通过梳理归纳现阶段我国"候鸟式"养老产业发展现状,对养老房地产业、健康与养老保险业、养老服务业、养老旅游与文化业所取得的成果及现存问题进行总结,并结合实地调研数据进行补充论证,从需方角度探讨"候鸟式"养老产业发展方向,在保障"候鸟式"异地养老需求的同时,推动相关地区养老产业健康发展,并对我国养老事业与养老产业提供借鉴.

我国人口老龄化日趋严重,探索和发展养老服务迫在眉睫.依托中医药蓝海战略,发展中医药健康养老服务模式,既能促进中医药的发展,也可以积极应对我国快速老龄化的问题.本文采用案例分析的方法 ,选取不同中医药健康养老模式下具有代表性的养老实践案例,分析当前中医药健康养老服务融合发展的现状及不同中医药健康养老服务模式下面临的主要问题,并依此提出合理的中医药健康养老发展建议.

2018年9月29日,国家卫生健康委员会、国家中医药管理局发布了《关于规范家庭医生签约服务管理的指导意见》(以下简称“《指导意见》”).《指导意见》在签约服务的提供主体、对象、协议等方面规范了家庭医生服务的管理,进一步保障了签约家庭的权益.相较于服务的接受方而言,《指导意见》对服务的提供方——家庭医生的权益保障还不到位.在责任承担、服务内容、服务地点、支付来源、培养体系等方面存在风险.因此,在防范签约家庭面临的风险的同时,也应考虑到服务提供方——家庭医生面临的风险并加以防控.

背景 上门医疗服务的过程中易发生医疗风险、医患纠纷、人员配置不足等问题,致使医务人员不愿意主动提供上门医疗服务,最终导致社区上门医疗服务供给量不足.目的 了解社区医务人员上门医疗服务的意愿及影响因素,为上门医疗服务顺利开展提供对策和建议.方法 2018年1—2月对北京市A区30家政府办社区卫生服务机构的医务人员进行问卷调查,采用文献研究法收集上门医疗服务相关文献设计问卷,内容包括社会人口学特征、机构出诊资源配置状况、出诊关注的问题及是否愿意提供上门医疗服务.采用二分类Logistic回归分析影响医务人员上门医疗服务意愿的影响因素.结果 总计发放问卷300份,回收有效问卷275份,有效回收率为91.7％.社区医务人员提供上门医疗服务的意愿率为66.5％(183/275).Logistic回归分析结果显示,性别、岗位、工作年限、是否关注医患纠纷、是否关注出诊补助和绩效评定是医务人员有无上门医疗服务意愿的影响因素(P<0.05).结论 医务人员有意愿提供上门医疗服务,但意愿仍有待提高.合理配置医疗资源,增加社区上门医疗服务供给量;健全法律保障制度,增强医务人员法律保护意识,避免医患纠纷的发生;完善上门医疗服务激励机制和考核机制,有助于提高社区医务人员的上门医疗服务意愿.

Objective:This paper introduced 1 case of applying acupuncture and Chinese herbal medicine in treating a 6-year-old child with relapsing-remitting chronic inflammatory demyelinating polyneuropathy (CIDP),which provided a new idea for preventing and treating CIDP.Methods:The child has received acupuncture combined with Chinese herbal medicine treatment for 3 months since October 1,2015.A total of 15 months' follow-up was closely recorded from the admission to after treatment,and an objective assessment on therapeutic effect of acupuncture combined with Chinese herbal medicine and recurrence was made.Results:All the indexes of the child were improved,and there was no recurrence in 15 months' follow-up.Hughes index score was normal,and Barthel index score showed normal activities of daily living capacity,with limb muscle strength V,and a 3 kg increase in weight.Conclusion:Acupuncture combined with Chinese herbal medicine treating children with relapsing-remitting CIDP has significant curative efficacy and can effectively prevent recurrence.It can be used to verify a large sample in the future,so as to provide a new view to the prevention and treatment for CIDP.

In 2013,China proposed the construction of the silk road economic belt and the "Silk Road on the sea" for the first time in twenty-first century.This is a win-win road to common development and common prosperity.With the increasing emphasis on the development of service industries,service trade has become a new driving force for world economic growth.The service trade of Chinese medicine,as a national health industry with completely independent intellectual property rights and original innovation potential,plays an important strategic role in the development of Chinese medicine service trade.In the background of the "Belt and Road" initiative,the service trade of Chinese medicine in China ushered in the opportunity of rapid development period.But we can not ignore the TCM service trade in development also faces many challenges,including the TCM service trade development is not balanced,the supporting policies are not perfect,foreign legal restriction,the overseas development of Chinese medicine "desinicization",compound talents insufficient storage.In view of these problems,the author puts forward some suggestions on the development of the service trade of Chinese medicine,improving the relevant policies of Chinese medicine trade in services,improving the service level of TCM and paying attention to the training of qualified oersonnel.

