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Este estudo se caracteriza como uma pesquisa documental e bibliográfica que objetivou analisar o percurso histórico, o arcabouço legal e a produção do conhecimento relativa aos fundos para o esporte no Brasil. Instituídos desde o Brasil Colonial, os fundos especiais são instrumentos de financiamento público que se disseminaram no país de maneira difusa e que possibilitam a vinculação, em lei, de determinadas receitas à despesas específicas. No setor esportivo, verificamos que tanto os fundos de esporte como mecanismo de financiamento, quanto a produção científica relativa aos fundos para o esporte são escassas. Considerando a discussão relativa à instituição de fundos nas três esferas federais, diversos desafios são levantados para o setor esportivo e para a solidificação do direito a prática esportiva no país a partir deste instrumento de financiamento público.
This study is characterized as a documentary and bibliographical research that aimed to analyze the historical course, the legal framework and the production of knowledge related to funds for sport in Brazil. Established since Colonial Brazil, special funds are public financing instruments that spread throughout the country in a diffuse way and that make it possible to link, by law, certain revenues to specific expenses. In the sports sector, we found that both sports funds as a financing mechanism and scientific production related to sports funds are scarce. Considering the discussion regarding the institution of funds in the three federal spheres, several challenges are raised for the sports sector and for the solidification of the right to practice sports in the country based on this public funding instrument.
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@#Objective To study the effect of Tangeretin on non-small cell lung cancer (NSCLC) and the tumor stemness, and to find the molecular mechanism of its effect. Methods We used cell counting and cell cloning experiments to study the effect of Tangeretin on the proliferation of NSCLC cells in vitro. The effect of Tangeretin on the invasion of NSCLC cells was detected by transwell assay. We detected the effect of Tangeretin on the proliferation of NSCLC cells in vivo by nude mouse tumor-bearing experiment. The effect of Tangeretin on tumor stemness of NSCLC cells was detected by self-renew assay, and CD133 and Nanog protein expressions. The expressions of PI3K/AKT/mTOR signaling pathway-related proteins were detected by Western blotting (WB). Results Tangeretin had a good inhibitory effect on the proliferation of NSCLC cells in vivo and in vitro. Cell counting experiment, clonal formation experiment and nude mouse tumor-bearing experiment showed that Tangeretin could inhibit the proliferation activity, clonal formation ability, and tumor size of NSCLC cells in vivo. Self-renew experiments showed that Tangeretin could inhibit the self-renew ability of NSCLC cells. WB experiments showed that Tangeretin inhibited the expressions of tumor stemness markers CD133 and Nanog in NSCLC cells. Tangeretin could inhibit the activation of PI3K/AKT/mTOR signaling pathway-related proteins in NSCLC cells, and the activation of PI3K/AKT/mTOR signaling pathway could partially remit the inhibitory effect of Tangeretin on tumor stemness of NSCLC cells. Conclusion Tangeretin can inhibit the tumor stemness of NSCLC cells, which may be related to the regulation of PI3K/AKT/mTOR signaling pathway.
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Objective:Clinical research is widely carried out in medical institutions, and there are differences in the use of research and conventional medical funds. This paper aimed to analyze the compliance issues of insurance fund in clinical research and explore the management strategies in the institutions conducting clinical trials or research.Methods:By consulting the literature, questionnaire, and work practice, this paper analyzed the current situation and existing problems of the compliance of the medical insurance fund in domestic clinical trials, proposed targeted management measures for the use of funds, and standardizes the corresponding workflow.Results:This paper summarized three payment methods of research-related funds and analyzed the main problems at present, including the definition of trial requirements, the payment of combined drugs specified in the protocol, the particularity of medical device trials, the payment of adverse events in clinical trial, the insurance of post-marketing research and clinical trial. According to the regulatory requirements and work practices, the corresponding management countermeasures were sorted out, including that the project funds and insurance audit should be carried out inside the medical institution. Clinical research, medical insurance management departments, ethics committees, and other departments should collaborate on establishing and improving a compliance management system. The research team should strengthen the management of adverse events, strengthen the publicity and education of the participants, and make good use of the sharing platform.Conclusions:The research institution should establish standardized and feasible processes, the research team should strengthen the management, and the use of the sharing platform is conducive to ensuring the compliance of the medical insurance fund and protecting the interests of the participants.
