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The process of establishing and improving the Employee Health Insurance Outpatient Co-payment Protection Mecha-nism is one of the major livelihood projects to deepen the reform of China's medical insurance system.The implementation of the mu-tual-aid mechanism for covering outpatient bills in each coordinating region is accompanied by the risks of squeezing outpatient medi-cal resources,the prevalence of fraud and deception,the increase of the government s economic burden and the lack of public ac-ceptance.In this regard,suggestions are made to improve the policy:open source and cut costs to make up for the shortage of funds,linkage of three medical institutions to build a medical security pattem,coordinated supervision to maintain the stability of medical insurance funds,and optimized policies to promote the reform of medical insurance payment methods.
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Objective:Efficiency is a key factor in the sustainable operation of the medical insurance system.By measuring the current efficiency of the urban employee basic medical insurance system in 31 provinces in China from 2020 to 2021,it discovers possible problems,and provides reference suggestions for improving the efficiency of the system.Methods:Using the super efficiency SBM model based on unexpected output and the Malmquist index to measure the static and dynamic efficiency of employee medical in-surance in 31 provinces in China,and using Tobit regression analysis to analyze its influencing factors.Results:The overall compre-hensive efficiency of the national employee medical insurance operation is 0.826 in 2020 and 0.827 in 2021 respectively.The efficien-cy of employee medical insurance operation in the eastern region is significantly higher than that in the central and westem regions.Over 60％of provinces have inefficient operation of employee medical insurance.The overall total factor productivity of employee medical insurance operation is showing a downward trend,and the decline in technological progress is the main limiting factor.The level of economic development has a significant promotion effect on the efficiency of employee medical insurance operation,and the degree of population aging has a significant inhibitory effect on it.Conclusion:The efficiency of employee medical insurance opera-tion in China still needs to be improved,and there is a significant efficiency gap among different regions.Therefore,investment and attention should be increased in the central and western regions to bridge regional gaps and promote the equity development of medi-cal insurance.Therefore,the reform efforts should be continuously intensified to achieve technological progress.In addition,attention should also be paid to the driving role of economic development in the efficiency of employee medical insurance operation and the for-mulation of positive policies on population aging.
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Objective To explore the social factors of health among staff of urban workers in Liaoning province and to provide scientific evidence for preparing propagation strategies. Methods Two thousand five hundred urban workers were surveyed using stratified, random sampling in Dandong city and Yingkou city of Liaoning province. The participants were investigated through questionnaires. Results Two thousand four hundred forty eight valid questionnaires were obtained. The self-rated health score of the respondents was 84.37 ± 13.72. The results of multiple linear reason showed that those with low family income satisfaction (B = -2.923,P = 0.019,95％ CI:-5.360——0.485),many working hours per day (B = -3.749,P = 0.023,95％ CI:-6.98——0.518),poor leadership (B = -3.688,P =0.014,95％ CI:-6.608——0.768),and low job satisfaction (B = -2.012,P = 0.034,95％ CI:-3.869——0.156) had lower self-rated health scores. However,those with more harmonious families (B = 3.105,P = 0.017,95％ CI:0.565-5.645) and types of social support (B = 2.684,P = 0.003,95％ CI:0.926-4.442) had higher self-rated health scores. Conclusion Social factors affecting health among staff of urban workers in Liaoning province are family income satisfaction,working hours per day,leadership approval degree,job satisfaction, social support and others.
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Objective To understand the performance of the basic medical security system in Guangxi for decision-making support on the development planning of the system during the 12th FiveYear Plan in Guangxi.Methods Descriptive statistics were made to analyze the annual report data of Guangxi's basic medical security system during 2009 to 2011,regarding the basic medical security for urban workers and that for urban residents,as well as those of the new rural cooperative medical system.Results The survey found that the three basic medical security systems in Guangxi have almost achieved full coverage; the compensation ratio keeps rising as the inpatient expenses of urban residents was up to 62.21％,64.96％ and 66.96％ respectively from 2009 to 2011,and that for urban residents up to 34.26％,39.96％ and 49.68％ respectively; the ratio for those covered by the new rural cooperative medical system has been maintained at 45％ for the three years; the coverage of the systems keeps expanding.Conclusion Recommend to integrate pilots of the three security systems and carry out serious diseases pilot programs; encourage reform of the payment system at institutions at or above county level; reform the risk-pooling of disease management of at primary medical institutions; strengthen the information systems of basic medical insurance system,in an effort to ensure the sound development of the basic medical insurance system.
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Objective: To summarize the existed problems and the relationship between the medical insurance and basic medical insurance policy, to find more reasonable payment mode to adjust with the medical insurance policy. Methods: On the basis of the endowment insurance implement experience, explore the payment mode of medical insurance. Results: It is very necessary to set the payment period of the basic medical insurance.
RESUMEN
Neste artigo usamos as noções de identificação e de projeto para discutir o tomar-se profissional, partindo da pesquisa com um grupo de trabalhadores urbanos: os pilotos de trem do Metrô carioca.
Starting from the research with a workers' group, the subway train drivers at the Metro of Rio de Janeiro, we use the notions of identification and project to discuss the process of become professional.
Dans cet texte les notions d'identification et projet aident à discuter le devenir profissionel selon la recherche avec un group de travailleurs urbains: les conducteurs de train du Métro de Rio de Janeiro.