ABSTRACT
Resumo As revistas científicas têm papel fundamental para o desenvolvimento da ciência. Contudo, no Brasil, existem grandes desafios para sua sustentabilidade, assim como do Programa SciELO. O artigo relata um cenário preocupante de baixo financiamento público e ausência de planejamento estratégico com financiamento de longo prazo para a publicação científica, na contramão do desenvolvimento das revistas brasileiras e do Programa SciELO. Tal cenário impõe grande pressão às revistas, com relatos de situações de encerramento de atividades, ou implementação de cobrança de taxas aos autores, ao mesmo tempo que traz insegurança financeira ao Programa SciELO. São informadas as ações tomadas por sociedades científicas Brasileiras e a posição do Fórum de Editores das Revistas da Saúde Coletiva, alinhada à do Comitê Consultivo da Coleção SciELO Brasil, de que a publicação de periódicos científicos editados no Brasil é estratégica e, portanto, deve ser incentivada por meio de políticas públicas e apoiada com recursos públicos provenientes das instituições mantenedoras e dos editais das agências de fomento.
Abstract Scientific journals play a fundamental role in the development of science. However, in Brazil, there are major challenges for their sustainability, as well as for the sustainability of the SciELO Program. The article reports a worrying scenario of low public funding and lack of strategic planning for long-term funding for scientific publication, contrary to the development of Brazilian journals and the SciELO Program. This scenario places great pressure on journals, with reports of situations of closure of activities, or implementation of fees charged to authors, while bringing financial insecurity to the SciELO Program. The actions taken by Brazilian scientific societies and the position of the Forum of Editors of Public Health Journals are aligned with that of the Advisory Committee of the SciELO Brazil Collection, namely that the publication of scientific journals edited in Brazil is strategic and, therefore, should be fostered through public policies and supported with public financing from the sponsoring institutions and grants from the research funding institutions.
Subject(s)
Humans , Male , Female , Periodicals as Topic , Public Policy , Brazil , Public HealthABSTRACT
Objective:To evaluate the impact of the reform of the county medical community on the expenditure of medical insurance funds, and to provide references for maintaining the stability of the medical insurance fund and deepening the reform of the medical community.Methods:Medical insurance data of urban and rural residents in M County, Yunnan province from 2016 to 2019 were collected, and a discontinuous time series model was used to analyze the impact of county medical community reform on medical insurance fund expenditures.Results:Since the reform, the number of patients discharged from county-level hospitals has shown a downward trend, averaging a decrease of 25.996 people per month; yet increases have emerged with the average hospitalization expenditure, the average hospitalization overall fund expenditure, and the average outpatient overall fund expenditure, averaging a monthly increase of 90.931 yuan, 50.014 yuan and 1.528 yuan respectively. The average hospitalization expenditure, the average hospitalization overall fund expenditure, and the average outpatient overall fund expenditure of the township hospitals all showed an upward trend, averaging a monthly increase of 31.191 yuan, 38.678 yuan and 0.085 yuan respectively. The flow of external medical insurance funds of the medical community has shown a continuous upward trend, averaging a monthly increase of hospitalization fund expenditures of 33.005 yuan, and a monthly increase of outpatient overall fund expenditures of 4.896 yuan overall.Conclusions:The M County medical community should further strengthen the top-level design, explore the reform of medical insurance payment methods, improve the regional information platform, standardize the referral system, and strengthen supervision to deepen the construction of the medical community to ensure the sustainable operation of medical insurance funds.