应用功效系数法评价卫生防病工作绩效的探讨

应用功效系数法评价卫生防病工作绩效的探讨马俊生，张立，马爱霞综合评价卫生防病工作绩效，是卫生防疫部门近年来为加强科学管理而进行研究探讨的课题之一。随着医学统计学的发展，目前探讨的评价方法主要有模糊综合评判法、层次分析法等。本文应用功效系数法对洛阳市所...     

基于变异系数赋权与功效系数的医疗质量评价

目的 主观赋权缺乏一定的科学性和客观性,为消除确定权重的人为干扰,依据变异程度确定各指标权重,使评价结果更客观. 方法 运用变异系数赋权与功效系数法对医院医疗质量进行综合评价. 结果 功效系数法原理简单、灵敏度高. 结论 该方法可在医疗卫生领域推广应用.     

基于功效系数法的医疗效率综合评价分析

目的对某医院医疗效率情况进行多指标综合评价分析,为医院管理决策提供科学依据。方法基于功效系数法对医院2004—2008年度反映医疗效率的8项指标进行综合评价。结果综合评价分析结果客观地反映出医院各个年度的医疗效率。结论运用功效系数法对反映医疗效率的多项指标进行综合评价,能客观地反映不同时期医院医疗效率的综合状况,是医院管理决策的重要依据。     

应用功效系数法综合评价医院医疗工作质量

目的 全面客观地评价医院医疗质量,为医院制订合理的工作计划提供科学的决策依据.方法 运用功效系数法,选取9项医疗工作指标,对某医院2005-2010年的医疗工作质量进行综合评价.结果 从总体看,医院的医疗质量呈逐年上升趋势.结论 功效系数法具有原理简单,易于理解的特点,在医疗工作质量综合评价中具有较好的应用价值.     

应用功效系数法综合评价学校卫生监督质量的探讨

综合评价学校卫生监督质量,目前常用的方法有模糊综合评判法、层次分析法等,但未见有关应用功效系数法的报道。本文应用功效系数法对学校卫生监督质量进行综合评价,并对该法做简要介绍。1 原理概述和计算方法功效系数法是依据多目标规划原理而建立的一种分析方法。其含义是:在评价某一整体的综合效益时,一般有多种指标,而这些指标的性质和度量单位往往不同,不能直接相加和汇总,需要通过一定形式的函数关系将其转化为同度量指标,再将这些同度量指标     

变异系数赋权的功效系数法在医院医疗质量综合评价中的应用

目的：客观、科学地评价某医院各临床科室的医疗质量。方法选取14个有代表性的指标组成医疗质量综合评价指标体系,运用变异系数赋权与功效系数法,对各指标进行综合评价。首先运用Excel求出各个指标的标准差及变异系数,根据指标包含的信息确定其权重,计算各科功效系数,然后采用加权几何平均法计算出总功效系数,得出各临床科室的医疗质量综合排序结果。结果评价指标中病死率的权重最大,满意度的最小。各科室总功效系数分别为：内一科79．65、内二科83．56、内三科77．57、儿科95．39、外一科87．57、外二科82．51、外三科74．27、五官科83．6、妇产科91．48、老年科66．28。从总功效系数排序表可看出,各科医疗质量排序从高到低为儿科、妇产科、外一科、内二科、内一科、外二科、五官科、内三科、外三科、老年科。结论依据样本数据变异程度来确定权重的变异系数法,能有效消除主观因素的干扰。功效系数法用加权几何平均法对指标值进行综合,原理简单,灵敏度高,指标处理保持方向一致。应用变异系数赋权与功效系数法相结合对临床科室进行综合评价,提高了评价的准确性、科学性,客观、合理地反映了医院实际的医疗质量。     

运用功效系数法对某院基于病种分值的绩效分配进行综合评价

目的 综合评价某院基于病种分值的住院绩效分配方案的效果,以发现目前绩效分配方案中存在的缺陷,探讨基于病种分值的绩效分配方案的合理性和可行性。方法 选取某市某三级综合医院2021年10个外科科室的13项数据作为综合评价指标,采用德尔菲专家咨询法确定评价指标权重,用功效系数法计算总功效系数并进行排序。结果 除病种较为单纯的产科,其余外科科室综合评价的结果与实际绩效分配结果一致或者基本一致。结论 目前该院基于病种分值的绩效分配方案能够相对合理地体现科室的服务质量和医疗价值。用功效系数法对该院绩效分配结果进行综合评价具有实际指导意义。     

功效系数法在医疗质量综合评价中的应用

对医疗质量综合评价的方法很多 ,如ＴＯＰＳＩＳ法 ,ＲＳＲ法、模糊综合评价法〔1～ 3〕等。本文应用经济统计领域中常使用的功效系数法〔4〕对我院 1996～ 2 0 0 1年医疗工作质量进行综合评价。原理与模型功效系数法根据多目标规划的原理 ,对每一评价指标分别确定一个满意值与不允许值 ,以满意值为标准上限 ,不允许值为标准下限 ,按线性正相关的方法将不同的评价指标无量纲化转化为相应的评价分数 ,经加权几何平均得出综合评价分数 ,对评价对象的综合状况作出评估。综合功效分数越大 ,表明评价对象其综合状况越佳。其数学模型 :ｄｉ =Ｘｉ-…     

功效系数法下的医疗质量综合评价方法探讨

通常来讲,医疗质量是评价一个医院好坏的标准,所以备受院方及广大市民的重视。本文主要就其质量中和评价方法做以探讨,论述功效系数法在进行此工作中的步骤及优势,供有关人士参考查阅。     

功效系数法在医院综合效益评价中的应用

医院综合效益是指整个医疗活动中投入、产出、效果三者的关系。如何对医院的综合效益进行评价,目前有许多评价方法。本文采用功效系数法对我院1987～1990年的综合效益进     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

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.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.