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The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) has become an increasingly active and influential organization in global health during the past two decades. It is now playing an increasingly important role in the prevention and control of major infectious diseases, international financing for health, public procurement market development across the world. The article outlines the basic architecture of the Global Fund, including its overall information, financing mechanism, operational models and key experiences accumulated. Based on previous cooperation, the article analyzes the importance of the long-term partnership between China and the Global Fund, and proposes policy suggestions to achieve more win-win outcomes in the near future.
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Resumo O financiamento público vem ganhando destaque nos estudos das políticas públicas esportivas, pois permite visualizar de forma mais transparente onde e como são alocados os recursos públicos para o setor. Este artigo tem como objetivo analisar o financiamento das políticas públicas de esporte do Distrito Federal (DF), a partir de matriz e proposta metodológica que possibilitam o levantamento e sistematização de dados referentes à identificação das fontes, magnitude e direcionamento dos gastos públicos orçamentários com o esporte de 2009 a 2019. A pesquisa apontou: (i) falta de legislação efetiva para garantia dos recursos esportivos; (ii) centralidade da execução do orçamento pela Secretaria de Esporte do Distrito Federal; (iii) elevado gasto com a construção do Estádio Nacional de Brasília; e, (iv) hierarquização dos gastos esportivos nos programas oferecidos, com priorização aos Centros Olímpicos e Paralímpicos, ação com gestão terceirizada, além de capilaridade e abrangência reduzidas.
Abstract Public funding has been gaining prominence in studies of sports public policies as it provides a more transparent view of where and how public resources are allocated to the sector. This article aims to analyze the financing of public policies for sports in the Federal District (FD), based on a matrix and methodological proposal that allows the survey and systematization of data referring to the identification of sources, magnitude, and direction of public budget expenditure on sports from 2009 to 2019. The research points out: (i) the lack of effective legislation to guarantee sports resources; (ii) the centrality of budget execution by the Secretariat of Sports of the Federal District; (iii) high expenses with the construction of the Brasília National Stadium; and (iv) the prioritization of sports spending in the offered programs, with priority given to the Olympic and Paralympic Centers, outsourced management, in addition to reduced capillarity and scope.
Resumen La financiación pública ha ido cobrando protagonismo en los estudios de políticas públicas deportivas, ya que permite tener una visión más transparente de dónde y cómo se asignan los recursos públicos al sector. Este artículo tiene como objetivo analizar del financiamiento de las políticas públicas deportivas en el Distrito Federal (DF), a partir de una propuesta matricial y metodológica que permite recolectar y sistematizar datos referentes a la identificación de fuentes, magnitud y dirección del gasto público presupuestario en deportes, de 2009 a 2019. La investigación señaló: (i) la falta de una legislación efectiva para garantizar los recursos deportivos; (ii) la centralidad de la ejecución presupuestaria por parte de la Secretaría de Deportes del Distrito Federal; (iii) altos gastos con la construcción del Estadio Nacional de Brasilia; y (iv) la priorización del gasto deportivo en los programas ofrecidos, con prioridad en los Centros Olímpicos y Paralímpicos, gestión externalizada, además de capilaridad y alcance reducidos.
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ABSTRACT The article analyzes aspects of the change in the legal nature of private healthcare from "for-profit" to "non-profit" entities. It is an exploratory research, supported by the policy analysis framework, focusing on secondary data from the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities - CNES) from 2012 to 2020 and a case study. The results show an increase in these entities in all regions of the country and evidence that they behave like profit-oriented entities. The change in legal nature hides a broader process of implicit commodification of healthcare services, encouraged by state policies and related to exemptions provided by law.
RESUMO O artigo analisa aspectos da mudança da natureza jurídica de instituições privadas de assistência à saúde, de estabelecimentos "com" para "sem" fins lucrativos. Trata-se de uma pesquisa exploratória, apoiada no referencial de análise de políticas, com foco em dados secundários, provenientes do Sistema de Cadastro Nacional de Estabelecimentos de Saúde (SCNES), de 2012 a 2020, e estudo de caso. Os resultados apresentam aumento dessas entidades em todas as regiões do país e evidências de que se comportam como estabelecimentos com fins lucrativos. A mudança de natureza jurídica oculta um processo mais amplo de mercantilização implícita dos serviços de saúde, incentivado por políticas estatais e relacionado às isenções previstas em lei.
