医疗设备招标的规范化进程

医院使用的专业设备种类繁多，设备质量和价格差别较大，供货商竞争激烈。为了规范医院医疗设备采购程序，降低设备采购价格，确保设备质量，对医疗设备、医院基建项目、后勤物资等实行集中招标采购。本文就医疗设备招标中的几个重点环节进行分析和探讨。     

医疗设备采购中常见问题及应对措施探究

医疗设备采购是医院运营管理活动的主要环节之一，加强采购管理能够辅助落实医院的成本控制、运营控制与医疗服务控制，具有综合效益。根据医院运营运行情况，医疗设备采购中经常出现一些问题，影响设备采购的有效性，不利于医院运营管理的有序运行。文章对医疗设备采购常见问题及其应对进行研究，目的是针对当前存在的问题提出解决措施，优化医疗设备采购过程，提高采购效率。简要阐述医疗设备采购中常见问题，分别从预算、组织架构、监督机制、内部控制、现代化技术等多个方面入手，对医疗设备采购常见问题的应对措施进行深入探究。     

医疗设备采购的全流程管理信息化建设

医疗设备是医院医务人员开展诊疗活动的重要工具，是维持医院正常运行的重要物质保障。医疗设备采购是医院采购工作中的重点和难点，现阶段医疗设备采购全流程管理信息化建设不健全易造成采购效率低下，采购风险增加。该研究通过对医疗设备采购管理现存的普遍性问题进行分析，对医疗设备采购信息化建设提出建议，旨在规范医疗设备采购流程、控制医疗设备采购风险、提高医疗设备采购效率，同时为医院发展的决策提供一定的信息数据支撑。     

如何做好医疗设备的集中招标采购工作

作者在论述了医疗设备集中招标采购的意义、基本程序以及医院在集中招标采购中的权利和义务后，重点论述了医疗设备集中招标采购中应注意的几个重要环节。     

医院设备采购流程管理探讨

本文提出根据医疗设备采购的几个关键环节进行管理，根据卫生事业改革与发展的新形式制定切实可行的相关制度，使采购工作规范合法，公平公正。     

医疗设备招标采购应加强的工作环节

目前大型医疗设备的招标采购工作已经不断完善与规范,但是为了进一步减少设备采购的盲目性、增加设备招标采购工作的透明度、提高设备招标采购的公正性,尚需对设备招标采购过程中的设备前期论证、供货商资质的审验、技术参数及设备配置清单核准等几个关键环节加强管理,以确保医疗单位在遵守公开、公平、公正的原则下,采购到性能价格比从优、真正符合临床实际需求、并可充分发挥社会效益和经济效益的医疗设备。     

医院保证医疗设备网上采购质量的对策

在介绍了医疗设备网上采购定义的基础上，从主要方面和相关细节入手，阐述了医院确保医疗设备网上采购质量的对策以及医学工程科作为职能科室在医疗设备网上采购中保证采购质量的作用和做法。     

从资源优化配置分析医疗设备使用效率的影响因素及低成本购置的方式

分析医疗设备使用效率低下的影响因素，优化医疗设备的采购方式，将提高医疗设备采购资金的利用效率，提高医疗设备资源的储备和利用。     

医疗设备招标采购前、后的问题及对策

为有效杜绝医疗设备采购中的不正之风，各级行政管理部门对大型医疗设备集中进行招标采购，本文就医疗设备招标采购前、后存在的问题进行分析，提出对策。     

医疗设备的采购风险管理

目的：研究医疗设备采购活动的特征以及行业采购的特性。方法：结合我院多年探索的采购实践经验，对医疗设备采购进行风险分析。结果：提出院内贷款、项目管理和系列的量化考评分析手段等多种降低和规避医疗设备采购风险的方法。结论：取得了良好效益和管理成果。     

