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1.
乡镇卫生院是农村三级医疗卫生网的中枢,在满足农村居民的医疗卫生需求方面起着重要的作用。但由于多种原因,乡镇卫生院业务量下降、医疗成本不断上升,不少卫生院入不敷出,面临生存危机。笔者通过调查,总结了经验,对农村卫生改革提出了四点建议。  相似文献
2.
Community Health Monitoring: Taking the Pulse of America's Children   总被引:1,自引:0,他引:1  
Objective: To describe the development, content, enablers/barriers, and impact of child health reports in nine communities participating in the Robert Wood Johnson Foundation funded Child Health Initiative (1991–1996). Methods: A qualitative, prospective, multiyear, longitudinal evaluation using a multiple case-study methodology. Three waves of structured in-per-son and telephone interviews of the project staff, community leaders, and key participants tracked the development of child health reports in all nine communities. A mailed survey of project directors was administered to assess accomplishments at the completion of the project. Content analysis of each community health report was conducted using different conceptual frameworks for health measurement and reporting. Results: All communities succeeded in creating a report that contained a broad set of outcome indicators reflecting children's health and well-being. The process of creating these reports, their content, level of analysis, presentation formats, and dissemination varied across sites based on available resources, data and analysis capacity, and other political considerations. While commonly accepted outcome measures were used in most reports (e.g., infant mortality, teen births, immunization rates), process indicators, important for quality monitoring and community health improvement, were notably lacking. In each community the reports were credited with providing a more comprehensive and integrated view of the health needs of children. Conclusions: Additional conceptual and technical work is needed to improve the ability of community health reports to capture key indicators of interest. Community reports can serve an important role in building the consensus needed to create program and policy changes. Community reports may have additional utility in monitoring the impact of health systems change on population health. Community reports can also facilitate a shared learning process for the participants and the community, and can be a useful tool to advance a children's health policy agenda.  相似文献
3.
军队医院集团化与一体化区域医疗服务平台的构建   总被引:1,自引:0,他引:1  
随着军队卫勤保障体制改革和卫生信息化建设的不断推进,军队医院集团化发展的趋势更加明显。通过建立包括临床数据中心、实时远程会诊系统和军人电子健康档案的一体化区域医疗服务平台,并使之具备标准规范、信息共享、诊疗便捷,安全保密的特性,可有效解决基层部队医疗条件及专业技术力量不足等问题。  相似文献
4.
本研究以宁夏回族自治区为案例,针对村医经济激励水平低下,按项目付费引发不恰当诊治行为,系统内缺乏引导供方提高自身服务效率和质量并促进服务与体系整合协调的经济激励等问题,从供方合理激励的角度出发,对新型农村合作医疗支付制度进行改革设计——以乡村为整体对乡镇卫生院和村卫生室提供的门诊服务实施基于绩效的按人头预付制。随后利用配对整群随机试验设计对改革效果进行评估和检验。研究发现,这一支付制度的实施有效降低了农村基本医疗服务中抗生素的使用率,优化了供方的处方行为,对降低村卫生室的单次门诊费用有一定作用,并且促进服务向村卫生室下沉。本文的政策分析和设计思路及严格的政策评估结果可以为我国支付制度的选择和发展提供政策参考和证据支持。  相似文献
5.
OBJECTIVE: To see if a new model of service delivery ensures that individuals with a mental illness in rural and remote settings could be assessed, treated and cared for in a more appropriate way. DESIGN: Community mental health teams (CMHTs), general practitioners (GP) and other agencies were provided with clinical and broader support services by consultant psychiatrists from public and private sectors. The occasions of service were logged, audited and relevant provider groups were interviewed. Ethics approval was provided by Human Research Ethics Community of University of New South Wales. SETTING: Far West Area Health Service (FWAHS), remote New South Wales. PARTICIPANTS: An enhanced service was provided for residents, specialist mental health and other healthcare providers. RESULTS: Regular access to psychiatrists for primary and secondary care was achieved in remote communities in FWAHS. 3908 new patients were seen by CMHTs between July 2002 and December 2003 and 380 by visiting psychiatrists between January 2002 and July 2003. Secondary consultation, mentoring and education opportunities were made available by tele-conference and face-to-face for CMHTs and others in FWAHS. GPs and CMHTs in remote settings were satisfied with improved access to psychiatrist care. CONCLUSIONS: This model appears to be sustainable with reasonable levels of funding in FWAHS and may be applicable to other remote contexts.  相似文献
6.
