欧洲药物战略（2020）及其对中国医药领域的启示

在当前国际制药技术出现重大创新和变革、药品研发技术信息化和数字化程度不断发展，以及新型冠状病毒肺炎（COVID-19）疫情大流行的背景下，欧盟委员会为满足未竟临床需求、激励行业创新、增强监管系统应变能力、巩固欧盟药品监管体系国际地位，于2020年底发布了《欧洲药物战略》（Pharmaceutical Strategy for Europe，PSE）。PSE被视为欧洲未来5年卫生政策的“基石”，对欧洲制药领域发展和管理具有重要指导意义。通过对PSE制定背景及发展战略目标、具体举措等内容进行梳理分析，并结合中国COVID-19疫情防控与行业发展、药品科学监管与鼓励创新等实际工作提出政策建议。     

微信打卡式监督法提高冠心病病人院外康复干预效果的观察

[目的]观察微信打卡式监督法提高冠心病病人院外康复锻炼干预的效果。[方法]将140例冠心病病人按随机数字表法分为观察组、对照组各70例,对照组实施常规冠心病院内护理及出院后电话随访,观察组将随访方式改为微信打卡式监督法,比较干预后两组病人心功能指标、锻炼依从性及满意度。[结果]干预后两组病人心功能指标均得到优化,但观察组优于对照组(P<0.05);干预后观察组病人心血管事件发生率低于对照组(P<0.05),依从性评分及满意度得分均高于对照组(P<0.05)。[结论]微信打卡式监督法在缓解冠心病症状、提高病人依从性与满意度方面均具有积极效应。     

刍议医院纪检监察在医院建设中的作用和实施

随着社会经济的快速发展,国内医疗事业的竞争日益激烈,医疗机构需要积极提高自身的业务水平和管理水平,才能强化医疗技术水平,获得更多的社会经济效益。在国内医疗体制深化变革的趋势下,纪检监察在医院建设中发挥着越来越重要的作用,主要职责是管理和监督医院各项制度的落实、健康环境的建设等,旨在规范机构医疗服务,提高机构服务质量,促使医院树立良好的社会形象,保障医院的社会经济效益。该文针对医院纪检监察在医院建设中的作用和实施展开分析。     

基于新政府会计制度探究公立医院财务精细化管理

随着社会的高速发展,政府会计制度不断革新,医院是医疗卫生行业的重要构成部分,应当不断适应社会的发展而改革。基于此,该文以公立医院的财务管理作为分析目标,对公立医院财务管理中已有的问题和未来改善措施进行分析探讨,从而为以后的发展提供意见。     

药品化妆品抽样及检验的有关问题探讨

目的:对药品、药包材、化妆品抽样及检验工作中发现的问题进行分析研究,旨在为监管部门和检验机构提供参考,规范抽样和检验,提高监管效能和服务水平。方法:通过抽样、样品寄送、收样、检验等环节,对药品、药包材、化妆品抽样及检验工作中发现的有关问题进行分析研究,提出相应的解决措施和意见建议。结果与结论:部分药品/药包材/化妆品的抽查检验存在抽样不规范、抽样信息不完整、抽样与检查未能兼顾、样品寄送不规范、检验登记单和检验报告信息不完整或填写不规范、检验不规范、部分产品的批号效期标识不规范,以及部分品种因抽样量大导致抽样难以覆盖基层等问题,影响了监管效能。应根据药品、药包材、化妆品的产品特性和监管要求,分类设置并完善抽样及检验检测信息,并从强化人员培训、监督和检验有机结合、针对基层用药特点完善抽检工作机制、加强学习交流提高检验报告质量等方面加以解决。     

浅谈医院药学部的危机管理体系

目的:通过探讨医院药学部的危机管理体系,提高药学工作者对安全事件相关的危机意识和反应能力,从危机变为转机。方法:从政策危机、管理危机、质量危机、素质危机、技术危机、安全与突发事件危机、公共关系危机、职业压力危机等方面分析。结果:危机管理体系能够及早发现问题,解决问题,杜绝不安全事件的进一步发扩大、发展。结论:危机管理体系的建立能够最大地保障公众的身心健康与卫生健康事业。     

