing health education and self-help. 1989 Academic Press, Inc.

Reform of Health System for People's Right to Health——An interview with Gao Qiang,Minister of Health

EDITOR＇S NOTE： In an interview given of late to our staff reporter, Gao Qiang, Chinese Minister of Health, spoke on the achievements made by China in medical and health work during the Tenth Five-Year Plan period （2001-2005）, the soaring medical costs that have invoked much public complaint, ways of carrying to depth the reform of the medical service system, development of the rural cooperative medical system and community-based medical services in cities, as well as prevention and control of AIDS. Following is a transcript of the interview.

Application of Experiential Teaching in the Reform of College Students' Mental Health Course from the Perspective of Life Education

In recent years,the phenomenon of college students5 indifference to life occurs frequently which seriously damages the healthy growth of college students.Life education should be integrated into mental health education courses in colleges.Experiential teaching is a type of teaching activity that is characterized by students5 personal experiences and initiative,focusing on the participation of practical activities.Compared with traditional lectures,it improves students'interest and enthusiasm.In the mental health course,experiential teaching applies theoretical knowledge to real life and promote the improvement of students9 mental health to shape stable and mature personalities and eventually,promotes the development of life.College students5 mental health course should be integrated with experiential teaching practice in the perspective of life education,so as to better improve the teaching effect and guide students to form a correct outlook of life.

保障健康权益 促进卫生改革发展

在当前复杂的国际形势下,健康权正受到严重的破环。本文探讨健康权的内涵以及对我国卫生改革的影响,从世界卫生组织对健康的定义出发,提出健康权在10个方面的表现;撰述生命权和健康权在《中华人民共和国宪法》《中华人民共和国民法通则》以及其他法律法规中的立法依据;展示医疗保险、医疗卫生服务和医药产业3个领域高质量发展在维护生命权、健康权方面获得的成果。卫生改革的目标之一是真正实现群众的健康权,应确保人民群众平等获得优质安全的医疗卫生服务,充分发挥政府作用,出台多种惠民政策,从改善政治、经济、立法、环境等条件出发,减轻全社会的疾病经济负担。应以人民健康为中心,不断提高人民群众的健康水平,为护卫人民群众的生命权和健康权而努力。

大健康背景下全球健康课程开设的初步探索

在我国大健康理念背景下,伴随着健康问题全球化进程的加速,世界卫生健康体系面临巨大挑战。伴随着全球健康问题不断升级,通过跨国家、多学科合作开展全球健康课程,加强对全球健康人才的培养,成为医学高校人才教育的一项重点工作。中国医科大学以本博连读临床医学专业(红医班)为试点,开设全球健康必修课程,在教学方案、培养目标、师资建设、教学模式和课程计划等方面进行了初步探索。

新形势下提升预防医学专业学生实践能力的教学改革探索

文章旨在探讨如何通过改革教育教学体系,提高公共卫生专业学生的实践能力,培养高素质的医学人才。公共卫生教育和人才培养处于关乎国家建设、发展与安全的全局性、基础性和战略性地位。作为公共卫生队伍建设的重要一环,高校承担着公共卫生人才培养的重任。文章结合国家新形势发展的需要和预防医学实践能力的培养现状,提出了特色创新预防医学专业实践能力培养体系框架,并分别从实施改革教学方法、完善教学大纲、重视实践操作以及构建考核方式四个方面提出了具体的举措。这些改革措施能够有效规范学生的实践操作,夯实其工作技能,为国家公共卫生事业输送高素质的医学人才。文章的研究成果将对未来公共卫生教育和人才培养领域的发展和改革具有重要的指导意义。

综合医疗制度改革对中国家庭财务脆弱性的影响

健康风险作为背景风险的重要组成部分,会给一般家庭造成明显的财务脆弱性。医疗制度作为重要的社会保障基础,可以为家庭提供关键的健康保障,从而有效缓解家庭财务脆弱性。引入2010—2020年中国家庭追踪调查数据(CFPS),构建准自然实验研究体系,采用双重差分法检验了综合医改政策对家庭财务脆弱性的影响特征及其作用机制。研究发现,综合医改政策的实施显著缓解了家庭财务脆弱性,并且这一效应在城镇家庭、有老年人的家庭、儿童健康风险高的家庭、弱社会网络家庭、使用互联网的家庭以及社会信任度高的家庭中表现更加明显。同时,综合医改政策可以通过降低家庭医疗负担、提升家庭劳动参与、改变家庭风险态度等途径缓解家庭财务脆弱性。本文为评估综合医改政策及其对家庭财务影响的有效性提供了新视角,为进一步从微观层面深化医疗卫生体制改革提供了重要的政策启示。

交叉融合探索性实验在食品营养与健康专业教学中的应用

依托华南理工大学食品科学与工程学院优质科研资源和实验条件,为新设立的食品营养与健康专业开设不同功效成分软胶囊生产和质量检测实验课。该课程为综合性探索性实验,融合食品专业多学科知识,采用学生为主体、教师指导的开放式教学模式,学生分组合作,包括设计配方、生产、包装、质量检测和撰写报告。实验内容贴合日常保健和健康,涵盖知识点多,可操作性强,能极大激发学生的实验兴趣和培养综合能力。两年的教学实践表明,教学效果反馈良好,学生认可度高。

