医疗

The purpose of this dissertation lies in perfecting relative laws of administration of medical waste,according to the lawmaking and law system of foreign countries.meanwhile,the notion is provided to consummate relative law system and achieve the purpose of holding in the administration of medical waste,environment protect and human health.this dissertation puts forward first-step conceivableness of perfecting lawmaking and law system concerning the administration to disposal of medical waste.because our country's law system concerning medical waste is too immovable and abstract,this research will make our country's law system of the medical waste more concrete and more definite,which will strengthen the operability in the fulfillment and make the lawmaking spirit embodied.simultaneously it provides legal basis and policy support for the administration to disposal of medical waste.the problem of the administration of medical waste enlarges the difficulties of disposal process.to perfect lawmaking,law-executing,law-supervising.is advantageous to strengthen the administration to disposal of medical waste of our country.meanwhile it has theoretic meaning and application value for environment safety and human health.this dissertation is totally divided into four parts.the first part explains the current condition of the administration to disposal of medical waste of our country,which introduces the concept of medical waste,the harm of medical waste,the necessity of administration, current lawmaking condition and present law system of the medical waste.the second part introduces the general situation of lawmaking concerning the administration to disposal of medical waste of the united states,eu,japan and korea.simultaneously it explains the apocalypse of administration to disposal of medical waste of our country.the third part points out the existent law problem of the administration to disposal of medical waste,including lawmaking problem,law enforcement problem and law system problem.the fourth part aims at the relative suggestions to the existent law problems of the administration to disposal of medical waste of our country.the suggestions want to raise lawmaking layer,perfect lawmaking contents,strengthens law enforcement,practice the law system of the manufacturer to be responsible for the medical waste.meanwhile,it gives the advice on the punishment-compensation system,the conduct permit system and the risk fund system.

本论文研究的目的在于借鉴国外有关医疗废物在立法、执法、法律制度等方面的经验，完善适合我国医疗废物管理的相关法律，提出我国有关医疗废物管理的立法构想，完善各项相关的法律制度，以达到规范医疗废物管理、保护环境、保护人类健康的目的。本论文为完善我国医疗废物管理的立法、执法和法律制度提出初步设想，由于我国有关医疗废物的法律制度规定得太原则、太抽象，通过本论文研究，使得我国医疗废物法律制度更具体、更明确，增强在实践中的操作性，使立法精神充分得到体现。同时可以为我国医疗废物管理工作提供法理依据和决策支持。我国医疗废物管理体制的问题加大了医疗废物治理的难度，立法、执法、监督等方面的完善有利于加强对我国医疗废物的管理；在保障可持续发展的环境安全和人类健康领域也具有理论意义和应用价值。本文共分为四个部分，第一部分说明了我国目前医疗废物管理的现状，介绍了医疗废物的概念、危害、进行管理的必要性、当前我国医疗废物的立法现状和法律制度现状。第二部分介绍了美国、欧盟、日本、韩国关于医疗废物管理的立法概况及对我国医疗废物管理的启示。第三部分指出了我国医疗废物管理存在的法律问题，包括立法问题、执法问题和法律制度问题。第四部分针对我国医疗废物管理存在的法律问题提出了相应的建议。建议要提高立法层次、完善立法内容、加强执法力度、实行生产者负责分类回收的法律制度、集中处置法律制度、惩罚性赔偿制度、经营许可证制度、环境责任保险制度和风险基金制度。

Abstract］ objective in order to strengthen and improve the action to prevent the medical dispute,we must understand the correlation factor between medical personnel and patients to reduce the medical dispute.methods with the questionnaire survey the principal factors,hope solution way and preservation way between medical personnel and the patients were analyzed.results there were 75 medical persons and 62 patients who considered that the two sides should take the responsibility about the medical service dispute.110 medical persons and 80 patients hoped that the medical dispute be solved by the consultative way.conclusion we should strengthen the management system of the hospital,the construction of the medical ethics,the construction of the environment,and the popularization of the medical knowledge,we also should take some measures about the suitable regulation on media propaganda and the establishment of perfect medical service dispute consulation and so on.

