On Rural Medical Care and Health Undertaking Development during New Medical Reform

Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

Government Responsibility in New Rural Cooperative Medical Care System from the Perspective of Equity and Efficiency

Equity and efficiency,as two essential parts of social security,always influence construction of China's new rural cooperative medical care system.The new rural cooperative medical care system is a rural social security system particularly intended to make it more affordable for the rural poor.It is a multi-channel fundraising system with fund of comprehensive arrangement for serious disease composed by the government,collectives and individuals.Since its implementation,it has made considerable achievements,but there are still many apparent and hidden problems.Through analyzing existing problems in the implementation of new rural cooperative medical care system,from the perspective of equity and efficiency,it reached the conclusion that government should take corresponding responsibilities.At the same time of constantly increasing efficiency,it is recommended to attach importance to the equity,so as to realize the objective of improving the security level of new rural cooperative medical care system.

Impact of the New Cooperative Medical Scheme on Health Care Service Utilization in Rural China

Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.

Great Care for Life——New-type of Beijing's rural medical care system

Shi Lianzhen, a 79-year-old villager from rural Beijing, has been suffering from coronary heart disease and myocardial irffarction. On October 15, 2003, she unexpectedly received 10,064 yuan (US$1,215) in subsidies for her diseases from the local government department in charge of rural co-operative medical care. This old female farmer, without any income source, was so excited that she couldn’t put her feeling into words. For the first time in their life, Chinese farmers can enjoy medical care insurance like those wage workers in dries, when their health fails them and their lives are in the menace of death.

Going the Distance A telemedicine company uses technology to meet Africa’s rural medical needs with prime health care

We have a scarcity of health care professionals in the rural areas and therefore we can offer medical services from a distance to the underserved rural population.

Health Training Needs at Primary Care Level Health Facilities in Rural Western Uganda

Introduction: Continual education is recognized worldwide as a tool for the professional development of health care practitioners. It is however effective when the training targets the appropriate needs of the target beneficiaries. This study was therefore aimed at identifying priority training needs of Primary Care Level health professionals in rural Western Uganda. Methods: This was a descriptive cross-sectional survey among 35 rural community health facilities represented by their managers in rural Western Uganda. Participants were invited to Mbarara University of Science and Technology and responded to a self-administered questionnaire and also participated in qualitative group discussions guided by Facilitators from the Community Based Education and Research Services unit within the Community Health Department of Mbarara University of Science and Technology. Priority health training needs were determined based on the computed weighted scores. Results: The majority of managers of rural primary care level health facilities were medical officers by the level of training (51.43%) and male by gender (68.57%). Priority health training needs identified were child health and maternal health with total weighted scores of 12.0 and 10.9 respectively. Qualitatively, emerging themes included;leadership and management, and supervisory roles during student field attachments. Conclusion: Priority health training needs at rural Primary Care level health facilities were child health, maternal health, leadership and management, and supervisory skills. There is dire need to train rural primary care level, health professionals. In-service training based on identified needs should be offered by MUST in partnership with regional stakeholders. This is likely to enhance the quality of services provided by rural primary care level health facilities.

农村医养结合型养老服务政策的演进逻辑

伴随着健康中国战略的稳步推进,我国农村医养结合型养老服务体系经历了从供给不足到供需相对均衡的发展过程,逐步形成了与经济社会持续健康发展相协调的高质量社会养老服务体系,在满足公众需求、缓解社会矛盾、促进社会公平、增进老年福祉等方面发挥了重要作用。深入挖掘其在政策目标、政策内容、价值取向等方面的阶段性特征和变化趋势,通过社会网络分析发现,我国农村医疗卫生与养老服务相结合由点到面逐步拓展,二者由彼此独立走向有机融合,其结合、融合与整合的体制机制逐渐成熟,二者相结合由逐步成熟向深度融合阶段迈进。为了促进医养结合政策的有效衔接,我国应加快推进农村医养结合型养老服务体系建设,以县域医共体为核心发展农村医养结合型养老服务,探究不同类型政策工具之间的合理匹配,全方位提高农村医养结合型养老服务质量,不断提升老年人健康保障水平。

