基于数据包络分析的乡镇卫生院经营效率评价

在我国实施加强农村医疗卫生服务战略的背景下，针对乡镇卫生院医疗卫生服务效率低下的现状，本文采用数据包络分析方法对沈阳市乡镇卫生院进行效率评价，以期对乡镇卫生院的优化资源配置和提高运营效率提供政策依据。     

乡镇卫生院转制带来的思考

为进一步探索乡镇卫生院卫生事业发展方向，理清发展思路，寻求医疗卫生事业发展的办法，以适应医疗卫生改革的时代需要，通过进行深入实地调查及查找资料，对宽甸地区乡镇卫生院转制后的运行和发展情况进行简要回顾和总结，以期为今后乡镇卫生院改革与发展提供借鉴经验。     

乡镇卫生院继续医学教育面临的问题及对策

乡镇卫生院继续医学教育面临的问题及对策李群良，曾放（四川省内江市东兴区卫生局６４１００３）乡镇卫生院是农村三级医疗卫生网的枢纽，加强乡镇卫生院医务人员的继续医学教育（简称继教，下同），提高医务人员的诊疗技术水平，对巩固、发展农村三级医疗卫生网、保障广...     

长春市乡镇卫生院的现状与对策

乡镇卫生院是农村三级医疗卫生保健网的枢纽,乡镇卫生院发展与否,直接关系到2000年人人享有初级卫生保健目标的实现。但是,近几年来,大部分乡镇卫生院面临“关门倒闭”的危险,经营情况已滑到了崩溃的边缘,如果长期发展下去,必将严重影响乡镇卫生院的发展,影响农村医疗卫生保健工作的实施。为此,我们对乡镇卫生院的     

乡镇卫生院班子建设刍议

乡镇卫生院班子建设刍议江油卫生医药局（６２１７００）张百万我市有医疗卫生单位６０个，其中分布在农村的全民中心卫生院５个，乡镇卫生院４１个。这些医疗卫生单位担负着８０多万人的治病防疫工作，基本保证了全市人民的健康，为发展江油经济作出了贡献。但是，我们还...     

不同经济水平地区乡镇卫生院检查设备使用调查分析

乡镇卫生院是农村三级医疗卫生网的中心环节,是卫生行政部门、上级医疗卫生业务单位和村级卫生组织的桥梁和枢纽。作为最基层的医疗卫生机构,乡镇卫生院在十年来的卫生改革中,采取了一系列与农村经济体制改革相适应的措施,大大改善了乡镇卫生院的面貌。目前大多数乡镇卫生院配有放射科、化验室、心电图室和B超室,为摸清我省目前乡镇卫生院上述科室的状况,探讨进一步提高上述设备的利用率。笔者     

加快乡镇卫生院发展的对策探讨

乡镇卫生院是农村三级医疗卫生网的枢纽，长期以来，对我国农村医疗卫生事业的发展作出了较大的贡献。然而．在当前形势下，乡镇卫生院的发展遇到了新的情况与问题。笔者就此提出以下建议。１、必须坚持主体开发，方方面面求得共识。加强对卫生事业性质的宣传，加强对乡镇卫生院在三级医疗预防保健网中的地位和作用的宣传，应当是现阶段农村卫生事业发展的首要任务。要让县以上各级政府重视和支持乡镇卫生院的巩固和发展，让乡镇政府把乡镇卫生院的建设纳入本地区社会发展的规划，坚持主体开发．方方面面求得共识。一方面呼吁各级政府对卫生…     

乡镇卫生院今后的出路问题

乡镇卫生院今后的出路问题张咸恒，李学成（山东栖霞县政府办公室２６５３００）乡镇卫生院是农村三级医疗卫生网络的枢纽，是实现＂２０００年人人享有卫生保健＂战略目标的成托，但在新旧体制的转换过程中，乡镇卫生院大部分陷入了难以为继的窘境。如何扭转这一局面，巩...     

