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41.
甲状腺癌已成为北京市增长较快的恶性肿瘤。本文通过介绍1例由全科医生首诊、术后连续随访4年的分化型甲状腺癌患者的诊疗经过,采用临床案例教学方法,重点关注甲状腺结节良恶性的鉴别,全科医生接诊甲状腺结节患者的诊治流程及对甲状腺癌患者术后长期监测、健康管理的内容,引导患者规范诊治,以期为逐步实现甲状腺癌患者个体化、不同风险分层的高质量管理,提高在职全科医生、全科医学专业住院医师规范化培训的学员对甲状腺结节、分化型甲状腺癌患者的规范诊治水平,提供参考。 相似文献
42.
探讨岗位价值评估方法在医院人力资源的管理过程中的应用和意义。采用国际岗位价值评估系统(IPE)对A医院现有140个岗位进行岗位价值评估,并利用岗位评分对人力资源管理问题进行剖析。A医院岗位评估分数的总趋势和总分布结果显示,岗位评估分值曲线现呈较平滑的递减趋势,这表明A医院职能处室内部各类岗位的岗位价值不存在明显差异。从各个职能处室内部来看,内部岗位评价结果分布比较均匀,说明部门内部分工相对合理。岗位价值评价有助于增强医院薪酬分配的公平性,提高薪酬的激励性,也有利于优化医院管理制度,推动医院可持续发展。 相似文献
43.
《Research in social & administrative pharmacy》2020,16(6):766-775
BackgroundVariation describing pharmacists’ patient care services exist, and this variation contributes to the prevalent misunderstanding of pharmacists' roles. In contrast, standard phraseology is a critical practice among highly reliable organizations and a way to reduce variation and confusion.ObjectiveThis work aims to identify and define pharmacists’ patient care service terms to identify redundancies and opportunities for standardization.MethodsBetween May to August 2018, terms and definitions were searched via PubMed, Google Scholar and statements/policies of professional pharmacy organizations. Two references per term were sought to provide an “early definition” and a “contemporary definition.” Only literature published in English was included, and data gathered from each citation included the date published, the term's definition, and characterization of the reference's source as either a regulatory or professional body. A five-person expert panel used an iterative technique to revise and verify the list of included terms and subsequent literature review results. Terms were then searched in the National Library of Medicine's Medical Subject Heading Database (MeSH) in July, 2019.ResultsThere are fifteen commonly misunderstood terms that refer to the patient care services provided by pharmacists. The appearance of these terms in the literature spanned nearly five decades. Nearly half of terms appeared first in regulatory, law or policy documents; of these, two terms had contemporary definitions appearing in the professional literature that differed from their early regulatory definition. Three opportunities to improve standardization include: (1) Implementation of standardized phraseology systems similar to nursing's Clinical Care Classification System; (2) Academics' adherence to standardized MeSH terms; and (3) Clarification of pharmacy education accreditation standards.ConclusionNumerous terms are used to describe pharmacists' patient care services, with many definitions of terms overlapping in several key components. The profession has made concerted efforts to consolidate and standardize terminology in the past, but more opportunities exist. 相似文献
44.
Simran Khanijo Rohit Kumar Amol Narayan Patil Gomata Bhusal Gopal Vishwas 《Expert review of clinical pharmacology》2020,13(7):797-806
ABSTRACT
Background
With the goal of improving the affordability of medicines, governments across the globe have instituted various forms of price controls. Since 2013, India has been regulating the prices of drugs included in its national list of essential medicines (NLEM). Here we evaluate the cost variations among available cardiovascular drugs and perform cost-analysis comparing essential and non-essential drugs. 相似文献45.
ABSTRACTObjectives: The consequences of polypharmacy (intake of ≥ 5 drugs) are diverse, including drug interactions, rising costs and side effects. Risk groups for polypharmacy are multimorbid and chronically ill people, such as patients with multiple sclerosis (MS). MS is the most common neuroimmunological disease in young adults worldwide. We aimed to provide a systematic overview of the current research status regarding frequency and predictors of polypharmacy in MS patients.Methods: A systematic literature search in the databases PubMed, Cochrane Library and Scopus was carried out according to the PRISMA guidelines. English and German original research articles were included.Results: Seven studies fulfilled the inclusion criteria of this review, while the research objectives and methods were very heterogenous. The polypharmacy rates in these studies ranged from 15% to 59%. Polypharmacy correlated with comorbidities, increased disability, cognitive deficits, increased hospitalization, higher relapse rate and lower quality of life.Conclusions: In MS patients, polypharmacy is common and closely associated with health issues. There is a great need for research in this area, especially regarding longitudinal changes in drug utilization. Effective networks between physicians and pharmacists are needed to optimize medication management for patients and to achieve the best possible therapy results. 相似文献
46.
随着人口老龄化的日趋严重,心房颤动(AF)已经成为我国乃至世界面临的重大公共健康问题。AF是引起脑卒中、心血管疾病、栓塞等疾病的重要危险因素,严重影响患者的健康水平和生活质量。国外研究表明,由多学科协作、以护士为主导、以患者为中心的综合管理模式,有助于降低AF患者的再入院率、心血管事件发生率及全因死亡率,提高患者满意度和生活质量。目前,我国AF管理存在诸多问题,尚未形成规范的综合管理模式。本文基于国内外AF管理指南和相关文献,梳理了AF综合管理模式的流程(包括筛查、综合评估、制定管理策略、健康教育、定期随访、转诊)及各流程的具体内容,初步制定出适合我国社区的AF筛查流程和综合管理过程,可以为构建社区AF规范化管理体系提供参考与依据。 相似文献
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49.
Elvira D'Andrea Niteesh Kumar Choudhry Benjamin Raby Gerald Lawrence Weinhouse Mehdi Najafzadeh 《International journal of cancer. Journal international du cancer》2020,146(3):781-790
Bronchoscopy is the safest procedure for lung cancer diagnosis when an invasive evaluation is required after imaging procedures. However, its sensitivity is relatively low, especially for small and peripheral lesions. We assessed benefits and costs of introducing a bronchial gene-expression classifier (BGC) to improve the performance of bronchoscopy and the overall diagnostic process for early detection of lung cancer. We used discrete-event simulation to compare clinical and economic outcomes of two different strategies with the standard practice in former and current smokers with indeterminate nodules: (i) location-based strategy—integrated the BGC to the bronchoscopy indication; (ii) simplified strategy—extended use of bronchoscopy plus BGC also on small and peripheral lesions. Outcomes modeled were rate of invasive procedures, quality-adjusted-life-years (QALYs), costs and incremental cost-effectiveness ratios. Compared to the standard practice, the location-based strategy (i) reduced absolute rate of invasive procedures by 3.3% without increasing costs at the current BGC market price. It resulted in savings when the BGC price was less than $3,000. The simplified strategy (ii) reduced absolute rate of invasive procedures by 10% and improved quality-adjusted life expectancy, producing an incremental cost-effectiveness ratio of $10,109 per QALY. In patients with indeterminate nodules, both BGC strategies reduced unnecessary invasive procedures at high risk of adverse events. Moreover, compared to the standard practice, the simplified use of BGC for central and peripheral lesions resulted in larger QALYs gains at acceptable cost. The location-based is cost-saving if the price of classifier declines. 相似文献
50.