“乡村医疗社会”的生成与显现——基于一个农村老人生病、治疗与护理的医学人类学观察与思考

乡村居家治疗与照护中的疾病不仅是科学的存在,也是宇宙论意义的存在以及在世的存在。就科学的存在而言,疾病是自然界的物质与病者的身体相遇而互构出来的一种界面,现代医学和传统医学在这个界面上实施干预。就宇宙论意义的存在而言,疾病是宇宙神秘力量的显象,需要借助秘术和民俗医疗手段进行救治。就在世的存在而言,疾病创建了以病人为核心的医疗社会,该类医疗社会是各种医学知识观念显象、具身与交流的场域,即科学的存在和宇宙论的存在在其中存在。然而,按照西方医学科学模式开展救治和护理的城镇医院则把上述诸多内容屏蔽在外。

人口老龄化背景下农村医养结合服务的现状与对策——以唐山市乐亭县为例

以唐山市乐亭县农村医养结合服务模式和现状为例,针对目前农村地区医养结合服务存在的供需失衡、“医”与“养”资源融合不足、设施落后、缺乏专业服务人员等问题,提出完善政策体系和保障制度,强化医养衔接,开展多层次医养结合服务,加强人才队伍建设,构建医养结合信息化系统的对策建议,从而推动农村医养结合的发展。

基于PEST模型的我国农村医养结合养老服务发展策略研究

我国老龄人口比例逐年攀升,尤其是农村地区,老龄化现象更为严重。文章对我国农村医养结合养老服务的发展状况进行梳理,运用PEST分析模型对其在政治、经济、社会和技术4个方面所面临的困境进行分析研究。在借鉴国外医养结合养老服务实践经验的基础上,针对性地提出加强政策支持、拓宽资金来源、增强宣传和社会参与,以及完善信息建设与人才培养等方面的发展策略,以期对我国农村医养结合养老服务的后续研究与实践提供参考。

基于社会资本理论的农村失能老人医养结合型互助照护体系研究

目的:基于社会资本理论,提出构建农村失能老人医养结合型互助照护体系的可行方案。方法:以西部某村的实践为典型案例,从“资源-关系-信任”维度,分析该村失能老人互助照护的做法和成效。结果:案例中,村民自发形成的互助照护模式充分挖掘了农村资源、关系和信任资本,是解决农村照护人力资源稀缺、照护资源可及性差和康复成本高等多重困境的有效手段。结论:在农村构建失能老人医养结合型互助照护体系,具有较强的可行性。通过协同整合挖掘农村现有医疗资源与人力资源的潜力,并适度补贴,形成层次性医养结合型互助照护体系,可缓解农村失能老人照护困境。

农村居民基层首诊认知偏差影响因素分析

目的:分析农村居民的就诊认知偏差及其影响因素,为促进基层首诊提供参考依据。方法:采用分层随机抽样对样本市675名农村居民开展问卷调查,利用分层回归模型分析其就诊认知偏差的影响因素。结果:农村居民的疾病认知偏差均值为0.097,基层服务能力认知偏差均值为-0.064;46.22%的就诊认知偏差结构为疾病认知偏差主导型;医院熟人、就诊决策人、风险规避等级及单次门诊价格接受度是疾病认知偏差的影响因素(P<0.05),居住地到乡镇卫生院的距离、就诊决策人及单次门诊价格接受度是基层能力认知偏差的影响因素(P<0.05)。结论:农村居民普遍对疾病严重程度认知过高、对基层医疗机构能力认知过低,导致基层首诊意愿不高;应提高居民的疾病甄别能力,提升基层就诊体验,加强对基层医疗机构和健康知识的宣传,提升农村居民的就诊认知,从而促进基层首诊。

Development of the New Rural Cooperative Medical System in China

Based on a survey conducted by our research team at the Chinese Academy of Social Sciences, the present paper reports on the development of China＇s new rural cooperative medical system set up in late 2002. The new rural cooperative medical system is different from the old system in that it is organized, guided and supported by the government but that rural residents voluntarily participate in its administration. It is financed by individuals, collectives and the government. The new cooperative medical system focuses on serious disease planning and mutual aid and fraternily between rural residents in health care. The results of our survey indicate that the new rural medical system has been successful up to now but that it also has some problems. China needs to pay more attention to overcoming the difficulties and challenges it faces in terms of future medical needs so that a mechanism for its sustainable development can be established.

