scholarly journals 誰應為醫療保健買單？——中國城鎮衛生籌資責任主體歷史演進的儒家反思

2017 ◽  
Vol 15 (1) ◽  
pp. 37-61
Author(s):  
Jingxian WU
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Transition Period ◽  
Initial Period ◽  
Health Care Financing ◽  
Urban China ◽  
Health Coverage ◽  
Financing Policy ◽  
Financial Responsibility ◽  
The Individual

LANGUAGE NOTE | Document text in Chinese; abstract also in English.一個道德上公正的醫療保健制度，不僅應該保障人人都可以均等地獲得基本的衛生保健服務，還應該是財務上可持續的。醫療保健制度籌資責任主體一般包括政府、個人、家庭等，各籌資主體責任大小對實現一國或一地區衛生資源的有效配置、為當地居民提供公平而又有效的醫療衛生服務至關重要。本文將建國以來中國城鎮地區醫療保健制度的發展演進劃分為四個階段，分別是計劃經濟時期、經濟制度轉軌時期、市場經濟初期、全民基本醫療保險時期，基於儒家生命倫理原則，對中國（內地）城鎮地區衛生籌資責任主體進行回顧、反思，分析認為中國衛生籌資責任主體發展經歷了「政府大包大攬、個人及家屬免費享受」——「政府財政逐漸退出、個人及家庭負擔加重」——「 政府責任回歸、個人負擔有所下降」——「政府、市場、個人責任逐漸趨於均衡」這一過程。基於儒家衛生正義觀，本文認為「仁政」不是絕對平均主義，也非個人全權負責；「家庭本位」的傳統文化在中國一直活躍至今，制度安排亟需家庭責任的回歸。在儒家看來，一個道德上合理的衛生籌資責任，應該是個人、家庭和政府的平衡與和諧。A morally justifiable health care system should not only ensure that everyone has equal access to basic health care services, but also be financially sustainable. It is normally supposed that governments, individuals and families take joint responsibility for health care in a certain country or region. Their levels of financial responsibility are a significant factor in the effective allocation of healthcare resources and fair delivery of health care services.This paper divides the historical evolution of health care financing responsibilities in urban China since 1949 into four periods: a planned economy period, an economic system transition period, an initial period of market economy and a universal health coverage period. Based on Confucian ethical principles, the author reflects on financing responsibilities in urban China. She determines that the financing responsibilities of different periods have changed from government- to individual-dominant, finally achieving a balance between government, the market and the individual. The author argues that from a moral standpoint, according to Confucian ethical appeals on health justice, a benevolent government should practice neither the doctrine of absolute equalization nor the principle of individual liberalism. As the idea that the family comprises the primary community is still active in contemporary China, family responsibility should be emphasized along with health care financing policy. According to Confucianism, a morally just health care financing responsibility requires a proper balance and harmony between individuals, families and governments.DOWNLOAD HISTORY | This article has been downloaded 401 times in Digital Commons before migrating into this platform.

scholarly journals Analysis of the Effect of Health Insurance on Health Care Utilization in Rwanda

2021 ◽  
Author(s):  
Roger Muremyi ◽  
Dominique Haughton ◽  
François Niragire ◽  
Ignace Kabano
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Health Care Utilization ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Living Condition ◽  
Care Utilization ◽  
Health Coverage

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.

A Survey on Health Care Services Using Wireless Sensor Networks

2015 ◽  
pp. 132-151
Author(s):  
Sunilkumar S. Manvi ◽  
Manjula R. B.
Keyword(s):  
Health Care ◽  
Heart Disease ◽  
Health Care Services ◽  
Health Centre ◽  
Ambient Assisted Living ◽  
Well Being ◽  
Wireless Sensor ◽  
Future Research ◽  
Care Services ◽  
The Individual

Although the present technology has aided in development of high-technology-based disease detection machines, potential medicines and devices, the well-being of the individual remains a challenge. Human beings are struggling to control diseases such as Parkinson's disease, Alzheimer's disease, asthma, hypertension, insomnia, heart disease, and diabetes due to non-availability of patient's real-time data for comprehensive study and analysis. Smart health centre environments represent the evolutionary developmental step towards intelligent health care. The Wireless Sensor Network (WSN) with pervasive and ubiquitous computing may be a solution for this predicament. WSNs are a key technology for ambient assisted living. The concept of WSN is used to measure the various health parameters like blood pressure, blood clot, allergy, ECG, cholesterol, RBCs, etc. In this chapter, the authors highlight the importance of WSNs with respect to health care services and discuss some of its challenging applications for diseases like Parkinson's, Alzheimer's, asthma, and heart disease. They delineate the challenges that researchers face in this area that may lead to future research.

Professional Growth and Development

2015 ◽  
pp. 165-181
Keyword(s):  
Health Care ◽  
Lifelong Learning ◽  
Professional Growth ◽  
Growth And Development ◽  
Health Care Services ◽  
Formal Education ◽  
Continuous Development ◽  
Care Services ◽  
The Individual

The purpose of this chapter is to explore why a medical professional's career is one of lifelong learning and growth. Even after the period of formal education is over, continuous development and maintenance of skills is essential. Along with this, attention is also directed towards the improvement of health care services at the individual and general levels.