卫生管理专业作为一门应用型很强的专业,单纯地结果性学习评价已经不能满足整个社会对卫生管理专业学生的要求.伴随新课改的提出,以学生为中心的教学模式已经逐渐形成,考核方式也应有所改变.全过程考核评价作为一种新的考核形式,已经逐渐被教学部门重视.本文主要对卫生管理专业实施全过程考核评价进行分析探讨,提出建议和配套保障措施,以期为卫生管理专业培养更多满足社会发展需要的高素质管理人才.

Objective To investigate and analyze the implementation conditions of the whole process assessment of health management,and to explore the feasibility of implementing the whole process assessment.Methods Based on the self-designed questionnaire,literature review and interview,junior students major in the health management of Beijing University of Chinese Medicine from September to December 2016 were surveyed.Results 70.1％ of the students from the junior year approved the establishment of professional teachers and the implementation of the whole process of evaluation.The teachers' professional academic level and occupation morals were considered more important.3-4 students needed to be instructed by the teacher.The subject participation and homework should be included in assessment indicators.Conclusion The implementation of process evaluation is necessary and feasible.It will change the current status mainly through grades,graduation thesis and internships to assess students,guide the effective communication between teachers and students and encourage students to participate in the professional learning and practicing,and achieve health management professionals training objectives.Therefore,they will be adapted to meet health reform and social development needs.

This paper reviews the development process of traditional Chinese medicine in community health service , and ex-plores the development of traditional Chinese medicine in community health service by combining the favorable policy of TCM and SWOT analysis method.Traditional Chinese medicine community health service has the advantages of "preventive treatment of dis-ease", the great potential of service and the preference of the grassroots for the use of traditional Chinese medicine.But there are some disadvantages such as the characteristics of Chinese medicine in community health services are not obvious , the allocation of human resources is irrational, and the cost of community health service in TCM is increasing constantly.We should encourage the community to promote the use of traditional Chinese medicine services , Safeguard the interests of grassroots Chinese medicine serv-ice personnel and expand the scope of TCM services in the medical insurance catalogue .

China's aging population has entered a stage of rapid development, it becomes the serious issue concerned by people and the government, through the reviewing of the literatures and analysising the survey results, we should choose the rational model for the aged under the present situation in our country, although there are several pension model choices. Meanwhile, there are many international advanced mode that provide. endowment home combination of self-help and mutual aid pension model is imperative.

Objective To understand the status quo and evaluation of the use of community health services by the elderly in the city at present,to explore the improvement direction of community health institutions in terms of home care under existing conditions.Methods The method of convenience sampling was used.The self-made questionnaire was used to investigate 1433 elderly people in the country from July to December 2015.The data were analyzed by descriptive analysis and Logistic regression analysis.Results The community health service utilization rate was acceptable,80％ of the elderly had the experience of community health institutions treatment.The regression analysis showed that the el derly whose income was lower (P =0.0009,OR =2.1201),medical expenses accounted for a higher proportion of total in come (P =0.0181,OR =0.5027) and who lived with children and their spouses (P =0.0100,OR =1.7564) were more inclined to choose community health services.The elderly aged 70-＜80 or the elderly who was suffering from ≥ 3 kinds of chronic diseases had the highest utilization rate of community health services.The number of chronic diseases was the main influencing factor of the elderlys' satisfaction with community health services (P ＜ 0.05).Conclusion Community health institution plays a vital role in solving the nursing needs of home care for the elderly with its advantages of broad mass base,lower cost and close distance.Taking into account the different needs of medical care services with different living conditions and health status,community health institutions should pay more attention to the individual needs of the elderly.

OBJECTIVE:To provide reference for exploring the strategy of promoting TCM formula granules.METHODS:The questionnaire was designed to investigate the cognition and attitude of TCM practitioners from different grades to TCM formula granules in our university,and the investigation data were analyzed statistically.RESULTS:A total of 312 questionnaires were collected and 306 questionnaires were collected with recovery rate of 98.08％.Among them,305 questionnaires were effective with effective rate of 99.67％.46.89％ of interviewed practitioners were found to know and understand about TCM formula granule,52.46％ knew but did not understand;the higher the grade,the higher the proportion of the known and the better understanding (P＜0.05);the cognitive channels included diagnosis and treatment course (69.64％),took by others (65.02％),took by oneself (51.49％).TCM formula granules were easy to take without decoction (95.71％) and easy to carry (87.13％),the advantage of which had high popularity,but there was not much knowledge about other advantages.7.54％ of interviewed practitioners fully appreciated TCM formula granules and 69.18％ recognized them;the higher the grade,the higher the degree of recognition (P＜ 0.05).89.51％ were willing to learn more about TCM formula granules.60.98％ said they would prescribed TCM formula granules in the furure.Among the influential factors for the attitude of the practitioners to TCM formula granules,the three factors with the highest influence were the influence of the teachers,the influence of the patients and their own practice.CONCLUSIONS:The practice of TCM practitioners in our university in Beijing is not ideal for the cognition of TCM formula granules.There is still a great room for improvement in the attitude to TCM formula granules.The teachers and patients are key influential factors for the attitude to TCM formula granules.

