Women's Health Care

No abstract available for this article.     

社会资本与卫生保健

社会资本概念于 2 0世纪 70年代后期由经济学家洛瑞在资本概念内涵扩展的基础上首次提出。 2 0世纪 90年代以来 ,社会资本逐渐成为人们关注的热门概念和分析的起点[1] ,对经济增长和社会发展起到了重要的推动作用并提供了科学的理论解释范式。近年来 ,世界银行对社会资本给予了充分的重视并鼓励各个领域引入社会资本理论进行研究。因此 ,阐明与卫生保健相关的社会资本要素 ,探讨社会资本的卫生保健功效对卫生保健工作具有重要的指导意义。1　社会资本理论的界定不同学者针对各自的研究领域和研究对象提出了不同的社会资本概念。国外学者中 ,…     

Mental Health and Managed Care

In this essay I continue the conversation going on today on the crisis in delivering mental-health care within the realities of managed care. A guiding perspective is represented briefly in material from the writings of Edmund Pellegrino. He recommends the norm of patient-centered relationships to direct and govern managed care so cost can be controlled, but not by the sacrifice of quality of care. This emphasis must be balanced with a struggle for the greater social good and fair allocation of goods to all citizens. Definitions are offered along with a discussion of controversial issues and constructive suggestions to make possible a better future for the work of mental health in relation to managed care.     

Surviving the Health Care Revolution

SUMMARY

The ongoing turmoil in the health care system exacts a significant toll on consumers, providers and society. New paradigms tor service and employment relationships pose a threat to professional and personal security. Understanding the dynamic phenomena in the system, as well as our own responses to these changes, can assist practitioners in overcoming barriers that undermine our future. Managing our feelings, developing perspective on the issues, adjusting expectations, acquiring skills that transcend medical necessity, and promoting the social contract in health care are recommended strategies for dealing with the crisis in confidence affecting health care professionals.     

卫生技术评估在医疗领域的开展

介绍了卫生技术评估的基本概念以及对医疗卫生领域的影响,并指出在开展评估过程中应注意的几个问题.     

卫生技术评估在医疗领域的开展

介绍了卫生技术评估的基本概念以及对医疗卫生领域的影响,并指出在开展评估过程中应注意的几个问题。     

Comparisons Between Patients Diagnosed with PTSD in Primary Care Versus Mental Health Care in Five Large Civilian Health Care Systems

Journal of Clinical Psychology in Medical Settings - Posttraumatic stress disorder (PTSD) is a serious mental health disorder that may not be adequately detected or treated in primary care (PC)....     

Health Risk Behaviors and Their Relationships to Health Care Utilization Among Veterans Receiving Primary Medical Care

This paper reports the findings of a behavioral health risk screening form and examines the interrelationships among behavioral risk factors and health care utilization. Participants were 1,000 veterans who completed a brief self-report questionnaire assessing affective distress and behavioral health risk factors while they waited to see their primary care provider. Participants reported a mean level of affective distress in the mild range on a scale of 0 to 20 (M = 6.4, SD = 4.95), and 22.4% reported moderate or high levels of affective distress. Fifty percent of the sample denied alcohol use; 5% of the men and none of the women reported a pattern of use that met established criteria for at-risk drinking. Twenty-six percent of the sample reported current tobacco use, 45% acknowledged concerns about diet and/or weight, and 54% reported concern about pain. These factors were largely significantly intercorrelated and several were related to indices of health care utilization. It was concluded that veterans receiving health care in primary care settings report significant levels of affective distress and other health risk behaviors and that the presence of these factors is associated with increased use of the health care system. These data encourage increased efforts to identify these factors and to develop behavior change interventions.     

Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System

Integrating mental health care in the primary care setting has been identified in the literature as a model for increasing access to mental health services and has been associated with enhanced clinical and functional patient outcomes and higher patient satisfaction. The Department of Veterans Affairs (VA), which operates the nation’s largest integrated health care system, has taken a leadership role in creating a health care system in which mental health care is provided in the primary care setting. This article examines VA’s efforts and progress to date in implementing evidence-based models of integrated mental health services nationally in community based outpatient clinics, home based primary care, and outpatient primary clinics at medical facilities. Psychology plays an important role in this progress, as part of an overall interdisciplinary effort, in which all professions are crucially important and work together to promote the overall well-being of patients. This article is based in part on a presentation by the first author at the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC) in May of 2007 in Minneapolis, Minnesota.     

Children with Special Health Care Needs: Impact of Health Care Expenditures on Family Financial Burden

We investigated the relationship between health care expenditures for Special Health Care Needs (SHCN) children and family perception of financial burden. Using 2005/2006 National Survey of Children with Special Health Care Needs data, a multivariate logistic regression model was used to estimate the relationship between the SHCN child’s health care expenditure and perceived financial burden, while controlling for family and child characteristics. Our analysis suggests that health care expenditures for a SHCN child of $250 and more are associated with family perception of financial burden. In addition, families with lower socioeconomic status also perceived financial burden at lower level of expenditures. Members of the health care team who treat children with SHCN have an important role in understanding and assessing family financial burden as part of the care delivery to the child and the family. Our study reinforces the need to treat the whole family as the unit of care, especially when caring for children with special health care needs.     

Citizenship and Community Mental Health Care

Citizenship is an approach to supporting the social inclusion and participation in society of people with mental illnesses. It is receiving greater attention in community mental health discourse and literature in parallel with increased awareness of social determinants of health and concern over the continued marginalization of persons with mental illness in the United States. In this article, we review the definition and principles of our citizenship framework with attention to social participation and access to resources as well as rights and responsibilities that society confers on its members. We then discuss our citizenship research at both individual and social‐environmental levels, including previous, current, and planned efforts. We also discuss the role of community psychology and psychologists in advancing citizenship and other themes relevant to a citizenship perspective on mental health care and persons with mental illness.     

医疗保健政策与医患关系

医疗保健政策深刻地影响着医患关系,并左右着医患关系的发展与变化.在实行"以公平为主,兼顾效益"的福利性的医疗保健政策时期,我国的医患关系是和谐的.但自从医疗保健政策向"经济导向型"方向转变之后,国家大幅度减少了对卫生事业的投入,医院必须从病人身上取得卫生发展必要的资金,医药费用上涨是必然的,也失去了公平和公正,并最终导致医患关系的恶化.调整医患关系不能仅从医、患两方面着手,建立符合医学伦理的卫生政策,才是问题的关键.     

Migration, Illness and Health Care

This paper draws on research and clinical experience in discussing the challenges migration poses to experiences of illness, focusing on the relationships between migrant and non-migrant kin, exposure to different paradigms of health care, racism and other forms of prejudice; language differences; and the positions of health care professionals who are themselves migrants.     

Re-Evaluating Professional Autonomy in Health Care

Professional autonomy, as the symbol of the traditional freedom ofdecision-making of medical professionals is criticized. This essayexamines the critique. It analyses the underlying assumption that theautonomy of health professionals is incompatible with the need fororganisation and management in order to control rising health carecosts. It is argued that the concept of professional autonomy should beredefined, not through restricting the decision-making freedom ofindividual health professionals, but through expanding the concept intothe sphere of management, so that managers will take responsibility forpatient care.     

不同语境下的初级卫生保健

初级卫生保健一词在国内文献中涵义不同,研究发现《阿拉木图宣言》中的初级卫生保健更多的具有卫生体系变革的涵义,强调公平性、多部门合作、社区参与、适宜技术和适宜人力的原则;选择性初级卫生保健则以推广具有成本效益的卫生干预措施为重点;国内政策语境下的初级卫生保健则更多的是具体的卫生服务内容。     

Positive Paradigm Shifts in Health Care

The American health delivery system is undergoing enormous change. Some of the changes threaten the spiritual underpinnings of the hospital movement and discount theological insights into the nature of healing. This article identifies and advocates six health care paradigms that are grounded in the Judeo-Christian ethic.