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政策我国基本医疗覆盖九成以上人口随着城镇居民基本医疗保险制度的建立,我国覆盖全体居民的基本医疗保障制度框架基本建成,90%以上的城乡人口有了基本医疗保障。截至去年底,城镇基本医疗保险参保人数4.3亿人,新     

精准扶贫完善贫困人群医疗保障政策

随着国家对医疗保障扶贫项目的关注,越来越多的贫困群体获得了医疗保障扶贫,一定程度上缓解了高昂的医疗费用压力,在实际运行中该制度还存在许多问题,本文拟对X县医疗保障扶贫情况梳理,进一步分析当前精准扶贫完善贫困人群医疗保障存在的困境,并在此基础上提出相应的改善建议,已推进我国医疗保障扶贫工作稳步发展.     

加强农村医疗救助，完善新型农村医疗保障制度的建设

随着新农村建设的不断深入和农村现代化的迅速发展，农民医疗保障问题已经成为中国农村社会健康发展的一大障碍。因此。进一步完善新型农村医疗保障制度，对合理界定政府在农村医疗保障等市场失灵领域的新职能，为加快农村公共卫生和医疗保障事业的健康发展具有重要的意义。虽然近几年新型农村合作医疗工作进展稳定，并取得了一定的成效。但从总体来看。新型农村合作医疗对贫困人口的保障力度不够，农村贫困人口没有能力支付参与合作医疗的费用，即使由政府补助参与了新型合作医疗，也无力承担应自负的费用；农村现有卫生服务能力还不能满足广大农民群众的需要。基础的公共卫生设施相对薄弱，一些贫困农民有痛得不到及时医治；医疗救助资金缺乏稳定可靠的来源，难以保障农村居民的基本医疗，也会影响经济的长期可持续发展和实现全面建设小康社会的宏伟目标。文章对此进行归纳和梳理，总结出自己的见解和理论。旨在为进一步深化和完善新型农村医疗保障制度，建立独立的农村医疗救助制度等领域提供参考。     

针对医疗费用上涨问题应采取的对策

<正>医疗费用的快速上涨已经成为社会普遍关心的问题,的确,近年来,"看病贵、药价高"已经成了老百姓的一块心病。卫生部公布的第三次全国卫生服务调查数据显示:我国约有48.9%的居民有病不就医,29.6%的居民应住院而不住院。医疗费用的上涨对于有医疗保障的人也是"存了一辈子,一场病耗掉一多半",因病致贫、因病返贫问题突出。     

国务院关于开展城镇居民基本医疗保险试点的指导意见

国发[2007]20号各省、自治区、直辖市人民政府,国务院各部委、各直属机构:党中央、国务院高度重视解决广大人民群众的医疗保障问题,不断完善医疗保障制度。1998年我国开始建立城镇职工基本医疗保险制度,之后又启动了新型农村合作医疗制度试点,建立了城乡医疗救助制度。目前没有医疗保障制度安排的主要是城镇非从业居民。为实现基本建立覆盖城乡全体居民的医疗保障体系的目标,国务院决定,从今年起开展城镇居民基本医疗保险试点(以下简称试点)。各地区各部门要充分认识这项工作的重要性,将其作为落实科学发展观、构建社会主义和谐社会的一项重要任务,高度重视,统筹规划,规范引导,稳步推进。     

国际典型医疗保障模式比较及启示

一、国际医疗保障模式 医疗保障是指通过保障减少被保障者利用医疗服务的经济障碍。医疗保障制度是医疗保障各种制度的统称，可分为医疗保险、医疗救助、免费医疗等形式。医疗保障模式是不同国家保障制度进行归类，同一类型制度的统称．如以英国和北欧为代表的国家卫生服务保障制度模式、以德国、新加坡为代表的社会医疗保险制度模式、以美国为代表的市场医疗保险制度模式和以巴西、印度为代表的发展中国家低水平全民医保模式。     

