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.

Issues concerning Migrant Workers' Participation in the New Rural Cooperative Medical System and Countermeasures——Based on the Survey in Wenjiang District and Jintang County, Chengdu City

We conduct questionnaire survey of migrant workers in Wenjiang District and Jintang County of Chengdu City,respectively,using the method of key-point investigation and the sampling survey. We describe the status quo of the sample migrant workers' participation in the New Rural Cooperative Medical System,analyze the issues concerning migrant workers' participation in the New Rural Cooperative Medical System,and put forward the countermeasures and recommendations as follows: using many types of medical insurance; establishing universal reimbursement points in strange land and premium-paying system for migrant workers; making the proportion of reimbursement open and transparent; establishing and improving medicare security system for migrant workers.

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.

Restraining Factors and Improving Paths for the Operation Mechanism of New Rural Cooperative Medical System in China

The new rural cooperative medical system has achieved periodical achievements since its establishment.Nevertheless,there are many factors hampering the development of the new system,such as the high cost,the difficulties in fund procurement,the lack of management,the narrow coverage of benefit,the ineffective constraint to the designated medical institutions,the high fund balance rate,and the poor medical facilities and services in rural areas.Countermeasures are put forward to solve these problems,including improving the system design,expanding the coverage of the system,expanding the fund sources,reducing the financing costs,strengthening the fund supervision,enhancing the supervision of designated medical institutions,and improving the capacity of health services in rural areas.

The New Rural Cooperative Medical Scheme and Its Implications on Rural Labor Migration in China：Evidence from Longitudinal Surveys

In 2003, China initiated the New Rural Cooperative Medical Scheme （NRCMS） in order to provide basic health care coverage for the rural population. However, the NRCMS has had a marked impact on rural-urban labor migration as its current regulations present a barrier for cross-region participation in the NRCMS, and its reimbursement system is biased when the enrollees seek medical services outside their location of hukou, a household registration system in China. This paper performs a variety of empirical tests on a panel data set from the China Health and Nutrition Survey （CHNS） to study how the NRCMS affects rural residents＇ work location choices. We observed a ＂locking effect＂ on potential rural migrant workers and a ＂pulling effect＂ on existing ones. According to the results, the NRCMS has discouraged rural residents from working outside their location of hukou, lowering the probability of relocation by 3.52 percent. Meanwhile, the NRCMS system actually encourages existing migrant workers to return home. This paper concludes that the NRCMS has to some extent restrained the free flow of the labor force and exacerbated the migrant worker shortage.

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.

Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in STI management and to assess the impact of a two-day training orientation among RMPs in Tangail district. Data were collected through a baseline survey of 225 practicing RMPs in the study area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV orientation training. The level of formal training among RMPs ranged from none (22.7%), to paramedical training (14.7%) and local medical assistant training (62.6%). The baseline survey revealed a low level of STI/HIV knowledge and misconceptions about the transmission of STI/HIV among RMPs. RMPs mostly prescribed first line antibiotics for treatment of common reproductive tract infections (RTIs) including STIs, but they rarely prescribed the correct dosages according to the national RTI/STI management guidelines. Only 3% of RMPs were able to correctly answer all four HIV transmission (unprotected sexual intercourse, blood transfusion, needle sharing and mother to child transmission) questions at baseline, while 94.9% of RMPs answered all four correctly at three months following the training (p = 0.001). Only 10% of RMPs reported suggesting the recommended drug (azithromycin) and only 2% mentioned about the recommended dosage (2 gm single dose) for the treatment of urethritis/cervicitis;compared to 49.5% suggested azithromycin at follow-up with 39.4% mentioned the recommended 2 gm single dose (p = 0.001). Our study found low level of knowledge and poor practices related RTI/STI management among RMPs. Short orientation training and education intervention shown promise to increase knowledge and management skills for RTIs/STIs.

