关注健康公平,保障健康权益

在卫生改革与发展的过程中,健康公平与健康权益的问题不断引出争论,而且,出现的许多新问题也都与健康公平相关.获得基本医疗服务对于全体居民来说,并不仅仅具有提高劳动力素质的意义,而且还是人们充分发挥自身潜力的一个前提,是人们参与社会经济政治决策过程的一个前提,有着超出个人投资回报的社会效益.因此,在卫生改革过程中应该关注健康公平,合理保护居民的健康权益.     

关于健康公平现实选择

健康公平是全人类共同追求的目标,然而由于经济、社会和文化等因素又造成了健康的极大不公平。如何在现有条件下满足人们对健康的需要,实现健康公平,揭示了健康公平的内涵,以及现实中健康不公平的表现形式;同时,提出健康公平的现实选择应从我国的现实国情出发,解决目前健康不公平问题。     

关于健康公平现实选择

健康公平是全人类共同追求的目标,然而由于经济、社会和文化等因素又造成了健康的极大不公平.如何在现有条件下满足人们对健康的需要,实现健康公平,揭示了健康公平的内涵,以及现实中健康不公平的表现形式;同时,提出健康公平的现实选择应从我国的现实国情出发,解决目前健康不公平问题.     

公平感对社会认知的影响:经济因素的调节作用

目的及方法:基于中国综合社会调查2010年数据,采用多层结构方程模型,探究中国民众公平感对社会认知的作用,及经济因素在其中的调节效应。研究结果:第一,公平感越高,则社会冲突感越低,外在政治效能感越高,越倾向于对社会不平等进行内部归因,即对于社会的整体认知更加积极; 第二,经济因素能调节公平感与社会不平等内归因的关系,具体而言,经济水平越低,则公平感对于社会不平等的内部归因正向预测作用越大。     

绩效、能力、职位对组织分配公平观的影响

旨在探索基于组织分配公平的认知评价和决策行为的影响因素,为此提出了不公平阈限的概念,即在追求公平和谋求自我利益的动机权衡中,个体为了追求公平而愿意放弃的最高限度的个人利益。采用最后通牒博弈和独裁者博弈的二阶段实验范式,样本量为60。结果发现,工作绩效、工作能力均对个体的不公平阈限有显著的影响;对于公平判断和基于公平的回应行为,工作绩效起着首要作用,工作能力的影响次之,再次是对方的提议数额的影响。第一阶段对方提议的分配方案对被试越有利,则第二阶段被试的回应行为越有利于对方。排除能力差别的作用之后,职位差别并未引起不公平阈限的显著差异。根据研究结果,总结出分配公平的三项原则：绩效原则、能力原则和互惠原则     

增加卫生改革的伦理含钽：兼论卫生改革中的效率与公平

卫生改革需要有包括卫生改革伦理理念在的全方位改革理念的联手支撑。伦理含金量失或者不足,卫生改革实践就难以取得圆满成功。因此,目前展开的新一轮卫生改革,必须以“效率与公平合理兼顾”为核心准则,在完善政策,规划目标,组织实施等全过程中切实保证卫生改革伦理学理念准确到位和正常运作。     

城市人口健康的性别差异及影响因素的实证分析

使用CHNS数据,在健康的社会分层模式下探讨城市人口健康的性别公平问题。研究认为,中国城市人口健康存在显著的性别不平等现象,男性健康水平要好于女性,而这种健康的性别差异主要是由于不同性别在社会经济地位上的差异造成的,女性处于明显的弱势地位。     

分配公平与程序公平对工作倦怠的影响

根据3家企业294份调查问卷的结果对工作倦怠量表MBI-GS进行了修订。然后,利用修订的MBI-GS和组织公平量表在6家企业进行了调查,524份有效问卷的调查进一步验证了MBI-GS的构想效度和信度;t检验和方差分析结果表明,人口统计学变量会影响组织公平和工作倦怠;分层回归的结果发现,在控制了人口统计学变量后,组织公平对工作倦怠具有较强的预测作用;进一步的优势分析表明,预测情绪衰竭时,分配公平相对来说更重要,贡献了已解释方差的65.91%;预测玩世不恭时,程序公平相对来说更重要,贡献了已解释方差的56.07%     

社会比较对大学生公平感知的影响：主观社会经济地位的调节作用

本研究考察社会比较对大学生公平感知的影响,并探讨主观社会经济地位在其中的调节作用。控制社会比较的方向、不公平程度及有无代价等因素,结果发现,社会比较会影响大学生的公平感知,在向上社会比较条件下,大学生更愿意选择平等选项;主观社会经济地位能够调节社会比较对大学生公平感知的影响,低主观社会经济地位大学生在向下社会比较时更愿意选择平等选项。大学生具有较强的公平感知,关注自身利益是否最大化。     

