充分利用境外智力资源创造对外合作美好前景：解放军总医院对外改？…

９０年代以来，解放军总医院充分发挥自身的优势和潜力，进一步加快改革开放、对外交流合作的步伐，不失时机地利用境外智力资源、为医院现代化建设服务、使总医院的各方面建设发生了历史的变化。文章论述了在新时期军队医院对餐加强合作的必要性和可能性，认为充分利用境上智力资源是加快医院现代化建设的必要手段，只要在观念和体制上进行适当调整，就能有效地引进国际上最先进的科学技术成果和人才，在医院现代化建设方面收到事半     

浅谈对外交流在医院建设中的作用

对外交流是医院的一项重要工作 ,其对加强医院人才建设、扩大医院影响及加强国际合作等均具有重要作用[1,2 ] 。改革开放以后 ,通过广泛的对外交流 ,我们不仅从国外汲取了大量先进的医学知识和科学技术 ,学到了许多先进的医院管理经验 ,引进了大批现代化的医疗设备 ,同时 ,还培养了大批的专业技术人员 ,从而加速了学科建设 ,使医院的医、教、研工作得到了很大提高。一、我院开展对外交流的基本情况(一 )医院和科室领导齐抓共管 :对外开放是我国的一项基本国策 ,是被实践证明了的实现现代化建设目标的必要途径和重要方针。我院是开展对外交流…     

某院对外医疗合作的做法

对外医疗合作是促进军队医院全面建设的一项重要举措。本文探讨军队小医院开展对外医疗合作的做法及应坚持的原则,旨在进一步规范对外医疗合作管理模式,确保军队医院的利益。     

从"请进来"与"送出去"中探讨医院科技能力的提高

90年代以来,中日友好医院加大对外学术交流力度,结合境外智力引进和公派出国留学,有效地促进了医院科技能力的提高,从而推动了医院医疗卫生事业的发展.     

医院对外项目合作常见法律风险及规避策略

因受资金、技术、人才等各方面限制,医院要生存、发展,就要开展对外项目合作,弥补自身弱点,快速提升竞争力.但在开展对外项目合作时存在诸多问题与潜在法律风险.本文就医院对外项目合作常见法律风险进行探讨、分析,总结,提出若干建设性规避法律风险策略.     

对外学术交流管理刍议

开展对外学术交流 ,是汲取世界先进医学知识、促进学科建设、培养高层次医学人才、提高医疗技术水平的重要途径。现就新形势下进一步深化对外学术交流 ,提高学术交流的水平进行探讨。一、对外学术交流的现实意义对外开放是我国的一项基本国策 ,是被实践证明了的实现现代化建设目标的必要途径和重要方针。多年来 ,通过不断发展和深化对外开放和学术交流 ,我们不仅从国外汲取了大量的先进技术和管理经验 ,而且培养了大批的专业技术人才 ,为加快我国现代化建设起到了积极的推动作用。作为医学科学与发达国家相比 ,还存在着很大的差距 ,有些甚至…     

浅谈军队医院如何开展对外医疗合作

阐述军队医院开展对外医疗合作的积极作用,并针对目前发展中存在的问题,提出如何进一步完善军队医院对外医疗合作,发挥对外医疗合作的最大功效。     

军队医院对外合作现状及对策

本文详细阐述近年来军队医院开展对外合作的背景、原因及带来的益处，针对医疗合作项目存在的问题，从军队医院的职能任务、政策调整、管理控制、发展模式等方面，提出规范军队医院合作的建议与对策。     

依托“远程医疗”推动医院对外合作的实践与思考

江苏省仪征市人民医院通过搭建“远程医疗”平台,推动医院和省内外知名大医院及科研院所之间的深度合作与交流,促进医院管理和学科建设,医疗技术和科研水平取得显著提升。同时推进医院对外合作,促进优质医疗资源的共享和医疗服务的均等化,为基层患者提供优质医疗服务,推进分级诊疗有效落实。     

医院开展对外合作自体免疫细胞治疗技术体会

自体免疫细胞治疗属于第三类医疗技术,国内进行自体免疫细胞治疗的医院有近百家。医院按照姓军为兵、依法办事、医疗行为独立的原则,通过严格项目科学论证,对外合作开展自体免疫细胞治疗技术;本文探讨军队医院开展对外合作自体免疫细胞治疗技术的做法及体会,旨在确保对外合作的规范化开展。     

Charitable care and the nonprofit paradigm

Nonprofit hospitals have begun to focus once again on serving the health needs of their communities. Governmental needs for additional revenue and for-profit hospitals' contention that tax exemptions give nonprofit hospitals an unfair competitive advantage have resulted in changes in laws and regulations and have caused a change in the role of nonprofit hospitals. As local governments become more responsive to the health needs of their communities, they are requiring nonprofit hospitals to become more responsive as well. Laws, regulations, and court decisions have begun to require nonprofit hospitals to provide charity care and services at levels equal to the amount of their exempt taxes. In response, nonprofit hospitals are developing community benefit programs and public health services.     

