论影响卫生资源分配公平性的因素

公平分配卫生资源是促进社会公正的重要方面.观念、体制与政策是影响卫生资源公平分配的重要因素.重医疗、轻预防的观念使宏观卫生资源分配失去公平,而城市尤其是大中城市优先的制度安排、按医疗项目付费方式的弊端、医疗保障体制的不公平等体制与政策因素则使微观卫生资源分配失去公平.从观念因素、体制与政策因素两个方面入手,改进卫生资源分配的公平性,是我国提高全民健康水平、促进社会公正的必由之路.     

拉丁美洲国家医疗保障制度探析

拉丁美洲国家的经济发展水平较高,公共健康开支和私人健康开支也比较高,医疗保障制度覆盖面较大,财政的健康开支公平性较高.但是国别之间,健康开支水平与经济发展水平之间以及健康开支水平与财政负担的公平性之间缺乏紧密的联系.这说明,社会医疗保险制度模式、收入差距等因素制约了医疗保障制度的作用的发挥和财政负担公平性的实现.     

国内城市社区健康教育和健康促进研究

分析了我国城市化加速发展过程中出现的城市社区健康问题及其影响因素.在对社区健康教育与健康促进的作用和意义进行探讨的基础上,提出解决这些城市健康问题的根本途径是城市社区健康教育与健康促进策略,并针对我国城市社区健康教育与健康促进的研究和发展现状提出对策建议.     

健康与卫生保健的公平性

１　对健康与卫生保健公平性问题广泛的国际关注近年来,在世界范围内,随着卫生改革的普及与深入,健康与卫生保健公平性的研究越来越引起卫生政策研究者与决策者的重视。９０年代中期,ＷＨＯ提出了有关公平性的全球性启动项目,其总目标是“促进和支持减少可避免的健康和卫生保健中社会差距的政策与行动”［１］。ＷＨＯ指出这个项目是构建在２０年前的“人人健康”（ＨｅａｌｔｈｆｏｒＡｌｌ）目标的基础上的。其具体目标是：１１　减少健康与卫生保健方面的社会差距,在优先选择的国家与国际组织中采取政策与行动,调整目前在经济、…     

健康城市建设中环境因素对健康的影响与分析

城市化进程加快导致环境对健康的影响日益突出.针对生活环境质量问题,应尽快出台环境与健康管理法规及条例,强化对生态环境保护的政策支持.通过开展健康城市建设项目,倡导环境保护,有效控制环境污染,坚持生态立市,加强环境质量监督管理及污染防治,提升人类生活质量和促进社会全面发展.     

"新农合"对农民收入公平性的影响研究

利用卫生经济学中的洛伦茨曲线和基尼系数分析河南省"新农合"试点县农民收入公平性的变化,评价"新农合"筹资、补偿以及医疗费用负担对农民收入公平性的影响.为新农合的推广和发展提供政策建议,使"新农合"这一中国特色的医疗保障模式为农民更好的服务.     

我国公务员绩效评估公平性的影响因素研究

本论文以国家公务员为对象,从背景、核心自我评价和组织文化的层面来探讨公务员绩效评估公平性的影响因素。结果表明,在公务员个人属性变量上,性别、职级、收入、工龄和年终绩效等级对绩效评估公平性上存在显著影响;单位组织文化各因子特别是诚信公正因子对公务员绩效评估公平性的影响最大,核心自我评价各因子对公平性的影响不大。     

流动人口生殖健康服务质量评价的相关理论研究

开展城市流动人口的生殖健康服务质量评价研究对于促进我国流动人口生殖健康状况持续改进和公平地享有生殖健康服务具有重要意义.从生殖健康的相关基本理论,我国生殖健康服务的政策支持,卫生服务质量评价的经典理论,系统思想及系统论,流动人口的特征等几个方面进行了流动人口生殖健康服务评价的理论基础系统论述.     

国内城市社区健康教育和健康促进研究

分析了我国城市化加速发展过程中出现的城市社区健康问题及其影响因素。在对社区健康教育与健康促进的作用和意义进行探讨的基础上,提出解决这些城市健康问题的根本途径是城市社区健康教育与健康促进策略,并针对我国城市社区健康教育与健康促进的研究和发展现状提出对策建议。     

拉丁美洲国家医疗保障制度探析

拉丁美洲国家的经济发展水平较高,公共健康开支和私人健康开支也比较高,医疗保障制度覆盖面较大,财政的健康开支公平性较高。但是国别之间,健康开支水平与经济发展水平之间以及健康开支水平与财政负担的公平性之间缺乏紧密的联系。这说明,社会医疗保险制度模式、收入差距等因素制约了医疗保障制度的作用的发挥和财政负担公平性的实现。     

The Impact of Economic Globalisation on Health

The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches.     

