通过规制实现健康保护——范围、方法和程序概览

风险规制法的目标和方法在于具体危险的防御和预防(可能的)风险。对于科技工艺和技术生产的物质或生物来说,除了惩罚禁止措施外,需要建构一套传统风险预防的前置制度,通过广泛的公众参与来对科技后果进行评估,从而采取相应的预防措施。风险规制的行政法方法包括传统的行政调控方式和信息规制方法、激励型规制手段等非禁令手段的方法。通过智慧的规制方法既可实现意欲达到的规制目标,同时也能降低行政管理成本和减少对经济活动的过度干预。     

Customary and contemporary resources for women's empowerment in Bangladesh

In Bangladesh, dramatic social and economic changes are transforming historical forms of patriarchy with various impacts on pathways to women's empowerment. We hypothesised contemporary resources would be more strongly associated with women's empowerment, as reflected in their influence in family decisions. In cross-sectional analysis, we found the contemporary resources of employment and membership in NGOs were most strongly and consistently associated with women's influence in family decisions. Education was only modestly associated, as were customary resources, including age and fertility. Programmatic efforts to enhance women's empowerment should consider the rapidly changing environment and the importance of women's economic participation.     

卫生法理论体系建构的前提

当前卫生法体系研究的进路多从体系内容建构的角度出发,论述卫生法体系中所包括的基本内容,但由于卫生法所调整的法律关系与调整方式的多样性,对卫生法的内涵与外延未有一致的认识,因而妨碍了卫生法的理论研究和在实践中的进一步发展。所以研究卫生法理论体系的建构,应当首先缕清其前提。大量的卫生立法与卫生法制活动为研究卫生法理论体系的建构提供了丰富的素材,是卫生法理论体系建构的基础;卫生法学的学术研究与学科建设发展为推动卫生法理论体系的建构提供了强大的助力,是卫生法理论体系建构的支撑;卫生法作为对社会变迁的回应装置,具有社会生长的属性,以对健康权的关切为核心的人文关怀作为卫生法的精神内核,也是构建卫生法理论体系的逻辑起点。在此基础上作为卫生法理论体系建构前提应该围绕着健康权核心来定义卫生法。     

The United Nations Convention on the Rights of Persons with Disabilities and Mental Health Law

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) took effect in 2008. This paper discusses a number of flashpoints where the CRPD will require real and significant reconsideration of English mental health and mental capacity law. The CRPD introduces a new paradigm into international disability law, relying on the social model of disability. While that is no doubt a good thing, there is as yet no clear sense as to how that is to be implemented. After providing an introduction to the Convention, the paper considers four specific areas: mental capacity law (focussing on the provisions of the Mental Capacity Act 2005), psychiatric treatment without consent, civil detention of people with mental disabilities, and mental disability in the criminal system (fitness to plead, insanity and diminished responsibility).     

公安院校学生参加跆拳道运动的体质和心理指标分析

跆拳道运动既是一项观赏性很强的竞技运动,又是一种具有实用性的健身运动。通过对公安院校大学生开展跆拳道运动身体及心理各项指标分析研究,跆拳道运动对改善学生体质和提高心理健康水平有着积极作用。     

新冠肺炎疫情防控与全球卫生治理--以世界卫生组织改革为主线

新冠肺炎疫情是当前国际社会遇到的极为严重的公共卫生安全危机,不但给全球政治经济发展带来前所未有的挑战,也对全球卫生治理机制构成史无前例的压力测试。作为全球卫生治理最重要的多边机制,世界卫生组织积极致力于新冠肺炎疫情防控,成为全球卫生安全命运共同体理念的"推动者"、全球抗疫合作的"协调者"、全球抗疫薄弱环节的"补位者"以及全球抗疫规范和技术的"提供者"。实际上,世界卫生组织一直通过机构改革来适应不断变化的全球卫生安全形势,优化和提升其全球卫生治理功能。特别是在谭德塞担任总干事后,世界卫生组织发起了该组织"历史上最广泛的改革",将项目规划、应急能力建设、对外关系和治理以及组织规范与标准作为其改革的四大支柱,使其全球卫生治理功能得到显著提升。然而,新冠肺炎疫情防控同样也暴露了世界卫生组织全球卫生治理功能的不足和局限。国际社会唯有诉诸通力合作、彰显责任担当,共同为以世界卫生组织为主体的全球卫生治理机制运作创造更有利的国际政治环境,新冠肺炎疫情方能尽快平息,全球卫生治理才能真正进入健康的运行轨道。     