目的 了解医务人员及患者对引发医疗纠纷的相关因素的认识情况，加强和提高医疗纠纷的预防措施。方法采用问卷调查法抽查临床医务人员和患者及其家属关于医疗纠纷发生的主因及患者和医方的各方面原因、希望的解决方式和预防方式等内容进行调查分析。结果 75名医务人员和62名患者认为引发医疗纠纷的主因是双方，110名医务人员和80名患者希望通过协商的方式解决所发的医疗纠纷。结论需要加强医院的制度管理、医德医风建设和环境建设，加强医疗知识的普及，适当调控媒体宣传和设立健全的医疗纠纷咨询机构等。

In this study, the employee's willingness-to-participate in and willingness-to-pay for hypothetical supplementary health insurance packages designed by the research team was measured through contingent valuation method in Shanghai and Wenzhou. In Chengdu, the employee's actual rate of participation in supplementary health insurance was obtained through household survey. Logistic model was employed to establish the demand function and analyze the influencing factors. The organization and operation models for supplementary health insurance in different cities were summarized and comparatively analyzed. Based on the above results, proper coverage of health care and operation model for supplementary health insurance was discussed. Policy recommendation include the clear definition of the government's responsibility in the development of supplementary health insurance, the implementation of tax subsidy policy, the rule of the purchase of supplmentary health plans with personal saving accounts, and education and propagandism measures. At last, the regulation of supplementary health insurance is emphasized.

本研究根据上海和温州两地基本医疗保险框架分别设计了几个补充医疗保险方案，采用条件价值评估法调查了职工对这些补充医疗保险方案的意愿参加与意愿支付；在成都通过家庭入户调查获得了职工实际参加补充医疗保险情况，运用logistic模型建立了需求模型，进行了需求的影响因素分析；对国内补充医疗保险不同运作模式进行了总结与比较分析，探讨了补充医疗保险适宜的覆盖范围及其组织运作模式，并提出要明确界定政府在补充医疗保险发展中的职能定位，运用税收减免政策、允许用个人帐户购买补充医疗保险和宣传教育措施来扶持与引导补充医疗保险的发展以及加强补充医疗保险监管等政策建议。

Policy recommendations: 1 Improve relevant policies, laws and regulations, including: the responsibility of governments at all levels, funds raise and management, program for Coordinating, the responsibility of public hospital. 2 Establish sustained and stable funding and management mechanism, emphasis fund-raising responsibilities of government at all levels, strengthen government and social organizations, set up special accounts of MAP, study the scientific and reasonable mechanism for distribution of funds. 3 Optimize Program for Coordinating MAP and NCMS, including: Free out-patient services, abolition of pay lines of out-patient and hospitalization, out-patient help including village health clinic and chronic disease; hospital help by disease, sub-object and pro-rata; increase sorts of serious disease, set reasonable pay line, cap line, and proportion in MAP; regular or occasional payment of a fixed payment or MAP cards, improve MAP coverage and benefit rates.4 Establish a new type of management for Coordinating MAP and NCMS.

政策建议：1完善相关政策法规，包括：各级政府的责任、医疗救助资金的筹集和管理、医疗救助与新农合衔接方案、管理与服务制度、公立医疗机构在医疗救助领域的职责等。2建立持续稳定的资金筹集和管理机制，强调各级政府在医疗救助资金的筹资责任，加强政府与社会组织的合作，建立医疗救助基金，研究科学合理的资金分配和管理机制。3优化新农合与医疗救助衔接方案，包括：开展免费门诊服务项目，取消门诊和住院起付线，将村卫生室纳入门诊报销范围，增加慢性病的门诊救助；按病种、分对象、按比例地给予住院救助，增加大病救助的病种，合理设定住院救助的起付线、封顶线、救助比例；定期或不定期发放定额的救助金，发放医疗救助优惠卡，提高医疗救助的覆盖面和受益率等。4建立新型的医疗救助与新农合衔接管理模式。

