What should be given a priority – costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel

Background  In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care-related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established.
Goals  To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services.
Method  One hundred thirty-two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health.
Outcomes  Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system's monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism.
Conclusion  Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues.     

心理评估技术在社区心理咨询中的应用

目的介绍心理评估在心理咨询中的应用。方法详细介绍了心理评估的方法及评价。结果显示了心理评估在心理咨询中的重要作用。结论心理评估技术的应用具有现实意义。     

The influence of audiotapes on patient participation in the cancer consultation

This study examined the effect of providing patients with an audiotape of a previous consultation on their level of participation during a subsequent consultation. 117 newly referred medical oncology patients randomised to receive a tape (n = 63) or not (n = 54) had two linked consultations which were both audiotaped. A content analysis revealed no significant differences between tape and control group in the mean number of questions asked during the second consultation. However, significantly more tape group patients (77%) asked for clarification of at least one piece of information compared to the control group (57%) (P = 0.04). A larger number of control group patients (61%) made at least one request for facts already provided in their first consultation compared to tape group patients (39%) (P = 0.05). Audiotapes appear to facilitate patients' requests for the clarification of previously given information and permit the re-absorption of complex information given when patients may have been too distressed for it to be assimilated.     

Emergency Department Services for Patients with Alcohol Problems: Research Directions

This report summarizes recommendations on research directions developed from the conference "Alcohol Problems among Emergency Department Patients: Research on Identification and Intervention." The conference was developed in order to evaluate the existing state of the art research on emergency department interventions for alcohol problems, and offer further recommendations for research.     

我院400例门诊药物咨询分析

目的：分析我院门诊药房用药咨询情况，促进医院药学服务全方位开展。方法：收集、整理我院2006～2007年400例门诊药物咨询资料进行比较分析。结果：咨询人群有医生、护士、患者，以患者居多，占80．5％。咨询内容较广泛，用法用量23．00％，不良反应21．25％，相互作用8．25％，药物适应证15．00％。结论：开展药物咨询体现了“以病人为中心”的理念，是临床药学开展的重要内容。     

远程影像诊疗中心建设及远程会诊流程的设计

山东省以省立医院为依托，建立覆盖全省91家县级医院的疑难病人远程会诊、医学影像会诊、远程医学继续教育，进而实现远程病理会诊、远程手术指导、手术观摩、远程手术点播等医学研究和教学功能。积极搭建共享医疗信息资源的桥梁。     

中毒抢救指南电子咨询系统的开发研究

目的探索中毒抢救指南电子咨询的更完美方式。方法应用Delphi 7.0和SQL建立数据库,通过数据库语言来封装知识库,编译成可执行文件。结果提供了方便快捷和近乎完美的电子咨询服务。结论中毒抢救指南电子咨询系统有助于临床解决疑难问题,是医务人员的良师益友。     

艾滋病患者和HIV感染者的卫生服务利用现状研究

目的:掌握艾滋病(AIDS)患者和人类免疫缺陷病毒(HIV)感染者的门诊量和住院量以及在各级医疗机构的分布,为开展 AIDS 医疗救治提供基础资料一方法:采用访谈法调查 AIDS 患者和 HIV 感染者的门诊量和住院量以及他们在各级医疗机构的分布,进行非 HIV 感染者和 AIDS 患者对照,分析 AIDS 患者和 HIV 感染者的卫生服务利用特征。结果:AIDS 患者、HIV 感染者和健康时照的3个月的就诊次数分别为23.672次、13.549次和2.724次,AIDS 患者和 HIV 感染者高于健康对照(X~2=925.526,P<0.000);AIDS 患者、HIV 感染者和健康对照的3个月住院次数分别为0.593 095次、0.176119次和0.078027次,AIDS 患者和 HIV 感染者高于健康对照(X~2=43.716,P<0.000);AIDS患者、HIV感染者和健康对照在村卫生室就诊的比例分别为80.83%、82-31%和65.72%(X~2=786.425,P<0.000),在乡镇卫生院住院的比例分别是68.19%、84.75%和43.68%(X~2=38.720,P<0.000)。结论:AIDS 患者和 HIV 感染者的门诊和住院服务利用率均高于对照人群;门诊病人集中在村级医疗机构,住院病人集中在乡镇卫生院。病人分布与对照人群存在较大差异。     

WEB双向DICOM传输在远程会诊中的应用

本文探讨DICOM格式的PACS图像在WEB上的远程传输应用，提出一种基于医生间的B／S构架远程双向会诊模式，并就与远程会诊相关的HIS与PACS的HL7后台关联技术、远程SSLVPN技术、无线网络应用技术、图像无损压缩、多点会诊应用以及虚拟网络隔离技术等做一阐述。WEB双向DICOM传输的应用，为医疗信息突破局域网限制、充分利用医疗资源，提供了一种新型技术方案。     

2000~2004年信阳市无偿献血者及血液筛查结果分析

目的了解信阳市无偿献血者及血液质量状况。方法对信阳市中心血站2000~2004年站内及流动采血车的无偿献血者及血液安全性指标的筛查结果进行统计分析。结果血液初、复检不合格淘汰率,除2001年与2002年、2003年与2004年比较无显著差异外,其它各年份之间两两比较均有显著差异(P<0.001);血液不合格淘汰率和因HBsAg、梅毒阳性淘汰率男女献血员之间有显著差异(P<0.001,P<0.05);登记的无偿献血者以18~25岁年龄人群为主,26~35岁年龄段血液不合格淘汰率最高,与其他年龄段比较均有显著差异(P<0.001)。结论加强健康教育及献血知识的宣传力度,对于改善血液质量具有重要的意义。