The costs of hospital services: a case study of Evangelical Lutheran Church hospitals in Tanzania.

The health care systems of many developing countries are facing a severe crisis. Problems of financing services leads to high patient fees which make institutions of Western health care unaffordable for the majority of the rural poor. The conflict between sustainability and affordability of the official health care system challenges both local decision-makers and health management consultants. Decisions must be made soon so that the existing health care systems can survive. However, these decisions must be based on sound data, especially on the costs of health care services. The existing accounting systems of most hospitals in developing countries do not provide decision-makers with these data. Costs are generally underestimated. The leadership of the 16 hospitals of the Evangelical Lutheran Church in Tanzania is currently analyzing how the existing health care services should be restructured. Therefore, reliable estimates of the costs of hospitals services are required. A survey on 'Costing of health services of the Evang. Luth. Church in Tanzania' was prepared, which summarizes the results of seven months of field investigations in Lutheran hospitals. The major findings are that the costs of providing adequate services are much higher than expected. The most important factors determining these costs are the administrative efficiency of the hospital and the scope of services offered. The paper closes with some recommendations on how to improve the services in order to make them both affordable for the rural poor and financially sustainable for the Church. It is concluded that even the best improvement of technical efficiency will not safeguard the survival of the hospital-based health care services of the Lutheran Church in Tanzania. These findings call for a reallocation of health care resources to lower levels of the health care pyramid.     

江苏医疗保障制度改革试点城市医院改革的调查与思考

医疗保障制度改革对医院产生了四个方面的影响：医院业务收入增长幅度明显下降;医院工作效率有所提高;医院服务结构有了变化;医院服务行为进一步规范。医疗保障制度改革必须地带动了医院内部改革向前发展：一是更新了思想观念;二是强化了经营管理;三是优化了内部资源配置;四是提高了工作效率;五是改进了医疗服务。由于国家改革政策不配套,当前医院改革面诸多困难和问题,如政府财政投入不足,医疗服务价格体系不合理,影响医     

北京市公立医院综合改革对医疗机构技术劳务收入的影响分析

目的:分析北京市医药分开和医耗联动综合改革对不同级别医疗机构体现医务人员技术劳务价值收入部分的影响。方法:利用参与北京市医药分开和医耗联动综合改革363家公立医疗机构2016年1月—2019年12月的监测数据,采用描述性分析结合多重间断时间序列模型,对改革前后不同级别医疗机构技术劳务收入及其占比的变化情况进行分析。结果:医药分开综合改革实施后,三级医院、二级医院、一级医院及社区的技术劳务收入较改革前分别增长了105.4%、119.7%和318.3%,其占比分别增长了5.91、6.44和5.87个百分点;医耗联动综合改革实施后,三级医院、二级医院、一级医院及社区技术劳务收入较改革前分别增长了26.2%、18.3%和11.6%,其占比分别增长了2.31、2.03和0.84个百分点。结论:北京市两项公立医院综合改革的实施有效促进了各级别医疗机构技术劳务收入的增长,医疗费用结构得到优化。建议进一步建立科学合理的医疗服务价格定价及动态调整机制,加强对基层医疗机构的重视,健全医疗服务行为监管体系。     

THE DETERMINANTS OF HEALTH CARE EXPENDITURE TOWARD THE END OF LIFE: EVIDENCE FROM TAIWAN

This paper empirically investigates the relationship between the health care expenditure of end‐of‐life patients and hospital characteristics in Taiwan where (i) hospitals of different ownership differ in their financial incentives; (ii) patients are free to choose their providers; and (iii) health care services are paid for by a single public payer on a fee‐for‐services basis with a global budget cap. Utilizing insurance claims for 11 863 individuals who died during 2005–2007, we trace their hospital expenditures over the last 24 months of their lives. We find that end‐of‐life patients who are treated by private hospitals in general are associated with higher inpatient expenditures than those treated by public hospitals, while there is no significant difference in days of hospital stay. This finding is consistent with the difference in financial incentives between public and private hospitals in Taiwan. Nevertheless, we also find that the public–private differences vary across accreditation levels. Copyright © 2013 John Wiley & Sons, Ltd.     

