Research on the current situation of development of trade in services of private medical institutions of traditional Chinese medicine in Beijing / 国际中医中药杂志

Objective To analyze the current situation and problems of the international service trade of private medical institutions of Traditional Chinese Medicine (TCM) in Beijing,and provide the basis for the relevant policies of the international servicetrade of TCM.Methods Combining the stratified samplingandtheconveniencesampling,103 private medical institutions of TCM in Beijing were investigated by questionnaire,and the survey data were analyzed.Results 66.99％ of the visiting institutions carried out international trade in services of TCM,and 1 institution had set up branches abroad.2.90％ institutions of which have carried out international trade of TCM were preparing for overseas branches,and 8.70％ planned to establish overseas branches within 5 years.Conclusions The private medical institutions of TCM developerapidly,but change frequently.Private medical institutions lack compound talents and the enthusiasm of the trade in service.The construction of laws and regulations on trade in services of TCM by the government need improvement.The trade barrier of foreign countries on TCM is increasingly higher.

A comparison of outpatient healthcare expenditures between public and private medical institutions in urban China: an instrumental variable approach.

The growth of healthcare expenditure provokes constant comments and discussions, as countries battle the issues on cost containment and cost effectiveness. Prior to 1978, medical institutions in China were either state-owned or were collective public hospitals. Since 1978, China has been trying to rebuild its healthcare system, which was destroyed during the 'cultural revolution', allowing private medical institutions to deliver healthcare services. As a result, private medical institutions have grown from 0% to 28.57% between 1978 and 2010. In this context, we compare outpatient healthcare expenditures between public and private medical institutions. The central problem of this comparison is that the choice of medical institution is endogenous. So we apply an instrumental variable (IV) framework utilizing geographic information (whether the closest medical institution is private) as the instrument while controlling for severity of health and other relevant confounding factors. Using China's Urban Resident Basic Medical Insurance Survey 2008-2010, we found that there is no difference in expenditure between public and private medical institutions when IV framework is used. Our econometric tests suggest that our IV model is specified appropriately. However, the ordinary least square model, which is inconsistent in the presence of endogenous regressor(s), reveals that public medical institutions are more expensive.

Current status of healthcare-associated infection management in 118 basic level private medical institutions / 中国感染控制杂志

Objective To investigate the current situation of healthcare-associated infection (HAI)management in basic level private medical institutions.Methods 118 basic level private medical institutions in a district of Chengdu were investigated through visiting and questionnaire.Results Of 118 medical institutions,only 2 had HAI manage-ment personnel,4 had HAI management system.22.03% had hand washing facilities in therapeutic rooms and con-sulting rooms,37.29% of institutions stored aseptic items in accordance with the requirements,55.93% of institu-tions disposed medical waste at disposal center;99.15% handled reusable items by users.Conclusion HAI manage-ment status is worried,health administrative department should strengthen support and supervision,especially in-tensified the supervision of private dental clinics.

The problems and suggestions on policy system of private medical institutions / 中国卫生政策研究

on the basis of systematic examination to the policy system of private medical institutions, this paper summarize the current situation and main problems of the policy system, including basic concepts, related issues a-bout the non-state owned enterprise management, important policies about the non-profit medical institutions, the ab-sence of some main policies. To solve these problems, this paper puts forward specific suggestions, such as to speed up the legislation, to make standards of non-profit medical institutions judging and qualification of exempt from tax in details, to construct the reasonable return system for the investors, to extend the tax holidays for the profit-making medical institutions, to make sure private medical institutions have equitable access to qualification in pilot hospital of healthcare insurance, to improve the transformation mechanism between Non-profit and profit-making institutions, to formulate specific measures.

Medical voucher system in Hong Kong and Macao and its implications to mainland China / 中国卫生政策研究

It is important and difficult to establish the market competition mechanism in the health care re-form. Medical voucher system in Hong Kong and Macao can provide policy guidelines for Mainland China to promote institutional innovation, force public hospital reform and the rational allocation of medical and health resources. This paper introduced the origin and development of medical voucher system. Based on the description of the implementa-tion background, similarities and differences and effects of medical voucher system in Hong Kong and Macao, the pa-per found that medical voucher system could help encourage the demander to make more frequent use of medical serv-ices, improve their consciousness of prevention and health care and promote family doctor system. Through analyzing the applicability of medical voucher system in mainland China, the paper pointed out it was consistent with the reform orientation and could be served as a useful supplement to the health care system to improve medical insurance, medi-cal assisstance system as well as an effective measure to develop private medical institutions.

