三种基本医疗保障制度卫生服务利用公平性研究

分析三种医疗保障制度卫生服务利用公平性.利用入户调查数据,比较三种保障制度卫生服务需要、利用状况,采用集中指教评价其公平性.三种制度的门诊公平性较好,住院公平性较差,新农合住院公平性最差.因此,应提高新农合和城镇居民的住院补偿水平,积极推动三种保障制度统筹,增加居民经济收入,提高卫生服务利用公平性.     

卫生服务公平性:理念、制度和实践——读《关于深化医药卫生体制改革的意见(征求意见稿)》有感

长期以来,我国的卫生服务一直存在着不公平的状况,看病难、看病贵等问题在农村表现十分突出,一直是社会关注的焦点。对卫生服务不公平问题的讨论也已经持续很久,正因为如此,人们对新一轮的卫生体制改革寄予厚望。人们深知,实现卫生服务公平性需要从理念转变到人、财、物的支持,从构建相应的制度、机制、法规到付诸实践等多方面着手,只有这样才能实现人人享有卫生保健的目标。     

基于基尼系数与洛伦茨曲线的辽宁卫生资源公平性分析

采用基尼系教与洛伦茨曲线,按人口分布和地理分布对辽宁省卫生资源的公平性进行分析评价,评价指标包括医院(卫生院)床位数、卫生总人员数、卫生技术人员数、医师数和护士(师)数等五项.评价结果显示,辽宁卫生资源配置的总体公平性较好,但部分指标的公平性较差,按人口分布公平性优于按地理分布公平性.     

基于泰尔指数的辽宁卫生资源配置公平性分析

利用泰尔指数对辽宁省卫生资源配置公平性进行分析评价,其中包括医院(卫生院)床位、卫生总人员、卫生技术人员、医师和护士(师)等五项.研究结果显示,辽宁卫生资源配置的总体公平性较好,但不同经济发展水平区域卫生资源配置的公平性存在较大差异,区域间差异是导致辽宁卫生资源配置不公平的主要成因.     

我国卫生资源配置公平性的研究概况

优化卫生资源配置、提高其配置公平性,满足人们的健康需要是我国深化医药卫生体制改革的首要问题之一。利用文献计量法和内容分析法对已有科研文献的分布情况和研究现状及进展情况进行统计分析。研究发现,文献主要采用Lorenz曲线、Gini系数和Theil指数等经济学方法研究我国省级范围的卫生人力和物力资源的数量配置公平性;我国省际间、区域间和省辖市间的卫生资源配置公平性总体向合理趋势发展,配置公平性人口优于地理,卫生物力优于卫生人力。卫生资源配置公平性的研究深度和广度还需扩展,配置公平性的研究和指导有待加强。     

农民卫生服务利用与受益公平性分析——基于广西桂林的调查

为分析广西桂林新农合参合农民卫生服务利用与受益的公平性,采取分层整群抽样的方法,利用集中指数和集中曲线对其卫生服务利用与受益的公平性进行评价。新农合参合农民门诊和住院服务利用的集中指数分别为0.178 5和0.198 9;补偿总费用的集中指数分别为0.404 5和0.161 6;门诊受益率和次均门诊补偿费用的集中指数分别为0.294 6和0.292 1;住院的集中指数分别为0.201 1和-0.018 8。新农合参合农民卫生服务利用与受益均存在不公平现象,门诊服务利用公平性好于住院服务,但门诊受益公平性较住院差,基层医疗机构的受益公平性好于市级及以上医疗机构。     

"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.     

我国医疗改革进程中卫生资源分配的公平性研究 ——基于合理问责框架的分析

面对日渐突出的卫生资源供需矛盾,卫生决策者必须重新审视卫生资源分配的优先次序与轻重程度,公平分配始终是中西学界关注的焦点,西方的“合理问责”框架自上世纪90年代提出,逐渐成为近十多年来保障卫生资源优先分配程序公平性的主导范式.运用“合理问责”的伦理学分析框架探讨在中国新医改背景下卫生资源分配的公平性问题,卫生资源分配趋向公平有赖于以决策部门有效执行力为基础的综合性改革,取决于在合乎公平道义的前提下,决策部门能否推动公开透明、公众参与、问责监督等机制,并明确资源分配标准和优先分配项目.     

