成都市精神卫生机构服务人员现状

目的 了解成都市精神卫生机构人力资源现状.方法 采用自制调查表对全市20家精神卫生机构的人力资源进行现状调查.结果 全市精神卫生从业人员1861人,其中医生334人,护士807人;博士研究生11人(0.74%),硕士研究生18人(1.21%),本科生124(8.36%);医师中高级职称者(包含正、副高)15.57%,中级职称36.83%;护士中高级职称0.62%,中级职称13.14%.结论 我市精神卫生服务人员中高级职称和高学历人员欠缺,精神卫生专业人才欠缺.其人员素质及服务质量有待提高.     

在基础卫生机构中结核病的预防能力研究

目的 通过对我市部分基础卫生机构的医疗设施及人员素质进行了解,研究其对结核病的预防能力.方法 采用问卷调查、座谈和实地考察的形式,对我市184所农村卫生室的整体近况进行调查,尤其是村医对结核病的预防知识的掌握情况进行深入了解.结果 村医对一般的结核病知识了解比较全面,如感染途径和预防措施等等,但对专业性较强的病理基础了解甚少.结论 加强对村卫生工作者的专业培训力度,改善落后的医疗环境,是提高基础卫生机构防治结核病的主要方式.     

扬州市农村集中式供水卫生状况调查报告

目的 掌握我市农村集中式供水卫生现状,了解我市农村水厂存在的主要卫生问题.方法 现场调查.结果 全市435家农村集中式供水单位,取用地下水为水源的占88%,以地表水为水源的占12%,卫生许可证持证率35%,292家单位无净化消毒设施,191家单位水质未检测.结论 农村水厂需要加大基础建设及净化消毒的投入.     

青海：基层卫生机构信息化建设启动

近日,青海省卫生计生委启动基层卫生机构信息化建设项目,旨在进一步加快基层信息化建设步伐,确保医改各项任务顺利完成。该省基层卫生机构信息化建设项目,是国家卫生信息化“3521”工程的一部分。2012年以来,国家持续加大卫生信息化建设投入力度,     

部队卫生信息管理系统（网络版）在护理工作中的应用

为了加强部队卫生信息化建设，提高部队卫生机构的规范化和科学化管理水平，更好地为广大患者服务，2001年初我院试运行部队卫生信息管理系统(网络版)。     

雅安市职业健康状况调查报告

目的 为了解我市主要职业病危害分布、职业病危害接触人群、职业病发病人数分布及主要职业病病种及特点,研究职业病的发病规律,为国家制定职业病防治政策提供科学依据.方法 按照属地化管理原则对全市职业病危害基本情况进行调查.结果 我市职业病存在以中小型企业为主,大部分企业职业病知识欠缺,职业卫生技术力量薄弱,情况不容乐观.结论 加强对企业的职业卫生监督管理,加强卫生技术服务机构的建设,确保全市职业健康状况好转.     

通州市医疗卫生机构消毒质量监测

为了解我市医院卫生机构消毒质量管理工作的情况 ,总结、改进、提高消毒工作的质量 ,我们于2 0 0 0年下半年 ,对全市乡镇级以上 66家医疗卫生机构进行了抽样监测 ,现将监测结果报告如下。1　材料与方法1 .1　调查对象　通州市乡 (镇 )级以上 66家医疗卫生单位的手术室、产室等 ,均为 类环境。1 .2　紫外线辐射照度测定　在各现场 ,开灯 5分钟后 ,用 ZG-5 A紫外线辐射照度计 (中国建材研究院产 )在距灯管垂直 1米处 ,测定紫外线辐射度值。1 .3　卫生监测内容　医院环境空气 :监测细菌总数、致病菌 (金黄色葡萄球菌、乙型溶血性链球菌 ) ;…     