A primeira residência brasileira de medicina de família dentro de uma instituição privada: a experiência das residentes / La primera residencia brasileña de medicina de familia dentro de una institución privada: la experiencia de las residentes / The first brazilian residence of family medicine inside a private institution: the experience of residents

A Medicina de Família é uma especialidade médica que propõe um novo modelo de profissional médico, com enfoque de formação diferenciada, centrada no cuidado do indivíduo, em atenção continuada e abrangente, coordenando também os componentes biopsicossociais. O médico de família credencia-se para responsabilizar-se pelo paciente no contexto hospitalar e contribuir para a coordenação dos cuidados, gerando por consequência uma maior qualidade no atendimento e satisfação por parte do paciente e seus familiares pelos cuidados recebidos. Seu enfoque centrado na pessoa contribui para que mesmo no ambiente hospitalar haja maior tranquilidade para a ponderação tanto do uso de recursos diagnósticos e terapêuticos muitas vezes desnecessários ou ineficazes, quanto no cuidado na aplicação de intervenções muito distantes da realidade doméstica do paciente e que após seu retorno para a casa deverão ser mantidas, tornando sua rotina mais difícil resultando em baixa aderência ao tratamento. A partir destas reflexões iniciais, o programa de residência médica em Medicina de Família é abordado com uma análise individual das atividades realizadas e as experiências cotidianas são comentadas a partir de casos clínicos vivenciados pelas residentes. E após 6 meses dentro de jornada da residência temos segurança em afirmar que hoje fazemos a medicina que sonhamos e que na prática, esta medicina faz a diferença na vida de nossos pacientes e seus familiares e que Medicina de Família é possível, e num país com tantas desigualdades sociais como o nosso, desponta com uma alternativa viável para uma saúde mais justa e humana.

Family Medicine is a medical specialty that proposes a new model for medical professionals, with a differentiated approach to education centered in caring for individuals, in a continued and broader assistance coordinating also biopsychosocial components. Family doctors is accredited to take responsibility for the patient in hospital settings and to contribute to the co-ordination of cares, producing consequently a higher quality of service and a greater satisfaction of patients and relatives to received care. An approach centered in the person contributes, even in hospital settings, better conditions for both deciding on the use of diagnostic and therapeutic resources very often unnecessary or ineffective and also in care in the application of interventions strange to the patients’ home reality but which must be maintained after they returning to their homes, making extremely difficult their routine in a way that almost prevents adhesion top treatments. From these initial reflections, the program of medical residence in Family Medicine is approached by means of an individual analysis of daily activities and a debate about daily experiences from clinical cases assisted by female residents After 6 months in residence we can certainly say that today we practice the kind of medicine we dream about and we know that in practice this kind of medicine makes a difference in the life of our patients and his relatives and which Family Medicine is possible We may also say in a country with so many social inequalities like ours, Family Medicine emerges as a viable alternative for a more just and human health care.

La Medicina de Familia es una especialidad médica que propone un nuevo modelo de profesional médico, dotado de un enfoque de formación diferenciada, centrada en el cuidado del individuo, en atención continuada e abarcadora, coordinando también los componentes biopsicosociales. El médico de familia acreditase para responsabilizarse del paciente en el contexto hospitalario y contribuir para la coordinación de los cuidados, generando por consiguiente una mayor cualidad en el atendimiento e satisfacción por parte del paciente y sus familiares por los cuidados recibidos. Su enfoque centrado en la persona contribuye para que el propio ambiente hospitalario proporcione mayor tranquilidad para la ponderación tanto del uso de recursos diagnósticos y terapéuticos muchas veces innecesarios o ineficaces, como del cuidado en la aplicación de intervenciones muy distantes de la realidad doméstica del paciente y que, después de su retorno a la casa, deberán ser mantenidas, tornando su rutina más difícil; y el resultado de eso es una baja adherencia al tratamiento. A partir de esas reflexiones iniciales, el programa de residencia médica en medicina de familia es abordado por medio de un análisis individual de las actividades realizadas, siendo las experiencias cotidianas comentadas a partir de casos clínicos vividos por las residentes. E, después de 6 meses en la jornada de la residencia, podemos afirmar con seguridad que hoy hacemos la medicina que soñamos y que, en la práctica, esa medicina hace la diferencia en la vida de nuestros pacientes y sus familiares; podemos afirmar de igual modo que la Medicina de Familia es posible y, en un país con tantas desigualdades sociales como el nuestro, despunta como una alternativa viable para una salud más justa y humana.