医疗保险模式对深圳市职工看病就医的影响分析

为了研究医疗保健模式对职工就知行为的影响，采用分层整群随机拉的方法对深圳市职工进行了调查分析，结果表明：实施医疗保险新模式，采用按平均费用标准偿付的支付方式，对职工看病就医的行为及卫生服务利用程度上都有很大的影响，职工两周就诊率和年住院率均高于１９９３年全国大城市平均水平，而年人均住院日与之比较则偏低。     

北京地区325家综合医院心理卫生服务状况

目的了解北京地区各级综合医院心理卫生服务状况。方法向北京18个区县的全部508家各级医院发放自制的《医院精神卫生情况调查表》,内容包括医院2001年提供心理卫生服务的种类、提供心理卫生服务人员的特征、心理卫生服务初诊患者数量及诊断、精神科药物的使用情况等。结果共有73％(373／508)的医院参加,其中综合医院占75％(325／436)。在325家综合医院中,171家(53％)提供1种或多种心理卫生服务;共有420名医务人员从事此项工作,但他们学历偏低,接受相关培训较少。61家设有心理门诊,其心理卫生初诊患者占全地区各类医院(包括精神专科医院)初诊患者的50％(47151／93891);其中90％(42578／47151)就诊于18家三级综合医院。综合医院有诊断分类资料的44441例心理卫生初诊患者中,43％为神经症,30％为抑郁症。所有接受调查医院售出的抗抑郁药总量的73％和氟西汀总量的97％是由103家综合医院售出的。结论应当重视综合医院的心理卫生服务,加强相关从业人员的培训,建立相应科室,尤其在一、二级医院。为监督综合医院心理卫生工作的发展趋势,提高质量及水平,应定期评估其心理卫生服务的种类和范围、诊断的准确性和治疗的合理性。     

Public health in hospitals: the missing link in health improvement

Traditionally, public health professionals have scorned hospitals as the antithesis of community health. Secondary care remains notably distant from public health practice and policy. Yet hospitals consume over 50 per cent of the health budget and over a quarter of the population have contact with hospital services every year. There is an important public health agenda in hospitals for promoting health and an environment that encourages community partnership and a healthy place to work and be. Public health skills have a key role in ensuring high-quality, safe and evidence-based health care. Epidemiological support for hospitals can promote a much-needed culture of monitoring and evaluation of health services. A public health approach to planning of secondary care services can encourage a more objective and strategic assessment of health needs and how these are best met. We argue that public health hospitals should not be an oxymoron, but an essential component of public health strategy. Different approaches to putting public health into hospitals are discussed.     

我国政府举办公立医院的理论依据和职责研究

根据人权理论、价值观、福利经济学、人力资本、公共产品等基本理论,公平提供基本医疗卫生服务、保障人群健康是政府不可推卸的责任,而举办公立医院,是政府履行保障人群健康职责的有效途径之一。根据社会组织学、公共选择、社会主义优越性等理论,我国公立医院具有公益属性,应当承担社会功能和责任。政府为公立医院提供良好的政治、经济、政策环境,是促使公立医院体现公益性、履行社会责任的重要保证,也是政府履行职责的表现形式。然而,目前我国各级政府及其相关部门在履行举办公立医院的职责方面存在许多问题,主要有：各级政府之间的职责没有完全理清;政府相关部门没有理顺关系,存在多头管理问题;卫生、财政、人事、物价等政府主要相关部门对公立医院的监管、经费投入、编制核定、医疗服务价格制定等职责落实不到位。     

A reform proposal from 2019 aims to improve coordination of health services in Poland by strengthening the role of the counties

Numerous attempts have been undertaken over the past two decades to improve the coordination of health services in Poland. These have usually focused on specific groups of patients or conditions, usually encompassing various types of specialist care, with only a few initiatives including a wider range of health services or sectors. These efforts have not been helped by the fragmentation of responsibilities between the various levels of territorial self-government, which are the founding bodies for different types of public providers. In 2019, a new policy initiative of the Ministry of Health proposed the establishment of County Health Centres that would improve integration of primary health care with specialist outpatient care, inpatient care in the county hospitals (hospitals of the 1st reference level), and other services at the level of the county. This would constitute the so-called “core system of health security” and support reorientation of health services towards PHC and the community and away from specialist hospitals. With its focus on health promotion and disease prevention and tailoring provision to the needs of the local populations, the proposal resembles examples of population health models introduced in several other countries, and offers a chance to improve the allocation of resources and to reduce the persisting health disparities across the country.