乡村振兴背景下农村医养结合养老政策执行的优化路径研究——以H省为例

医养结合的高质量发展取决于相关政策的高效执行及顶层设计。随着我国人口老龄化的进程日益加快,农村地区的养老问题也逐渐受到人们的高度关注。推动高质量农村养老服务的可持续发展与乡村振兴密切相关,农村地区作为养老问题的主阵地,老年人口占比相对较大,解决农村地区的养老问题是构建多层次农村养老保障体系的重点与难点。基于史密斯政策执行理论分析H省医养结合政策执行过程中存在的问题,并在乡村振兴视角下提出建议,以期促进农村医养结合养老模式的养老服务质量和整体水平的全面提升。

都市圈新城区乡村医疗服务中心地网络结构及其影响因素研究——以武汉市新城区为例

医疗服务是维护居民健康的重要保障。基于修正引力模型和社会网络分析法,分析武汉市6个新城区乡村医疗服务中心地空间网络结构及其影响因素。研究表明:(1)新城区乡村医疗服务中心地呈现网络结构,多中心层级化共存。医疗服务网络密度整体上处于初级阶段,总体关联度偏低,且大部分联系限于各区内部,整体节点聚集度较低。医疗服务中心地的网络非均衡性明显,形成了不同尺度的空间嵌套格局。(2)医疗服务中心地可分为6个子群,并呈现由内到外的圈层结构。6个子群的空间关联网络由北向南形成层次分明的板块,而且呈现出小团体现象。特别需要指出的是,子群的划分表现出鲜明的邻近指向特征,地理邻近关系对医疗服务中心地关联强度的影响比较明显。(3)空间邻近性、农业产值、第二产业企业注册资本、人口数量、城镇化水平、道路密度和交通可达性对新城区乡村医疗服务中心地空间关联网络强度的提高具有显著影响,而第三产业企业的影响并不显著。

健康中国视域下乡村医疗服务数字化发展研究

乡村医疗服务数字化是夯实乡村振兴基础、促进数字乡村发展、实现健康中国战略目标的重要抓手。人民健康是健康中国的应有之义,农民健康是人民健康的重要组成部分。为满足农村日益增长的多层次、多样化健康服务需求,乡村医疗服务数字化具有可及性、可供性、可得性三大优势,同时面临着数字基础差、数字建设短板、数字监管难题及数字意愿被动等现实问题。为加快乡村医疗服务数字化建设,应夯实数字化基础设施,促进医疗服务与数字技术深度融合;统一乡村医疗服务数据标准,构建医疗服务公共数据库;强化数字立法保护,积极构建乡村智慧化监管体系;加强农村群众数字培训,提高医疗服务数字化应用意识,旨在充分利用数字赋能,切实提高乡村医疗服务数字化水平,扎实推进乡村振兴。

农村慢性病老年人医养结合型照护模式实现路径

目的:通过实地走访广东省某村,调查慢性病老年人的照护现状,并探讨实现农村慢性病老年人医养结合型照护模式的可行性对策。方法:选取广东省某村慢性病老年人照护实践作为研究案例,采用案例分析法,对村民间互助照护的实践做法及其成效进行深入分析与评价。结果:农村地区存在较为紧密的社会关系网络。案例村通过动员闲置劳动力资源,有效缓解了慢性病老年人的照护压力,减轻了家庭照护负担。同时,病人通过共同购买康复辅助器具,实现了成本分摊,降低了康复治疗费用。共同的康复需求促使病人频繁聚集,有利于促进彼此的身心健康,形成了一种有效的医疗互助照护模式。结论:医养结合型互助照护模式可以在一定程度上缓解基层慢性病老年人的养老困境,有助于解决农村养老照护人力资源短缺、照护服务水平低下以及康复成本高昂等问题。

医学生志愿服务参与乡村社会治理的路径研究

开展志愿服务,是有效治理基层社会的有效途径,对于形成乡村社会治理新格局具有重要作用。首先,高校应突出价值引领,开展义诊宣教;开设相关课程,完善激励机制;组织建立爱心学生诊所。其次,社会应加强组织机构建设,改变传统家庭观念,创新服务模式,互联网赋能传播来提高基层治理水平。最后,政府应完善各项志愿服务制度,强化农村社会治理理念,拓展志愿服务平台,聚焦生态保护,推动绿色发展。

农村医养结合服务分级整合体系构建——基于M村的经验研究

随着人口老龄化进程的加快,我国农村养老问题日益突出。医养结合被广泛认为是积极应对人口老龄化的重要举措。基于整体性治理理论的分级整合分析框架,结合京郊M村的医养结合实践,本研究构建了纵横交织的农村医养结合服务分级整合体系,以期为相关研究提供理论与实践参考。在纵向上,需求、供给和整合三个程度分级子系统揭示了医养结合的运行机制。在横向上,自主型、辅助型和依附型三种医养结合的供给方式可有效满足农村养老需求。因此,农村医养结合服务分级整合体系的构建为有效解决我国农村养老问题提供了一个可行路径。