我国区域医学检验中心的发展现状与挑战

在国家相关医疗改革政策的引领下,区域医学检验中心快速涌现,市场竞争加剧。作为医疗机构服务能力的有益补充,区域医学检验中心因其属性、规模、能力和发展阶段等不同,在竞争中处于不同地位并面临不同的挑战,其未来的发展态势也将在激烈的市场竞争中出现明显分化。连锁化、综合性区域医学检验中心因为技术、人才、规模、网络和临床服务能力等综合实力而进一步强化其市场竞争优势。     

湖北区域医疗联合体的实践与思考

湖北省在医改试点中探索了6种区域医疗联合体实践模式,针对区域医疗联合体实践中存在的困难和问题进行了深入的剖析,提出了相应的思考与建议,以期为正在进行的公立医院改革试点提供参考性意见.     

基于新医改背景下构建区域医疗联合体的实践与思考

国家新医改政策是引导优质医疗资源下沉,构建各类医疗机构协同发展的服务体系、推动建立分级诊疗制度。衡阳市珠晖区以区域内三甲医院南华大学附属南华医院牵头,联合7家公立医院,4家社区医疗服务中心建了区域医疗联合体。通过加强领导和科学组织、以创新模式提升服务质量、以多种形式实现医疗资源共享、开展各项医联体远程医疗项目等方式探索建立具有地区特色的区域医联体,初步实现区域内医疗资源的纵向整合,并使基层医疗机构能力得到提升和发展。对如何进一步促进医联体建设提出了加强顶层设计等具体的政策建议。     

区域心电平台关键技术的研究

以互联网+心电为前期技术手段,开展医疗联合体建设,能有效整合区域内医疗资源,提升基层医疗服务能力,更好地实施分级诊疗和满足群众健康医疗的需求。本研究从实际出发,结合大量的院内院外环境,对区域心电平台的关键技术进行了深入探讨,以进一步推动区域心电技术平台的发展。     

北京市朝阳区构建区域医疗联合体的实践与探索

区域医疗联合体是构建连续性医疗服务体系的重要途径,有利于提高医疗资源的整体利用效率。北京市朝阳区积极探索区域医疗联合体建设,相继建成了中部、北部、东部3个医联体,形成"大小一体化、上下一体化、城乡一体化",发挥了三级医院优质医疗资源的辐射作用,提高了基层医疗机构的能力,引导居民就医回归,在一定程度上缓解了"看病难、住院难"。     

北京友谊医疗共同体建设的实践与思考

2012年5月,北京市医管局发布《北京市医院管理局关于在北京朝阳医院等3家医院开展区域医疗共同体试点工作的通知》,正式开启医联体试点工作。同时,为在全市范围内全面积极稳妥地推进医联体政策的顺畅运行,市卫生局、市发改委、市人力社保局及市中医药管理局于2013年11月26日联合出台了《北京市区域医疗联合体系建设试点指导意见》,进一步推进医联体政策的实施。北京友谊医院作为试点医院之一,     

基于远程区域医疗联合体的实践与探索——以大连市中心医院为例

组建医联体、推进医疗资源纵向整合是落实国家新医改方案,推进公立医院改革,构建新型城市医疗服务体系的一项探索性举措。在借鉴上海、湖北、河南等地经验的基础上,结合大连市中心医院医联体具体实践,提出一种推动医联体发展的可行模式——基于远程医疗系统区域医疗联合体,并就该模式的现状、未来设想以及我国医联体的发展进行探讨。     

我国发展区域医疗联合体的SWOT分析

医改下一步重点建立医疗联合体,解决日益突出看病难的问题。建立医疗联合体,对提升基层医疗机构能力,提升群众对基层医疗机构的信任度,有效缓解"看病难、看病贵"有着重要意义。同时也存在许多问题。笔者运用SWOT分析法,分析了发展区域医联体的优势、劣势、机遇、挑战,并提出对策建议。     

广州市白云区社区肿瘤随访人员现况分析

目的了解我区肿瘤随访的情况和基层医疗机构开展随访工作人员队伍的情况,为进一步提高随访质量提供科学依据。方法采用问卷的方式对基层医疗机构的肿瘤防治人员和肿瘤病人进行调查。结果随访队伍年轻、职称水平偏低、缺乏掌握肿瘤相关知识,工作任务繁重,不能满足病人的需求。大部分医生在随访过程中都遇到病人的拒访,主要原因之一是涉及私隐和对社区医生的不信任。结论需加强肿瘤相关知识培训尤其是肿瘤心理、康复知识,以满足肿瘤随访实际需要,同时加大宣传肿瘤防治知识,提高病人的依从性。     

区域医疗中心综合评价模型的构建及应用研究

目的 通过构建综合评价模型,对四川省区域医疗中心发展状况进行评价研究。方法 调查2013 - 2015年区域医疗中心相关指标数据,采用综合评分法构建综合评价模型。运用Microsoft Excel 2010和SPSS 17.0软件处理数据。结果 对各指标数据进行集中化处理,建立区域医疗中心综合评价模型,以加权求和的方式计算评分。区域医疗中心在三级、二级、一级指标和总评分间存在一定的差异。总评分结果显示:3年平均A医院排名第一,B医院排名第二,C医院排名第三,G医院和F医院排名最后。结论 地区间医疗水平发展不平衡,对于相对落后地区行政部门在分配卫生资源时应予以考虑。区域医疗中心各有所长,相互间应取长补短,不断提升医院自身及区域整体医疗水平,为患者提供更优质的服务。     

