老大,今天下午看到这两段,一直没看懂意思,你能不能帮我译一译,我搞了一下午 ,搞的头都大了,谢谢你啊,老大!!!
As a result of financial decentralization, the three-tier health service network in rural China has been challenged by the decline of public investment. One of the manifestations is the notable decline of the share of public health expenditure in the total financial expenditure. [3] The share of public health expenditure declined from 2.49% in 1980 to 1.71% in 2000. The cooperative health care system virtually disappeared following the collapse of the People’s Commune System, and the overwhelming majority of village health clinics were privatized. Subsidies for public health services at and above township levels were reduced, [4] and rural health service became increasingly profit-oriented. As medical services and drug markets remain far from well regulated, corruption in the process of drug procurement has become rampant. It has been no more secret that hospitals and drug stores receive considerable amount of sales commission from medicine producers while they also obtain a large price margin by selling drug to patients with price hike. Compared with 1995, the cost of hospitalized treatment for appendicitis in 2000 increased by 37.2%, the cost of hospitalized treatment for pneumonia increased by 83.2%, whereas during the same period the net per capita income of rural households increased only by 25.9% (Diagram 1).
The above-stated changes resulted in a backwards-turning point from the pre-reform policy that had effectively combined basic biomedical intervention and public health care (Wilson, 1992). In order to reverse such a trend, the Chinese government has been making efforts to re-establish the cooperative health care system, as well as to carry out experimentation with various forms of health risk sharing system in regions at different development levels, while making investments in upgrading public health care facilities and addressing the problems in the health care and drug market. However, the over-all trend has not yet been reversed, as the strength of the intervention is far from sufficient.
2. Growing inequality and vulnerability
The impact of changes in health care financing on the rural population are not directly manifested by the overall health outcome as the health outcome is determined also by other factors, such as nutrition, clothing, housing, jobs, education, living environment, behavior, lifestyle, etc., (Fuchs, 2000). Nevertheless, the impacts may be observed in the following:作者: DZ 时间: 2007-6-7 16:27