Chapter 2 passes the analytical medical treatment crime of composing important item, the corpus, a body, subjective important item and objective important items of the analytical medical treatment crime, announce to public the appearance of the medical treatment crime, and constituted some problems with a little bit difficult theories of the important item to do the further research to the medical treatment crime, including a body that medical treatment faultily commit crime in a specific way, illegal the penal code of the law characteristic and medical treatment mistake that practise medicine the criminal corpus, the medical treatment behavior learns the meaning etc. problem.

第二章通过分析医疗犯罪的构成要件，来分析医疗犯罪的主体、客体、主观要件和客观要件，揭示医疗犯罪的形态，并对医疗犯罪构成要件的一些理论难点问题做了进一步的研究，具体包括医疗过失犯罪的客体、非法行医犯罪的主体、医疗行为的法律特征以及医疗过失的刑法学意义等问题。

First, it designs a model of medical care price level regulation in China. The model is based on the natural monopoly price level regulation theory and model, considering the particularity of medical care service market, the main problems of medical care price regulation in China, the change of price index, the imbursement for the cost of service provided to the poor and the information held by the regulator. Second, the mode of medical care provider payment is seen as an important part of medical care price regulation content, and the impact of different payment system especially diagnostic related groups system on medical care costs and quality are analyzed. This develops the basic theory of medical care price regulation to some extent.

一是以自然垄断产业价格水平规制理论和模型为基础，结合医疗服务市场的特殊性与我国医疗服务价格规制的实践，对医疗服务价格水平规制的基础进行深入分析，综合考虑物价指数的变动、为弱势人群提供医疗服务的成本补偿以及医疗服务价格规制者掌握信息等因素，提出我国医疗服务价格水平规制的理论模型；二是将医疗费用支付方式作为医疗服务价格规制的重要内容，并从规制经济学的角度对不同规制模式尤其是按病种预付制对医疗费用和医疗服务质量的影响进行了理论分析，在一定程度上拓展了医疗服务价格规制的基本理论。

KT101.1 Computer Keyboarding Lab 1.5 KT101.2 Computer Keyboarding Lab 1.5 A101.1 Accounting I Lab 1.5 A101.2 Accounting I Lab 1.5 E102.1 Business Communications 1.5 E102.2 Business Communications 1.5 C108.1 Spreadsheet Applications Lab 1.5 C108.2 Spreadsheet Applications Lab 1.5 C110.1 Computer Medical Applications Lab 1.5 C110.2 Computer Medical Applications Lab 1.5 ME101 Medical Terminology 3 ME102.1 Medical Office Procedures Lab 1.5 ME102.2 Medical Office Procedures Lab 1.5 ME104.1 Medical Insurance Records 1.5 ME104.2 Medical Insurance Records 1.5 ME106.1 Advanced Medical Coding 1.5 ME106.2 Advanced Medical Coding 1.5 MA110.1 Anatomy and Physiology/Musculoskeletal, Integumentary, Eye, Ear, and Endocrine Systems 1.5 MA110.2 Anatomy and Physiology/Musculoskeletal, Integumentary, Eye, Ear, and Endocrine Systems 1.5 MA111.1 Anatomy and Physiology/Digestive, Urinary, Reproductive, Nervous, and Cardiovascular Systems 1.5 MA111.2 Anatomy and Physiology/Digestive, Urinary, Reproductive, Nervous, and Cardiovascular Systems 1.5 MA112.1 Medical Office Administration 1.5 MA112.2 Medical Office Administration 1.5 Total Quarter Credit Hours - 36

