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1.
近年来,世界各国卫生费用都在急剧上升,尤以医疗费用为甚,已经成为影响国家经济发展的沉重负担,因此,各国政府都在积极研究控制医疗费用的对策。我国对医疗费用支付方式的研究在理论上已有了很大的进展,有些医院的实践活动也取得了较好的成果。  相似文献   

2.
过快的医疗消费增长,使政府采取宏观调控,当前医院面临的社会主义市场经济体制和将出台的医疗保险制度及人民不断提高的医疗消费水平以及补偿不足、队伍不稳和消费费用上升等客观情况,医院深化改革的必然趋势是:限制药品、检查费总金额省下的卫生资源用于调劳务性收费价格;满足病员对医疗服务性消费的需要,行政部门要公布平均医疗费用水平;医务人员要普遍增强费用意识。  相似文献   

3.
医院全成本核算项目工作的实践与体会   总被引:1,自引:0,他引:1  
1背景 我国医院主要为公立医院,自然地承担着社会福利的义务,这种义务应是通过执行政府对医疗收费的统一定价和享受政府的补贴和免税来体现的。但目前政府财政补贴全国平均值已不足5%,医疗收费成为医院运行支撑和补偿来源。而我国医疗定价长期以来一直沿用的费用测算法致使医疗定价中价格和价值分离,  相似文献   

4.
调整医疗消费结构开展质量效益竞争是医院深化卫生改革的必然趋势上海市卫生局(200002)杨百华一、医院费用的快速增长及宏观调控措施近年来,本市的医疗费用上涨过快,使工厂、企业和财政不堪负担职工的医疗费用,并已经引起市民、社会舆论和政府有关部门的关注。...  相似文献   

5.
目的:研究患者对医疗费用感受的区域性差异及医疗服务定价的合理性,以期为医疗服务价格改革提供一定的参考依据。方法选取东西部同等级医院2013—2014年度腹腔镜胆囊切除术的住院患者,分析比较两所医院的住院费用、医疗服务定价标准及当地居民收入。结果应用某一成熟医疗技术诊治疾病的费用,上海高于昆明。费用差距的主要原因在于部分项目定价及医师的治疗项目选择。对比人均收入,上海居民的价格感受优于云南昆明。结论按项目付费的方式存在明显弊端,省级之间定价差不合理因素较多,因此需加快医疗服务定价方式的改革,推行临床路径,以稳步推动区域化医疗的进程,实现区域间医疗和费用公平性。  相似文献   

6.
网络化医院经济管理的特点与方法   总被引:6,自引:0,他引:6  
当前,军队医院信息化建设快速发展,医院网络化已经成为一种普遍的医院运营模式,对卫生经济管理产生着越来越重要的影响。北京军区卫生部注重所属医院解决网络环境下医院卫生经济管理出现的新情况、新问题,与医院信息化建设同步研究,认识医院网络环境下卫生经济管理的特点规律,先后总结制发了“医院网络模式下卫生经济管理流程”;组织研发了“医院医疗成本核算会计软件”;全区统一应用了“医疗费用实时查询系统”,落实了医疗费用公开制度,促进了医院内在质量建设。全区各医院充分利用医院  相似文献   

7.
军队卫生经济管理工作建设与展望   总被引:6,自引:3,他引:3  
1 军队卫生经济管理工作与研究现状1.1 主要成绩1.1.1 卫生经济法规政策研究有了较快的发展 以医疗费用管理、医疗成本核算为重点,出台了一批有较大影响的法规制度。如:《军队人员及其家属医疗费用管理规定》、《军队医院医疗成本核算管理办法》、《军队医院会计核算管理暂行办法》等。对加强医院医疗成本核算管理、规范医院经济活动、提高医院管理水平起到了很好的作  相似文献   

8.
分析影响医院效率的因素,提出改善医院效率的建议。应用全国卫生服务调查和卫生机构调查的资料分析医院工作的效率。结果显示卫生人力增长、卫技人员素质低下,医疗费用上升超过物价上升幅度。群众接受卫生服务能力下降和医疗保障覆盖率下降是影响医院效率的主要因素。建议控制卫生人力过快增长和提高人员素质,控制医疗费用过快增长和推进医保改革是提高医院效率的关键。  相似文献   

9.
加强医疗服务价格管理的思考   总被引:2,自引:0,他引:2  
医疗服务价格是指在医疗服务市场中,政府有关部门和医院根据成本投入等对医疗服务项目所制定的收费价格。合理的医疗服务价格管理体系是发挥市场机制、优化卫生资源配置、提高资源使用效率、引导患者需求的重要条件。随着卫生体制改革的日渐深入以及医疗服务市场化进程的推进,给“以药养医”提出了严峻挑战。笔者认为,现代医院应该将医疗服务价格管理作为切入点,不断调整和理顺医院补偿机制,完善医疗服务价格体系,正确运用价格策略,以比较低廉的费用提供比较优质的医疗服务,从而提高医院市场占有份额和社会经济效益,促进卫生事业长远发展。  相似文献   

10.
医疗机构面临的问题和对策   总被引:1,自引:0,他引:1  
文章就宁波市医疗机构目前情况作了论述,指出目前存在问题主要是卫生资源配置不合理,其原因有体制和政策方面;各级医院的功能错位,导致医疗费用急剧增加;医疗费用构成不舍理,药费比例偏高:医疗机构管理体制和运营机制不能适应市场经济形势;针对上述问题,文章提出的对策为实施区域卫生规划,优化卫生资源配置;加快社区卫生服务建设,增强社区基层卫生服务力量,调整医疗收费价格体系,实行医药分开核算;推进干部人事制度改革,引进竞争机制。  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.
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   

16.
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   

17.
The repeatability and validity of a questionnaire for upper limb and neck complaints were assessed in a population of 105 hospital outpatients with a range of upper limb and neck disorders (including cervical spondylosis, adhesive capsulitis, lateral epicondylitis, carpal tunnel syndrome and Raynaud's phenomenon). Subjects were asked to complete a modified Nordic-style upper limb and neck discomfort questionnaire on two occasions closely spaced in time. The repeatability of their responses was assessed by calculating a kappa coefficient (kappa), and the sensitivity and specificity of component items in the questionnaire were determined for specific diagnostic categories of upper limb and neck disorder. Symptom reports for pain in the upper limb and neck, pain interfering with physical activities, neurological symptoms and blanching were all found to be highly repeatable (kappa = 0.63-0.90). A number of regional pain reports proved to be very sensitive in relation to specific upper limb disorders, but, with the exception of reported finger blanching in patients with Raynaud's phenomenon, none proved to have a good specificity (range = 0.33-0.38). We conclude that a modified Nordic-style questionnaire is repeatable and sensitive, and is likely to have a high utility in screening and surveillance. However a complementary examination schedule of adequate specificity and repeatability is essential to establish a clinical diagnosis.  相似文献   

18.
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   

19.

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   

20.
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