美国卫生保健的公正和分配问题

除了卫生保健服务的费用问题以外,美国社会中关于医疗卫生保健的比较严重的问题是服务的公平和分配问题,在美国无论是城市还是农村,在经济上处于弱势地位的人,在医疗上也处于不利地位,另一个由公平性问题影响的社会层面是;大量的美国人没有参加健康保险,他们中的大多数人是生活贫困的究人或接近于贫穷的人。此外,美国卫生保健提供体系在地理分布上是不均衡的,初级保健医生或家庭医生在医生中也没有充分的代表性,医生的矩缺不只限于农村,也扩展至城市的某些区域。     

Evaluation of a Swedish version of the Job Stress Survey

The present study assesses and evaluates the psychometric properties of a Swedish version of the Job Stress Survey (JSS; Spielberger, 1991; Spielberger & Vagg, 1999). This instrument is constructed to measure generic sources of occupational stress encountered by employees in a wide variety of work settings, settings that often result in psychological strain. The JSS was administered to metal assembly industry workers and medical service personnel in northern Sweden (n= 1186). The exploratory factor analysis showed that there is a high similarity between the present Swedish version and the original American version. Internal reliabilities of the scales, as well as test-retest reliabilities were shown to be high, and concurrent validity, as examined by comparisons with the Perceived Stress Questionnaire Index (Levenstein et al., 1993) was found to be satisfactory. The consistency of these findings is discussed with particular focus on groups of employees, gender, and cross-cultural evaluations.     

Intimate Partner Violence in African Immigrant Communities in the United States: Reflections from the IDVAAC African Women’s Round Table on Domestic Violence

African women face many challenges when they come to the United States due to the immigration experience, acculturation, and leaving family members in countries of origin. Intimate partner violence (IPV) complicates African women’s experience within their home countries as well as in the United States. There is little literature on IPV in African ethnic groups. This information is even sparser regarding IPV among African immigrant and refugee communities in the United States. To better address the needs of these communities, the Institute on Domestic Violence in the African American Community brought together service providers and survivors representing 16 different African countries to attend a roundtable and explore issues of IPV. This article highlights the unique challenges they identified.     

社区卫生服务的“管理模式”与“治理模式”比较

依据社区卫生服务的提供方与消费方之间的权力关系,社区卫生服务模式可以划分为管理模式和治理模式。在管理模式中,社区卫生服务提供方与消费方之间是建立在行政和技术权威基础上的管理与被管理关系。在治理模式中,社区卫生服务的提供方与消费方则是建立在沟通基础上的合作关系。我国社区卫生服务模式的发展趋势是从管理向治理的转变。     

如何减少医疗差错

医疗差错是危及医疗安全、制约医疗质量、影响医患关系、引发医患纠纷的核心问题,是医院管理的重点和难点。本文通过对医疗差错的分析和美国七大减少医疗差错的借鉴来探讨如何结合我国医院的实际来有效地减少医疗差错的发生。