上海市精神卫生服务筹资状况调查

目的 调查上海市精神卫生服务的筹资状况,为完善上海市精神卫生服务财政保障机制提出政策建议.方法 采用自制问卷对2008年上海市19个区(县)精神卫生中心和上海市精神卫生中心的收入(包括政府财政补助收入、医疗收入、药品收入、其他收入)和支出(包括财政专项支出、人员支出、公用支出、对个人和家庭的补助支出)情况进行调查,获得上海市2008年精神卫生机构的收入和支出情况相关数据.结果 2008年上海市精神卫生机构的收入总额为7.746 100亿元,其中政府财政补助收入、医疗收入、药品收入和其他收入分别占21.37%、48.34%、28.25%和2.04%;2008年上海市精神卫生机构的支出总额为8.633 998亿元,其中财政专项支出、人员支出、公用支出以及对个人和家庭的补助支出分别占8.45%、40.91%、47.39%和3.25%.结论 上海市政府财政对精神卫生服务的投入比例较低;政府应加大对精神卫生服务的投入,建立以政府投入为主的多渠道、多方位、多层次的精神卫生服务筹资模式.     

太原市2007年美容美发场所专项抽检结果分析

<正>为了解我市美容美发场所的卫生管理情况和公共用品用具消毒效果,以便提高我市美容美发场所的卫生监督管理水平,太原市各级卫生监督部门对所辖美容美发场所进行了监督监测。1对象与方法1.1调查对象按单项美发、单项美容、美容美发综合分类,对全市1235     

武警基层部队官兵医疗需求和卫生服务利用情况调查

[目的]研究武警部队基层官兵卫生服务需求和卫生服务利用的基本情况和特点.[方法]采用多阶随机抽样法调查不同地区中的11个支队,共调查基层官兵2202人.采用自行设计的健康调查表,调查人员按调查表内容,逐个询问每位官兵的患病、就诊、住院及一般情况并加以记录.[结果]慢性病病例总数为554人,就诊率为12.58％,其中干部慢性病就诊率显著高于战士(P＜0.05);基层官兵在各级卫生机构就诊的构成比统计学上差别无显著性;按执行任务的不同,基层官兵的住院服务利用情况构成差异有显著性(P＜0.05).其中,看押看守支队在地方医院住院人次数最高,占总住院人数的22.22％;机动、警卫支队住院人次数则主要集中在总队医院和支队卫生队.[结论]本研究调查数据将为武警部队卫生机构今后更好地开展卫勤保障工作,调整和加强各层次卫生医疗机构的建设提供科学依据.     

The Informatics Opportunities at the Intersection of Patient Safety and Clinical Informatics

Health care providers have a basic responsibility to protect patients from accidental harm. At the institutional level, creating safe health care organizations necessitates a systematic approach. Effective use of informatics to enhance safety requires the establishment and use of standards for concept definitions and for data exchange, development of acceptable models for knowledge representation, incentives for adoption of electronic health records, support for adverse event detection and reporting, and greater investment in research at the intersection of informatics and patient safety. Leading organizations have demonstrated that health care informatics approaches can improve safety. Nevertheless, significant obstacles today limit optimal application of health informatics to safety within most provider environments. The authors offer a series of recommendations for addressing these challenges.This position paper focuses on next steps in using health informatics to improve patient safety. The paper does not attempt to provide a comprehensive review of patient safety-related technical accomplishments, because recent Institute of Medicine (IOM) reports have done so. This paper focuses instead on current pressing issues and opportunities for addressing them in the short-term future. The intended audience includes provider organizations responsible for the safe delivery of health care; policy makers responsible for funding and regulatory decisions that influence health care safety, and the health informatics developers community (including vendors) who build the computer systems that support patient care.     

An informatics agenda for public health: summarized recommendations from the 2011 AMIA PHI Conference

The AMIA Public Health Informatics 2011 Conference brought together members of the public health and health informatics communities to revisit the national agenda developed at the AMIA Spring Congress in 2001, assess the progress that has been made in the past decade, and develop recommendations to further guide the field. Participants met in five discussion tracks: technical framework; research and evaluation; ethics; education, professional training, and workforce development; and sustainability. Participants identified 62 recommendations, which clustered into three key themes related to the need to (1) enhance communication and information sharing within the public health informatics community, (2) improve the consistency of public health informatics through common public health terminologies, rigorous evaluation methodologies, and competency-based training, and (3) promote effective coordination and leadership that will champion and drive the field forward. The agenda and recommendations from the meeting will be disseminated and discussed throughout the public health and informatics communities. Both communities stand to gain much by working together to use these recommendations to further advance the application of information technology to improve health.     