医疗保险干预能否缓解三级医院的“虹吸效应”?——基于某大城市的实证研究

【问题】患者普遍偏好在三级医院就诊,而三级医院对患者的“虹吸效应”直接影响了医疗服务体系的运行效率。差异化报销的医保政策干预成为各地推行“分级诊疗”的普遍手段。虽然三级医院的“虹吸效应”已经得到学界的普遍关注,成为医改领域的热点研究问题,但现有相关研究还主要停留在理论探讨层面。而且,医保政策干预作为分级诊疗推动措施究竟能够发挥多大作用,在实证方面还缺乏足够的文献支持。【方法】文章基于A市的医疗保险数据,使用固定效应等研究方法,对三级医院的“虹吸效应”和医保政策干预效果进行了分析。【发现】三级医院对使用社会医疗保险患者的门诊就医选择有“虹吸效应”,每10万人配备的三级医院数量每增加1家,赴三级医院门诊就医的患者比例就提高5.8%。“虹吸”的主要对象来自二级医院而非一级及以下医疗机构的患者群体。“虹吸效应”存在异质性:无慢性病群体、高收入者、儿童更容易被三级医院“虹吸”。医保政策干预能够缓解“虹吸效应”,且对“小病、常见病”的影响程度更大,可以有效引导把价格敏感的患者向基层医院分流。【贡献】文章从实证上检验了三级医院对需求方的“虹吸效应”及其程度,首次揭示了中国二级医院的“夹心层”困境;通过检验医保政策干预对“虹吸效应”的效果,为医保补偿政策推动分级诊疗提供了新的经验证据。文章对于推动分级诊疗、优化医疗资源配置具有重要的现实意义。     

Brunei's strategic dilemmas

Abstract

This paper compares health policy trends in Indonesia, Malaysia, the Philippines and Thailand with the purpose of drawing usable lessons in reform. The study finds that governments in the region are rapidly privatizing the provision of healthcare at the same time as they are expanding the government's role in financing. The paper argues that expansion of public financing at the same time as private provision is misconceived as the combination would aggravate instances and severity of market failures peculiar to the sector. The dysfunctional trend is particularly evident in Indonesia and the Philippines. In Thailand, in contrast, the expansion of public financing has occurred in the context of a health system dominated by public providers, which has had the effect of restraining healthcare costs. Malaysia occupies a mid position between Indonesia and the Philippines on the one hand and Thailand on the other. All four cases underline the value of state capacity in designing optimal policies and implementing them effectively.     

多重角色对现代女性健康影响的实证研究

本文以2008-2009年在北京、武汉、石家庄、广州四城市的1102位年龄在18-65岁的女性作为调查样本,探讨了多重角色对现代女性健康状况的影响关系。根据角色替代理论、角色互补理论和角色组合紧张理论所提出的理论观点,检验了婚姻状况、职业类型、居住情况和生育子女四个变量的特定组合对现代女性健康所产生的交互作用。研究还进一步检验了女性在不同生命周期所扮演的社会角色同健康的关系,以及年龄和工作类型的相互作用对健康的影响。     

Health Care Reform in Vietnam: Chasing Shadows

The purpose of this paper is to analyse and assess health care reforms in Vietnam since the late 1980s. It will argue that shortcomings of the reforms centre on three related sets of measures: substitution of budgetary allocation with user charges, expansion of social insurance and promotion of decentralisation. Reduction in fiscal support for providers offered them the motive to concentrate on revenue-generating activities while user charges provided them with the means to do so. With both the motive and the means for maximising revenues in place, providers vigorously pursued income-maximisation which had the effect of raising overall expenditures while reducing access. To deal with the problem of declining access due to rising user charges, the government is in the process of vigorously expanding social insurance. However, social insurance does not deal with the root causes of the problem of rising expenditures which lie in paying providers on a fee-for-service (FFS) basis. The paper will further argue that decentralisation has aggravated the adverse effects of FFS by diluting control and accountability.