走向全民健康保险:论中国医疗保障制度的转型

中国已经进入全民医保的时代,但医疗保障体系呈现碎片化的特征,其内部的若干制度安排之间出现了不协调。中国医疗保障体系亟待进一步转型,转型的重点和方向是将基本医疗保障体系从现行分散化、碎片化的社会医疗保险制度,改造为集中化、一体化的社会医疗保险制度,即全民健康保险。推进全民健保是"发展型社会政策"的体现,具有同时促进经济增长和社会发展的双重功效。从短期来看,这是一种简单易行而又可持续的减税计划,可以促进经济增长,有助于经济发展模式的转变;从长远来看,全民健保制度的建立标志着"社会性基础设施"的建设又迈上了一个新的台阶,这必将为中国福利国家的重建奠定基础。     

重庆市北碚区农村医疗卫生现状分析及建议

该文以重庆市北碚区的农村居民为主要调查对象,以其医疗卫生现状为主要调查分析项目,调查新农合发展及现状、村民家庭收入及医疗费用比、农村医疗点分布及就医便利等问题以及农村卫生教育、医疗卫生常识、饮食卫生知识等。通过对比分析与总结,该文在完善农村公共卫生体系建设方面提出建议,即加大资金投入,改善农村公共卫生服务条件、增强农村居民的公共卫生意识、拓展人员培训和人才培养模式,努力提高队伍素质、加强公共卫生服务网站建设,提高公共卫生服务能力等。     

Performance Management in Australia's Public Mental Health Service: A State Based Perspective

This article investigates the implementation of key performance indicators (KPIs) in Western Australia's public mental health system. A nationally agreed performance measurement framework forms part of the much needed reform now taking place within Australia. However, progress in the effective monitoring and reporting of KPIs is slow in most states, including Western Australia. The authors report on the results of a selective case study involving semi‐structured interviews with mental health administrators and offer a more nuanced insight into the intricacies and difficulties involved in performance measurement reform. The principal finding is that effective performance measurement and reporting can be internally problematic, particularly within a fragmented and networked system. This tends to give rise to a conformance‐only approach to performance measurement.     

全面禁食野生动物的法理基础与制度构建

面对新冠疫情全球蔓延,第十三届全国人大常委会第十六次会议表决通过了全面禁食野生动物的决定.全面禁食野生动物的决定主要建立在公共安全与生命伦理两大法理基础之上:前者侧重于社会整体利益的维护与风险规制,是一个功利性标准;而后者则侧重于对生命的尊重和人与自然和谐关系的维护,主要为伦理性标准.现实中,对"野生动物"概念范畴的理...     

Procedural justice in mental health court: an investigation of the relation of perception of procedural justice to non-adherence and termination

Mental health courts (MHCs) operate on the principles of procedural justice (PJ). PJ highlights the importance of process over outcomes in encounters with authority. Subjective perceptions of having voice, being heard by decision-makers, and being treated with respect and concern by figures of authority are influential in assessment of fairness and in cooperation with decisions, regardless of favorability of the outcome. In this paper, we investigate MHC participant perception of PJ in interactions with MHC staff and the association between perceptions and recidivism (i.e. time in jail, new arrests, and probation violations), treatment adherence, and MHC termination. Participants from two MHC programs (n?=?80) took part in this study. Results suggest that perception of PJ during interactions with the entire MHC team is significantly associated with program termination, but not with participant behaviors during MHC. Implications for MHC practitioners and researchers are discussed.     

Service utilization in a cohort of criminal justice-involved men: implications for case management and justice systems

In the era of re-entry, a great deal of attention has been paid to the ‘risk-need-responsivity’ model. Most attention to the utilization of services designed to meet need has focused on post-release behaviors. However, little attention has been paid to the pre-incarceration utilization of services that might influence receptivity to post-release utilization. Using constructs borrowed from health services utilization, the current paper examines the associations among CJ-involvement, social and health services utilization, and health status in a cohort of CJ-involved men living in the community. Results from the current cohort, combined with those of previous research, suggest that follow-through on services by released individuals’ remains problematic. Suggestions for future research and questions about the role of criminal justice agencies in improving follow-through are raised.     

Mental health specialized probation caseloads: Are they effective?

With the large and growing number of persons with mental illnesses under probation supervision, a form of specialized probation called specialized mental health caseload (SMHC) has been implemented. This study explores the effectiveness of a prototypic SMHC implemented statewide. A quasi-experimental design was used to compare criminal justice, mental health, and community engagement outcomes among three caseloads: a newly established SMHC supervising no more than 30 clients per officer (N = 1367); an established SMHC supervising roughly 50 clients per officer (N = 495); and a traditional caseload of clients receiving mental health treatment and supervised by officers with average caseloads of over 130 clients (N = 5453). Using a mixed methods approach, we found that the SMHC was implemented with high adherence to fidelity, and comparisons based on different caseload samples generally support the effectiveness of the specialized mental health caseload, particularly on criminal justice outcomes. Future studies using random assignment are needed to examine the connection among mental health symptoms, compliance with treatment and probation supervision, and recidivism.     

Community Wise: Paving the way for empowerment in community reentry

Theoretical approaches traditionally applied in mental health and criminal justice interventions fail to address the historical and structural context that partially explains health disparities. Community Wise was developed to address this gap. It is a 12 week group intervention informed by Critical Consciousness Theory and designed to prevent substance abuse, related health risk behaviors, psychological distress, and reoffending among individuals with a history of incarceration and substance abuse. This paper reports findings from the first implementation and pilot evaluation of Community Wise in two community-based organizations. This pre–posttest evaluation pilot-tested Community Wise and used findings to improve the intervention. Twenty-six participants completed a phone and clinical screening, baseline, 6- and 12-week follow-ups, and a focus group at the end of the intervention. Measures assessed participants' demographic information, psychological distress, substance use, criminal offending, HIV risk behaviors, community cohesion, community support, civic engagement, critical consciousness, ethnic identification, group cohesion, client satisfaction, and acquired treatment skills. Research methods were found to be feasible and useful in assessing the intervention. Results indicated that while Community Wise is a promising intervention, several changes need to be made in order to enhance the intervention. Community Wise is a new approach where oppressed individuals join in critical dialogue, tap into existing community resources, and devise, implement and evaluate their own community solutions to structural barriers.     

Offending and Early Death in the Cambridge Study in Delinquent Development

Criminal offending has many negative outcomes. Researchers have recently begun to consider the impact offending has on offenders' health, with a few studies focusing on differential mortality risk. Yet, prior research has been limited due to selective samples, restricted range of follow-up time period, limited set of explanatory variables, and lack of theoretical guidance. This paper examines the risk of early death among 411 South London males in the Cambridge Study in Delinquent Development followed into their late 50s. Attention is paid not only to differential risk of death between nonoffenders and offenders, but also to the risk within the population of offenders and through consideration of theoretical frameworks and associated predictor variables. Results show that high-rate chronic offenders evince the highest risk of death, an effect that continues even after controlling for childhood individual and environmental risk factors as well as participation in a range of analogous behaviors.