北京市综合医改前后社区卫生服务机构治疗费用的受益人群分析

背景厘清社区卫生服务机构主要服务的人群特点,对下一步社区卫生服务机构的精准改革具有十分重要的意义。目的通过分析综合改革前后北京市社区卫生服务机构治疗费用的受益人群特征,为下一步改革政策制定和调整提供精准的数据支持。方法本研究基础数据来源于2016—2019年北京市卫生总费用核算基础数据库,其他数据来源于2016—2019年《北京市卫生健康统计年鉴》《北京市卫生财务统计年报》《北京市卫生费用核算报告》等。采用多阶段分层整群抽样的方案选取社区卫生服务机构,从HIS系统纳入全年的门诊数据、住院患者的数据。采用卫生费用核算体系2011(SHA2011)核算、分析社区卫生服务机构治疗费用的受益人群状况。结果2016—2019年北京市社区卫生服务机构治疗费用从121.81亿元增长至222.45亿元,年均增长19.07%。40岁以上中老年患者治疗费用历年占比均在92%以上,60~岁、80~岁两个年龄组患者治疗费用增长较快,年均增速分别为24.08%、25.84%;治疗费用中内分泌、营养和代谢疾病,症状、体征和检验异常、循环系统疾病占比最高,内分泌、营养和代谢疾病,神经系统疾病,症状、体征和检验异常疾病治疗费用增长较快,年均增速分别为40.11%、48.40%和32.43%。结论综合改革后分级诊疗成效初显,社区医疗服务资源主要由中老年患者、内分泌、循环系统等慢性非传染性疾病患者所消耗,改革引导更多中老年和慢性病患者流向社区,社区卫生服务机构应该从服务能力、人才队伍、慢性病管理、医联体建设等多方面着手,提升其服务能力,巩固和维持改革的效果。

新加坡安宁疗护服务发展经验及其对我国的启示

安宁疗护是保障终末期患者善终权益,提升终末期患者生活质量的有效手段之一。新加坡安宁疗护发展迅猛,目前已逐步建成完善的安宁疗护服务体系,并在最新发布的国家死亡质量排名中位于亚洲前列。本文通过梳理新加坡安宁疗护现状,公众宣教、人才培养、慈善支持以及相关政策法律保障等方面的实践经验,最终提出我国应加强安宁疗护的社会认知、教育培养,发挥慈善团体和非政府组织的力量,提高现有安宁疗护承载力,构建安宁疗护相关制度和法律保障,以期达到实现终末期患者善终需求的目的。

健康中国背景下的“看病贵”与政府支出——基于资源配置结构性失衡视角的分析

“看病贵”意味着医疗卫生资源转化为医疗卫生服务的成本高,有限资源下医疗卫生服务供给的数量和质量难以满足公众健康需求,从而直接影响健康中国建设。同时,人口快速老龄化带来的医疗卫生需求爆发式增长,将形成医疗卫生体系的额外压力,加剧供求矛盾。基于医疗卫生资源配置结构性失衡视角研究“看病贵”与政府支出之间的关系发现:政府增加卫生支出会通过加剧人力资源配置的结构性失衡而加剧“看病贵”问题;只有将增加政府卫生支出与深化医疗卫生体制改革相结合,才能真正缓解全社会“看病贵”问题。因此,应深化公立医院改革,优化政府对医疗卫生资源的配置方式,加强基层医疗卫生体系建设,重塑医疗卫生服务治理模式,构建专业化治理模式,系统性重构中国医疗卫生领域人才建设。

“破五唯”背景下上海市医务人员健康科普传播意愿及影响因素研究

目的在“破五唯”和卫生专业人员职称评审改革出台的背景下,分析公立医院医务人员健康科普传播意愿及其激励和制约因素,探讨提升医务人员健康科普传播意愿的有效路径。方法2022年11—12月,采用自制线上问卷对上海市4所三级甲等医院的医务人员进行问卷调查。内容包括医务人员基本信息、医务人员健康科普传播现状及需求分析、医务人员健康科普传播的意愿及影响因素等。结果共有762名医务人员参与本次调查,79.9%的人表示愿意参与健康科普传播。多因素logistic回归分析显示,中级职称、实现个人价值与社会责任感、增加患者资源、职称晋升、科普相关奖项、纳入绩效考核、缺乏科普技巧是影响医务人员健康科普传播的影响因素(P<0.05)。结论医务人员开展健康科普传播意愿强烈,医院应通过构建长效激励机制、加强科普能力培训和提升人文素养调动医务人员健康科普的积极性。

中医药“三医联动”现状与对策研究

中医药“三医联动”是坚持以人民健康为中心,推动中医药融入医改的必然路径,也是建设普惠、便民、高效的中国特色医药卫生服务体系的重要支撑。文章通过分析“三医”联动现存的政策同步部署难、业务精准对接难、数据流通共享难等问题,积极探索推动中医药“三医”全方位、深层次、高质量联动的有效对策,提出建立有利于中医特色优势发挥、医保基金高效利用、中药质量安全的“三医联动”协同创新发展格局等建议,对促进中医药振兴发展与实现健康中国建设具有重要意义。

紧密型托管模式下优质医疗资源下沉的实践与探索

目的探讨紧密型托管模式的特点及优势,为推动优质医疗资源下沉提供经验和建议。方法通过文献分析,梳理出我国医院托管改革的历程及特点,结合“结构-过程-结果”理论,通过比较研究法,比较分析紧密型、半紧密型和松散型托管模式的差异,归纳总结出紧密型托管模式的主要特点及优势;并通过对山东省某大型省属三甲公立医院紧密型托管模式的案例剖析,深入探讨紧密型托管模式的具体实践措施、成效及存在的问题。结果紧密型托管模式通常是政府全面托管,托管医院按照院区形式实行统一领导,在人事管理、财务管理、业务管理、信息化等方面趋于一体化、同质化,托管关系较为稳定,实施效果较好。结论紧密型托管模式更有利于实现大型公立医院品牌、人才、技术、信息等优质医疗资源要素向基层流动,是新时期推动优质医疗资源扩容下沉和区域均衡布局的一种有效方式。