预防医学在社区卫生服务中的运用探讨

目的:探讨预防医学在社区卫生服务中的运用效果。方法:将该地区的社区卫生服务工作分成两个阶段,对两个阶段居民对环境卫生、食品卫生、劳动卫生、心理卫生等相关知识的掌握、年家庭食物中毒发生例数以及对社区卫生服务工作的满意度情况进行比较。结果:第二阶段的居民相关知识掌握、年家庭食物中毒发生例数、社区卫生服务工作满意度明显优于第一阶段,均具有显著性差异,P<0.05,有统计学意义。结论:预防医学在社区卫生服务中具有重要地位,可显著提高社区居民的健康水平,应继续扩大预防医学在卫生服务中的应用范围,提高人民预防疾病发生的意识。     

城市医院与社区卫生服务机构互动合作模式的选择——基于关系租金视角

随着我国新型两级医疗卫生服务体系的建立,构建两级医疗卫生服务体系间的良好互动体系,成为新型医疗卫生服务体系研究的焦点。本文从经济组织的关系租金视角,对城市医院与社区卫生服务机构的互动合作模式选择问题进行探索性研究。研究结论表明,建立长期关系导向的互动合作模式是最优模式,组建医院集团的互动合作模式,是一种帕累托改进结果。     

Using users: When does external knowledge enhance corporate product innovation?

Prior research on corporate innovation highlights the importance of accessing external knowledge from other firms and universities. However, survey evidence indicates that product users are perhaps the most important source of external knowledge. We build on existing theory to identify the conditions under which user knowledge contributes to corporate innovation and when the benefits will be greatest. Using a panel dataset of medical device companies and their collaborative efforts with innovative physicians, we find evidence that inventive collaborations with users enhance corporate product innovation and that the benefits are greatest in new technology areas and in the generation of radical innovations. Copyright © 2013 John Wiley & Sons, Ltd.     

Conditions influencing the adoption of a soda tax for public health: Analysis of the French case (2005–2012)

Although over 40 jurisdictions have adopted a tax on sugar-sweetened beverages (SSBs) for public health worldwide, it is still debated in many places. Policy processes can influence the prospect of an SSB tax, its design and its public health benefits. To get an insight into such processes, we undertook a case study of the soda tax enacted in France on the 1^st of January 2012. Newspaper articles (2003–2013) and institutional documents (2007–2012) were identified using keywords and search engines. Qualitative data extraction and analyses were performed on a thematic and chronological basis, with guidance from Kingdon’s multiple streams theory (MST). Triangulation was enhanced by using complementary sources. This study shows that in August 2011, the French government surprisingly announced a €3.58 cent/L excise tax on SSBs, excluding juices with no added sugars and non-calorically sweetened beverages (NCSBs). As part of a large budgetary plan, the proposal aimed to reduce SSB consumption and raise revenue that was earmarked for health care. Several conditions contributed to opening a policy window: The announcement occurred in the context of severe budgetary deficits; soda tax scenarios had already been discussed at a high level; and the bill was supported by convinced political leaders. Subsequently, the tax successfully passed through the legislative process due to a series of unexpected events, but its public health rationale and design were weakened. The first event was the disorganised reaction by the food industry, despite their sharp opposition to the tax. The next event was the support of the soda tax that came from a majority of Deputies, provided that the revenues would serve another purpose: relieving wage costs in the farming sector. Finally, policy entrepreneurs favoured a compromise to make the tax politically acceptable and legally viable: The tax rate doubled, the scope was extended to NCSBs and revenues were split between health care and agriculture. This study sheds light on influence factors that could be taken into account by public health actors willing to influence soda tax policy processes.     

从中国医药卫生体制改革看卫生教育的发展方向

新医改方案的出台,对卫生管理人才队伍建设和医学教育发展提出了更高的要求。新医改方案并不是最终的方案,需要不断地试点、摸索,加大对卫生管理人才队伍建设是当务之急。探讨我国卫生教育的发展方向,提出应大力培养医学创新人才和应用型卫生管理人才,加强人文素质教育,并使中医教育回归。     

全民健保战略目标下的医疗救助理念研究——浙江省新型社会救助体系的启示

在全民健保的战略目标下,医疗救助的地位被弱化,只是对因病致贫人员和特殊群体实行的临时性救助。然而,以缴费型保险为主的医疗保障体系不能从根本上解决贫困人口的医疗费用问题。因此,从目前过渡到全民健保阶段,医疗救助的地位不应该被削弱。目前我国医疗救助的理念定位不清,没有充分化解贫困人口的疾病风险。本文以全民健保的战略目标和医改为背景,对基本风险、最低需求、政府责任这几个基本概念加以界定;并从医疗救助化解的社会风险出发,分析全民健保战略目标下仍需医疗救助处理的基本风险;再以浙江省分层分类的覆盖城乡的新型社会救助体系为例,阐述医疗救助理念定位需要重点解决的两个关键问题,反思医疗救助与社会医疗保险的关系和医疗救助水平,促进公平和效率。     

Interim Realities

Abstract

This paper presents findings from a study of information technology implementation practices in National Health Service hospitals in England. The results suggest that there is a general direction of travel, which involves the progressive linking together of individual systems, so that they are interoperable. We argue that the findings are consistent with meta-governance arguments, but that it is necessary to complement this perspective with an understanding of the nature of information technologies in order to understand them properly. We suggest that ‘interim systems’ will be the reality on the ground for many health care organizations for the foreseeable future.     

Social Return on Investment (SROI) and Performance Measurement

Abstract

Social enterprises are being promoted as responsive and innovative way to deliver public services. As part of this promotion, these organizations are being required to demonstrate the social and economic value they generate. Social return on investment (SROI) is a performance measurement tool currently being encouraged to capture this impact. This paper draws on survey and interview data to analyse how SROI is used and understood in health and social care settings. It indicates that despite being accepted as an internationally recognized measurement tool for social enterprise, SROI is underused and undervalued due to practical and ideological barriers.     

Interactive identity work of professionals in management: a hospital case study

ABSTRACT

Hybrid professional managers appear less effective in introducing management into public professional settings than policymakers hope. To date, research has offered little understanding of professionals’ identity transition challenge and the role of social interactions underpinning this process. We studied the identity work of hybrid doctors inside a large public health-care organization, finding that it takes place through processes of familiarizing with management, rationalizing being a hybrid, and legitimizing the new role-identity. We contribute to the literature by showing that identity work is distributed and enabled by social interactions beyond the professional group. Implications for policymakers and executives are discussed.     

试述用人单位在职业病防治中易忽视的问题及对策

用人单位是《职业病防治法》所规定的各项职业病防治措施的主要落实者,是劳动者职业健康及其相关权益保护的第一责任人。明目张胆违反《职业病防治法》的用人单位减少了,但在具体工作中,办事不严、忽视、执行不到位的情况依然存在。文章列举了这些问题并提出了解决措施。