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Public Policy , Voluntary Health Agencies/legislation & jurisprudence , Unified Health System , Hospitals, Private , Health Management , Fund RaisingABSTRACT
ABSTRACT The objectives of this article are to describe the interventions carried out by the Strategic Fund of the Pan American Health Organization to facilitate access to and availability of antihypertensive medicines and devices for measuring blood pressure across the Region of the Americas as part of the HEARTS initiative, and to present the preliminary results of price analyses of antihypertensive medicines. The study methodology included a review of reports made by the Strategic Fund between 2019 and 2020, an evaluation of modalities of procurement, a review of the public procurement databases for five antihypertensive medicines, and a comparison with the price obtained by the Strategic Fund. Differences in price ranging from 20% to 99% were identified, indicating significant opportunities for savings. The study also presents interprogrammatic actions that can support the HEARTS initiative, such as the inclusion of antihypertensive medicines recommended by the World Health Organization, consolidation of regional demand and competitively-priced long-term agreements to manage the procurement of quality generic products, and the definition of technical specifications and regulatory requirements to support the procurement of devices to measure blood pressure. This mechanism will enable Member States to reduce their costs significantly, while extending treatment and diagnostic coverage to more people.
RESUMEN Los objetivos del presente artículo son describir las intervenciones realizadas por el Fondo Estratégico de Organización Panamericana de la Salud, para facilitar el acceso y disponibilidad de medicamentos antihipertensivos y dispositivos para la medición de la presión arterial a los países de la Región de las Américas en apoyo a la implementación de la Iniciativa HEARTS; y presentar los resultados preliminares de los análisis de los precios de los medicamentos antihipertensivos. La metodología del estudio incluyó la revisión de informes realizados por el Fondo Estratégico durante los años 2019-2020, la evaluación de las modalidades de adquisición y revisión de las bases de datos de compras públicas para 5 medicamentos antihipertensivos, y el análisis comparativo con el precio obtenido por el Fondo Estratégico. Se identificaron diferencias que oscilaron entre 20% y 99%, lo que evidencia oportunidades de ahorro significativas. Asimismo, se presentan las acciones interprogramáticas desarrolladas en apoyo a la Iniciativa HEARTS, entre las que se destacan la inclusión de medicamentos antihipertensivos recomendados por la Organización Mundial de la Salud; la consolidación de la demanda regional y el establecimiento de precios competitivos con acuerdos a largo plazo para gestionar la adquisición de productos genéricos de calidad; y la definición de especificaciones técnicas y requisitos regulatorios para apoyar con la adquisición de dispositivos para la medición de la presión arterial. A través de este mecanismo, los Estados Miembros pueden disminuir sus costos significativamente, extendiendo cobertura del tratamiento y diagnóstico a más personas.
RESUMO Os objetivos deste artigo são descrever as intervenções realizadas pelo Fundo Estratégico da Organização Pan-Americana da Saúde para facilitar o acesso e a disponibilidade de medicamentos anti-hipertensivos e aparelhos de medição de pressão arterial aos países da Região das Américas, em apoio à implementação da iniciativa HEARTS; e apresentar os resultados preliminares da análise dos preços dos medicamentos anti-hipertensivos. A metodologia do estudo incluiu a revisão de relatórios feitos pelo Fundo Estratégico durante os anos de 2019 e 2020, a avaliação das modalidades de aquisição e revisão dos dados de compras públicas de 5 medicamentos anti-hipertensivos e uma análise comparativa com o preço obtido pelo Fundo Estratégico. Foram identificadas diferenças que oscilaram entre 20% e 99%, o que evidencia oportunidades de economia significativas. Da mesma forma, são apresentadas as ações interprogramáticas desenvolvidas em apoio à iniciativa HEARTS, entre as quais se destacam a inclusão de medicamentos anti-hipertensivos recomendados pela Organização Mundial da Saúde; a consolidação da demanda regional e o estabelecimento de preços competitivos com acordos de longo prazo para gerenciar a aquisição de genéricos de qualidade; e a definição de especificações técnicas e requisitos regulatórios para subsidiar a aquisição de aparelhos de medição de pressão arterial. Por meio desse mecanismo, os Estados Membros podem reduzir seus custos significativamente, ampliando a cobertura de tratamento e diagnóstico para atingir mais pessoas.
