Methods of payment have always been a key part of health reform in various countries of the world. The paper gives a general account of the evolution of methods of payment for hospital care throughout the universe and the evolution and prospects of CP DRG. It expounds the necessity and viability of adopting CP DRG in China and suggests that we take the initiative in using the experience of other countries for reference, learn from other countries practice, speed up reform in methods of payment for hospital care, publish relevant policies, and reinforce theoretical and applied research on CP DRG.

Objective To analyze the effect of the new cooperative medical care on the use of outpatient services by rural residents so as to provide scientific basis for its improvement. Methods Using the stratified cluster sampling method, house-to-house surveys on the residents of Dongying via interviews were conducted both before and after the implementation of the new cooperative medical care. Results Although the two-week rate of seeking medical services by the rural residents after the implementation of the new cooperative medical care did not increase, changes did take place in the flow direction of the patients and the rate of seeking medical services at the end of two weeks took a downward turn. Fairness in the use of health services by the residents was enhanced. Conclusion The new cooperative medical care strongly guarantees rural patients' access to medical care.

Objective To investigate the physical and mental health of Shandong medical personnel.Methods 3200 medical personnel were randomly selected from hospitals of Shandong province,selfhealth,depression and sense of work stress were measured and analyzed statistically.Results 36.3％ of medical staff was in depression state,and even about 22.5％ of the subjects was in moderate or severe depression state.Male and female medical staff showed no difference in sense of work pressure.Senior medical staff showed higher working pressure than middle-class,junior-class and low-level medical personnel,but middleclass,junior medical staff and low-level medical staff showed no significant difference.In the aspect of self-health status,male and female medical personnel showed no significant differences,senior,middle-class and junior-class medical staff reported worse self-health status than low-level medical personnel.Conclusions Managers should pay attention to physical and mental health of medical personnel,adopt pertinent measures to reduce their mental pressure in order to promote their physical and mental health.

Fairness, which is of special importance to health economy policies, has the following three major implications: fairness of the state of health, fairness of the delivery of health services and fairness of health fundraising. Traditional methods for measuring fairness include those of range, Lorentz curve, Jeany coefficient, difference index, and, for measuring unfairness, those of slope index, relative index and comprehensive curve. Recently WHO put forward 3 new fairness indexes and measurement methods, viz. measuring the fairness of residents health via the distribution index of child survival rate and disability adjusted life expectancy; measuring the fairness of the delivery of health services via reactivity; and measuring the fairness of health fundraising via the fairness and reasonableness index for the contributions of funds.

With accelerated population aging, traditional pension mode cannot adapt the diversified medical and nursing requirements of the elders. Therefore, it should reposition the function of medical service in pension career and encourage combining medical service with pension service. Through the methods of setting medical insti-tutions in pension institutions with conditions, developing social pension service in medical institutions, pension in-stitutions cooperating with medical institutions,both professional medical service and basic pension service would be offered to the elders, and thus to realize the integration of medical and nursing resources and to improve health con-dition of the elders.

Objective To provide the administrative departments in the health sector with a method for estimating hospital beds when making regional health plans. Methods The method of general surveys was adopted to make relevant investigation on all the cities and districts in Shandong Province. Data collected were estimated by borrowed and self-developed formulas. Results By 2005, the total number of hospital beds in the province will be reduced by 5.19%, the number of beds in the city seats will be reduced by 4.97%, the number of beds in the county seats will be reduced by 1.03%, and the number of beds in the township seats will be reduced by 9.68%. Conclusion The findings of the study have filled in a gap at present when there is a lack of estimating methods. They are viable and yet still need to be polularized and perfected in practice.

Objective To find out about the financing mix of various hospitals and the changes in effects in the period of economic transition. Methods An investigation was made into the employment of funds and the efficiency and performance of 45 hospitals in the two provinces of Shandong and Henan by means of sampling and review. Results From 1987 to 1999, the proportion of government subsidies in the total income of each of the 45 hospitals was on the decrease, with that in hospitals at the county level and above dropping on the average from 24 7% to 8 0%, while the proportion of patients payments and income from pharmaceuticals was on the increase. At the same time, the productivity and social efficiency of the 45 hospitals all showed a tendency towards decrease. Except for township public health centers, hospitals of the other three kinds all witnessed an increase in their economic vitality. Conclusion Patients payments and income from pharmaceuticals have become the main sources of hospital financing. While attention ought to be paid to economic benefits, it is imperative to properly readjust health policies and improve the productivity of hospitals and the social efficiency of health services.

Objective To understand the demand for chronic disease care by Dongying residents so as to provide basis for the formulation of disease control strategies by the government. Methods A sample survey was made on family health services dehvered to Dongying residents and an analysis was made using an economic model of demand elasticity. Results The coefficients of price elasticity for basic chronic disease care in the urban and rural areas of Dongying were respectively -0.268 and -0.469 and the coefficients of income elasticity were respectively 0.176 and 0.370. The price and income factors had a fairly big influence on the demand of the rural residents. Conclusion The price factor of health services must he taken into serious consideration in managing medical and health services institutions so as to genuinely improve the demand for health services by residents.

Objective To find out social support status and its influencing factors in left-home-kids in rural areas. Methods 893 left-home-kids and 335 non-left-home-kids were interviewed with the social support rating scale. Results The total score of social support of left-home-kids was obviously lower than that of non-left-home-kids; in the same way, the score of female was higher than male, the score of low age group was higher than high age group, the score of kids with father or mother as the custodian was higher than that of other custodian subjects; the score of children whose left-home duration was more than five years was higher than that of lower than one year. Conclusions The social support of left-home-kids was poorer than non-lefthome-kids. There is some difference in the social support in left-home-kids with different sex, age, custodian subject, left-home duration. Social support should be given to children with low social support.

Objective The turnover intention and the work states of the health technicians were investigated to analyze the influencing factors of turnover and the relationship between turnover intention and work state,to guide the health technicians who want to dimission to make a correct decision,and to make some suggestions to improve their work states.Methods Multistage stratified cluster random sampling method was adopted to survey 2903 health workers on the job of all the county-level public hospitals in Shandong Province by the questionnaire of the Fourth National Health Services Survey.Analysis methods included Two Logistic classification regression and three evaluation methods based on two weights.Results 32.4 percent health technicians had turnover intention.The risk factors of the turnover intention were as follows:medical department,bad assessments of the practice environment,low degree of the diversity of job skills,small level of improving the individual's capacity,low degree of job satisfaction,high degree of job autonomy,high requirement for the expression of individual emotions,high working pressure,high job burnout.The higher turnover intentions were,the lower synthetical evaluation scores of the work states were.Conclusion The county hospitals ought to pay more attention to the health technicians with high tumover intention,and to guide the health technicians who want to dimission to make a correct decision,and to make some suggestions to improve their work states through having a heart-to-heart talk,training,and career planning,etc.