城乡基本医疗保险制度实施对家庭消费的影响效应及作用机制

基于1988—2018年中国家庭收入调查数据,以城乡基本医疗保险制度实施为准自然实验,采用双重差分法考察了城镇基本医疗保险与新型农村合作医疗保险(即新农合)对家庭消费率的影响及其机制。结果显示:相较于未参保家庭,参加城镇医保的家庭消费率显著高出1.01%,但新农合的影响不显著;机制分析发现,城镇医保促进了参保家庭的总消费和分项消费支出,但新农合对消费支出无显著影响,同时,城镇医保和新农合对总收入和大部分分项收入无显著影响,这与基准回归结果一致;异质性分析表明,城镇医保更多地提升了中老年、非富裕、不健康群体,以及西部地区的家庭消费率。对此,应当充分发挥基本医疗保险制度对提振家庭消费率的积极作用,对“大水漫灌”式的财政补助应进行反思;改变基本医保“户保分离”“业保分离”的现状;加强针对特定人群的医保政策;注重提高参保青年和健康群体的获得感。

新质生产力发展视角下山西省农机专业合作社提质增效优化研究

农机专业合作社发展离不开新质生产力的推动,而劳动者、生产关系、生产工具和生产要素创新性配置等,都是新质生产力形成过程中不可或缺的要素。该文采用文献研究、问卷调查,以及与农机专业合作社相关领域专家及负责人深度访谈交流的方式,从山西省农户调查、农业职业经理人经营能力和村镇银行信贷满意度调查3个视角对农机专业合作社提质增效进行分析研究,剖析产生问题的原因,提出深化联合社发展、构建新型服务模式,改革联合社人才选聘机制,充分发挥农业中介专业组织作用,以及优化农村金融贷款服务等促进农机专业合作社提质增效优化的建议。

合作经营对新型农村集体经济组织韧性的影响

基于陕西、甘肃两省微观调查数据,从冗余性、敏捷性、稳定性、能动性四个方面构建新型农村集体经济组织韧性测度指标,论证了合作经营对新型农村集体经济组织韧性的影响。研究结果显示,采取合作经营的方式使新型农村集体经济组织韧性明显提高约17.8%,该结论能通过稳健性和内生性检验;但合作经营对新型农村集体经济组织韧性的影响程度会受到村域社会资本和自然资源禀赋的调节。进一步检验发现,合作经营对新型农村集体经济组织韧性的正向影响在兼业化水平低、村集体经济收入较高、户籍人口较多的村庄中更为明显。因此,应该因地制宜,逐步采取合作经营的方式发展新型农村集体经济;同时应规范集体资产管理,保障组织成员主体性地位,以促进新型农村集体经济发展壮大。

大病保险、医疗服务升级与农民健康

“健康中国2030”规划纲要明确了健康对经济社会发展的重要作用,在新型农村合作医疗制度未能显著改善农民健康的背景下,研究农民健康水平的提升机制具有重要意义。本文聚焦2012年8月开始试点实施的城乡居民大病保险制度,基于2011—2015年中国健康与养老追踪调查(CHARLS)数据,以样本所在城市是否试点实施农村大病保险作为依据构造“农村大病保险”参保变量,运用计量模型实证检验农村大病保险对农民健康的影响效应及机制。实证结果显示,试点农村大病保险使农民自评健康显著提高0.08个单位,并且在对健康水平和农村大病保险等变量进行重新调整的情形下,实证结果依然稳健。异质性分析结果显示,农村大病保险对低收入群体的健康促进作用更大,并且对社区内有医疗点的群体影响效果更为显著。机制分析结果显示,对于需住院群体而言,农村大病保险通过促进农民做出住院决策进而改善了健康;而对于住院群体,农村大病保险通过促进农民选择级别更高的县区级医院进而改善了健康。为进一步提高农民健康水平,应丰富农村大病保险的筹资主体,引入个人缴费和财政补贴,在扩大大病保险基金规模的前提下,进一步提升大病保险待遇水平;同时,应改善农村基层医疗资源分配,提高农民基层医疗服务可及性和服务水平。

医疗设备信息化管理在新医改背景下现存的问题及解决路径

鉴于新医改背景下医院发展逐渐朝着现代化方向迈进。本文将以医疗设备信息化管理为研究对象,从概述医疗设备信息化管理的重要意义展开,着重分析新医改背景下医疗设备信息化管理存在的问题,探讨解决问题的可行性路径。

Health Insurance and Its Reimbursement Arrangements： Policy Evaluation on New Cooperative Medical System in Rural China

Disease has been one of the top reasons accounting for impoverishment in rural China. The government subsidizes health care through the New Cooperative Medical System since 2003 （ NCMS ）. The paper studies the effectiveness of various reimbursement arrangements in reducing the financial burden caused by health care in rural China. Using data from China Health and Nutrition Survey（CHNS） , it finds that the severity of illness, the type of illness, medical cost and other costs of the treatment are significantly influencing the choice of a type of treatment. Based on the estimated demand function, the paper concludes that the reimbursement for inmpatient care only has little effect on reducing the financial burden and the incidence of catastrophic expenditure and that expending subsidies to outpatient care is a more effective policy.