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RESUMO Discute-se o Fundo de Saúde do município de São Paulo, destacando a apropriação dos seus recursos pelo setor privado, especialmente pelas Organizações Sociais (OS). Para tanto, a primeira parte apresenta os fundamentos mais gerais do Fundo Público. A segunda parte analisa a trajetória histórica do Fundo Municipal de Saúde e a utilização de seus recursos, em grande medida, para o financiamento da atenção básica, via Programa de Saúde da Família, executado pelas OS. A terceira apresenta as características das OS, analisando a evolução da apropriação dos recursos do Fundo de Saúde entre 2011 e 2021. Percebe-se que os recursos do Fundo de Saúde passam a ser cada vez mais apropriados por essas entidades de caráter privado, apresentando uma tendência de crescimento, alcançando um patamar de 89,2% do total dos recursos em 2021. Desse modo, constata-se o movimento de mercantilização implícita, marcado pela lógica de ampliação dos mecanismos de mercado no Sistema Único de Saúde municipal.
ABSTRACT The Health Fund of the municipality of São Paulo has been discussed, highlighting the appropriation of its resources by the private sector, especially by Social Organizations (OS). To this end, the first part presents the more general foundations of the Public Fund. The second part analyzes the historical trajectory of the Municipal Health Fund and the use of its resources, to a large extent, to finance primary care, via the Family Health Program executed by the OS. The third part presents the characteristics of the OS, analyzing the evolution of the appropriation of resources of the Health Fund between 2011 and 2021. It can be seen that the Health Fund resources are increasingly appropriated by these private entities, with a growing trend, reaching a level of 89.2% of total resources in 2021. Thus, the movement of implicit mercantilization is verified, marked by the logic of expansion of market mechanisms in the municipal Unified Health System.
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Resumo O objetivo deste artigo é analisar a realização de transferências fundo a fundo e avaliar se ela tem contribuído para a coordenação e cooperação federativa de políticas voltadas à segurança pública no Brasil. Para tanto, o trabalho foi dividido em três etapas: (i) levantamento dos valores do Fundo Nacional de Segurança Pública (FNSP), destinados aos estados e ao Distrito Federal, no período de 2000 a 2022, antes e depois da adoção das transferências fundo a fundo; (ii) realização de entrevistas semiestruturadas para levantar as percepções dos gestores responsáveis pela elaboração e coordenação do processo de descentralização e pelo acompanhamento da execução dos recursos descentralizados; e (iii) análise dos mecanismos de coordenação/cooperação previstos nos planos de aplicação elaborados pelos estados no período supracitado. Os achados da pesquisa confirmam resultados de estudos anteriores sobre o poder de indução das transferências fundo a fundo na cooperação e coordenação de políticas nacionais, também para a área de segurança pública. Verificou-se que a ampliação de recursos e a obrigatoriedade de seu compartilhamento com os estados favoreceram o alinhamento das políticas estaduais às diretrizes estabelecidas pela União, mas que ainda é incipiente a interação entre os órgãos, organizações e membros da sociedade em relação ao tema.
Resumen El objetivo de este artículo es analizar si las transferencias de fondo a fondo han contribuido a la coordinación y cooperación federal de las políticas dirigidas a la seguridad pública en Brasil. Para ello, el trabajo se dividió en tres etapas: (i) Relevamiento de los montos del Fondo Nacional de Seguridad Pública asignados a los estados y al Distrito Federal en el período 2000-2022, antes y después de la adopción de las transferencias fondo a fondo; (ii) Realización de entrevistas semiestructuradas para conocer la percepción de los gerentes responsables de preparar y coordinar el proceso de descentralización y monitorear la ejecución de los recursos descentralizados; y (iii) Análisis de los mecanismos de coordinación/cooperación previstos en los planes de aplicación elaborados por los estados en el período. Los hallazgos de la investigación confirman los resultados de estudios previos sobre el poder de inducción de las transferencias fondo a fondo en la cooperación y coordinación de políticas nacionales también para el área de seguridad pública. Se verificó que la ampliación de los recursos y la obligatoriedad de compartirlos con los estados favorecieron el alineamiento de las políticas estatales con las directrices establecidas por el Gobierno federal, pero que la interacción entre organismos, organizaciones y miembros de la sociedad sobre el tema es aún incipiente.