医院和医疗保险的经济学分析

随着医疗卫生体制改革的深入,应对老龄化危机,降低不断提高的医疗服务费用,提高医疗服务质量,提高医疗服务可及性和公平性,是我们面对的切实问题.医院是提供医疗卫生服务的场所,也是提供医疗卫生服务的主体单位,了解医院的经济学特性和组织特点,有利于我们对市场经济环境下的医院行为有所了解,为卫生体制改革和医疗保险改革提供理论依据.     

卫生制度与分配正义的伦理考量

对卫生制度的正义性问题进行伦理分析,是卫生制度改革的核心议题之一。在对当前卫生制度的公平性问题进行现实考察的基础上,认真分析卫生制度与顶层设计之间的关系,阐明卫生制度的基本价值与目标,指出卫生资源分配的四个基本层次,进而论述卫生制度的四种公平性概念。为了保证卫生制度的公平性,应该采取系统性、多元化的战略模式,才能有效地解决各种价值之间的冲突,才能构建一个在道德上得以辩护、在实践上得以实施的可行方案。     

对大学生心理健康教育几个误区的思考

针对大学生心理健康教育中,在心理健康水平的评估、心理健康教育的内容与形式、心理咨询和心理档案的建立等四个方面可能出现的误区,提出了合理化的建议.认为当代大学生心理健康水平总体是较高的,心理健康教育应内容活泼、形式生动、具有针对性;心理咨询应有利于学生隐私的保护;心理健康档案不宜机械使用,应动态追踪.     

“Sugary drinks” and graphic warning labels: Critique of a recent U.S. study of parents' beverage choices for their children

A laboratory experiment by U.S. public health researchers Hall et al. claimed to demonstrate that a graphic picture-and-text warning label placed on so-called sugary drinks would substantially reduce parents' purchase of them for their children. Hall et al., however, misclassified the alleged “sugary drinks,” omitting those containing natural but equally harmful sugars such as fructose in fruit juice and lactose in milk. They also implied that artificially sweetened “non-sugary” drinks are harmless when available research indicates otherwise. The experiment was further invalidated by the fact that warning labels are illegal in the U.S., and those that Hall et al. used would not be permitted in any case because they partially obscured the manufacturer's brand label. There were many other methodological problems with Hall et al.'s experiment, among them the failure to do what any competent consumer researcher would do—namely ask the parents afterwards why they made the choices that they did.     

Measuring alcohol-related protective behavioral strategies among college students: further examination of the Protective Behavioral Strategies Scale.

Heavy drinking among college students has been recognized as a public health problem on American college campuses (e.g., R. Hingson, T. Heeren, M. Winter, & H. Wechsler, 2005). Recently, protective behavioral strategies, or cognitive-behavioral strategies that can be implemented when using alcohol to reduce consumption and resulting negative consequences, have been shown to be associated with less alcohol use and fewer alcohol-related problems (e.g., S. L. Benton et al., 2004; M. P. Martens et al., 2005). The purpose of the present study was to conduct additional psychometric work on a measure designed to assess the use of such strategies: the Protective Behavioral Strategies Scale (PBSS; M. P. Martens et al., 2005). Data were collected on 505 undergraduate students from 2 universities who reported having consumed alcohol at least once in the past 30 days. Results of a confirmatory factor analysis supported the hypothesized 3-factor version of the PBSS, and scores on each subscale were correlated in the expected direction with both alcohol use and alcohol-related problems. Thus, the PBSS appears to be reliable and valid for use among college student drinkers.     

心理健康双因素模型指标的再探讨及稳定性研究

摘 要 采用整群抽样以1293名中学生为被试,并对其中531名进行纵向追踪,探讨以生活满意度和内化问题构建的心理健康双因素模型（DFM）的可行性、稳定性及其影响因素。结果：(1)以生活满意度和内化问题为指标的DFM在中国中学生中适用;(2)完全心理健康组的学业和社会功能最好,疾患组最差;(3)完全心理健康组的稳定性最高,有症状但满足组最低;(4)管理消极情绪效能感和学业情绪显著预测生活满意度和内化问题。结论：以生活满意度和内化问题为指标的DFM为复合指标DFM提供了新的研究视角;管理消极情绪效能感和学业情绪是中学生心理健康的核心影响因素。     

From programs to lives: A comment

Reviewed the article by Bond et al., and suggested that the perspective used to frame the issues distorts the nature of the problems we currently face in mental health policy. The conventional evaluative frame is no longer useful in the "inclusionary" system of care that operates. Researchers should study lives, placing programs in the background and putting the person in the foreground.     