医疗服务向健康服务转型背景下的我国健康信息学研究

阐述医疗服务向健康服务转型的涵义及具体表现,简要分析医学信息学和健康信息学内涵、关系、研究现状,探讨面向健康中国建设目标的我国健康信息学学科建设目标、要求、发展路径等,为健康信息学学科建设与发展提供参考。     

Informatics,evidence-based care,and research; implications for national policy: a report of an American Medical Informatics Association health policy conference

There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health Policy Conference was convened to focus and propel discussions about informatics-enabled evidence-based care, clinical research, and knowledge management. Conference participants explored the potential of informatics tools and technologies to improve the evidence base on which providers and patients can draw to diagnose and treat health problems. The paper presents a model of an evidence continuum that is dynamic, collaborative, and powered by health informatics technologies. The conference''s findings are described, and recommendations on terminology harmonization, facilitation of the evidence continuum in a “wired” world, development and dissemination of clinical practice guidelines and other knowledge support strategies, and the role of diverse stakeholders in the generation and adoption of evidence are presented.     

Sociotechnical challenges to developing technologies for patient access to health information exchange data

Background

Providing patients with access to their medical data is widely expected to help educate and empower them to manage their own health. Health information exchange (HIE) infrastructures could potentially help patients access records across multiple healthcare providers. We studied three HIE organizations as they developed portals to give consumers access to HIE data previously exchanged only among healthcare organizations.

Objective

To follow the development of new consumer portal technologies, and to identify barriers and facilitators to patient access to HIE data.

Methods

Semistructured interviews of 15 key informants over a 2-year period spanning the development and early implementation of three new projects, coded according to a sociotechnical framework.

Results

As the organizations tried to develop functionality that fully served the needs of both providers and patients, plans were altered by technical barriers (primarily related to data standardization) and cultural and legal issues surrounding data access. Organizational changes also played an important role in altering project plans. In all three cases, patient access to data was significantly scaled back from initial plans.

Conclusions

This prospective study revealed how sociotechnical factors previously identified as important in health information technology success and failure helped to shape the evolution of three novel consumer informatics projects. Barriers to providing patients with seamless access to their HIE data were multifactorial. Remedies will have to address technical, organizational, cultural, and other factors.     

中美公共卫生信息学教育比较及对策

概述公共卫生信息学的内涵与特点,分别介绍中美公共卫生信息学教育及学科建设现状并进行比较,分析我国公共卫生信息学教育和学科发展在学科体系建设、人才培养教育模式等方面面临的挑战并提出发展对策。     

重庆市基本公共卫生服务项目绩效考核指标体系实证研究

  目的  对2017年度全市40个区(县)的国家基本公共卫生服务项目实施评估,使重庆市国家公共卫生服务项目实施与管理更加规范,并讨论绩效考核指标体系的优缺点。  方法  将重庆市40个区(县)根据区域经济发展水平分为主城区、近郊区、渝东北和渝东南,共4个区域,应用更适合重庆实际情况的基本公共卫生服务绩效考核指标体系(即组织管理、资金管理、项目执行、项目效果、家庭医生签约服务,共5个1级指标)对全市2017年度的基本公共卫生服务项目于2017年12月份进行现场考核,不同区域之间的考核结果进行差异性分析。  结果  考核指标除组织管理、资金管理外,总分、项目执行、项目效果和家庭医生签约服务在4个不同经济区域比较差异有统计学意义(均P < 0.05),主城区各项指标得分(组织管理6.23分、资金管理4.76分、项目执行69.35分、项目效果8.99分、家庭医生签约服务2.07分)都处于全市前列,渝东南经济发展区各项得分(组织管理6.07分、资金管理4.48分、项目执行60.94分、项目效果8.42分、家庭医生签约服务2.04分)处于末位;项目效果考核指标在各区县得分普遍偏低。  结论  通过考核评价,重庆市基本公共卫生服务区域间差距明显,基本公共卫生服务均等化仍需提高;重庆市基本公共卫生服务质量不高,效果不佳;新指标体系弥补了对重庆市基本公共卫生服务绩效考核面不全、指标简单不够量化等不足。      

