Prognostic differences in 8th edition TNM staging of esophagogastric adenocarcinoma after neoadjuvant treatment

Background

Prognostic differences between pTN- and ypTN-categories and the prognostic accuracy of the 8th edition UICC-pTNM- and AJCC-ypTNM-staging-system for esophageal and gastric adenocarcinoma are unclear.

基于云计算模式的省级区域协同医疗建设

基于当前医疗卫生行业存在资源分布不均衡,特别是基层优质医疗资源短缺等问题,介绍河南省区域协同医疗的建设目标、总体架构及建设内容,通过信息化技术手段规范医疗服务流程,推进区域医疗信息系统标准化建设和信息互联互通。     

多部门协作在病区备用药品持续质量改进管理中的应用

目的:探讨多部门协作在病区备用药品持续质量改进管理中的应用效果。方法:将2018年1-12月份病区备用药品管理设为对照组,实施各部门独立质控的常规管理方法;2019年1-12月份病区备用药品管理设为实验组,采用多部门协作联合质控管理的模式,明确各部门的职能、督查方法及考核机制等。对比两组病区药品质量相关要点问题的评价效果。结果:通过在病区备用药品持续质量改进管理中应用多部门协作模式,病区备用药在不同品名药品混放,备用药基数与实际不相符,麻、精类药品未落实双锁双人管理,大输液剩余量多、且有个别过期现象,用药缺陷等管理方面均取得较好效果,两组差异有统计学意义(P<0.05)。结论:通过采取病区备用药品多部门协作联合督查管理的模式,医院相关工作人员用药安全意识得到进一步提高,病区备用药管理更加规范,部门之间的沟通更加方便快捷,工作效力提升,能及时协助病区解决相关管理问题,医院住院患者的用药安全得到保障。     

Can governments push providers to collaborate? A comparison of hospital network reforms in France and the United States

France recently implemented a program to encourage greater collaboration among public hospitals, which represent about 65 percent of total capacity, by placing them into regional groupings known as Groupements Hospitalier Territoire (GHTs) and mandating that facilities within them share several core functions. The strategy echoes that of Accountable Care Organizations (ACOs) in the United States, which offer financial incentives to providers to form networks that foster collaboration. While the programs share an underlying strategy for improving care and reducing costs, the difference in approaches, mandatory versus voluntary, could significantly affect outcomes. We analyzed aspects of the programs that could lead to differences in their results. ACOs appear to have several advantages, as financial inducements have proven effective in shaping provider behavior in other contexts. GHTs may benefit from a more direct approach, but mandatory participation risks pushback. Regardless of whether the programs succeed in fostering effective care integration, they may accelerate provider consolidation, which could impair access in already underserved areas by concentrating resources in larger facilities and promoting the closure of smaller ones.     

医教协同视域下高职临床医学人才培养模式改革分析

随着我国教育事业的不断发展,人们对于人才的培养要求发生了变化,不仅需要其具备丰富的专业知识,同时还希望其能够具备一定的实践经验以及创造性思维.对于临床医学来说,深化医学职业教育改革、落实医教协同改革制度成为了当前医学人才培养的有效机制.临床医学作为我国医学教育体系中最重要的专业,其中不仅包含了大量专业医学知识,同时也对...     

家属协同护理对乳房切除患者伤口愈合及瘢痕美观性影响

分析家属协同护理对乳房切除患者伤口愈合及瘢痕美观性的影响。方法 选择2022年7月-2023年 9月于本院进行诊疗的60例乳房切除患者为研究对象,采用随机数字表法分成对照组和观察组,每组30例。 对照组实施围术期护理,观察组在对照组基础上增加家属协同护理,比较两组伤口愈合情况、瘢痕淡化情 况、焦虑及抑郁程度。结果 观察组甲级伤口愈合率高于对照组（P＜0.05）;观察组OSAS、PSAS评分低于 对照组（P ＜0.05）;观察组SAS、SDS评分低于对照组（P ＜0.05）。结论 对乳房切除患者实施家属协同 护理干预可优化伤口愈合程度,淡化伤口瘢痕,促进其心理状态好转。     

Collaboration between local public health and community mental health agencies

Public health agencies (PHA) and community mental health agencies (CMHA) generally are organizationally and functionally autonomous. Collaboration between PHA and CMHA was explored in a statewide survey of nursing directors of PHA (n = 135) and executive directors of CMHA (n = 214). Findings indicated staff did not know each other well; clients, funds, and information were infrequently exchanged; public health nurses rarely were included in planning for the care of those with mental illness; and satisfaction with relationships was minimal. Path analysis was used to test an interagency collaboration model. Awareness of staff from other agencies increased satisfaction with interagency processes and interagency relationships. © 1997 John Wiley & Sons, Inc. Res Nurs Health 20: 153–160, 1997     

基于政策工具的南京市医养结合政策文本分析

目的:分析医养结合政策文本内容的特征及不足,并在此基础上提出优化完善医养结合的政策建议。方法:本文以政策工具为视角,结合医养结合发展阶段、医养结合部门协同构建三维分析框架,对样本城市的37篇政策文本进行内容分析和定量分析。结果:研究发现,医养结合政策力度还存在相对不足。从政策工具维度看,政策工具使用失衡;部门协同维度发现部门之间缺乏明确的协同机制。结论:从完善配套政策、健全医养结合协同治理机制、均衡政策工具使用力度等角度提出政策建议。     

冠心病患者院间协作介入模式治疗初探

目的探讨冠心病患者院间协作介入治疗模式对患者的疗效费用等的影响。方法选择本院符合筛选条件的220例冠心病住院患者,去三级协作医院介入治疗,同时选择对方医院200例对照,比较两者之间的治疗效果、并发症及治疗费用等。结果院间协作治疗患者的治疗效果、并发症和三级医院治疗情况相似,而治疗费用明显降低。结论合理的院间协作模式提高了冠心病患者的介入治疗水平,同时提高了卫生资源的使用效率,是一条符合国情、行之有效的新途径。