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英国NHS向每个公民提供足够的卫生保健服务,不论其年龄、性别、种族、收入、居住地区、雇佣状况和有无保险。由于卫生服务具有外部效益,因此,免费或补贴提供卫生服务,使其具有普遍性、平等性、公平性。目前,英国的政策是鼓励卫生服务市场竞争。 NHS的资金:1987年英国卫生保健总费用259亿英镑,其中86%由政府支付,14%由个人支付。政府支付的费用中大部分来自税收,一小部分来自国家保险的收益(约10%)。卫生保健费用的预算取决于卫生部门和财政部年度协商解决,政府根据不同地区的人口资料分配卫生资金。 NHS的组织机构:NHS下设RHAs和SHAs,RHAs负贵审核DHAs的日常活动和预算,管理FRCs和LAs。SHAs则监督处方、定价DHAs,FPCs,LAs是服务提供者。初级卫生保健:PHC主要由FPCs组织实施,负责处理常见病、多发病和危重病人的转诊,还包括计划免疫、计划生育等预防医学工作。由DHAs协调社区卫生服务。资源的利用:近年来,英国住院率呈现上升趋势,而住院天数与住院床日数呈现一种下降趋势,说明服务利用水平高,卫生服务成本是有效的。英国体制的评价:NHS深受群众欢迎,它的筹资方式具有公平性,可避免多方提供保险的竞争,有效控制卫生费用支出和增长,合理分配卫生资金,保障病人与医生之间的双向选择。
The UK NHS provides each citizen with adequate health care regardless of age, gender, race, income, area of residence, employment status, and insurance coverage. Since health services have external benefits, they provide free or subsidized health services to make them universal, equal, and fair. At present, the British policy is to encourage competition in the health service market. NHS funds: The total cost of health care in Britain in 1987 was 25.9 billion pounds, of which 86% was paid by the government and 14% by individuals. Most of the fees paid by the government come from taxes, and a small part comes from the national insurance revenue (about 10%). The budget for health care costs depends on annual consultations between the health authorities and the Ministry of Finance. The government allocates health funds based on demographic data from different regions. NHS organization: RHSs and SHAs are set up under the NHS. RHAs are responsible for reviewing the daily activities and budgets of DHAs and managing FRCs and LAs. SHAs supervise prescriptions, pricing DHAs, FPCs, and LAs are service providers. Primary health care: PHC is mainly implemented by FPCs and is responsible for handling referrals for common, frequently-occurring and critically ill patients. It also includes preventive medical work such as planned immunization and family planning. Coordination of community health services by DHAs. Utilization of resources: In recent years, the rate of hospitalization in the UK has shown an upward trend, while the days of hospitalization and the number of hospital beds have shown a downward trend, indicating that the level of service utilization is high and the cost of health services is effective. Evaluation of the British system: The NHS is well received by the masses and its funding methods are fair, which can avoid competition for providing insurance on multiple sides, effectively control the expenditure and growth of health expenses, allocate health funds rationally, and ensure the two-way choice between patients and doctors.