关于我国城镇贫困人口问题的几点思考

在我国农村贫困人口逐年减少的趋势下,我国城镇贫困人口数量近年来却呈现日益增加的态势。虽然,各级政府和社会各界在城镇扶贫工作中已经做了一些工作。但是,从总体上看,对城镇贫困问题的严重性、艰巨性以及长期性普遍认识不足。采取的手段和措施多为一些临时性的救急措施,不能适应城镇贫困的严峻现实。为了从根本上解决城镇居民贫困问题,就要寻求影响城镇贫困人口的内在决定因素,进而探索一条城镇贫困人口脱贫的根本途径。     

拓宽扶贫思路,构建和谐社会

改革开放以来,我国扶贫工作成绩显著.全国贫困人口已从30%降至4%,但目前无论相对贫困还是绝对贫困,情况仍然十分严重.绝对贫困方面,全国农村低于国家规定的贫困线(人均年收入667元人民币)的人口有2 600多万,其温饱问题还未完全解决;全国城镇低于低保线(人均月收入159元人民币)的人口有2 200多万,生活状况仍十分艰难.     

税收为源

加拿大医疗保险基金筹资途径是联邦政府、省政府和投保者三方。联邦和省政府投入占95%以上,税收是其最主要的来源。加拿大现行的医疗保障制度是包括10个省和3个特区医疗保险计划的完整体系,称为国家医疗保险计划,或医疗保障,为所有加拿大国民提供各种必要的住院和门诊服务。各省(特区)政府管理和提供基本的医疗服务,并在联邦政府的资助下,负担医疗服务的费用支出。各省(特区)为得     

关于城镇居民基本医疗保险制度的思考——基于湖北省的试点情况

城镇居民基本医疗保险制度的建立,为解决城镇非从业居民的基本医疗需求提供了制度保障,使我国的医疗保险制度实现了真正意义上的全覆盖。由于制度运行时间不长,在实施过程中还存在诸多问题,需要按照国家医药卫生体制改革的要求,重视医疗保险制度的整体设计,通过适当降低医保基金结余,加强医保基金监管,提高统筹层次等措施来提高医保基金的使用效率,逐步提高参保居民的医疗保障待遇。     

社区卫生事业管理的统计学分析及实证研究——以南京市江宁区为例

文章主要运用实证分析方法来探讨影响江宁区社区居民健康状况与卫生服务需要的因素和被调查者人口学特征。通过多阶段分层整群抽样方法,对南京市江宁区15岁以上的常住居民进行问卷调查,经过统计分析,掌握南京市江宁区社区慢性病患病率与城乡差异、性别差异、年龄差异以及文化程度之间的关系,从而采取针对性措施,有效地控制社区医疗及卫生服务成本,提高卫生服务质量。     

Empirical research on smart city construction and public health under information and communications technology

Big data and the internet of things in smart cities play an increasingly important role in the health of urban residents. However, few studies have collected empirical evidence to determine whether the implementation of smart cities can have a positive impact on healthcare. Using three years of panel data from the CHARLS national baseline survey, we examined whether and how smart city construction affects the health status of residents. The results show that the construction of smart cities improves residents’ health status. This relationship is achieved by reducing the use of outpatient services and increasing the utilization of inpatient services. Furthermore, compared with urban residents, rural residents show more significant behavioural changes in their use of medical services under the influence of smart city construction.     

中国医疗卫生事业效益分析之系列研究——2005-2009年全国传染病医院效益分析

目的:中国是肝炎大国,研究全国传染病医院投入与产出效益分析并找出影响因素并提出对策。方法:收集2005年-2009年统计数据,采用平均增长量、平均发展速度、平均增长速度计算出投入、产出指标值。结果:职工人数(包括医生数)、医疗仪器设备、房屋建筑面积(包括业务用房面积)等投入指标保持年均正增长速度。诊疗人次数、入院人数、病床工作日、病床周转次数等社会效益产出指标保持年均正增长速度,病床使用率提高16.4个百分点,出院者平均住院日每年缩短0.55日。净资产经济效益产出指标年均增长速度达32.47%,病毒性肝炎出院者人均医药费用年增长速度4.6%。结论:全国传染病医院属于朝阳事业,但应加大传染病预防的宣传力度,加强卫生管理,从源头消除传染源。加快完善新型农村合作医疗、城镇居民和职工医疗保险。     

Utilization control in HMOs.