Abstract This article aims to analyze whether fund-to-fund transfers have contributed to federal coordination and cooperation of policies aimed at public security in Brazil. To this end, the work was divided into three stages: (i) Survey of National Public Security Fund amounts allocated to the states and the Federal District in the period from 2000 to 2022, before and after the adoption of fund-to-fund transfers; (ii) Conducting semi-structured interviews to raise the perceptions of managers responsible for preparing and coordinating the decentralization process and monitoring the execution of decentralized resources; and (iii) Analysis of the Coordination/Cooperation mechanisms foreseen in the Application Plans prepared by the states in the period. The research findings confirm the results of previous studies on the induction power of fund-to-fund transfers in the cooperation and coordination of national policies for public security. It was verified that the expansion of resources and the obligatoriness of their sharing with the states favored the alignment of state policies with the guidelines established by the Union but that the interaction between bodies, organizations, and members of society on the subject is still incipient.
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Safety , Brazil , FederalismABSTRACT
Resumo: Este artigo visa identificar a participação e os limites do fundo público no ciclo do capital da economia dependente brasileira. Para isso, aborda as implicações do intercâmbio desigual, da transferência de valor e da superexploração da força de trabalho para a composição e direcionamento do fundo público no Brasil, utilizando-se da coleta e análise de dados acerca do sistema tributário brasileiro.
Abstract: This article aims to identify the participation and limits of the public fund in the capital cycle of the Brazilian dependent economy. To this end, it addresses the implications of unequal exchange, value transfer and overexploitation of the labor force for the composition and direction of public fund in Brazil, using the analysis of data about the Brazilian tax system.
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Resumo: Este artigo apresenta o debate acerca da política de Assistência Social na contemporaneidade do ponto de vista do padrão das políticas sociais brasileiras, delineado a partir da Teoria Marxista da Dependência. Sinaliza seu caráter estruturalmente restrito e localiza seu ciclo breve de construção, gradualmente inviabilizado após 2016.
Abstract: This article presents the debate about the Social Assistance Policy in contemporary times from the perspective of the pattern of Brazilian social policies, delineated from the Marxist Theory of Dependence. It points out its structurally restricted nature and locates its brief construction cycle, which gradually became unfeasible after 2016.
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Mutual Fund is a fund establishment in the form of a trust to raise money through the sale of units to the public or a section of the public under one or more schemes for investing in securities, including money market instrument. The investors want to know about the present and past performance of the selected mutual funds. This information must be supported by certi?ed documents. The system of accounting for Mutual Fund is different from conventional system of accounting which is followed in industrial sectors. Hence, only proper accounting for mutual funds can show the real picture of risk and return of a speci?c mutual fund. An investor may compare accounting information relating to a mutual fund with its benchmark return. He can do the comparison with con?dence on the basis of audited report of a particular fund. Moreover proper system of mutual fund accounting leads the fund manager to minimize cost
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Gender-based violence refers to all forms of detrimental actions to target a single person or a group of them depending on their gender. This predominantly includes violence directed against women and includes all forms of violence (in the real world to online violence). We must understand and accept that even though these incidents are happening in the online world, the internet has become such an integral part of human life that the outcome of such violence is seen in the real life. The United Nations Population Fund has initiated a new online campaign in the name of Bodyrights, which is the new copyright mark to proclaim and demand security from the various incidents of digital violence. To conclude, gender-based violence has been reported universally, and the same things are on the rise even on the online platform, wherein women and girls are being targeted and their dignity and reputation are being tarnished. This calls for the need to raise to the occasion and the policy-makers and the technology companies should offer complete support to not only punish the offenders but even reduce the incidence of such events in the present and the future.
