健康险赔付与医院收入长期联动效应分析——基于VAR和VEC模型的实证

近年来我国健康险发展较快,但其高赔付率成了进一步发展的\"瓶颈\",这主要源于医险市场中的道德风险。本文运用计量经济学方法,对保险赔付和医院收入的关系进行了实证分析。结论:医院医疗收入、门诊收入和住院收入是导致保险赔付上升的原因,健康险赔付对医院收入的影响作用不显著,健康险业务的健康发展离不开医方的紧密协作。建议:保险公司需重视与医院和医生的合作,突出合作重点、改革合作方式和革新合作内容。     

城市化对健康的影响研究评述：利弊分析与未来展望

快速的城市化对健康产生双重影响,既有积极的一面,也有消极的一面。城市化使城市人群能够分享现代医疗技术的最新成果,从而使城市人群的预期寿命更长,婴儿死亡率、孕产妇死亡率等更低;但同时城市化的过程也伴随着城市环境的污染和城市生活方式的改变,从而又使城市人群在许多疾病的发病率上高于农村。城市化对健康的影响到底是利大于弊还是弊大于利,目前在学术界还没有达成共识。文章尝试对此问题做一评述性研究。     

Renal function changes and NHS resource use in breast cancer patients with metastatic bone disease treated with IV zoledronic acid or oral ibandronic acid: a four-centre non-interventional study

Abstract

Aims: To describe renal function monitoring practice in patients with metastatic bone disease (MBD) treated with IV zoledronic acid (ZA) and oral ibandronic acid (IA), the management pathways and NHS hospital resources used.

Methods: Medical records of 189 patients; IA (91), ZA (98) with primary breast cancer and MBD were reviewed, and data collected on renal monitoring and hospital visits during bisphosphonate therapy. Time and motion review of resources to administer the bisphosphonates was also conducted.

Results: Only 30% of patients given ZA and no patient given IA had baseline creatinine clearance (CrCl) recorded. Calculated baseline CrCl suggested impaired renal function in 33% ZA and 29% IA patients. Dose reductions were not made correctly in 29 ZA and 2 IA patients whose monitoring suggested it. ZA patients made more clinic and day care attendances than IA-treated patients, at twice the cost. Staff activity and patient time per visit was higher with ZA than IA.

Conclusion: Although limited by retrospective design, these results demonstrate that in many patients, CrCl is not calculated before or during treatment with bisphosphonates. Renal function deteriorated in many patients during therapy. In view of these effects, practice should be reviewed to ensure appropriate dosing.     

建立质量、职业健康安全和环境整合管理体系的实践与探索

阐述了建立质量、职业健康安全和环境整合管理体系的必要性、可行性，以及建立整合管理体系的具体措施和取得的效果。提出了推行整合管理体系的几点建议。     

论药品专利和公共健康问题——以人权和“价值平衡”理论为视角

WTO建立的TRIPS协议将包括药品在内的一切发明都纳入可以给予专利保护的范围，这使发展中国家在解决本国因艾滋病、结核病和疟疾等传染病引起的公共健康问题时，和发达国家相关药品的专利保护之间产生冲突。从当前全球的公共健康现状出发，运用人权和“价值平衡”理论对此分析，可以得出这样的结论：作为基本人权，发展中国家人民的生命健康权应该优于知识产权加以保护。     

职业院校开展大学生心理健康教育活动新思考

开展大学生心理健康教育活动,是大学生心理健康教育的两翼之一,对提高大学生的心理健康水平至关重要。笔者通过三年的一线实践活动,就职业院校大学生心理健康教育活动的开展及大学生人格完善的心理问题进行了有益的探索。     

以行动为导向的“老年中医养生”课程案例教学实践创新

“老年中医养生”课程是老年服务与管理专业学习领域课程中的一门职业核心课程。教学中运用多媒体案例教学法、行动引导教学法等有效方法,培养学生的学习兴趣,建立学生的自信心,提高学生的自我学习能力,以使学生具备中医养生的基本素养,在实训中能够指导老年人进行因人、因时和因地摄养等养生实践活动。     

It's not what you know but who you know that's important: the influence of social networks on communities

Since its conception in 1945, the UK National Health Service (NHS) has been the focus of extensive political rhetoric regarding the involvement of patients and the public in the provision of health‐care services both locally and nationally. However, achieving substantial user involvement within local communities has proven to be a complex task. The exploratory research presented in this paper investigates the influence of social networks within local communities and its relevance for user involvement. Four main findings emerged: interviewees have strong informal social networks; there is a strong sense of generalized reciprocity; diversity is limited within the social groupings; and there exists a lack of trust in governmental institutions. With regards to health issues, there is an overriding feeling that ‘things like that should be left to the people who know’. If user involvement is to be achieved at the level envisioned by the UK government, achieving a greater relevance for users is essential.     

Genetically modified organisms and the age of (Un) reason? A critical examination of the rhetoric in the GMO public policy debates in Ghana

Using narrative policy analysis we examined the adversarial rhetoric of claims-makers in their bid to undermine alternative and conflicting accounts of GMOs as environmental and human health risk and to forestall any challenges to the scientific authority of the technological deterministic account of the GMO policy debates in Ghana. The study shows that the GMO discourse was built with the rhetorical frames of smallholder farmer vulnerability and entitlement used in the account it contradicts, thereby legitimating its own appeal for responsive remedies. Civil society claims attacked GMOs as discriminatory and as an environmental and human health risk. Government and scientists engaged in unsympathetic counter rhetorical strategies in hopes of debunking or neutralizing the claim made by civil society. In other words, Government and scientists were denying the claim that GMO was discriminatory and posed significant human health risk, as well as the call to action to do something about GMOs. Civil society adapted the counter rhetoric of insincerity, claiming that scientists had some kind of “hidden agenda” behind their claim, such as eagerness to just earn money from their patents on GMOs. It is imperative that communication on GMOs includes the underlying assumptions, the uncertainties and the probabilities associated with both best and worst case scenarios. This is a necessary condition to minimise misinformation on GMOs but may be insufficient to completely erase conspiracy theories from the minds of the public especially when scientists and government are perceived to be biased towards multinational corporations that are ostensibly preoccupied with making profits.     

商业健康保险是否促进了居民健康——基于微观数据的实证研究

党的十九大报告明确提出全面实施"健康中国"战略,强调商业健康保险参与多层次医疗保障体系建设,服务广大人民群众健康保障的重要作用。明确商业健康保险如何从微观层面提高居民健康是有效发挥其助力"健康中国"作用的前提与基础。本文基于中国健康和营养调查(CHNS)2000～2015年面板数据,利用面板工具变量法解决内生性,考察商业健康保险对居民健康水平的影响,同时对不同收入阶层和年龄阶段进行异质性分析,并进行机制探讨。研究表明,商业健康保险能够显著提高居民的健康水平,而且这一正向影响对高收入阶层和中年人群的正向影响更为明显。此外,机制分析表明商业健康保险能够提高居民的医疗服务利用,改善居民健康行为,从而提高健康水平。