基于清晰集定性比较分析的地方政府县域医共体创新实践影响因素及其组合路径分析

背景地方政府创新的影响因素分析一直是地方治理创新研究的重要议题。目的探究影响地方政府县域医共体创新实践的因素，并分析其组合路径。方法于2021年3月，以中国医院协会医共体分会举办的第二届"寻找县域医共体实践价值案例"评选活动的初选结果为案例源，将"政策创新类型"作为结果变量（中央主导型创新/地方回应型创新=0，地方自发型创新=1），以经济发展水平、行政层级、地理区位、问题属性及平台作为条件变量，采用清晰集定性比较分析（csQCA）法，通过必要条件分析、充分条件组合分析，探究影响地方政府县域医共体创新实践的因素并构建地方政府县域医共体创新实践的影响路径模型。结果5个条件变量一致性均<0.9，即经济发展水平、行政层级、地理区位、问题属性及平台均不是地方自发型创新的必要条件。条件变量组合分析（基于中间解）结果显示，共得到5组前因条件组合，分别为：经济发展水平*~地理区位*平台，行政层级*~地理区位*平台，经济发展水平*问题属性*平台，~经济发展水平*地理区位*~问题属性*平台，经济发展水平*行政层级*地理区位*问题属性（*表示"且"，~表示"非"）。5组前因条件组合一致性指标均为1，原始覆盖率为0.14~0.43，净覆盖率为0.14~0.43，总体覆盖率为1。地方政府县域医共体创新实践主要呈现出两类模式，即平台型创新模式和动机型创新模式。结论若要实现高水平的医共体创新实践，应该关注政策与当地经济发展水平之间的强相关性，激活地方政府的主动创新意愿，以及加强对县域医共体的平台支持。本研究对于理解地方政府县域医共体创新实践的机理乃至地方政府创新都具有一定价值。     

Is Obesity Policy in England Fit for Purpose? Analysis of Government Strategies and Policies, 1992–2020

Policy Points

• This analysis finds that government obesity policies in England have largely been proposed in a way that does not readily lead to implementation; that governments rarely commission evaluations of previous government strategies or learn from policy failures; that governments have tended to adopt less interventionist policy approaches; and that policies largely make high demands on individual agency, meaning they rely on individuals to make behavior changes rather than shaping external influences and are thus less likely to be effective or equitable.
• These findings may help explain why after 30 years of proposed government obesity policies, obesity prevalence and health inequities still have not been successfully reduced.
• If policymakers address the issues identified in this analysis, population obesity could be tackled more successfully, which has added urgency given the COVID‐19 pandemic.

ContextIn England, the majority of adults, and more than a quarter of children aged 2 to 15 years live with obesity or excess weight. From 1992 to 2020, even though the government published 14 obesity strategies in England, the prevalence of obesity has not been reduced. We aimed to determine whether such government strategies and policies have been fit for purpose regarding their strategic focus, nature, basis in theory and evidence, and implementation viability.MethodWe undertook a mixed‐methods study, involving a document review and analysis of government strategies either wholly or partially dedicated to tackling obesity in England. We developed a theory‐based analytical framework, using content analysis and applied thematic analysis (ATA) to code all policies. Our interpretation drew on quantitative findings and thematic analysis.FindingsWe identified and analyzed 14 government strategies published from 1992 to 2020 containing 689 wide‐ranging policies. Policies were largely proposed in a way that would be unlikely to lead to implementation; the majority were not interventionist and made high demands on individual agency, meaning that they relied on individuals to make behavior changes rather than shaping external influences, and are thus less likely to be effective or to reduce health inequalities.ConclusionsThe government obesity strategies’ failure to reduce the prevalence of obesity in England for almost 30 years may be due to weaknesses in the policies’ design, leading to a lack of effectiveness, but they may also be due to failures of implementation and evaluation. These failures appear to have led to insufficient or no policy learning and governments proposing similar or identical policies repeatedly over many years. Governments should learn from their earlier policy failures. They should prioritize policies that make minimal demands on individuals and have the potential for population‐wide reach so as to maximize their potential for equitable impacts. Policies should be proposed in ways that readily lead to implementation and evaluation.