广州市新型城市医疗卫生服务体系构建的策略研究

在新的历史条件下,构建新型城市医疗卫生服务体系有着积极的现实意义.文章在深入分析了当前广州城市医疗卫生服务体系现状的基础上,提出了构建广州新型城市医疗卫生服务体系的具体策略.     

完善社区卫生投入机制研究

发展城市社区卫生服务是深化卫生体制改革、调整城市卫生资源、构建新型医疗卫生服务体系的一项重要举措。如何加大对社区卫生服务的投入力度,建立稳定的投入机制,是当前的一项重要工作。本文通过对常州市城市社区卫生财政补助及其投入方式的分析,对完善城市社区卫生投入提出了相关政策建议。     

社区全科医疗服务中的人性化理念

加强城市社区医疗卫生服务系统的建设是世界各国医疗服务体系发展的一个重要方面,而近年在国内兴起的以全科医学为基础的社区医疗卫生服务正逐渐成为社区医疗卫生服务体系的主体。目前,我国的城市社区全科医疗服务系统建设还处于起步阶段,存在许多问题,亟待完善,因此,针对复杂多样的社区医疗卫生服务问题,提出与之相适应的解决方案,无疑是一种科学的研究思路。     

构建基层医疗卫生机构医学装备质量控制体系

国家为了健全基层医疗卫生服务体系,划拨专款加大基层医疗卫生机构医学装备配备投入,如何使得基层医学装备为保障人民健康充分发挥作用,各级必须重视基层医疗卫生机构医学装备规范化管理,充分认清加强质量控制体系建设重要性。通过分析当前基层医疗卫生机构医学装备管理现状,阐明基层医疗卫生机构医学装备质量控制影响因素和基本控制方法,提出科学构建基层医学装备质量控制体系初步思路。     

基于系统动力学的城市医疗卫生服务研究

文章基于系统科学理论提出城市医疗服务体系的复杂系统,并从分析城市医疗卫生服务的参与主体及其相互关系入手,构建了城市医疗卫生服务的系统动力学模型.在此基础上,以山西省为例,使用Vensim PLE5.11软件对模型进行仿真分析.文章一方面探索系统动力学在医疗卫生服务领域的可用性;另一方面定量分析城市医疗卫生服务的现状及未来发展趋势.     

关于构建新型医疗服务体系的思考

该文以系统论为基础,剖析了新型医疗服务体系的系统形成、功能与特征,以及组成系统的不同层次的子系统的功能和相互关系,对医疗卫生资源配置的经济学特征及其主要影响因素作了重点的系统分析,提出构建新型医疗服务体系的目标、原则以及资源配置的理论与方法,为不同区域科学构建新型医疗服务体系及其发展规划提供依据.     

卢湾区社区中医人才队伍的现状与对策

中医药是祖国传统文化的瑰宝，是我国医疗卫生事业独有的特色和优势，加强中医特色社区卫生服务体系建设，是构建新型医疗卫生服务体系，使全体居民公平享有基本医疗卫生服务的重要基础。2010年上海市促进中医药发展大会上，提出全市95．00％的社区卫生服务中心中医药服务规范达标，     

无锡新区社区卫生服务问题及对策分析

随着新型城市医疗卫生服务体系的不断深化,无锡新区社区卫生服务发展取得了重大成效,但当前仍然存在各种不足.通过调查分析,总结分析主要现存问题,并对解决主要问题提出针对性的建议和对策.     

社区卫生与医疗救助迎来新的春天 UHPP 总结经验 继往开来 加快发展 再创辉煌

2005年3月，国务院转了《民政部等部门关于建立城市医疗救助制度试点工作意见的通知》，提出进行医疗救助试点。2006年2月，国务院下发了《关于发展城市社区卫生服务的指导意见》，要求“将发展社区卫生服务作为深化城市医疗卫生体制改革，有效解决城市居民看病难，看病贵问题的重要举措，作为构建新型城市卫生服务体系的基础”。     

威海市社区医疗卫生服务体制存在问题分析与对策探讨

社区医疗卫生服务体制建设关系着人民群众的切身利益,是构建和谐社会的重要内容.如何推进社区医疗卫生服务体制建设,使人人享有医疗卫生保障,是目前面临的理论问题和现实问题.温家宝总理在十届人大四次会议上指出:大力发展城市社区卫生服务.要通过调整城市医疗卫生资源,加大政府投入、加强人才培养、完善服务功能、推进技术创新等措施,加快构建以社区为基础的新型城市医疗卫生服务体系.因此,加强社区卫生服务体制建设,实现有效、经济、方便、综合、连续的卫生服务目标,促进社区卫生服务健康发展势在必行.     