Three Decades of Research on Computer Applications in Health Care: Medical Informatics Support at the Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality and its predecessor organizations—collectively referred to here as AHRQ—have a productive history of funding research and development in the field of medical informatics, with grant investments since 1968 totaling $107 million. Many computerized interventions that are commonplace today, such as drug interaction alerts, had their genesis in early AHRQ initiatives.This review provides a historical perspective on AHRQ investment in medical informatics research. It shows that grants provided by AHRQ resulted in achievements that include advancing automation in the clinical laboratory and radiology, assisting in technology development (computer languages, software, and hardware), evaluating the effectiveness of computer-based medical information systems, facilitating the evolution of computer-aided decision making, promoting computer-initiated quality assurance programs, backing the formation and application of comprehensive data banks, enhancing the management of specific conditions such as HIV infection, and supporting health data coding and standards initiatives.Other federal agencies and private organizations have also supported research in medical informatics, some earlier and to a greater degree than AHRQ. The results and relative roles of these related efforts are beyond the scope of this review.Three decades ago, when the federal government''s National Center for Health Services Research and Development began to support research on computer applications in health care, few imagined the impact that information systems and sciences would have on medical care today. For most, the idea of a national clearinghouse of guidelines, available through a computer that sits on a home office desktop, seemed like science fiction. For a few researchers and those supporting their work, however, visions of what could become possible in the management of health care information called for development of computerized systems and the evaluation of their effects on quality, cost, and access to care.The Agency for Healthcare Research and Quality (AHRQ, from 1999) and its predecessor agencies—the National Center for Health Services Research and Development (beginning in 1968) and the Agency for Health Care Policy and Research (from 1989 to 1999)—have a rich history of funding research, development, and evaluation in medical informatics. Although the grant investments since 1968 total only $107 million ($246 million in 2000 dollars), they supported initiatives that have established a research framework for many of the computer applications now being used today.The focus of AHRQ''s early research funding in medical informatics was on acquiring patient care data and communicating patient care management information. The goal was not only to improve the quality of care, but also to achieve reductions in costs and medical personnel resource use by processing data more efficiently. Research aimed at improving communication of information was targeted at what we would call today “getting the right information to the right place at the right time.” The promise of this research was its ability to provide findings that would guide reorganization of care delivery, take advantage of the more rapid communication of necessary information, and reduce manpower needs.¹ Over time, AHRQ''s funding has emphasized the application of health services research methods to evaluations of information technology used in community health settings. This article highlights key accomplishments emerging from AHRQ''s funding that have improved the quality of patient care in studied sites and have the potential to improve health care in all settings.Other federal agencies (such as the National Library of Medicine, the Veterans Health Administration, and the Department of Defense) and private organizations (such as The John A. Hartford Foundation, The Robert Wood Johnson Foundation, and the American Hospital Association) have supported developments in medical informatics, with some having greater research expenditures and earlier histories than AHRQ. Nevertheless, it is the Agency''s contributions to medical informatics that are the focus of this study. The purpose of this article is to provide a historical perspective for understanding the benefits of past research funded by AHRQ that supports health care applications of information technology today and that foreshadows AHRQ''s medical informatics initiatives for the future.     

重庆市专科层次临床医学专业培养现状分析及对策研究

目的分析重庆市专科层次临床医学专业的培养现状,提出适应我市城乡社区卫生发展的人才培养新思路。方法分别对我市12个社区卫生服务机构、42名新进社区全科医师和50名应届专科层次临床医学专业毕业生进行问卷调查,小组访谈上述机构负责人。结果全科医师是社区医疗战线上的主要力量。近三年新进医师重医轻防,缺乏基本公共卫生相关知识和技能,临床基本诊疗水平和沟通能力也有待提高。54.55%的临床医学专业毕业生不愿意选择社区工作。结论社区卫生服务机构对全科医师的需求量较大,现有专科层次临床医学专业培养不适应我市社区卫生服务的发展,建立和推行以社区为基础的教育结合问题为基础的学习三年制临床医学专业(全科医学方向)的培养模式迫在眉睫。