公立医院法人治理视域下的会计治理作用探讨

坚持公立医院的公益性和非营利性,构建现代公立医院的法人治理结构,积极发挥会计治理在信息披露和监管中的作用,致力于在医疗服务信息不对称的条件下,有效提升公立医院服务质量和效率,真正实现公益目标是推动"新医改"顺利进行的保证。依据这一原则,文章对构建现代公立医院法人治理结构并发挥会计治理作用的原则和问题进行了分析,并提出了对策建议。     

健康共治与健康城市建设展望

本文从城市、健康和建设三个关键词,一方面强调了必须要以系统论的思维来理解城市,以人群健康的方法论去关注在同一城市里不同人群的健康差距和健康公平性,以及同一人群中健康指标或疾病分布的连续谱;另一方面建议要建立"参与式"的健康城市治理的新模式——健康共治,来推进健康城市的建设。最后还介绍了Hancock教授2019年在新西兰召开的IUHPE第23届世界际健康促进大会提出的"健康城市2.0-朝着一个星球的城市"的内容。     

Has the clinical governance development agenda stalled? Perceptions of New Zealand medical professionals in 2012 and 2017

Clinical governance is a key policy and organisational foundation for health care quality improvement. This study sought to measure progress with clinical governance development from the perspective of practicing medical professionals in the New Zealand public health system. A short fixed-response survey, with questions derived from a government policy statement, was sent in 2012 and 2017 to all registered medical professionals in ongoing employment in New Zealand’s public health system. Respondents, therefore, worked across New Zealand’s 20 District Health Boards (DHBs), which own and manage public hospital and health care services. The survey sought to gauge medical professionals’ perspectives around performance on, and implementation of, key clinical governance components. The overall performance in clinical governance development declined or stalled between the two survey periods across eight out of 10 key survey questions. There were improvements on two questions relating to respondent familiarity with clinical governance concepts, and to management support for clinical leadership development, but no change in areas such as having a structure to support clinical governance, or working in partnership with management. Limited government and DHB policy attention to clinical governance may well have contributed to stalled development across the New Zealand health system. If so, this finding has lessons for other countries and health systems in which there has been varying government support for the clinical governance agenda with ramifications around expectations for clinical leadership on, and involvement in, quality improvement.     

Do we practice evidence based medicine with regard to drain usage in knee arthroplasty? Results of a questionnaire of BASK members

Clinical governance requires our clinical practice to be evidence based. We wished to see if British Orthopaedic surgeons are using the current evidence with regards to the use of drains in knee arthroplasty. A questionnaire was faxed to all UK members of BASK to ascertain their current practice regarding the use of drains in knee arthroplasty and the rationale for their drain policy. The study suggests that the majority of practising members of BASK do not practice evidence based medicine with regard to the use of drains in knee arthroplasty.     

The AREST CF experience in biobanking — More than just tissues,tubes and time

Research to further improve outcomes for people with CF is dependent upon well characterised, archived and accessible clinical specimens. The recent article by Beekman et al. published in Journal of Cystic Fibrosis summarised a scientific meeting at the 13th ECFS Basic Science Conference. This meeting discussed how well-annotated, clinical biobanks for CF could be established in Europe to meet the needs of therapeutic development. The Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) has conducted biobanking of CF research and clinical specimens since the late 1990s and is custodian of the most comprehensive paediatric CF biobank in the world that focuses on the first years of life. This short communication will describe the approach undertaken by AREST CF in establishing a clinical specimen biobank.     

Mapping the Zambian prison health system: An analysis of key structural determinants

Health and health service access in Zambian prisons are in a state of ‘chronic emergency’. This study aimed to identify major structural barriers to strengthening the prison health systems. A case-based analysis drew on key informant interviews (n?=?7), memos generated during workshops (n?=?4) document review and investigator experience. Structural determinants were defined as national or macro-level contextual and material factors directly or indirectly influencing prison health services. The analysis revealed that despite an favourable legal framework, four major and intersecting structural factors undermined the Zambian prison health system. Lack of health financing was a central and underlying challenge. Weak health governance due to an undermanned prisons health directorate impeded planning, inter-sectoral coordination, and recruitment and retention of human resources for health. Outdated prison infrastructure simultaneously contributed to high rates of preventable disease related to overcrowding and lack of basic hygiene. These findings flag the need for policy and administrative reform to establish strong mechanisms for domestic prison health financing and enable proactive prison health governance, planning and coordination.     

医疗卫生治理与行业组织关系的国际经验与启示

医疗卫生领域存在着明显的“政府失灵”和“市场失灵”。在我国推进社会治理体系创新的过程中,理顺行业组织与医疗卫生治理体系间的关系显得十分重要。介绍了相关理论基础和借鉴国际经验及政府与行业组织在医疗卫生治理体系中政府与行业组织的互动合作关系,以期为我国构建和完善多元化医疗卫生治理体系,促进医疗卫生行业组织发展提供参考。     

公立医院财务治理绩效评价体系的指标权重研究

在公立医院财务治理绩效评价体系中,指标权重具有非常重要的导向作用。本文在前期研究的基础上,综合采用层次分析法和德尔菲法确定了指标权重。权重最大的指标为非营利性(0.25),其次为财务责任、资产绩效、财务绩效与风险,三个指标权重均为0.18,权重最低的指标为社会满意,仅为0.06。最后对指标权重的导向和指标体系的实际应用进行了延伸解释,以期能够发挥评价体系的绩效导向作用。     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。