山东省某县农民参加新农合意愿及受益公平分析

通过调查农民参加新型农村合作医疗（新农合）意愿选择及受益程度,对影响参合因素及政府补助分配的公平性进行研究,认为：影响参合因素主要有家庭收入、家庭医疗支出、补偿比例等;从受益角度看,总补助的集中指数是负值,不同人群的受益趋于公平。从不同服务看,住院的公平程度好于门诊。     

临床决策与卫生政策

从讨论趋利性临床决策与泛企业化卫生政策的共同作用是造成我国医改失败的根本原因入手,在对3个典型案例进行深入剖析的基础上,论证了临床决策和卫生政策相互依存、相互作用的基本关系;研究了临床决策与卫生政策的决策主体、影响因素、决策过程、信息反馈、关系调整的循环路径;认为完善决策机制是保证临床决策和卫生政策正确有效的必要条件,提出了进一步完善临床决策和卫生政策的决策机制的具体意见和建议。     

Connecting adverse childhood experiences and community health to promote health equity

Adverse childhood experiences (ACEs) can have negative effects on health outcomes across the lifespan. Furthermore, the effects of ACEs are often compounded by social determinants of health and historical and contemporary trauma that can affect entire communities. The socio‐ecological model is a valuable framework for understanding the complex systems in which efforts to promote health equity are situated. Using a trauma‐informed lens, community health becomes a powerful focal point for viable prevention and treatment options to address ACEs and promote health equity. Self‐healing on a community level involves collective engagement; people most affected by ACEs and trauma come together around activities that have the potential to lift up the entire community and foster individual and community resilience. The use of community health research and evaluation methods that are consistent with trauma‐informed, empowerment approaches can contribute to community healing. This paper is intended to establish a common language for how community healing can address ACEs and foster health equity.     

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.     

Access to antiretroviral treatment,issues of well-being and public health governance in Chad: what justifies the limited success of the universal access policy?

Universal access to antiretroviral treatment (ART) in Chad was officially declared in December 2006. This presidential initiative was and is still funded 100% by the country’s budget and external donors’ financial support. Many factors have triggered the spread of AIDS. Some of these factors include the existence of norms and beliefs that create or increase exposure, the low-level education that precludes access to health information, social unrest, and population migration to areas of high economic opportunities and gender-based discrimination. Social forces that influence the distribution of dimensions of well-being and shape risks for infection also determine the persistence of access barriers to ART. The universal access policy is quite revolutionary but should be informed by the systemic barriers to access so as to promote equity. It is not enough to distribute ARVs and provide health services when health systems are poorly organized and managed. Comprehensive access to ART raises many organizational, ethical and policy problems that need to be solved to achieve equity in access. This paper argues that the persistence of access barriers is due to weak health systems and a poor public health leadership. AIDS has challenged health systems in a manner that is essentially different from other health problems.     

Support for employment equity policies: A self-enhancement approach

The effectiveness of employment equity (EE) policies has been hindered by negative reactions to these policies. We draw on the self-enhancement literature to expand self-interest accounts of reactions to EE policies to explain inconsistent findings showing that both nonbeneficiaries and beneficiaries react negatively to EE policies. Across four studies, we found that self-image threat influences reactions to gender-based EE policies. Studies 1 and 2 established that EE policies threaten the self-images of both men (nonbeneficiaries) and women (beneficiaries). Study 3 found that those least likely to experience self-image threat when faced with a gender-based EE policy are the most likely to show positive reactions to EE policies, while Study 4 showed that both men and women react more favorably to EE policies when self-images threats are mitigated through a self-affirmation task. Implications for our understanding of reactions to EE policies are discussed.     

Promoting Mental Health Equity: The Role of Integrated Care

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.     

Predictors of conflict over the household division of labor among women employed full-time

This empirical study examined predictors of conflict over the household division of labor among a group of 319 middle class, less traditional married women in order to examine the degree to which equity factors predicted conflict. Forty of the women were either African American, Hispanic, Native American, or Asian. An analysis of covariance indicated that there were no differences by race/ethnicity. The study explored the following: (1) the degree to which equity factors predict conflicts over household labor, (2) which equity factors best account for conflict, (3) the degree to which particular equity factors mediate the relationship of conflict with other variables, (4) whether equity factors are more compelling in predicting conflicts than practical or status variables, and (5) whether women's perceptions of the reasons for conflict put more emphasis on equity than on other issues. Results indicated that while both equity and practical factors predicted conflict, equity factors were more statistically significant. The best overall model of conflict suggested that it was predicted by lower satisfaction with the division of labor (which, in turn, was contingent upon time differentials between spouses and the time a womans' spouse spent on traditional women's tasks), a larger number of household members, a woman's younger age, and performing a greater number of overall household tasks. Equity is important to such women and constitutes a basis for making arguments about justice. However, these employed women devote twelve hours more per week to household labor than their partners and are relatively satisfied with the division. Chaeftz's theory of gender equity identifies where this sample of employed women may be located in the process of change.Thanks to Diane Blohowiak for statistical assistance and to Susan Jacquet, Laura Thieme, Annette Tierrien, and Mark Hoven Stohs for assistance with data gathering. Special thanks to the reviewers.     

Cultural Considerations for Psychologists in Primary Care

Many health concerns in the United States (e.g., diabetes) are routinely managed in primary care settings. Regardless of the medical condition, patients’ health is directly influenced by factors such as healthcare providers and cultural background. Training related to how behaviors influence health, coupled with training on how cultural diversity intersects with mental health, allows psychologists to have the relevant expertise to assist in the development of primary care behavioral health interventions. However, many psychologists in primary care struggle with how to integrate a culture-centered paradigm into their roles as behavioral health providers. This paper provides an introduction on how three culture-centered concepts (providers’ cultural sensitivity, patient–provider cultural congruency, and patients’ health literacy) can be applied in primary care using the Five A’s Organizational Construct and a model of cultural competence. In addition, the paper includes a section on integration of cultural considerations into consultation and training and concludes with a discussion of how the three culture-centered concepts have implications for health equity.