KT101.1电脑键盘操作实验室1.5 KT101.2电脑键盘操作实验室1.5 A101.1会计本人实验室1.5 A101.2会计本人实验室1.5 E102.1企业通信1.5 E102.2企业通信1.5 C108.1电子表格应用实验室1.5 C108.2电子表格应用实验室1.5 C110.1计算机医学应用实验1。 5 C110.2计算机医学应用实验室1.5 ME101医疗术语3 ME102.1医疗办公室程序实验室1.5 ME102.2医疗办公室程序实验室1.5 ME104.1医疗保险记录1.5 ME104.2医疗保险记录1.5 ME106.1高级医疗编码1.5 ME106.2高级医疗编码1.5 MA110.1解剖生理学/骨骼，体被，眼，耳，和内分泌系统1.5 MA110。 2解剖生理学/骨骼，体被，眼，耳，和内分泌系统1.5 MA111.1解剖生理学/消化，泌尿，生殖，神经，心血管系统和1.5 MA111.2解剖生理学/消化，泌尿，生殖，神经，心血管系统和1.5 MA112.1医疗办公室行政1.5 MA112.2医疗办公室行政1。 5 总数的四分之一学时- 36

To discuss on a new way of preventing malpractice and dispute,to lower the atio of medical accident,and to give reference to improving management under new situation,the author put forward view points from links influencing medical safe as followed:Firstly,improve quality of health service stop revent medical malpractice and dispute.Secondly,streng then safe education to firm the foundation of prevention.Thirdly,enforce management of military wounded to prevent their misdeed. Fourthly,pay attention to key position and key link to actualize the regulations of medical safe management.

为了探讨医疗事故和纠纷防范的新路子、新方法，降低医疗安全事故的发生率，以及为新形势下提高医疗安全管理水平提供参考，本文针对公立医院特点，从影响医疗安全的各环节入手，提出了防范医疗事故和纠纷的有效措施：一是努力提高医护质量，从源头预防各类医疗事故和纠纷的发生；二是大力加强安全教育和作风建设，打牢医疗安全防范的思想根基；三是加强对病员管理，预防病员违法违纪；四是抓住重点部位、关键环节安全管理，制定并确保各项医疗安全管理制度落到实处。

Delimitating the conception of health , disease risk and medical insurance etc ., inducing the basic characteristic and the main function of the medical insurance ; recalling the history proceeding in the medical insurance law system in the world and establishment , development and reformation of our country ' s medical insurance law system ; analyzing the shortcomings of our traditional medical insurance law system and comparing it with the current law system from the aspects such as insurance efficiency , relation of right and duty , security level , covering scope and management methods etc .

界定了健康、疾病风险与医疗保险等概念，归纳了医疗保险的基本特征与主要作用；回溯了世界医疗保险法律制度的历史沿革和我国医疗保险法律制度的建立、发展与改革，剖析了我国传统医疗保险法律制度存在的弊端，并将之与我国现行医疗保险法律制度进行了比较分析，客观地指出了现行医疗保险法律制度与传统制度相比所取得的进步以及需要进一步完善的问题；探讨了当前完善我国医疗保险法律制度的相关政策建议。

Based on the research of the medical security systems in seventeen typical countries, this dissertation concludes that all systems are composed of the following five models, namely social medical aid, social medical insurance, national health services, market-oriented medical insurance and individual saving medical security. These five models could be further divided into three types, i. e. public benefit type (including social medical aid model and national health services model), insurance type (including social medical insurance model and market oriented medical insurance model) and self-security type (individual saving medical security).

在对17个案例国家和地区医疗保障制度体系分析研究的基础上，本文归纳出了构成各国医疗保障制度体系的最基本的制度单元——五种制度模式，即社会医疗救助制度模式、社会医疗保险制度模式、国家卫生服务保障制度模式、市场医疗保险制度模式、个人储蓄医疗保障制度模式，并将这五种制度模式进一步归并为福利型(社会医疗救助制度模式和国家卫生服务保障制度模式)、保险型(社会医疗保险制度模式和市场医疗保险制度模式)、自保型(个人储蓄医疗保障制度模式)三种体制类型。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。