Mental health problems in rural contexts: A broader perspective: Response to Jackson et al. (2007) Mental health problems in rural contexts: What are the barriers to seeking help from professional providers?

The objectives of this article are to expand and comment upon a recent review in Australian Psychologist of the literature in relation to mental health problems in rural contexts by Jackson et al. (2007). In the present article we review recently published qualitative research on the help‐seeking attitudes and experiences of rural Australian adolescents. While we agree on the utility of the Macintyre, Ellaway, and Cummins (2002) conceptual framework based on notions of health and place, we note that this framework specifically emphasises the importance of the collective dimension. We present a broader perspective on health and place than Jackson et al. (2007) by incorporating social geographic research. We argue that rural mental health research has been hampered by a simplistic view of social stigma of mental illness and that a more thorough conceptualisation of the phenomenon is needed. Finally, we make some further recommendations based on a broader perspective of mental health in rural contexts: one that incorporates an in‐depth understanding of the help‐seeking attitudes and experiences of rural adolescents as well as an appreciation of the collective social functioning of rural communities.     

Cultivating the Therapeutic Alliance in a Telemental Health Setting

Contemporary Family Therapy - Telemental health services have broadened during the last decade (Choi et al. 2019; Pierce et al. 2020). More recently, Severe Acute Respiratory Syndrome Coronavirus...     

Perspectives of people with mental health problems at hot spots: Attitudes and perceptions of safety,crime, and the police

People who live in places with high levels of crime and disorder are more likely to experience mental illness compared with those who do not live in these types of place (Weisburd et al., 2018; Weisburd & White, 2019). The increased police presence on high crime streets may also increase the likelihood that these individuals will encounter law enforcement. There is a strong body of literature focused on the relationship between neighborhoods and the physical and mental health of residents (e.g. Arcaya et al., 2016; Duncan & Kawachi, 2018; Leventhal & Brooks‐Gunn, 2003), but there are very few studies that look at the perceptions of people with mental illness directly, particularly as they relate to the environment of the street on which they live and attitudes toward the police. In turn, existing studies generally look at the most serious mental health problems (e.g. schizophrenia), ignoring more common mental health concerns such as post‐traumatic stress disorder (PTSD) and depression. This paper uses self‐report data from a large in‐person survey of people who live on crime hot spot and non‐hot spot streets in order to assess attitudes among a broader group of persons with mental health problems. Furthermore, we examine the interaction between living in crime hot spots and non‐hot spots and perceptions of these residents. Our findings in this broader sample confirm earlier studies that identify greater fear and less trust of the police among persons with mental illnesses. At the same time, our findings suggest that fear of crime and perceptions of police are moderated by living in a crime hot spot.     

Psychiatric Issues Among Adjudicated Youth: Challenges,Failures, and Successes

ABSTRACT

Children and adolescents afflicted with psychiatric illness are at particularly high risk for becoming part of the juvenile justice system. More than two thirds of justice-involved youth have psychiatric disorders (Abram et al., 2003; Shufelt & Cocozza, 2006; Teplin et al., 2002). Given the involvement of the legal system, youth being separated from families, and a host of other factors, mental health service delivery in a juvenile detention facility poses unique challenges. This article focuses on an overview of the problems commonly encountered in this setting. A clinical vignette will be used to highlight key points. The role and significance of trauma, common psychiatric disorders, and relevant medication rationale will be explored.     

互联网使用动机、行为与其社会-心理健康的模型构建

以581名大学生为被试,采用结构方程模型技术构建了互联网使用动机、病理性互联网使用行为与其相关社会-心理健康的关系模型。其中,互联网使用动机包括信息获取性动机和人际情感性动机两种模式;病理性互联网使用行为包括上网冲动性、分离/逃避和网上优越感三个初级因素;互联网相关社会-心理健康包括孤独感、社会参与度、一般抑郁、生活幸福感和生活满意度五个初级因素,并进一步概括为社会健康和心理健康两个维度。研究结果表明,基于信息获取性动机而使用互联网有助于相关社会-心理健康水平的提高;基于人际情感性动机而使用互联网更容易导致病理性互联网使用行为,并由此对使用者的社会-心理健康产生负面影响;大学生使用互联网的积极效应大于消极效应,且信息获取性动机对社会健康具有更大的积极效应,而人际情感性动机对对心理健康具有更大的消极效应