Health Maintenance Organizations (HMOs) have emerged as a major vehicle to reduce transaction costs associated with defining the limits of health insurance coverage and to provide appropriate provider incentives. This article explains the heterogeneous set of incentives used by HMOs to reimburse providers and performs empirical tests of their effectiveness. The empirical analyses reveal that utilization of health care services is reduced when (1) physician compensation is based on salary or capitation arrangements rather than some measure of output; (2) bonuses and paybacks are based on individual rather than group performance; and (3) when the HMO operates as a proprietary (for-profit) organization. Utilization is not significantly affected by incentives placed on the hospital. Finally, physician ownership of the HMO was found to lead to higher levels of utilization.     

应用全面质量管理理论提升医院医疗和管理水平

医院的医疗技术水平和管理水平是医院的生命线,医院应用全面质量管理理论,牢固树立"质量就是生命"的理念,提高医疗安全,提升医院的优质服务水平,持续改进医院在管理中存在的问题,探索医院质量管理的新思路。     

Barriers to entry in the healthcare markets: Winners and Losers from certificate-of-need laws

In states with Certificate of Need (CON) laws, medical services providers must file an application and demonstrate community need before being permitted to start or expand a service. We examine CON laws for magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) scanners to test the hypothesis that the approval process favors established incumbent hospitals over new hospital entrants and nonhospital providers. Using Medicare claims data in 2013, we find that states with CON laws have 20 to 33% fewer providers, depending on the type of scanners to which the laws apply. As a result, residents of CON law states are 3.4–5.3 percentage points more likely to travel outside their home county to obtain imaging services than residents of non-CON states. In addition, there is a notable shift in the type of provider: CON laws are associated with 27–53% fewer scans by nonhospital providers per beneficiary, 23 to 70% fewer by new hospitals, but 6 to 21% more scans in older hospitals.     

Doctors Versus Workers

The National Health Service is claimed to be a unique and effective instrument for maintaining the health of the mass of the people. Dr David Green claims that the evidence from research into the 19th century development of health services indicates almost the contrary: that the medical profession, faced by the resolute and often superior bargaining power of the working people organised through friendly societies and other voluntary organisations, gradually moved to replace them by the state as a source of finance (1911) and ultimately the organiser of the medical services (1948). In the event, they have undermined the bargaining power of the ordinary consumer, especially the poor, and subjected him to the control of politicians and bureaucrats. The people are not sovereign in medical care, but subject.     

中国医疗卫生事业效益分析之系列研究——2010年基层医疗卫生事业之效益分析

研究2010年基层医疗卫生事业发展,基层医疗卫生机构主要分布在农村,以公立、非营利为主,承担发挥良好社会职责和社会效益,确保基层卫生人员的队伍及稳定性,加强资产、成本核算、成本支出的管理,提高资产利用率。     

基层医院病案管理问题与思考

目的:查找医院病案管理中存在的问题,采取积极有效的措施,为提高基层医院病案管理质量提供依据。方法:对二级以上医院利用随访方式调查,随机到实地病案室查看。结果:病案室缺少管理人员,业务知识差,基础设施不齐,制度不健全等。结论:基层医院病案管理急需医院重视,应主动采取有效措施,促进基层医院病案管理事业的发展。     

A multivariate analysis of the determinants of physician utilization

This study examines the determinants of health services utilization among 2168 households in five New York and Pennsylvania counties. The purpose is to identify sub-population groups with relatively homogeneous patterns of health service use behavior and to determine for each the relative importance of various predictors, categorized into three broad dimensions—the need for care, predisposing factors and enabling factors. A two stage approach using multivariate analysis technique is employed.Overall, the proportion of expenses paid by health insurance, Medicare, social class and the physician-population ratio in the country where health services are recieved are found to be important predictors of health services use. The significance of these and other predictors varies, however, from one subgroup to the next. The analytical strategy employed proves to be helpful both in understanding the differential patterns of health services utilization in subpopulations and in indentifying impediments to health care. Moreover, the predictive models of physician utilization are formulated.