基于层次分析法的区域医疗中心评价指标体系研究

目的 建立区域医疗中心评价指标体系,并确定各层次指标的权重,为进一步评价医院在区域内的整体实力打下基础。方法 采用文献回顾和专家咨询的方法建立区域医疗中心评价指标体系。运用层次分析法确定指标权重。运用Microsoft Excel2010和SPSS17.0软件处理数据。结果 评价指标体系包含5项一级指标、12项二级指标和31项三级指标。一级指标中所占权重最大的为医疗服务状况（0.3390）,其次是卫生资源配置（0.2883）。在组合权重中,超过平均权重0.0323（1/31）的指标有14项。结论 运用层次分析法确定区域医疗中心评价指标体系权重具有适用性,下一步可以结合综合评价模型开展区域医疗中心评价研究。     

Organization development at work in a medical center

Organization development can work: Valley Medical Center in San Jose, California, has successfully restructured multiple lines of authority in the process of installing modern management and fiscal control processes.     

The value of a new family practice center patient to the academic medical center

BACKGROUND. Family practice centers are important contributors to the financial viability of academic health centers, although they often are not the direct beneficiaries of their own labor. The greater time commitment and lower costs of most primary care creates significant financial hardships for departments of family medicine in university centers. This study describes the use of inpatient and outpatient health care services by new patients at a university family practice center. METHODS. A sample of 215 new adult enrollees at a university family practice center were examined for a 1-year period after their initial visit to the center. Total billings by the university hospital, specialty services, and the family practice center were tabulated by insurance type. RESULTS. Medicare patients generated the highest average charges (+2501 per patient per year); self-indemnity patients generated the lowest average charges (+301 per patient per year). The largest portion of health services charges was generated by the university hospital inpatient service, which was responsible for approximately 60 cents of every dollar billed to patients in this study. Conversely, the Family Medicine Department billings generated only 17% of the total charges. CONCLUSIONS. The findings of this study indicate that university-based family practice centers are significant contributors to the financial and educational base of the academic health center. If family medicine and associated primary care centers are forced to reduce their size or services because of financial difficulties, the impact will be felt by the university hospitals and by other specialty departments.     

区域性核与辐射事故应急医学中心的构建

探讨区域性核与辐射事故应急医学中心的选取方法,根据核与辐射事故的特点以及建设核与辐射事故应急医学中心的必要性,将中值模型选址理论和协同创新理论用于核与辐射应急医学中心的选址与建设,提出构建核与辐射事故应急医学中心的的原则和措施,缩短救援半径和救援时间,降低救援费用,提高救援效率。     

上海市某区多元化办医调查分析

为适应社会主义市场经济的发展,深化卫生改革,加快卫生事业发展,上海市某区卫生局根据国家“鼓励社会资本投入,发展多层次、多样化的医疗卫生服务,统筹利用全社会的医疗卫生资源,提高服务效率和质量,满足人民群众多样化的医疗卫生需求”的政策要求,近年来对部分公立医院进行了多种形式的转制,并进一步放开市场,鼓励和引导社会资本投资医疗市场。该区的社会办医疗机构近十余年得到迅速发展,数量由少到多,规模由小到大,     

基于层次分析法的区域医疗中心评价指标体系构建研究

目的：构建区域医疗中心评价指标体系,并确定各层次指标权重,为评价区域内医院的整体实力提供参考依据。方法：采用文献分析、德尔菲法建立区域医疗中心评价指标体系,并运用层次分析法确定指标权重。结果：评价指标体系包含5个一级指标,11个二级指标,36个三级指标。一级指标中所占权重最大的指标为高水平临床诊疗(0.3553),其次为高层次人才培养(0.2615)。结论：运用德尔菲法和层次分析法构建的区域医疗中心评价指标体系具有较高的权威性和科学性,为评价区域医疗中心提供科学有效的工具。     

A medical school's involvement in the development of a community-based health center

This paper presents a planning model developed by the Department of Community Medicine of the Mount Sinai School of Medicine to facilitate the interactions between the medical school and the community. The planning process involved application of the model, exemplified through the growth and development of a neighborhood health center governed by a community agency. The main characteristics of the medical school, of the community, and of the community agency are presented briefly and the seven-year history of the development of the neighborhood health center is summarized. In recapitulating that history three distinct phases are identified in the planning process: how the planning was planned, how the plan was prepared, and how the services program was implemented. The role of the Department of Community Medicine in each phase is analyzed.Dr. Merino is Assistant Professor, Department of Community Medicine, Mount Sinai School of Medicine, New York, NY 10029. Dr. Rose is Instructor, Departments of Medicine and Community Medicine, Mount Sinai School of Medicine, New York, NY 10029. Dr. Bosch is Professor and Deputy Chairman, Department of Community Medicine, Mount Sinai School of Medicine, New York, NY 10029.     

Student body selection for a regional medical graduate education training center

The results of analysis of the composition of experts from the Northwestern region of the Russian Federation, who improved their skills at the Medical Academy of Postgraduate Training, Saint Petersburg, i.e. a regional training center for continuous postgraduate education of medical personnel, are presented in the article. The influence of the selected forms and purposes of such training as well as of the development level of outdoor training sessions and of need in certified personnel was defined. The study results promote the planning of the training-and-production activity of the regional training center for the purpose of meeting, as full as possible, the needs of health care institutions in the sphere of postgraduate training of personnel.