对乡镇卫生院运营情况的调查

乡镇卫生院是联系村卫生室和县级医疗卫生单位的中枢。但改革开放以来，随着市场经济的实行，竞争的加剧，以及“财政分灶吃饭”，政府支持力度的弱化，加上经营机制不活、管理不善等原因，使乡镇卫生院医疗服务质量长期停滞不前，业务量下降，人浮于事，大部分入不敷出。为此，我们对山东省的部分乡镇卫生院及河北省赵县的2个乡镇卫生院进行了调查。     

山东乡镇卫生院改造“1127工程”基本完成

近日，以健全农村医疗卫生服务体系为目标的山东省乡镇卫生院改造“1127工程宣布基本完成。据了解，为整体提升级镇卫生院的医疗卫生服务能力，从2005年底开始，山东省全面实施“360工程”，先后投入近4亿元．基本完成对全省360所乡镇中心卫生院的改造升级从根本上解决这些乡镇中心卫生院在医疗用房、设备配置和培养技术骨干等方面的难题。     

新医改下我国农村居民就诊流向变化趋势与成因分析

目的研究新医改前后我国农村居民就诊流向变化及其原因。方藩综合分析《中国卫生服务调查研究》、《中国卫生统计年鉴》和医改监测与评价相关数据,并结合典型地区调研和专家咨询。结果新医改实施以来,患者的首诊机构选择变化不大,但农村居民就诊流向发生了重大变化。结论基本医疗保障制度、基苓药物制度、基本医疗卫生服务体系、基本公共卫生服务体系和乡镇卫生院综合改革对农村居民就医流向有着重要影响．同时存在着交互作用。应进一步明确农村医疗服务体系功能定位、优化农村医疗卫生网络布局、加强农村卫生服务制度建设、发挥新农合制度导向作用和推进乡镇卫生院综合改革。     

城市医院在新型农村合作医疗中的作用

新型农村合作医疗试点工作的深入开展,给医院带来一系列的新问题、新情况。提出了城市医院加快建立新型农村合作医疗制度以及坚持"优质、便捷、价廉"的医疗卫生服务原则,制定出农民参加新型农村合作医疗的就医规定和政策,下派医务人员到农村医疗机构对口支援,帮助制定农村医疗卫生的诊疗常规和管理制度,培养技术骨干、建立稳定长效机制,严格资金管理和封闭运行,建立农村合作医疗计算机管理系统等,促进医院健康发展。     

乡镇卫生院股份合作制改革的初步成效

股份合作制是当前乡镇卫生院产权制度改革的常见形式。它在调动职工积极性、拓宽卫生院筹资渠道、保值公有资产、完善内部经营管理机制等方面取得了初步成效 ,提高了卫生院的卫生服务水平 ,增强了自我生存与发展能力。股份合作制有可能成为新世纪我国乡镇卫生院体制改革的一条希望之路。     

军队医院开展新农合促进军地融合式发展

军队医院兼具社会公益性和军事保障性的双重性质。新型农村合作医疗是新时期政府为了解决＂三农＂问题,促进城乡医疗公平所实施的一项重大民生工程。军队医院是军队卫生机构开展新农合的前沿和重点,开展新农合对促进军队医院军地融合式发展起到了重要的作用。     

Do rural hospitals lag behind urban hospitals in addressing community health needs? An analysis of recent trends in US community hospitals

Objective:  This study examined whether rural and urban hospitals differ in their level of responsiveness to community health needs.
Design:  This study used a multivariate, longitudinal research design.
Research setting:  A cross-sectional survey was the setting for this study.
Participants:  The participants were rural or urban hospitals in the United States.
Main outcome measures:  The dependent variables were selected from the American Hospital Association hospital survey questions that are related to community health needs. The independent variable was rural or urban location.
Results:  Rural hospitals improved more than urban hospitals in addressing community health needs from 1997 through 2006 for most of the indicators, especially in working with other providers to conduct a community health assessment. However, rural hospitals still lag significantly behind urban hospitals in tracking health information.
Conclusions:  This study suggests that rural hospitals do not lag behind urban hospitals in addressing community health needs. Further research is needed to understand the role of community hospitals in influencing local health delivery system activities regarding the potential community benefits and their impact on improving health of local populations.     