A role for clinical psychology in health care and policy concerning the physical environment

Some persons adversely react to specific environments, while others are impervious or actually thrive. Medical attention often overlooks such sensitivities to the physical environment. Such sensitivities, including phobias and seasonal affectivity, fall within clinical psychology's purview. A theoretical/clinical approach called the Synchronous Systems Model, which defines and uses individual differences in people and in settings, could serve medical health care and policy. When specific people are matched appropriately with specific treatments within the most propitious settings, cost effectiveness and medical efficacy rise. Such documented accountability could make clinical psychologists central to triage of medical services as well as health care policy in these days of the shrinking health care dollar. The Synchronous Systems Model provides theory, supportive data, and clinical assessment devices to strengthen clinical psychology's role in medical settings.     

弱势群体与医疗保健服务公平问题初探

我国医疗保健服务中受到不公平对待的主要是弱势群体,这种不公平有来自政策层面的,也有来自各种医疗保健服务实践环节的.为了改善这种现状,促进医疗保健服务公平性,必须做到:党和政府高度重视:积极完善医疗保障体系,重视弱势群体的话语权;摆正公平和效率的关系,构建专门针对弱势群体的医疗救助制度;加强部门之间的合作,共同提高弱势群体的健康水平.     

Health Care Reform and Psychologists in Medical Schools: Stress, Challenge, and Change

Psychologists from 45 academic health science centers throughout the United States and Canada gathered at Georgetown University for a national conference November 2–5, 1995 organized by the Association of Medical School Psychologists. This paper introduces the proceedings of that conference described in the next four articles in this issue of the Journal of Clinical Psychology in Medical Settings[Volume 4, number 1]. Papers prepared by the working groups focus upon clinical services, education and training, research, and governance and administration within the academic medical setting.     

Establishing psychological services in a community-based,health care setting: A 3-year case study

Health care practitioners are being challenged to reorganize service delivery and psychology providers are emerging as important participants in shaping the development of primary health care practices. The article outlines the 3-year process of a community/academic/health care center partnership to develop a new model for providing interdisciplinary health care services. The authors describe the process of integrating psychological services into an interdisciplinary, primary care community-based health care center, outline specific planning strategies, and identify the roadblocks and barriers encountered.     

医院的社会责任:伦理学视角

讨论了评价医院管理行动的伦理框架,严峻的卫生形势,医院的社会责任,其中着重讨论参与全面建设小康社会;向社会提供公平的卫生保健服务;重建医患信托关系以及调整与企业关系防止利益冲突.     

Masked ball: Ethics,laws and financial contradictions in hungarian health care

Corruption is a major problem in the societies of the post-communist Central European countries. Corruption in health care has some unique characteristics undermining the efficacy of and respect for Hungarian health care. One of the forms of corruption is tipping. This highly contested phenomenon is present in most of the patient/health professional’s interactions in a sophisticated manner, raising serious ethical and legal dilemmas. The present paper analyzes tipping and other corruption-related factors, such as financial conflict of interest between industry and health care and argues that since ethical and legal considerations are often ignored in the country, patient care and clinical research are affected by these controversial issues to a great extent.     

社区卫生服务在医疗体制改革中的作用和地位—英国的经验与教训

社区卫生服务通过六位一体的服务可以合理疏导医疗服务需求,解决医疗服务的公平性和合理控制医疗费用增长过快,在医疗体制改革中扮演着制约医院服务的重要角色。没有社区卫生服务组织和全科医生的积极参与和强有力的制约,医疗市场很难形成有效的竞争,医疗体制改革的初衷就很难实现。英国在该方面的经验与教训,足以引起起我们的关注与警惕,结合中国国情来借鉴,渴望我国在该方面的发展更趋稳定和合理。     

国际健康目标与卫生改革的新导向——重视预防保健的作用

由于认识到卫生系统的大部分资源主要花费在疾病的治疗上,这种资源配置不当不仅导致巨额医疗费用负担和低效率,并没有获得好的健康结果;因此,近年许多发达国家的健康目标与卫生改革出现了一个新的导向,日益重视预防保健的作用;并采取优先选择的方式,确保资源优先配置给对人群健康最需要、资源投入最具有成本效果的保健服务。这种改革已取得了一些成效。这一改革导向对我国正在进行的医药卫生体制改革的制度设计与政策开发提供了启示。     

Clinical psychology in medical settings: Psychology's role in health care

The number of clinical psychologists working in medical settings has grown along with the range of services provided by psychologists to patients with a multitude of medical problems across the lifespan. Medical care cost savings brought about by these psychological interventions is highlighted along with issues of public policy and specialization of training. The opportunity for ongoing development of clinical psychology in medical settings is described as unlimited and the mission of the newJournal of Clinical Psychology in Medical Settings is presented as supporting that growth.