基于岗位管理的基层医院专科护士使用及考核的现状调查研究

目的调查四川省基层医院专科护士使用和考核现状,对其使用和考核体系进行探索。方法于2017年9月7-15日,采用问卷调查法对四川省38所二级及三级乙等医疗单位专科护士的使用和发展现状进行调查。结果共有38所医院参与网络问卷调查,其中34.21%的医院未针对专科护士设置岗位,岗位职责不清晰。有73.68%的专科护士未进行资质再认证,60.53%的专科护士学成后未进行专科资质再考核。结论我国对专科护士能力的评价认证体系尚未形成统一标准,对专科护士的培养条件也未形成统一标准。护士岗位管理中设置专科护士岗位能促进专科护士的职业发展规划,有利于专科护士使用和考核。     

Are hospitals prepared to support newborn survival? – an evaluation of eight first‐referral level hospitals in Kenya*

Objective To assess the availability of resources that support the provision of basic neonatal care in eight first‐referral level (district) hospitals in Kenya. Methods We selected two hospitals each from four of Kenya’s eight provinces with the aim of representing the diversity of this part of the health system in Kenya. We created a checklist of 53 indicator items necessary for providing essential basic care to newborns and assessed their availability at each of the eight hospitals by direct observation, and then compared our observations with the opinions of health workers providing care to newborns on recent availability for some items, using a self‐administered structured questionnaire. Results The hospitals surveyed were often unable to maintain a safe hygienic environment for patients and health care workers; staffing was insufficient and sometimes poorly organised to support the provision of care; some key equipment, laboratory tests, drugs and consumables were not available while patient management guidelines were missing in all sites. Conclusion Hospitals appear relatively poorly prepared to fill their proposed role in ensuring newborn survival. More effective interventions are needed to improve them to meet the special needs of this at‐risk group.     

医院综合效益评价案例分析

运用层次分析法建立了医院综合效益评价指标体系，开发了医院综合效益九型评价图，用于显著评价结果。在此基础上进行了３个案例的评价分析。论述了通过对西南地区２７所医院综合效益４年多的追踪分析所发现的共性问题，并提出了相应的管理对策。     

Lucian Leape on Patient Safety in U.S. Hospitals

PURPOSE: To describe and discuss the status of patient safety in U.S. hospitals. METHODS: Personal interview. This report is part of a series of discussions with a leading expert on patient safety. FINDINGS AND CONCLUSIONS: Some improvements have been made in the past 10 years. But changes have not been adequate. Continuing barriers include the punitive environment in hospitals, physicians' denial of the scope of the problem, lack of national leadership, and lack of systems thinking.     

三级医院病人就诊流向探讨

研究通过对包括专科医院在内的多家三级医院住院病人资料的分析，将疾病种类按ICD－9编码分为19类，研究各类疾病应往低级别医院分流的比例。结果表明：各大类疾病的分流比例不同，分流比例较高的主要是常见病和多发病，总的分流比大约在60％左右。     

Managing retrenchment in French public hospitals: philosophical and regulatory constraints.

The French hospital system is experiencing economic stresses similar to those experienced by US hospitals. Pressures for cost containment have occurred due to changes in health care funding. The public hospital system is facing unprecedented severe retrenchment. Innovative strategies for managing retrenchment have been restricted by regulatory and philosophical constraints. What is needed is to provide more autonomy for individual hospital managers together with greater accountability for achievement of results.     

Assessment of costs to donor hospitals for organ transplantation

In 1987, die Department of Health in the UK set up a working party to identify reasons contributing to a shortfall in donor organs. One recommendation was reimbursement to the District Health Authorities for costs incurred in providing the donor organs. The figure chosen was not to be seen as an incentive to donate organs, merely as an appropriate compensation for the costs incurred. There would be no direct payment to doctors, trustees or relatives of the donor. With the development of the competitive health care environment in the United Kingdom, the reimbursement of donating hospital costs is being considered with these data.     

Revisiting the Relationship between Managed Care and Hospital Consolidation

Objective. This paper analyzes whether the rise in managed care during the 1990s caused the increase in hospital concentration.
Data Sources. We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000.
Study Design. We employ linear regression analyses on long differenced data to estimate the impact of managed care penetration on hospital consolidation. Instrumental variable analogs of these regressions are also analyzed to control for potential endogeneity.
Data Collection. All data are from secondary sources merged at the level of the Health Care Services Area.
Principle Findings. In 1990, the mean population-weighted hospital Herfindahl–Hirschman index (HHI) in a Health Services Area was .19. By 2000, the HHI had risen to .26. Most of this increase in hospital concentration is due to hospital consolidation. Over the same time frame HMO penetration increased three fold. However, our regression analysis strongly implies that the rise of managed care did not cause the hospital consolidation wave. This finding is robust to a number of different specifications.     

中澳咸阳农村卫生综合项目乡镇卫生院院长管理培训效果调查

目的：评估中澳农村卫生综合项目乡镇卫生院院长管理知识培训效果。方法：采用问卷调查、焦点组访谈、个人深入访谈、现场走访等方法进行现况调查。结果：多数卫生院院长在管理基础知识的收获、分析问题的能力、观念的转变、管理行为的改变、员工士气的提高、卫生服务的改善方面都有所提高；被调查的三所中心乡卫生院的所有职工都认为所在卫生院近半年来的工作总体上有所改进；病人及周围居民对三所卫生院的总体满意度都在55％以上。结论：乡镇卫生院管理培训效果良好。