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RESUMEN Los objetivos del presente artículo son describir las intervenciones realizadas por el Fondo Estratégico de Organización Panamericana de la Salud, para facilitar el acceso y disponibilidad de medicamentos antihipertensivos y dispositivos para la medición de la presión arterial a los países de la Región de las Américas en apoyo a la implementación de la Iniciativa HEARTS; y presentar los resultados preliminares de los análisis de los precios de los medicamentos antihipertensivos. La metodología del estudio incluyó la revisión de informes realizados por el Fondo Estratégico durante los años 2019-2020, la evaluación de las modalidades de adquisición y revisión de las bases de datos de compras públicas para 5 medicamentos antihipertensivos, y el análisis comparativo con el precio obtenido por el Fondo Estratégico. Se identificaron diferencias que oscilaron entre 20% y 99%, lo que evidencia oportunidades de ahorro significativas. Asimismo, se presentan las acciones interprogramáticas desarrolladas en apoyo a la Iniciativa HEARTS, entre las que se destacan la inclusión de medicamentos antihipertensivos recomendados por la Organización Mundial de la Salud; la consolidación de la demanda regional y el establecimiento de precios competitivos con acuerdos a largo plazo para gestionar la adquisición de productos genéricos de calidad; y la definición de especificaciones técnicas y requisitos regulatorios para apoyar con la adquisición de dispositivos para la medición de la presión arterial. A través de este mecanismo, los Estados Miembros pueden disminuir sus costos significativamente, extendiendo cobertura del tratamiento y diagnóstico a más personas.
ABSTRACT The objectives of this article are to describe the interventions carried out by the Strategic Fund of the Pan American Health Organization to facilitate access to and availability of antihypertensive drugs and devices for measuring blood pressure in the countries of the Region of the Americas, supporting implementation of the HEARTS initiative; and to present the preliminary results of price analyses of antihypertensive drugs. The study methodology included a review of reports made by the Strategic Fund during 2019-2020, evaluation of modalities of procurement, a review of the public procurement databases for five antihypertensive drugs, and a comparison with the price obtained by the Strategic Fund. Differences ranging from 20% to 99% were identified, indicating significant opportunities for savings. Interprogrammatic actions in support of the HEARTS initiative are also presented, such as the inclusion of antihypertensive drugs recommended by the World Health Organization; consolidation of regional demand and establishment of competitive prices with long-term agreements to manage the procurement of quality generic products; and the definition of technical specifications and regulatory requirements to support the procurement of devices to measure blood pressure. Through this mechanism, Member States can reduce their costs significantly, enabling them to extend treatment and diagnostic coverage to more people.
RESUMO Os objetivos deste artigo são descrever as intervenções realizadas pelo Fundo Estratégico da Organização Pan-Americana da Saúde para facilitar o acesso e a disponibilidade de medicamentos anti-hipertensivos e aparelhos de medição de pressão arterial aos países da Região das Américas, em apoio à implementação da iniciativa HEARTS; e apresentar os resultados preliminares da análise dos preços dos medicamentos anti-hipertensivos. A metodologia do estudo incluiu a revisão de relatórios feitos pelo Fundo Estratégico durante os anos de 2019 e 2020, a avaliação das modalidades de aquisição e revisão dos dados de compras públicas de 5 medicamentos anti-hipertensivos e uma análise comparativa com o preço obtido pelo Fundo Estratégico. Foram identificadas diferenças que oscilaram entre 20% e 99%, o que evidencia oportunidades de economia significativas. Da mesma forma, são apresentadas as ações interprogramáticas desenvolvidas em apoio à iniciativa HEARTS, entre as quais se destacam a inclusão de medicamentos anti-hipertensivos recomendados pela Organização Mundial da Saúde; a consolidação da demanda regional e o estabelecimento de preços competitivos com acordos de longo prazo para gerenciar a aquisição de genéricos de qualidade; e a definição de especificações técnicas e requisitos regulatórios para subsidiar a aquisição de aparelhos de medição de pressão arterial. Por meio desse mecanismo, os Estados Membros podem reduzir seus custos significativamente, ampliando a cobertura de tratamento e diagnóstico para atingir mais pessoas.
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The economic burden of medication for hemophilia patients is heavy. Charitable donation is a key way to supplement relief funds for the patients. In order to explore the appropriate and efficient usage of the relief funds, Nanfang Hospital was one of the earliest ones that launched the "one-stop finance service" of relief funds. The practice and experience of the service have been widely referred to and applied in other places, and achieved good results. This article reviews the practice and cases, and discusses the significance in reducing the burden of patients and in improving the efficiency of hemophilia relief.
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As suggested by regulatory feedbacks from relevant national regulatory agencies on the use of medical insurance funds, noticeable problems were found in the compliance and rationality of medical service charges among Chinese hospitals. Based on the practice of hospital management, the authors summarized common problems of various medical service charge management as reported by the management authorities at all levels. These problems referred to name-replaceable charges and affiliated charges, splitting charges, repeated charges, and multiple(false) charges. On this basis, the paper analyzed such hospital management risks incurred as regulatory penalties, fee disputes and medical disputes, as well as their internal and external causes. In the end, the paper put forward countermeasures and suggestions for reference by hospitals in their management of medical service charges.