卫生经济成本效果分析的前沿评价方法研究

健康与卫生保健是卫生领域里最受关注的经济和政治问题。由于卫生经济学涉及公共政策的制定和实施,所以,我们必须系统地评价可供选择的政策方案。通过对国内外相关文献中3种经济评价方法的阐述,着重介绍和分析了成衣效用分析法,并认为该方法在现阶段的中国更具有实际应用价值。     

浅谈投资分析在大型医疗设备购置中的应用

运用投资分析的方法来论证医院购置大型医疗设备的可行性,着重讨论质量技术分析和财务分析各自不同的分析结果,结合实例说明了此方法的实用性及对决策的影响。     

A Unified Framework for Classification of Methods for Benefit-Risk Assessment

BackgroundPatients, physicians, and other decision makers make implicit but inevitable trade-offs among risks and benefits of treatments. Many methods have been proposed to promote transparent and rigorous benefit-risk analysis (BRA).ObjectiveTo propose a framework for classifying BRA methods on the basis of key factors that matter most for patients by using a common mathematical notation and compare their results using a hypothetical example.MethodsWe classified the available BRA methods into three categories: 1) unweighted metrics, which use only probabilities of benefits and risks; 2) metrics that incorporate preference weights and that account for the impact and duration of benefits and risks; and 3) metrics that incorporate weights based on decision makers’ opinions. We used two hypothetical antiplatelet drugs (a and b) to compare the BRA methods within our proposed framework.ResultsUnweighted metrics include the number needed to treat and the number needed to harm. Metrics that incorporate preference weights include those that use maximum acceptable risk, those that use relative-value–adjusted life-years, and those that use quality-adjusted life-years. Metrics that use decision makers’ weights include the multicriteria decision analysis, the benefit-less-risk analysis, Boers’ 3 by 3 table, the Gail/NCI method, and the transparent uniform risk benefit overview. Most BRA methods can be derived as a special case of a generalized formula in which some are mathematically identical. Numerical comparison of methods highlights potential differences in BRA results and their interpretation.ConclusionsThe proposed framework provides a unified, patient-centered approach to BRA methods classification based on the types of weights that are used across existing methods, a key differentiating feature.     

Genome scan for association and linkage

In this paper, a genome search is performed on the GAW Problem 1 data, in an attempt to determine which, if any, of the marker loci are associated and/or linked with the disease. Since there was no clear indication from the data of the likely mode of inheritance, methods were used which did not require such assumptions to be made. A two-stage procedure was used to test for association. Firstly a standard unmatched case-control test was applied to all the loci. The family-based method of Self et al. [1991] was then applied to those loci which gave a positive result in the first stage. This procedure correctly detected loci 1 and 2, and that disease risk was increased for homozygote carriers of the disease allele at each locus, although a false positive result was also found. The affected sib pair method of Holmans [1993] was also applied to the data, although the sample contained far too few sib-pairs for such an analysis to be effective. This analysis failed to find any of the disease loci. ©1995 Wiley-Liss, Inc.     

Genetic Analysis Workshop II: further consideration of segregation and linkage analyses in Problem 3

We analyzed disease-marker associations in Problem 3 for the Genetic Analysis Workshop II, using PAP for segregation analysis and LIPED for linkage analysis. In this report we present aspects of our analyses that are not reported in the summary [MacCluer et al, 1984]. Certain features that we added to the running of LIPED to facilitate the analysis are discussed. Furthermore, we tested for Mendelian transmission in the hypothetical trait locus and we calculated modified relative risks for marker-trait genotypes. Some of the problems involved in analyzing complex associations among loci are discussed.     

Semiparametric transformation models for joint analysis of multivariate recurrent and terminal events

Recurrent event data occur in many clinical and observational studies, and in these situations, there may exist a terminal event such as death that is related to the recurrent event of interest. In addition, sometimes more than one type of recurrent events may occur, that is, one may encounter multivariate recurrent event data with some dependent terminal event. For the analysis of such data, one must take into account the dependence among different types of recurrent events and that between the recurrent events and the terminal event. In this paper, we extend a method for univariate recurrent and terminal events and propose a joint modeling approach for regression analysis of the data and establish the finite and asymptotic properties of the resulting estimates of unknown parameters. The method is applied to a set of bivariate recurrent event data arising from a long-term follow-up study of childhood cancer survivors.     

