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1.
浅谈大医院的中高层管理队伍的职业化   总被引:20,自引:4,他引:16  
作者对大医院的中高层管理队伍的现状分析认为,有管理意识但没有管理人才的概念:管理科学教育滞后,高层管理仍未能职业化。并在分析现状后指出,大医院的中高层管理队伍实行职业化非常必要,一是医学模式改变;二是医院竞争加剧,三是医学运作复杂;四是管理岗位技能要求高等。为此,促进管理队伍中的业务型干部向职业型干部转化,建立退任评估制度和引进职业管理人才。  相似文献
2.
Illness narratives: fact or fiction?   总被引:11,自引:3,他引:8  
There is currently considerable renewed interest in narrative analysis in the humanities, social sciences and medicine. Illness narratives, particularly those of patients or lay people, are a particular focus in health related settings. This paper discusses the background to this interest, especially its roots in critiques of medical dominance and distinctions between disease and illness, drawn by sociologists and anthropologists in the 1970s. The current emphasis on patient or personal narratives can also be seen to stem from changes in morbidity patterns, the expansion of information about disease and illness, and in public debates about the effectiveness of medicine. The paper then goes on to outline a framework for analysing illness narratives. This involves exploring three types of narrative form: 'contingent narratives' which address beliefs about the origins of disease, the proximate causes of an illness episode, and the immediate effects of illness on everyday life; 'moral narratives' that provide accounts of (and help to constitute) changes between the person, the illness and social identity, and which help to (re) establish the moral status of the individual or help maintain social distance; and 'core narratives' that reveal connections between the lay person's experiences and deeper cultural levels of meaning attached to suffering and illness. Here, distinctions are drawn between such sub forms as heroic, tragic, ironic and comic, and regressive/progressive narratives. Finally, the paper discusses some of the methodological issues raised by narrative analysis. Given the complex character of illness narratives, their social and psychological functions, together with the motivational issues to which they relate, it is suggested that they constitute a major challenge for sociological analysis. From this viewpoint current claims about narrative analysis in medicine need to be treated with caution.  相似文献
3.
谈我院医院信息系统局部故障应急预案的建立   总被引:11,自引:1,他引:10  
作者对医院信息系统故障的内涵、判断方法及建立应急预案的必要性进行了阐述,提出了应急预案组织管理的具体方法;①明确各类故障排除的责任与分工;②做好故障排除中的组织协调;③对有关人员严格进行培训;④随时进行检查、监督、通过这套方案提示医院信息系统管理者对故障预防要引起足够的重视。  相似文献
4.
经济学评价方法在环境健康影响评价中的适用性   总被引:7,自引:0,他引:7  
通过比较分析多种环境健康经济学评价方法的机制发现,人力资本法和预防性支出法难以全面评价环境污染的健康效应,数据质量及数据可得性限制了特征工资法和特征价格法的应用,因其结果外推性不佳,不适宜全国水平的健康影响评价,依据研究者主观意愿的条件价值法能够独立评价不同环境因素所致的健康损害,其灵活独特的方法受到研究者的普遍青睐,但这几种方法均不能体现健康效应对国民经济的影响;通过模拟经济系统内多部门间相互依存、相互影响的机制,基于Walars一般均衡理论的可计算一般均衡方法,能比较客观地反映环境污染所致健康损害对国内生产总值(GDP)的影响。可计算一般均衡方法用于健康影响评价的研究在中国尚处于起步阶段,亟待深入研究以便于进行不同评价方法之间的比较。  相似文献
5.
Smith RD 《Health economics》2003,12(8):609-628
Contingent valuation (CV) has been criticised for being too hypothetical, with expressed values bearing little relation to actual values. The magnitude of this divergence, however, depends upon how realistic and believable the contingent market is. This paper presents an overview of five key aspects in the construction of the contingent market: (i) scenario development and presentation; (ii) payment vehicle; (iii) expression of risk; (iv) time period of valuation; and (v) survey administration. CV studies in health care since 1985, totalling 111, are critically reviewed with respect to these five aspects. It is concluded that CV studies in health care have performed poorly in the construction, specification and presentation of the contingent market, and that there has been little, if any, improvement in this respect over the last 15 years. Suggestions are made concerning why this may be the case, and how the construction of the contingent market may be improved in future.  相似文献
6.
Estimating rural households’ willingness to pay for health insurance   总被引:5,自引:0,他引:5  
In many developing countries limited health budgets are a serious problem. Innovative ways to raise funds for the provision of health services, for example, through health care insurance, have a high priority. Health care insurance for rural households shields such patients from unexpected high costs of care. However, there are questions about whether, and how much, rural households are willing to pay to purchase such insurance, as well as the factors determining willingness to pay. In recent years the Iranian government has tried to improve health and medical services to rural areas through a health insurance program. This study was conducted to estimate rural households demand and willingness to pay for health insurance. A contingent valuation method (CVM) was applied using an iterative bidding game technique. Data has been collected from a sample of 2,139 households across the country.  相似文献
7.
赴利比里亚维和医疗分队卫勤保障工作思路   总被引:4,自引:2,他引:2  
派遣机动卫勤分队出国执行维和卫勤保障任务,对锻炼医疗队伍,提高自我保障条件下医疗救治能力,取得海外部署军队卫勤保障经验十分重要。本文结合赴利维和医疗分队所担负的卫勤保障任务,提出了“以保安全为底线,以保核查为重点,以保生活为基础,以保任务为根本,以保协调为前提”的工作思路,以期对维和分队的工作提供借鉴和指导。  相似文献
8.
紧急医疗救援指挥中心信息系统规划设计与研究   总被引:4,自引:1,他引:3  
处理突发事件需要尽快建立一个具有现代化和国际化水平的紧急医疗救援指挥中心。从整合现有的“120”急救中心资源出发,按照“平战结合”的原则,综合运用先进的计算机网络技术、现代通信技术、呼叫中心系统、地理信息系统、卫星定位系统等建立和完善紧急医疗救援指挥中心。可以迅速提高政府在应对突发事件时实施紧急医疗救援的快速反应能力、指挥调度能力和防范处理能力。  相似文献
9.
目的完善我国突发公共卫生事件应急预案体系建设。方法结合卫生应急工作的实践,回顾了我国突发公共卫生事件应急预案体系建设中存在的问题并进行了分析。结果我国突发公共卫生事件应急预案体系已初步形成,但仍需要在今后的工作中进一步发展和完善。结论完善我国相关卫生法律法规,及时更新和修订预案,重视预案的培训和演练,加强预案的宣传教育,加强应急预案体系的管理,是当前发展和完善我国公共卫生事件应急预案体系建设的重要措施。  相似文献
10.
医院信息系统故障应急预案的建立与实施   总被引:3,自引:0,他引:3  
本文对医院信息系统故障应急预案建立的原则、必要性和具体实施方法进行了阐述,提出应急预案组织管理的具体方法。  相似文献
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