The impact of the New Rural Cooperative Medical Scheme on the“health poverty alleviation”of rural households in China

This study investigates the impact of the New Rural Cooperative Medical Scheme(NRCMS)on rural households to escape poverty.We employ the instrumental variable method,the IVProbit model,to analyze the national data from the rural-resident field survey by the China Family Panel Studies(CFPS)in 2016.Based on the large-scale data,we found that,first,the hospitalization of family members is the key factor in increasing the risk of the family falling into poverty.The NRCMS has significantly reduced the likely risk of falling into poverty.Second,the impact of the NRCMS on poverty alleviation varies among groups with different levels of income.There is no impact on the upper-middle and high-income groups;in contrast,the NRCMS has substantially improved the capacity of low-income rural families to prevent poverty due to illness,especially for the lower-middle-income group.Third,there exist significant regional differences in the impact of NRCMS on the health poverty alleviation of rural households in China.The NRCMS has successfully reduced the risk of rural households in the western region falling into poverty,simultaneously,no significant impact on those in the eastern and central regions.In order to diminish and eliminate poverty eventually and boost rural residents'capacity for income acquisition,we propose the following:raise the actual compensation ratio of the NRCMS,control the rising expense of NRCMS by promoting the payment method reform,construct the comprehensive healthcare system in the western region,strengthen the medical security for the poor in remote area,and enhance the living environment for rural residents.

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.

Availability and Affordability of Therapeutic Monoclonal Antibodies After the New Medical Reform in Hubei Province,China

Objective In 2017,China launched a new round of medical reform(NMR)to address the inaccessibility of high-priced drugs for patients with serious diseases.This study explored the impact of the NMR on the accessibility and affordability of high-priced monoclonal antibodies(mAbs),and the effective promotion policies after the NMR.Methods We used a standard method developed by the World Health Organization to conduct two surveys on the availability of mAbs and their prices before and after the NMR in the public hospitals in Hubei province,China.By interviewing hospital pharmacy experts,we identified the potential value of the current NMR in improving the access to therapeutic mAbs.Results The average availability of 13 mAbs increased by 8.1%in the surveyed hospitals of Hubei province after the NMR.The median unit price of 10 mAbs dropped by 34.3%.The average affordability of a treatment cycle of 10 mAbs dropped from 680 days to 298 days of the disposable daily income for a middle-income resident(56.2%reduction).The drug price negotiation of medical insurance inclusion and the promotion of consistent evaluation of generic and original drugs could effectively promote the accessibility of mAbs.However,the zero markup of drug pricing and the limit on the proportion of drug revenues in public hospitals showed certain negative effects on the availability of mAbs.Conclusion Not all current NMR policies play a positive role in promoting the accessibility of mAbs.To further improve the accessibility of mAbs in the future in China,it is therefore critical to increase the investment in independent research and development of high-quality mAbs,establish localized guidelines for the rational use of mAbs in clinical practice,and have a cost-sharing mechanism for high-priced drugs with multiple stakeholders.

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.

How to Promote Financial Management Level of Public Hospital under the New Medical Reform

Following the continuous development of our country's economy,the new medical reform of our country is also gradually speeding up.And potential problems existing in public hospital's financial department are being gradually magnified that has brought new challenge to financial management.The financial staff are studying the problems and trying to solve the problems through their working experiences from long-term practices and on a certain basis.Therefore,in this article,we try to find out the existing problems and to explore efficient solutions to the problems under the background of new medical reform and in the light of the importance of financial management to public hospital's development.The main purpose of this study is to try to solve the existing problems in financial management of public hospital so as to promote perfecting the systems of public medical institutions to get a better development.

The Pathway of China’s Integrated Delivery System:Based on the Analysis of the Medical Consortium Policies

With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery system,a medical consortium plays an important role in integrating public hospitals and primary care facilities.The first medical consortium policy issued after the COVID-19 pandemic apparently placed hope on accelerating the implementation of a medical consortium and tiered health-care delivery system.This paper illustrates the possible future pathway of China’s medical consortium through retrospection of the 10-year process,changes of the series of policies,and characteristics of the policy issued in 2020.We considered that a fully integrated medical consortium would be a major phenomenon in China's medical industry,which would lead to the formation of a dualistic care pattern in China.

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.

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.

New medical reform and the sustainable development of the pharmaceutical industry in China

The national economy development and the demanding of the drugs request the pharmaceutical industry in China to keep sustainable development especially under the background of the new medical reform. According to the status of industry development and drug consumption in China, the trend and the driving factors for pharmaceutical industry in the future were estimated. Based on the analysis of the background and conditions for pharmaceutical industry sustainable development in China, the problems and challenges, the goal as well as the main measures for the sustainable development of pharmaceutical industry were put forward.

