预备役医院转化医学技术创新体系建设思考

新军事变革引领了卫勤保障模式的变革,促成了预备役医院的建设。转化医学以其“从基础到临床、从创新到实践、从研究到应用”的独特作用,切合了预备役医院“立足市场、面向战场”从理念到实践、从局部到整体、从要素到体系的方方面面和时空的全维需求。技术创新是转化医学的核心,也是满足Et益增长的战时卫勤保障需求的根本途径。因此,大力加强转化医学技术创新体系建设,不仅为预备役医院平时建设指明新方向、注入新活力,更是实现平战快速转换、高效发挥医学救援能力的重要保证。     

山东省县级中医院中医医疗服务效率评价

目的:对山东省县级中医院的中医医疗服务效率进行评价,为合理配置基层中医发展资源提供决策和参考.方法:典型指标的筛选使用主成分分析方法,使用DEA数据包络方法分析县级中医院的中医医疗服务效率.结果:从总体上看,综合效率有效的县级中医院为40所,综合效率平均值为78.22％.纯技术效率有效的县级医院为54所,纯技术效率平均值为83.64％.规模效率递增的为16所,规模效率不变的有40所医院,规模效率递减的为45所医院.从规模上看,效率有效比例和纯技术效率有效比例最高的均为中小规模,而比例最低的均为大规模组.对非DEA有效县级中医院的投入产出的投影分析,非总体有效决策单元在所有投入指标均有不同程度的过剩与浪费.结论:控制县级中医院规模,强化中医药服务项目的财政补助,控制非中医特色医疗设备的配置.     

公立医院公益性评价研究——以海口市公立医院为例

目的:了解海口市公立医院门诊病人满意度现状,分析影响门诊病人满意度的因素,为改善医疗服务提供决策依据.方法:2011年对海口市16家公立医院已就诊过的门诊病人2 122人采用随机方式进行问卷调查,对调查结果进行频数分析,采用秩和检验(卡方分析)对各类型人员各问项的满意度对比分析.结果:78％的人对总的医疗服务质量满意,就医费用、检查、化验费用、药品费用对总体满意度的影响最大.对策:转变服务理念,一切工作以病人为中心;提供便民服务;建立费用动态监测机制,控制医疗费用.     

广东省公立医院财政项目支出绩效评价指标体系构建研究

财政项目支出的绩效评价问题逐步受到关注,目前没有对公立医院的行为建立一个指导性的指标体系.作为公立医院过程管理的控制手段,在对国内外相关文献进行回顾的基础上,结合经济学、会计学和公共管理学等相关理论,设计并形成公立医院绩效评价指标体系,为当前医院管理者及医院绩效评价工作者提供借鉴和参考.     

2011年安徽省二、三级医院医疗资源配置分析

目的了解安徽省二、三级医院医疗资源现状。方法采用普查方法,调查安徽省二、三级公立综合性医院和中医医院的医疗资源的分布。结果在所调查的131家安徽省二、三级公立综合性医院和中医医院中,16家三级综合性医院有医生6133名,护士8527名,床位数14599张,医护比为1：1．39;63家二级综合性医院有医生9749名,护士14725名,床位数26010张,医护比为1：1．51;4家三级中医医院有医生I135名,护士1086名,床位数2427张,医护比为1：0．96;48家二级中医医院有医生3539名,护士3954名,床位数8045张,医护比为1;1．12。结论安徽省公立医院的医生、护士以及床位等医疗资源多集中在三级综合性医院。同卫生部规定标准相比,公立医院医护比偏低,护理人员配置不足。建议应结合实际情况在各级医院间合理配置各种医疗资源,并增加护理人员数量,使之与全省医疗保健需求相适应。     

民营医院发展的现状与问题：以广东省东莞市为例

促进民营医院发展是我国目前医改的重要内容,本研究通过总结东莞市民营医院的发展经验,以期为我国民营医院发展提供借鉴。东莞市政府通过合理规划、严格管理和公正对待等一系列措施支持民营医院发展。目前,东莞市民营医院的床位数、服务量和技术力量在地区医疗服务市场占据重要地位;但其发展还面临一些问题,如政府政策的某些偏颇、人才结构不合理、中小型医院管理不规范;建议政府进一步落实相关政策,民营医院加强自身人才建设和内部管理,通过政府和民营医院共同努力加强行业自律管理,使民营医院获取社会的认同。     

Evaluation of reprocessing medical devices in 14 German regional hospitals and at 27 medical practitioners‘ offices within the European context – consequences for European harmonization

Safe reprocessing of medical devices through cleaning, disinfection, and sterilization is essential for the prevention of health care associated infections (HAI) and to guarantee patient safety. Several studies detected residual contamination and even severe infections of patients, despite carrying out reprocessing. To develop appropriate solutions, the existing situation in Germany and selected European countries was analyzed. Additionally, in 27 medical practitioners’ offices and 14 hospitals, the true practice of reprocessing was analyzed using a questionnaire, a checklist, and inspection on site. A structured analysis of potential alternatives to the internal reprocessing was conducted within the German and European context. The results indicate that the conditions for the execution of the reprocessing process in the analyzed health facilities in southern Hesse (Germany) do not satisfy legal requirements. The detected deficiencies were consistent with other reports from Germany and Europe. The analysis gave insight into several reasons for the detected deficiencies. The three main reasons were the high costs for proper implementation, the subjective value assigned to the reprocessing unit in health care facilities, and deficits in monitoring by the health authority. Throughout the European Union, a similar regulatory framework for the performance of the reprocessing process exists, while the environment, structures of the health systems and administrative supervision vary significantly. The German states as well as selected European countries are currently discussing the challenges of increased quality-assured execution of the reprocessing process. For instance, the same supervisory system for hospitals and medical practitioners should be established at an equal standard. Alternatives such as the use of single-use medical devices, outsourcing the decontamination processes, or the cooperation of health facilities may be considered. This paper also discusses economic and ecological aspects. Finally, different options are recommended to ensure the exclusive use of reliable medical devices for surgical procedures that guarantee an adequate standard of patient safety within economic constraints.     

哈尔滨市中医药进社区现状分析与对策研究

调查哈尔滨市南岗区、道里区、道外区、香坊区和平房区现有120个社区医院或社区卫生服务中心,分析中医药进社区现状,提出存在的问题及相应对策。     

Application of Theory to Family-Centered Care: A Role for Social Workers

Family-centered care is an emerging trend in health care settings today. An explanation, principles, and a definition of family-centered care are offered and discussed. A theoretical framework, Balance Theory of Coordination, which can be utilized by social workers to develop and enhance family-centered care practices, is explained and discussed. Various family-centered care practices are examined within the context of Balance Theory of Coordination as examples.     

芜湖市公立医院综合目标绩效考核的实践与思考

介绍芜湖市公立医院综合目标绩效考核的做法.公立医院应建立健全以突出公益性为核心内容的绩效考核体系,真实反映管理业绩和工作实效,构建激励约束机制,促进公立医院加强管理、提高质量、控制费用,为群众提供安全、有效、方便、价廉的医疗卫生服务.