社区卫生服务适宜技术项目试点应用体会

近年来,党中央、国务院高度重视发展城市社区卫生工作,并将发展社区卫生服务作为深化城市医疗卫生体制改革和有效解决群众"看病难、看病贵"等问题的重要举措,作为构建新型城市卫生服务体系的基础。2007年,社区卫生服务适宜技术项目开始在全国部分城市试点。在两年多的运作过程中,我中心取得了一定的成绩,对下一步的发展也有一些思考。本文旨在通过分析适宜技术项目的运行情况,为相关部门合理制定下一步的发展策略提供参考依据。     

Telemedicine services in the Republic of Ireland: an evolving policy context

The Republic of Ireland is characterised by few urban conurbations and a high rural population, including significant numbers of island dwellers. Information communication technologies (ICT), including telemedicine, present opportunities to address rural health-service delivery issues. As in other countries, the recent National Health Information Strategy is regarded as pivotal to the modernisation of the Irish health care system. There is, however, a dearth of research about telemedicine in Ireland. This paper reports, to the best of our knowledge, the first systematic review of telemedicine in the two regional health boards in the Republic of Ireland. Details of 11 telemedicine services, all initiated by local policy, will be presented. Results of an interview study with service providers about their experiences of the practices and processes involved in telemedicine service delivery are also provided. The focus of our analysis is two-fold. We assess the resonance of these Irish data with the international literature with particular reference to a recently developed model for the normalisation of telemedicine. For the first time, this model which was developed in the United Kingdom is applied to a fresh set of empirical data in a different health care context. We then discuss a number of health information policy issues for Ireland and elsewhere arising from our analysis.     

远程医疗对基层官兵医疗卫生保障的作用

随着远程医疗的各种优势不断展现,其应用领域逐渐扩展。在目前信息时代的条件下,基层官兵的医疗卫生保障不断步入信息化管理,远程医疗逐渐应用到基层官兵的医疗卫生保障之中,并起到了越来越重要的作用。通过阐述远程医疗发展的概况,对远程医疗在基层官兵医疗卫生保障中的作用进行分析,进而对远程医疗有了更充分的认识,远程医疗在基层官兵医疗卫生保障中具有广阔的应用前景。     

三级医院医疗服务与社区公共卫生服务纵向整合的探讨

分析了国内外卫生服务整合的现状,结合我国卫生服务存在的问题,提出将三级医院医疗服务与社区公共卫生服务进行纵向整合的观点,并对实施的必要性和可行性进行分析,对实施的具体方式提出自己的思考。     

发展城乡基层卫生事业是实施基本卫生保健制度的基础

当前城乡基层卫生事业存在卫生资源不足且城乡差距明显、基本医疗得不到保障舍近求远使看病难导致看病贵、公共卫生服务缺失使危害居民健康因素的隐患增大等主要问题，提出发展城乡基层卫生事业是实施基本卫生保健制度基础的观点，提出把巩固完善城乡基层卫生体系和提高卫生服务能力作为基础工程、把增加卫生投入和实行公共卫生服务政府埋单作为保障工程、把改造不良生活卫生环境和倡导健康生活方式作为配套工程等三个发展城乡基层卫生事业和实施国家基本卫生保健制度的政策建议。     

Integration of telemedicine into emergency medical services

We developed an integrated model of telemedicine services in emergency medical care. The architecture was designed to support pre-hospital management. The experimental work was carried out with the collaboration of the emergency medical services (EMS) in Madrid. Two different study populations were defined: a control population using conventional EMS protocols and a population using the telemedicine system. The telemedicine system was based on a telepresence service; electrocardiograms and images were transmitted from the ambulance to the health emergency coordination centre. The cost of dealing with 100 patients using telemedicine was C6030 less than the cost of conventional care. The response times using telemedicine were significantly lower.     