Beijing has entered the aging society,the situation of providing for the aged is very serious.The development of old-age service task is pressing,traditional Chinese medicine (TCM) has a unique advantage in the old-age health services.It is necessary to promote combination of Chinese medicine health services and social services during the development process of old-age service system.This paper explains the reason about development difficulties and its countermeasures of old-age health service industry proceed from the current situation of old-age service,and old-age care institutions should enhance nursing of TCM function,impel innovation of old-age care service mode,let TCM service for old-age go into communities and residents families,build TCM old-age service model areas,upgrade intelligentization and informatization of TCM old-age service,support and development conducive medical health products and measures for elderly group.

Objective:To survey the elderly's recognition degree;demands and suggestions of the integration of pension service and medical service in fixed-point institutionsof medical care aad elderly care surwunding communities in Beijing.Methods:The questionnaire survey was conducted in 313 elderly people over-60s from the surrounding communities of two institutions.Results:More than half of the elderly did not know the integration of pension service and medical service and hoped the pension costs be below 3,000 yuan.They learned integration of pension service and medical service more through television and thght highly of the costs when they chose an institution.The public or private pension institutions,age,disposable income,health statuls and gender had statistically significant differences with the choice of charging standards(P＜0.05).The different self-care conditions and sex styles both had statistically significant difference with elderly lifestyle(P＜ 0.05).The different chronic conditions,self-care conditions and sex styles had statistical significant difference with the elderly's understanding level of integration of medical service and pension service(P＜0.05).The different disposable income had statistical significant difference with knowing the integration of pension service and medical service or not(P＜0.05).Conclusion:This pension model is widely accepted by the elderly around the fixed-point institutions of medical care and elderly care in Beijing,but there are some problems that the recognition degree is not high,and the charging standards are dissatisfied.We need to strengthen publicity efforts,set reasonable costs and classify the pension service.

The class teaching of Health Administration uses case teaching method. With a few years of practice, the case teaching library is established. Case teaching includes case preparation and discussions process, case selection and requirement for teaching should be come from the Health Administration practice, and it should be purposeful, typical and refined. The students are required to participate actively and put forward their views during the discussion process, and teachers should provide the necessary summary. Practice has proved that the preparation of case study library is a gradual process, case writing and teaching through group practice are suitable for the need of Health Administration.

新医改政策下如何完善和解决当前医保制度设计上的缺陷和问题，是有效提高大学生医保水平的关键。针对目前国内大学生医保制度存在的诸如层次性不高、参保意识不强、商业合作性差及医疗水平低等问题，文章有针对性地提出了完善医保层次、提高学校医院报销比例等建议，促进大学生医保制度的健全。

In order to analyze the development strategy of old - age care institutions of medical - nursing combined in Beijing,this study analyzed the problems existed in the development and put forward the targeted improvement suggestions through consulting literature and field investigation. We believed that there were some problems existed in the development of old -age care institutions of medical - nursing combined,such as the loose combination between medical resources and pension resources,the failed linkage in the relevant policies,the lack of the high level staff of medical treatment and nursing,and the limited choice for the elderly in Beijing. Therefore,it was suggested to take action to improve medical - nursing combined from combined mode,publicity and promotion,pension products,management mechanisms,personnel training,policy concessions and selection level.

目的:对国产保健食品的保健功能现状进行研究.方法:对1996年11月4日至2015年8月27日经卫生部和国家食品药品监督管理局批准的保健食品的保健功能进行分类,对于宣称具有多种功能(≥2个)的产品,按所宣称的功能的第一个功能来统计,信息录入Excel数据库,用Excel 2015进行分类统计.结果:列入27项保健功能的保健食品过度集中于增强免疫力和缓解体力疲劳这两项保健功能,2005年7月1日以前批准的原有保健食品的保健功能主要集中在免疫调节,补充钙、铁、锌以及多种矿物质,补充维生素和调节血脂等.结论:我国保健食品的功能过于集中,应进一步规范已批准的2005年7月1日以前批注的保健食品的保健功能,在现有保健功能中加入中医药术语表述的保健功能.