新医科背景下以学生发展为中心的医学生理学教学模式实践

新医科建设背景下医学教育目标是以理论知识与实践能力为基础,着重培养创新能力,提升学生综合素质,培养复合型、创新型卓越医师。该研究以学生发展为中心,通过首次创新的IPA教学模式、注重教学中的课程思政教育、逻辑思维能力培养、情景教学运用及课程多元化评价等教学新探索,构建医学生理学教学模式的创新与实践,经过5年的探索和实践,以创新教学模式促学、促教、促建,进一步提高教学质量,培养一流医学人才。

高等医学教育课程改革及发展

医学教育作为培养医学人才的重要途径,如何顺应全球的医学发展,培养国际化的医学人才是新时代医学教育面临的新课题。医学课程改革作为医学教育改革过程中的核心内容,在医学教育的发展中起着不可替代的作用,因此如何在课程中融合各种教育理念及教育思想、结合各类教学方法及教学模式是培养符合新时代要求的多元化全面性高质量医学人才的重要课题。

党建引领视角下医疗卫生人才培养的实践研究

加强党建工作建设,充分发挥党组织领导核心的作用,为医疗卫生教育机构深化医疗人才培养提供坚强保障。在党建引领背景下对医疗卫生人才培养进行探索和研究,构建全员、全方位、全过程育人体系,聚焦党建引领,建强育人队伍,凸显全员育人合力,培养兼具扎实专业理论和综合素质能力的复合型人才成为重要的育人目标。推动党建引领实践育人工作,即有利于强化党对医疗卫生教育机构的领导,还有利于创新党建引领、医疗卫生教育机构主导和社会力量参与的实践育人模式。文章从党建引领,在医疗人才培养的实践探索、实践策略等方面,探索党建引领实践育人策略,以为相关工作提供一定的借鉴和参考依据。

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。

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。

基于DEMATEL模型的三级公立医院运营效率影响因素分析及对策研究

目的 分析影响医院运营效率的主要因素并提出意见建议,为医院管理部门提升医院运营效能提供参考依据。方法 利用决策试验和评价试验法(dematel)模型分析影响因素之间的相互作用关系。结果 员工工作负荷、人员结构比例、岗位责任、绩效考核方式等12个要素是影响三级公立医院运营效率的关键影响因素。结论 三级公立医院的高效运转是多种因素共同作用产生的结果,提高运营效率要从合理配置人力资源,完善绩效考核模式,优化医疗流程布局,创新发展运营模式等方面入手。

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。

新医科与新工科融合背景下医学统计课程教学探索及实践

在健康中国建设以及新医科建设的大背景下,为临床医学和公共卫生提供实验设计和统计分析方法的医学统计课程的教学面临诸多困境,需要新的探索与实践。基于在医学统计学和实验设计方面的多年教学实践与经验,系统分析当前医学统计教学效果不佳的主要原因包括如下几个方面,医学教育对医学统计的重视程度不够、教材和教师与教学需求相关性弱、教学模式单一和学生主动学习和兴趣较低。并提出“六位一体”的教学改革思路和教学实践,包括增强思政教育和增加对医学统计学的重视程度、明确新医科背景下医学专业对医学统计的新需求、优化教师知识体系、修订教学内容、改革教学方法和强化过程管理等,以满足新医科建设的医学统计课程教学改革思路与措施。

医保政策与健康伦理的冲突与对策分析

针对现行医保政策与患者健康伦理的冲突现象进行原因分析,汇总原因如下:医保基金的可持续发展状况堪忧、医保管理体系有待完善、医保管理部门与医疗机构协商谈判机制不健全、医疗卫生资源配置和人民群众的卫生服务需求不匹配。针对上述原因,应从调整医保基金筹资机制、构建多层次医疗保障体系、健全医保管理体系、建立医保管理部门与医疗机构协商谈判机制、促进医疗机构精细化管理程度等方面入手,维护医保基金安全,提高患者就医满意度。

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。

新医科背景下医学影像技术人才培养路径探索

随着全球医疗健康领域的快速发展,医学影像技术已成为疾病诊断和治疗中不可或缺的工具,其发展正受到前沿信息技术,如人工智能的深刻影响,并推动了医学影像技术朝着更高精度、更深层次解析力和更个性化治疗的方向迅速发展。同时,新医科教育改革强调跨学科融合、创新能力的培养和实践技能的提升,为医学影像技术领域的人才培养指明了新方向。文章旨在探讨新医科背景下,医学影像技术人发展趋势和现有人才培养模式存在的问题,同时提出了医学影像技术人才培养的创新策略和培养思考,以期培养出具有创新能力、跨学科知识结构和强大临床实践能力的医学影像技术人才,满足未来医疗健康领域的广泛需求和医学影像技术学科健康发展。