Systematic review of health economic evaluation studies of dengue vaccines

Objectives

To review the literature on economic evaluation of dengue vaccination to produce evidence to support a local cost-effectiveness study and to subsidize the decision to introduce a dengue vaccine in the Brazilian National Immunization Program. Methods: We systematically searched multiple databases (MEDLINE (via PubMed), EMBASE, SCOPUS, NHS Economic Evaluation Database (NHS EED), HTA Database (via Centre for Reviews and Dissemination – CRD) and LILACS), selecting full HEEs of dengue vaccine. Two independent reviewers screened articles for relevance and extracted the data. The methodology for the quality reporting was assessed using CHEERS checklist. We performed a qualitative narrative synthesis. Results: Thirteen studies conducted in Asian and Latin America countries were reviewed. All studies were favorable to the incorporation of the vaccine. However, the assumptions and values assumed for vaccine efficacy, safety and duration of protection, as well as the choice of the study population and the type of model used in the analyses, associated to an insufficient reporting of the methodological steps, affect the validity of the studies’ results. The quality reporting appraisal showed that the majority (8/13) of the studies reported less than 55% of the CHEERS checklists’ items. Conclusions: This systematic review shows that the economic evaluation of dengue vaccination did not adhere to key recommended general methods for economic evaluation. The presented cost-effectiveness results should not be transferred to other countries. It is recommended to conduct studies with local epidemiological and cost data, as well as assumptions about vaccination that reflect the results observed in clinical trials.     

两生物制品研究所疫苗项目的经济学评价

该以中立的观点，对A和B生物制品研究所的疫苗项目进行学评价。研究结果表明：两所的静态和动态投资回收期都分别为8年和9年，并以企业利润率、成本变动和贴现率为指标进行敏感性分析。在经济学评价基础上，该分析了保本业务量，影响成本的可能因素，寻求降低疫苗单位成本的途径，并提出了两项可能方案。     

Logistic判别分析及其在医学中应用

Logistic判别分析对总体分布的条件限制较弱。有广泛的适用性。它适用于连续型、离散型与混合型资料。亦可用于两类与多类判别。无论理论上、实用上都很有生命力。此法一般用最大似然法求判别系数。作者用此法处理8个医学资料,其中有5个回代判别符合率为100％。而例1逐步判射分析回代翔别符合率为88.68％。文中讨论了变量筛选、判别符合率与迭代次数关系,以及与其他判别分析的比较。     

Advances in statistical human genetics over the last 25 years

The past 25 years has seen an explosion in the number of genetic markers that can be measured on DNA samples at an ever decreasing cost. Although basic statistical methods for analysing such data gathered on samples of either independent individuals or family members, one or two markers at a time, were already well developed before this explosion occurred, there has been a corresponding burst in activity to develop multiple marker models to find disease-causing gene variants, capitalizing on the data that have become available, to increase the power of such methods. This has required the concomitant development of faster algorithms to speed up the computation of various likelihoods. For linkage analysis, to obtain the approximate locations for genes of interest, Mendelian segregation models have been extended to be more realistic and statistical models that do not assume specific modes of inheritance have been extended to allow for the analysis of larger pedigree structures. For association analysis, to obtain more precise locations for genes of interest, the recent completion of the first stage of the HapMap project has spurred the development, still underway, of novel experimental designs and analytical methods to combat the curse of dimensionality and the resulting multiple testing problem. Perhaps the greatest current challenge concerns how best to gather and synthesize the many lines of evidence possible in order to discover the genetic determinants underlying complex diseases.