State Health Policy and Rural Hospitals

Many rural hospitals are experiencing difficulties. This article explores the views of various government and hospital officials on state health policy for rural hospitals. The authors discuss how these officials define the rural hospital issues and suggest appropriate state interventions to assure hospital viability and local access to care. The authors recommend that states, hospitals, and communities decide through a formal process what level of health and medical care should be available in rural areas, and states assist in low-cost ways those rural hospitals that are ready to change or that, with help, will be ready to make such operational changes as service reconfiguration, affiliations, and working agreements with other health care organizations to continue and improve local access to health care.     

Rural Hospitals: Trends, Challenges, and. a Future Research and Policy Analysis Agenda

Previous reviews of the status of rural hospitals conclude that rural hospitals play a major role in ensuring the provision of health services in rural areas, are an essential part of the social and economic identity of rural communities, have had mixed success in their ability to respond to environmental threats, and are very sensitive to public policies due, in part, to their small size. The evolving hospital paradigm in the United States and a turbulent economic and health care environment have created an uncertain future for the rural hospital. Hospitals are being forced to shift their emphasis from filling acute inpatient care beds to providing a more diversified set of services through linkages with other institutions and provider groups. This presents challenges for rural hospitals, which often serve as the foundation for health care delivery in rural communities yet struggle to Overcome the effects of troubled local economies, shortages of health professionals, and public policy inequities. This article reviews key trends and challenges facing rural hospitals from the perspective of their structure and organization, financial sustainability, quality of care provided, and strategic linkages with other entities. It concludes with the presentation of a research and policy analysis agenda that addresses the feasibility of the role of the rural hospital as the hub or coordinator of the rural health care delivery system, the fiscal viability of the rural hospital in the post-Balanced Budget Act period, strategies for measuring and improving the qualify of care provided by rural hospitals, and the structure and value of horizontal and vertical linkages of rural hospitals.     

Rural community hospital closure and health policy.

Closure of rural community hospitals in the U.S.A. is a growing and important trend with serious implications for rural communities and the overall health care system. This study analyzes characteristics of all U.S. rural hospitals that closed between 1980 and 1986. Variables correlated with risk of closure--for-profit ownership status, non-government not-for-profit ownership status, number of other hospitals in the county, presence of a nursing or other long-term care unit, few facilities and services offered, lack of accreditation by the Joint Commission of Accreditation of Hospitals, lack of membership in a multihospital system--indicate that a rural hospital's survival depends upon its ability to compete and adapt in a volatile, competitive health care marketplace. five policy options are discussed: changes in Medicare payments, expansion of the number of hospitals designated as sole Community Hospitals, the use of swing beds, establishment of state offices of rural health, and short-term federal and state grants. Allowing hospitals the flexibility to adapt and compete, while ensuring adequate quality health care to rural residents, is suggested as the priority in rural health policy.     

Hospital-sponsored rural health clinics: an effective diversification alternative for rural hospitals.

Changes in rural health care are resulting in new challenges for the administrators of rural hospitals. The lack of available care, economic deterioration, and demographic changes in rural America are contributing factors to rural health care problems and are detrimental to the financial well-being of rural hospitals. Diversification is becoming commonplace in these hospitals as administrators seek strategies to gain financial viability for their facilities. The concept of hospital-sponsored rural health clinics is more than a decade old, yet there are fewer than 30 such clinics nationwide. Reasons for the underutilization of such clinics may include the lack of knowledge that such clinics exist as well as inadequate information describing the establishment, operation, and financial feasibility of the clinics. The hospital-sponsored rural health clinic "concept" will be introduced, including potential benefits of such clinics to both the hospital and the communities they serve, factors to be considered in developing such a system, and problems that may arise in this development. This article presents a case study of how one rural hospital incorporated such clinics into its long-range plans.     

Linkage strategies of rural hospitals--independent hospital, local health system, and/or externally linked facility

Strategies associated with ownership or management of a range of health service facilities, service sharing, and other coordination activities are important to the viability of many rural hospitals. This article articulates a set of linkage strategies employed by rural hospitals. Such strategies and their environmental and organizational correlates are assessed in a sample of 46 rural Pennsylvania hospitals.