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Objective:To study the role of the Administration Research Fund in promoting the high-quality development of hospitals.Methods:This study conducted a comprehensive analysis of all projects funded by the Administration Research Fund in terms of the quantity of applying and granting, the specialties or the fields involved, the heads of projects, the outputs of the projects, and the trends and characteristics of the selected topics, further, analyzed and evaluated the role played by the projects in promoting hospital development through questionnaires and in-depth interviews.Results:Since the establishment of the fund, a total of 113 projects have been funded (204 have been declared). Encompassing a wide range of professions or fields. More than 80% of the project leaders were from administrative departments, showing the characteristics of high education and youthfulness.Conclusions:The Administration Research Fund reached its goal at the time of establishment and formed a stable influence. The selection of project topics revolved around the aspects of continuous improvement in hospital development and presented a certain pattern, which can promote the growth of management cadres and is one of the important ways to promote hospital development. It is recommended to further improve the quality of administration research projects by strengthening the whole process of management, setting up project guidelines, and improving the review mechanism.
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Objective:To construct and verify a model of excessive medical behavior clues enrichment, for the technical support for the safe and rational use of medical insurance fund.Methods:A model of excessive medical behavior clues enrichment was constructed by the rank assignment method. The inpatient transaction records of medical insurance for employees and residents in 5 tumor hospitals in Beijing from 2016 to 2019 were obtained to verify the validity of the model. The patients were grouped according to age and gender, and each transaction record was converted into a standardized score V(0-100 scores), all transactions were divided into 22 groups according to V value. The Cochran-Armitage trend test was used to analyze the variation trend of enrichment rate with the increase of V value. Chi-square test was used to compare the chargeback rates of different groups. The correlation between the standardized score V and the amount of chargeback was tested by Pearson.Results:There were 872 599 and 86 356 hospitalization transactions for employee and resident medical insurance patients, with included 1 164 and 103 chargeback records respectively. The average score and median of V-value of employee and resident medical insurance transactions were scores of 49 and 50 respectively.When V>0, the enrichment rates of the employee and resident medical insurance were on the rise with the increasing of V( Z=23.86, P<0.001; Z=11.02, P<0.001), the refusal rates among different groups was significant different( χ2=1 307.16, P<0.001)and the correlation between V value and the chargeback amount was statistically significant( r=0.29, P<0.001; r=0.30, P=0.003). Conclusions:This study established a clue enrichment model of excessive medical behavior based on the rank assignment method. By analyzing a large number of medical insurance transaction records, the model can focus on the medical insurance transaction with suspected excessive medical treatment behavior, and has a certain guiding role in the management of medical insurance fund.
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In recent years, the medical insurance coverage of China has been increased significantly, and the medical insurance policies have been launched continuously, so the traditional manual audit method is unable to support medical institutions to effectively supervise the medical insurance fund. In view of this situation, a tertiary hospital in Beijing had successfully built an intelligent medical insurance audit system for drugs, diagnosis and treatment projects under key supervision, realized the prior audit and in-process control of the illegal use of medical insurance funds, through the establishment of intelligent audit rules, the design of audit trigger points and the interception level of illegal medical orders, and the establishment of a pre-operational preparation system and continuous improvement mechanism. In March 2021, the hospital officially launched the system. After the application of the system, the amount and quantity of outpatient medical insurance refusal from April to September 2021 were 10 587 yuan and 72 respectively, which decreased by 79.21% and 77.50% compared with the same period in 2020. This system effectively improved the quality and efficiency of medical insurance fund supervision.
ABSTRACT
Objective:By optimizing the fund management mode, a scientific research management platform with high efficiency can be created, which can innovate the vitality of scientific research and improve the level of scientific research management.Methods:Applying the scientific research fund management model based on information platform interconnects each system and forms a new fund management model.Results:The fund management mode based on the information platform standardizes the business process, reduces the risk of internal control and facilitates the scientific researchers and financial personnel to control and manage the quality of scientific research.Conclusions:The fund management mode based on the information platform achieves the management goals of improving work efficiency, standardizing business process, strengthening internal control and innovating scientific research vitality by integrating system resources and business process.