目的 建立一套医院和社区卫生服务机构在纵向服务整合过程中影响其实施效果的影响因素指标体系.方法 通过文献复习、问卷调查、个人深入访谈等形式收集初步数据,运用层次分析法和德尔菲专家咨询法构建影响因素指标体系.结果 形成了与南京、武汉、镇江3个地区医院和社区卫生服务机构纵向服务整合现状相吻合的影响因素指标体系,包括一级指标4个、二级指标10个、三级指标35个.结论 本研究为医院和社区卫生服务机构完善服务整合制度提供了依据,弥补了国内医疗服务体系纵向整合实施效果影响因素研究方面的不足,对其他地区和模式的医疗服务体系纵向整合有一定的借鉴意义和价值.  相似文献
7.
目的探讨以公共卫生与基本医疗为主导的社区慢性病防治一体化服务。方法建立慢性病防治与社区卫生服务结合的机制,强调防治结合,充分利用全科团队深入社区的优势,注重健康教育,发挥中医药特色,以社区常见病干预为重点,规范社区卫生服务的工作内容。结果制订并实施社区慢性病综合防治一体化服务方案,使临床和预防慢性病防治相结合的社区卫生服务成为开展慢性病社区综合防治工作的重要服务平台。结论以公共卫生与基本医疗为主导的社区慢性病防治一体化服务,有利于慢性病社区综合防治的开展,有利于提高社区居民的健康水平。  相似文献
8.
我国护理服务价格一直处于较低水平,难以真正体现护理人员的劳务价值.同样,其他综合医疗服务项目的价格也不尽合理,不利于医疗机构的经济运行和发展.文章基于对上述现象的分析提出调整综合服务项目收费价格的一些建议.  相似文献
9.
目的:了解全国卫生监督机构综合业务岗位人员的年龄、学历、学位和专业等基本信息,以期为综合业务岗位的建设发展提供参考。材料与方法:对全国卫生监督员进行普查,抽取综合业务岗位人员基本信息,利用SPSS 16.0进行数据分析。结果:全国卫生监督机构综合业务岗位人员年龄集中在30~49岁,42.21%的是大学本科学历,无学位的占55.18%,有31.22%的最后专业是公共卫生与预防医学。结论:不同地区、不同级别卫生监督机构综合业务岗位人员的数量、年龄、学历、学位和专业分布有差异。其中,中、西部和县级机构人员均数较少,且学历、学位水平相对较低。  相似文献
10.
The first global overview of basic water and sanitation indicators in refugee camps is presented (using data from 2003–2006) and compared with selected health and nutrition indicators. This demonstrates that average levels of water and sanitation provision are acceptable at camp level but many refugee operations are suffering from gaps that cross-cut these sectors; e.g. typically poor sanitation provision is corresponding with low per capita availability of water. These findings were confirmed at household level with two household surveys undertaken in African refugee camps; households reporting a case of diarrhoea within the previous 24 hours collect on average 26% less water than those not reporting any cases. In addition, typically higher levels of morbidity of one infectious agent are also reflected across other infectious agents; this is reinforced by comparing the relationship between morbidity and nutrition status from selected camps. The importance that hygiene, environmental conditions and local settings have on health (both of refugees and also local communities) is underlined. Interventions to improve indicators across the water, sanitation, health and nutrition sectors rely not only on increased and sustained resources but must entail an integrated approach to simultaneously tackle short-comings across all these vital sectors.  相似文献
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