医院药品DDD数排序分析的原理及利用

本文较全面地介绍了ＷＨＯ推荐使用的以ＤＤＤ数为指标的药物利用研究方法，对该方法的基本原理和具体方法作了深入的说明，在此基础上，利用ＤＤＤ数分析方法对１９９２～１９９４年军队１０家综合性医院的药品消耗进行了统计分析，在分析中本研究尝试使用＂日用药金额＂作药品费用高低的尺度，并进一步提出了用＂相同治疗类别药品日用药金额参考值＂（日用药金额）来考察某类药品的用药费用的社会平均水平。     

Automatic Implantable Cardioverter Defibrillator: Cost Effectiveness

Unexpected out-of-hospital cardiac arrest is in most cases due to ventricular fibrillation or rapid ventricular tachycardia. The usual therapeutic strategy in survivors starts with drug treatment, in case of failure followed by nonpharmacological therapy, which may include catheter ablation, ablative surgery, and finally defibrillator implantation. In most cases, this strategy is long lasting and very expensive. Implantation of a defibrillator as a first choice therapy may be cost effective, especially if the probability of successful drug treatment is low. However, cost-effective aspects have been studied only retrospectively and in models. In 1989 we started a prospective cost-effectiveness analysis of implantation of the automatic implantable cardioverter defibrillator (AICD) as first choice therapy ("early" AICD implantation) in successfully resuscitated postinfarct patients. Evaluation is being done in a randomized way with one group having early AICD implantation and the other group following the usual conventional therapeutic strategy. We compare medical, economic, and quality-of-life aspects. As of June 1992, 46 patients have entered the study. Totally 60 patients will be included. Results are expected in 1993 and will be expressed as cost effectiveness ratios in both study arms.     

Encouraging fruit consumption in primary schoolchildren: a pilot study in North Wales, UK

OBJECTIVE: To explore the feasibility and cost of promoting fruit consumption among primary schoolchildren across Anglesey, a region in North Wales, UK. DESIGN, SETTING AND SUBJECTS: A postal survey of the head teachers of all 51 primary schools across Anglesey to ascertain their attitudes to promoting fruit consumption and current initiatives in place was conducted. This was followed by a 1-week pilot study in a single primary school to assess parents' support and willingness to bear or share costs, to determine children's fruit preferences, and to calculate fruit waste. Finally, the cost to local government of providing a piece of fruit to each primary schoolchild daily was calculated. RESULTS: A 53% response rate was obtained in the postal survey of primary school head teachers. All respondents expressed an interest in participating in future fruit promotion programmes. Of 27 primary schools, 26 that responded (96.3%) had programmes in place in which 18 had adopted specific food policies. In the pilot study at the single Anglesey primary school, a response rate of 97% from parents who expressed support for fruit promotion in school was obtained. Parents expressed their willingness to pay at least 15 pence per day towards fruit provision at break time for their children if such a service was not provided by local government. If local government was to invest in this initiative, the total cost of providing one piece of fruit per day to all primary school children in Anglesey would be 211,000 pounds per annum (2004 prices; 19 pence per child per day). CONCLUSION: This pilot study shows support by teachers and parents for initiatives to encourage primary schoolchildren to eat more fruit. Waste can be minimized by choosing fruit that children prefer, in this study, grapes, apples and oranges. The decision as to whether local government or parents are asked to pay for fruit provision is political, depending on local socioeconomic circumstances, local government priorities, national education and nutrition policies.     

中山市登革热预防控制的经济效益分析

目的：通过对中山市登革热预防控制进行经济效益分析，为政府建立登革热预防控制和应急机制的常规经济投入及其效益评价提供科学依据。方法：用流行病学方法对中山市登革热预防控制情况进行调查。用比较分析法对登革热预防控制进行经济效益分析。结果：采取常规措施共投入225390元；发生登革热疫情后，共投入疫情调查处理费212197元；病人的总诊疗费用为86770．9元，平均每例为3099．O元；病人及其家属消耗误工费用为15050元，平均每例为537．5元；中山市登革热预防控制费用效益比率为1：5．7。结论：查出中山市登革热预防和控制费用以及登革热预防控制的经济效益；证明该市实施的登革热预防控制策略取得了良好的经济效益。     

血吸虫病查治费用投入有效性评价模型

本文分析了普治、筛治和组合3种常用血防查治方案费用的效应部份和非效应部份的主要构成因素,并建立了以数学模型表达的评价指标.结果显示:普治方案费用效应的决定因素为人群感染率;筛治方案则以人群感染率和治查费用比为主,其次查病方法的敏感性和特异性亦能产生影响;组合方案的费用效应由分别符合前二者之基本规律的两部份构成.作者认为对查治方案的选择必须兼顾方案的防治效果、可供的查治能量大小和费用使用的合理性等诸个方面.     

浅谈医院成本核算管理的现状及建议

成本核算是医院经济管理的基础,核算工作的质量直接影响医院成本管理的成效.本文在分析医院成本核算现状的基础上,对医疗成本核算在医院管理中的重点问题及医院成本核算管理的改革思路进行了探讨.     

L''évaluation du coût des complications peut-elle contribuer à la poursuite du développement de la radiothérapie ?

At the present time, the current improvement of technical and dosimetric aspects of radiation oncology has to be evaluated in terms of potential benefit for the patient and the society. For this last point of view, specially designed economic analyses must be performed in order to justify the number of resources involved by these technical improvements. If the question is how the current technical procedures could reduce the risk of undesirable side-effects, the response cannot be immediately drawn from the literature. This paper emphasizes the possibility to evaluate the role of side-effects as endpoints of economic analyses when using special models in medical decision making such as Markov's. Only few oncologic situations are reliable to properly analyze the relationship between sophisticated radiation techniques and the incidence of post-radiation complications. These situations should be selected when prospective economic analyses are planned in the field of radiation therapy.     

妇幼卫生服务项目成本测算探讨

采用成本法，以福建省和黑龙江省为现场，测算2001年妇幼保健机构妇幼卫生服务项目实际消耗，并对测算结果进行分析讨论。得出重医疗、轻保健的现状导致了妇幼卫生服务工作数量和质量的下降，妇幼保健服务与人群健康水平提高的关系等，并提出保持妇幼保健机构的独立性，调整卫生资源配置方向等建议和意见。