新型农村集体经济的市场化经营路径选择:自主经营还是合作经营

发展新型农村集体经济是党的二十大做出的重要部署,国家对此也做出了制度性安排,但对于集体经济组织如何有效参与市场,理论研究与实践探索都尚未形成明确共识。本文基于新型农村集体经济发展的组织特征和现实基础,深入剖析自主经营与合作经营两种发展路径的优劣。分析表明,两种方式各有优劣,发展新型农村集体经济不应该采取“非此即彼”的策略,而应该采取“互相补充”的思路。在农村集体产权制度改革取得阶段性成果的当下,农村集体经济重点应该基于农村集体禀赋优势,更多采取合作经营的模式以提高市场效率,并积极培育可以自主经营的发展领域以兼顾集体公共利益。

农村新型合作经济组织财务管理研究

农村新型合作经济组织财务管理是我国乡村经济发展的有机组成部分,随着乡村改革的持续深化,各地在构建农村财务管理机制,实行村级财务工作中取得了良好的成效。结合农村新型合作经济组织财务管理的内涵,明确其所存在的问题,提出丰富筹资方式、健全财务制度、加强队伍建设等管理策略,以期提升新型合作经济组织的发展质量,助推我国农村经济的蓬勃发展。

新文科背景下医学信息管理专业创新创业人才培养体系的构建与实践

新文科建设强调传统文科与其他相关的学科深度融合,为医学信息管理专业的高质量发展提供了新契机。创新创业教育现已经成为高校应用型人才培养教育教学改革的核心内容。有关该专业的“双创教育贯穿人才培养全过程”的系统研究较少,存在“管理学+计算机科学与技术+医学”深度融合难、创新创业教育融入难和创新创业教育评价难等问题。桂林医学院医学信息管理专业开展了“融合、进阶和协同育人”创新创业人才培养体系的构建与实践,取得了一些成效,现将主要做法及其取得成果进行总结,以期为其他高校的相关专业教育教学改革实践提供借鉴。

“新医科”背景下药事管理学信息化教学探索

药事管理学具有极强的实践性和政策性,是药学专业重要课程之一。分析药事管理学教学过程中存在的问题,对如何利用信息化教学技术对药事管理学教学的优化和改革进行探索,以期提高课堂教学效率和学生自主学习能力,为“新医科”背景下我国制药工程专业人才培养提供一定参考。

乡村振兴视角下农民对新农合满意度影响因素研究——来自全国2152个农户的微观数据

人们对美好生活的向往是乡村振兴的关键衡量指标,农民对新农合满意度评价影响到农民对于乡村振兴建设的满意度。本文关注乡村振兴视角下,农民对新农合满意度影响因素,利用全国2152个农户入户调查数据,采用Eveiws软件对数据进行了有序Logistic回归分析,结果表明:整体上农民对新农合满意度高于不满意度比例,55%对新农合表示满意,37%则对新农合持有一般态度;年龄、文化程度、农民纯收入对新农合满意度具有显著正向作用,说明提升文化程度以及改善人民收入,有利于提升新农合满意度;通过网络获取医疗信息便利度对新农合满意度有显著正向影响,表明互联网的使用,强化了农民信息获取、便利了农民之间的交流,从而带动了人们对农村新农合的满意度;比照东北区域村庄,东部区域和中部区域村庄居民对新农合满意度要低一些。

信息化建设在高等医学院校考试管理工作中的探索与实践

随着信息化的迅猛发展,对新时代形势下的高等医学院校考试管理工作提出了新的挑战。研究通过分析当前高等医学院校考试管理过程中存在的问题和短板,在完善制度、规范考试管理,加强培训、提升考试专业化水平,搭建基于网络考试评卷和网上评卷系统相结合的考试平台、促进课程试题库建设、提升高校考试信息化水平等方面进行有益的探索实践,构建起了新时代背景下高等医学院校的信息化考试管理新模式,提升高校医学考试管理工作效率、促进考试安全,强化高校考试的育人成效,进一步提高考试管理的数字化水平。