Overview—Sustainability and Finance: Supporting Partnerships over Time

2019 ◽  
pp. 325-328
Author(s):  
Craig W. Thomas ◽  
Brian C. Castrucci
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Population Health ◽  
Health Care Services ◽  
Health Improvement ◽  
Care Services ◽  
Financial Investments ◽  
Closing The Gap ◽  
The Individual ◽  
Over Time

This chapter introduces the next section of the book which is about sustainability and finance when it comes to cross-sector collaboratives for population health improvements. It states that the focus should be on closing the gap when it comes to health disparities and a goal needs to be reducing the need for health care services. Effectively acquiring, managing, and sustaining financial investments in health is fundamental to the success of multi-sector and community-led health improvement initiatives. The chapter outlines the topics covered by the individual chapters in this section.

scholarly journals MULTICAGE CAD-4: Psychometric characteristics for the screening of addictive behaviors

2018 ◽  
Vol 35 (1) ◽  
pp. 41-46
Author(s):  
Mª Teresa Rodríguez Monje ◽  
Eduardo J. Pedrero Pérez ◽  
Mª Teresa Rodríguez Monje ◽  
Elías Rodríguez Alonso ◽  
Elías Rodríguez Alonso ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Least Squares Method ◽  
Daily Practice ◽  
Addictive Behaviors ◽  
Care Services ◽  
Primary Health ◽  
Scale Levels ◽  
The Individual

Addictive behaviors are not limited to drugs use, but also include certain daily behaviors that can cause gratification. Their progression to more severe pathological patterns entails grave consequences for the individual, including multiple psychopathological manifestations. The early detection of this type of behavior is of concern to primary health care. Therefore, in order to detect risk at early stages, reliable and valid tools for daily practice are essential. The MULTICAGE CAD-4 questionnaire is a screening tool for simultaneously detecting addictive behaviors. This study includes a new scale for the detection of smartphone abuse. The objective is to evaluate the adequacy of its psychometric properties. A sample of 2,074 subjects that were recruited from primary care centers ofMadrid(Spain) completed the MULTICAGE CAD-4 questionnaire. A confirmatory factor analysis, using unweighted least squares method, was performed. The test showed good internal consistency both at item and scale levels. The questionnaire structure was consistent with theoretical expectations. The MULTICAGE CAD-4, including the new smartphone scale, is a robust, reliable tool with a valid structure for assessing the presence of dysfunctional or potentially addictive behaviors, and especially useful in primary health care services.

Surgonomics: Health Care Financing Policy for Hospitalized Otolaryngology Patients

1988 ◽  
Vol 114 (11) ◽  
pp. 1317-1320
Author(s):  
E. Munoz ◽  
G. Zahtz ◽  
J. Goldstein ◽  
T. Benacquista ◽  
K. Mulloy ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Financing ◽  
Financing Policy

Bridging Domains in Efforts to Reduce Disparities in Health and Health Care

2006 ◽  
Vol 33 (4) ◽  
pp. 440-458 ◽  
Author(s):  
Shiriki K. Kumanyika ◽  
Christiaan B. Morssink
Keyword(s):  
Health Care ◽  
Population Health ◽  
Health Care Services ◽  
Social Dynamics ◽  
Task Force ◽  
Integrated Approach ◽  
Individual Level ◽  
Advantages And Disadvantages ◽  
Care Services ◽  
The Individual

The concept of health disparities is a familiar one, but we must continually challenge our thinking on how disparities issues are framed. The 1985 Report of the Secretary’s Task Force on Black and Minority Health established a disease-oriented focus on “excess deaths” as the primary targets of disparities initiatives. However, progress in reducing disparities has been limited. The disease focus, which emphasizes the individual-level and health care services, may be too narrow. A “population health” perspective can foster a more comprehensive and integrated approach. Both disease-oriented and population health perspectives have advantages and disadvantages, for both policy and practical purposes. The challenge is to effectively leverage both approaches to improve the health of ethnic minority and other disadvantaged populations. We need bridge builders who can articulate and hear diverse perspectives, work with systems, and maintain a long-term vision for affecting the social dynamics of society

scholarly journals The Changing Role of Government in Financing Health Care: An International Perspective

2014 ◽  
Vol 52 (2) ◽  
pp. 480-518 ◽  
Author(s):  
Mark Stabile ◽  
Sarah Thomson
Keyword(s):  
Health Care ◽  
Health Care Financing ◽  
The United States ◽  
International Perspective ◽  
Wait Times ◽  
Hospital Competition ◽  
Role Of Government ◽  
Financing Policy ◽  
Changing Role

This paper explores the changing role of government involvement in health care financing policy outside the United States. It provides a review of the economics literature in this area to elucidate the implications of recent policy changes on efficiency, costs, and quality. Our review reveals that there has been some convergence in policies adopted across countries to improve financing incentives and encourage efficient use of health services. In the case of risk pooling, all countries with competing pools experience similar difficulties with selection and are adopting more sophisticated forms of risk adjustment. In the case of hospital competition, the key drivers of success appear to be what is competed on and measurable, rather than whether the system is public or private. In the case of both the success of performance-related pay for providers and issues resulting from wait times, evidence differs within and across jurisdictions. However, the evidence does suggest that some governments have effectively reduced wait times when they have chosen explicitly to focus on achieving this goal. Many countries are exploring new ways of generating revenues for health care to enable them to cope with significant cost growth, but there is little evidence to suggest that collection mechanisms alone are effective in managing the cost or quality of care. (JEL H51, I11, I18)

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