武汉市社区老年人健康相关问题调查分析

目的了解武汉市社区老年人口的健康需求,寻求符合城市老年居民生活方式和老年社区卫生服务基本功能需求的健康教育策略.方法采取系统随机抽样的方法对武汉市2463名老年人进行了问卷调查.结果武汉市社区老年人健康状况不够理想,这与社区老年人文化素质较低、卫生知识缺乏、存在较多不良行为、健康教育与健康促进开展得不够、社区卫生服务机构对老年健康管理不力等因素有关.另外经济因素起着很重要作用.结论社区老年卫生服务应以建立适应当前需要的新型老年卫生服务体系、构建新的"医患关系"、开展多种卫生服务形式为突破口,加强健康教育,形成适合于武汉市社区老年人卫生服务特色.     

Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?

This paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims' data gathered by a major Swiss health insurer, over a period of 6 years and involving 160 000 insured adults. In Switzerland, health insurance is mandatory, but everyone has the option of choosing between a managed care plan and a fee‐for‐service plan. This paper focuses on a conventional fee‐for‐service plan including a mandatory access to a telemedicine service; the insured are obliged to phone this medical call centre before visiting a physician. This type of plan generates much lower average health expenditures than a conventional insurance plan. Reasons for this may include selection, incentive effects or efficiency. In our sample, about 90% of the difference in health expenditure can be explained by selection and incentive effects. The remaining 10% of savings due to the efficiency of the telemedicine service amount to about SFr 150 per year per insured, of which approximately 60% is saved by the insurer and 40% by the insured. Although the efficiency effect is greater than the cost of the plan, the big winners are the insured who not only save monetary and non‐monetary costs but also benefit from reduced premiums. Copyright © 2010 John Wiley & Sons, Ltd.     

高校附属医院城市社区妇幼保健服务模式探讨

目的:探索高校附属医院城市社区妇幼保健服务模式,为公立医院改革提供新思路、新方法。方法:采用便利抽样方法,对辽宁省锦州市区由三级医院管理的某社区395名孕产妇进行问卷调查,分析孕产妇对保健知识和医院社区医疗服务模式的需求。结果:不同社会人口学特征的孕产妇对健康教育知识及健康教育方式的需求均不同。结论:高校附属医院城市社区妇幼保健作为一种新的妇幼保健管理工作服务模式,能增强医院对妇幼保健服务的支持,加快妇幼保健专业人才的培养,强化护理人员对妇幼保健护理的主动服务意识,为促进更加有效的妇幼保健管理模式和公立医院改革提供了新的工作思路和方法。     

Evaluating telemedicine systems and services

The evaluation of telemedicine involves attempts to answer a wide range of questions involved in making decisions about safety, about practicality and about utility. Roughly speaking, if we wish to provide a telemedicine service we should first establish that it is safe, next that it is practical and finally that it is worthwhile. In establishing safety, most laboratory studies of telemedicine have a common structure, and consist of the following steps: (1) selection of cases; (2) interpretation; (3) comparison with a gold standard; (4) statistical analyses. Most of the studies to establish the practicality of telemedicine have been carried out as demonstrations, to show that a proposed application can be implemented in a chosen setting. In terms of utility, telemedicine has been used to improve the efficiency of an existing service or to make an existing service available to a new community. One of the difficulties is that the vendors of relatively expensive telemedicine systems and services disseminate much of the information on the topic. We have to focus not on the glamorous technology but on the underlying issue of how the participants in health care (patients, general practitioners, specialists) can communicate more effectively, using the range of technological options open to them. Ensuring that the most appropriate technology is used in the most effective way should be the primary aim of telemedicine research. There is now sufficient evidence for us to be confident that telemedicine is a safe alternative to conventional care in a variety of situations and for a number of clinical conditions. Reliable evidence that it is a practical and cost-effective alternative is, at the time of writing, harder to find.