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1.
应用病例分型评价医疗质量费用的体会   总被引:4,自引:1,他引:3  
医疗质量管理与评价方法较多。为适应当前国家医疗制度改革的新形势,采用病例分型指标引导模式的管理,旨在探索深化医院医疗质量管理,提高医院效率、降低医疗成本,规范医疗行为。经过1年的应用实践我们体会到,医院要在医疗市场竞争中处于不败,首先要深化医院质量建设,要积极倡导“大质量”管理[1],从抓每一个病种和每一个病例质量、费用入手,用计算机管理,用指标引导,用数据评价,才能真正实现医院“优质、高效、低耗”的管理目标。一、应用方法1.采用病例分型质量、费用管理方法:将病种病例分型质量、费用管理列入医院全面质量管理范畴,在原…  相似文献   

2.
应用指标引导模式加强医疗质量管理的实践   总被引:3,自引:0,他引:3  
应用病例分型指标引导模式进行医院医疗质量管理。体会是:①总体设计符合医院“优质、高效、低耗”的管理模式;②指标评价体系能够反应医疗质量、工作效率和医疗费用以及医疗综合评价质量;③对平均住院日、医疗费用、药品费用进行标准化管理;④目标明确,可比性强,有利于分析判断医疗质量缺陷因素。病例分型对提高医院医疗质量管理和规范医疗行为有重要价值。  相似文献   

3.
病例分型在医疗质量管理中的应用研究   总被引:6,自引:0,他引:6  
医疗质量问题是医院管理的核心 ,也是医患双方十分关注的问题。近年来 ,病种医疗质量管理方法已被普遍接受。而最新发展趋势则是 :将病种质量管理与病例医疗质量管理结合起来[1] 。病例分型将普通病例与疑难病例区分后进行分析评价 ,其优点在于各病种 /病例分型组组内的病例在卫生资源消耗上具有相当的一致性 ,从而使医疗质量评价能科学、客观地反映医疗单位的实际 ,使质量管理发挥正面导向作用。我们研究引进“病例分型”方法 ,对长海医院危重病例的收容、病种 /病例分型组医疗质量的评价及病例分型的费用进行了探讨。一、材料和方法1.材料…  相似文献   

4.
疑难危重率对医疗费用的影响   总被引:6,自引:0,他引:6  
目的:研究人均医疗费用与危重率的关系。方法:收集某三级甲等医院2003年出院病人病例信息,运用《病例分型质量管理系统》和Excel2000研究月危重率与人均医疗费用的相关关系。结果:该医院月危重率与人均医疗费用呈正相关,危重率是影响费用增长的重要因素。结论:以危重率与标准评价医疗费用,有利于控制费用过度增长,最终以医院技术的发展使费用降低。  相似文献   

5.
病例分型质量评价系统的研究与应用   总被引:7,自引:2,他引:5  
目的 研究病例科学分类的方法,实现住院病例质量一费用指标管理。方法 (1)计算机病例分型;(2)第一诊断相同的病例组合;(3)病例单元包罗模型评价方法。结果 建立病例质量,效率,费用指标引导系统。结论 病例分型有利于科学评价医疗质量,有利于病例费用成本控制;有利于完善医院质量管理体系,促进医院提高科学化管理水平。  相似文献   

6.
新形势下医院医疗质量管理模式转变与实践   总被引:19,自引:11,他引:8  
为适应医疗保障制度改革的需要,建立以单个病例为评价对象、以病种病例分型为评价单元,具有质量、效率,医疗消耗三大指标特征的医疗质量管理和评价系统,实现新形势下医疗质量管理模式的转变。①强调用现代“大质量”观的医疗质量管理和评价;②突出“以病人为中心”,提高医疗质量管理的目的性、针对性、有效性;③规范医疗行为,在规范单病种诊疗基础上,对每一病例进行疾病病种、病情程度、治疗方法,平均住院日和医疗费用标准化的医疗质量管理、控制和评价;④建立与“优质、高效、低耗”相配套的医疗质量管理指标体系、标准体系和评价体系。并对模式方法、特点以及应用的关键问题进行了分析。  相似文献   

7.
病例分型质量综合值的应用研究   总被引:1,自引:0,他引:1  
目的:应用病例分型法对医院年度质量综合值分析,发现医院管理中存在的问题,提示改进方向,实现“优质、高效、低耗”的管理目标。方法:以3所三级甲等医院(2所综合性医院和1所专科医院)2000年1月1日至2003午12月31日所有出院病人219238份病案信息数据库为资料来源,运用《病例分型质量管理系统》软件将出院病例以各医院各年度进行病例质量分析,以同医院跨年度进行同期对比,并统计描述。结果:医院效益与医院资源配置、医疗质量、技术特色、收治疾病危重度有关。结论:提高医院效益,关键要注重内涵发展,达到医患双赢。  相似文献   

8.
病种病例分型实验分析研究   总被引:3,自引:0,他引:3  
目的:对病例分型方法进行实验研究。方法:①病例按病情分型;②再依第一诊断ICD-9三位数类目编码;③进行病种病例组合。结果:合理解释单位质量共性问题;合理剖析个性问题的主要原因;深化病种质量、效率、效益规范管理;将病例费用合理评价纳入病例医疗质量评价体系。结论:病例分型方法科学、简便、易行,可以在医院推广应用,为医院医疗质量评价奠定了基础。  相似文献   

9.
病例分型的难点和对策   总被引:2,自引:1,他引:1  
近年,有学者提出医疗质量新概念[1]:①以病例为确认医院服务质量的综合单元;②按病例单元将医疗服务质量诸特性包罗在质量判定范围之内;③医疗服务质量特性基本达到标准化要求;④区分医疗质量范围与非质量范围,把非质量因素排除在质量判定范围之外;⑤采用适当的数据化方法判定病例医疗服务质量。病例分型研究正是基于这种医疗质量新概念而从理论到实践逐渐成熟的。作为一种医疗质量管理的新方法,在应用推广中还会遇到很多问题和难点。医院实行病例分型管理的难点主要有以下4个方面:①传统的生物医学模式,对管理者思维方式的影响;②传统的管…  相似文献   

10.
开展病种病例分型管理的实践与体会   总被引:7,自引:0,他引:7  
目的为提高医院对病种质量费用的自我控制能力,在确保医疗质量的同时减少不必要的医疗资源消耗.方法对全院住院病例实行病种病例分型,建立全病种的质量费用参考标准,完善病种质量反馈与分析制度、考评制度,开展对科室或医生的医疗质量和工作绩效的评价.结果科室病种质量费用意识加强,病例质量优良率由80.01%上升到86.22%,药品费用比例下降到40.32%.讨论实施病种病例分型管理,对提高医院管理水平、提高医疗工作效率、降低医疗成本、规范医疗行为等起着十分重要的作用.  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

14.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

15.
Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L?1 to a maximum of 79?mg·L?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.  相似文献   

16.
The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.  相似文献   

17.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

18.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

19.
20.
Occupational health hazards in mining: an overview   总被引:1,自引:0,他引:1  
This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.  相似文献   

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