我国医疗机构药品集中采购工作回顾性研究

通过文献研究等方法,系统回顾我国医疗机构药品从分散采购到集中采购经历的萌芽阶段、初创阶段、调整阶段和深化阶段,梳理分析不同发展阶段的工作特点、取得的成效、存在的问题.针对当前药品采购面临的问题和挑战,提出改革和完善公立医院药品集中采购办法,坚持以省为单位集中采购的方向,坚持“四个有利于”的基本准则,全面破除“以药补医”机制,同步推进医保、流通、价格改革联动,加强综合服务和监管.     

以培养创新能力为核心改革药物化学实验教学

药物化学是一门实践性和应用性较强的学科,其在药学专业课程中对培养学生专业素质与创新能力起着重要作用。分析目前药物化学实验教学中存在的不足,并提出改革方法。     

Early Childhood Education in Hong Kong and its Challenges

There is an increasing demand from the public and the field to improve the quality of early childhood education in Hong Kong. The Hong Kong Education Commission has recently released an "education blueprint for the 21st century", which presents a set of reform proposals for the education system in Hong Kong. In the document, early childhood education has been acknowledged as the foundation for life-long learning. A key reform proposal is to build a new culture for quality early childhood education through upgrading professional competence and enhancing quality assurance mechanisms. The present paper provides a general background of existing practices in the preschool years, highlights issues that require attention in order to improve quality, and outlines the reforms introduced by the Education Commission. The implications of these reforms and the associated challenges are then discussed in the areas of quality assurance, curriculum, professional development, parental involvement and financial assistance for the early childhood education sector.     

浅析医疗服务不能完全照搬市场经济

医疗服务不能完全照搬市场经济是由卫生事业的特性决定的。市场经济虽有其不可否认的积极作用,但 也难免有一定的局限性。因此,照搬市场经济对医疗服务会带来一些弊病,需要政府的调控与管理以及医疗单位自身 的努力。     

医院集团的实践探索--上海瑞金医院集团案例解析

通过对上海瑞金医院集团的形成、发展及成效的解析,阐述了集团化改革对提高集团管理水平,发挥资源效益,增强竞争实力,以及促进卫生事业发展等方面所起的良好作用。     

以医改为契机 推动区域卫生规划的实施进程

1990年,九江市被列为卫生部推行区域卫生规划试点市之一,1995年又被国务院确定为全国职工医疗保险制度改革的试点市。从以下几个方面介绍了九江市区域卫生规划的实施情况:区域卫生规划实施前状况;推动职工医疗保险制度改革,加快区域卫生规划的实施进程;积极稳妥地推进厂矿企事业自办医疗机构社会化,逐步实现卫生全行业管理。     

坚持公益性——公立医院改革的核心：公立医院改革也可在持续和常态中实现

公立医院的改革是一个持久的、常态的、循序渐进的过程,不可能＂一刀切＂,也无法追求十全十美。因此改革需要紧扣主题,创造良好的改革环境,因地制宜地推进。     

Healthcare reforms in Cyprus 2013–2017: Does the crisis mark the end of the healthcare sector as we know it?

As part of a bailout agreement with the International Monetary Fund, the European Commission and the European Central Bank (known as the Troika), Cyprus had to achieve a fiscal surplus through budget constraints and efficiency enhancement. As a result, a number of policy changes were implemented, including a reform of the healthcare sector, and major healthcare reforms are planned for the upcoming years, mainly via the introduction of a National Health System. This paper presents the healthcare sector, provides an overview of recent reforms, assesses the recently implemented policies and proposes further interventions. Recent reforms targeting the demand and supply side included the introduction of clinical guidelines, user charges, introduction of coding for Diagnosis Related Groups (DRGs) and the revision of public healthcare coverage criteria. The latter led to a reduction in the number of people with public healthcare coverage in a time of financial crises, when this is needed the most, while co-payments must be reassessed to avoid creating barriers to access. However, DRGs and clinical guidelines can help improve performance and efficiency. The changes so far are yet to mark the end of the healthcare sector as we know it. A universal public healthcare system must remain a priority and must be introduced swiftly to address important existing coverage gaps.     

Shared Governance within the market-oriented health care system of New Zealand

The New Zealand health reforms, announced in 1991 and implemented over the 3-year period 1992-1994, were market-oriented, following a competitive model that had been applied across New Zealand's public sector. Consideration is given to the effects of the health reforms on nursing and midwifery at Capital Coast Health Limited (CCHL), with the introduction of a market/economic model of health care and its accompanying managerialism. The market model, or the economic era of health care, as some describe it, created an environment where nurses felt powerless. All the directors of nursing and on-going hospital educational programs were disestablished in the public sector; nurses were disheartened, confused and lacked representation at senior management. Integral to, and accompanying, corporatization is managerialism. With corporatization, came managers from the non-health care sector who had no understanding of the complexities of health care. Accompanying managerialism is the notion that any able manager was capable of managing any agency, whether public or private. Naturally, there was an underlying conflict between the caring relationships and their related work in the clinical environment, and the desire for efficiency and economy. It seemed that we were dealing with contrasting themes of 'the market' and 'humanity' This led to further confusion and disempowerment, as the dollar gained prominence, for nursing has always been grounded in the 'humanities'. It was into this environment, after 5 years of the health reforms, that a Nurse Executive was appointed and the concept of Shared Governance was introduced. This article describes why Shared Governance was considered an appropriate model to introduce at CCHL, and identifies some of the tangible benefits being realized 18 months post implementation. Discovering that membership in cross-organizational teams provides a mechanism for networking and creating a broader understanding of the organization has been but one of the major benefits.     

Shaping the health future in Turkey: a new role for human resource planning

The expanding health needs and expectations of a growing and changing population in Turkey are placing new pressures on a health system that is increasingly financially constrained. These pressures are bringing into sharp focus the need to take radical approaches to the organization, planning and management of the health sector; and, in particular, in the planning and management of health human resources. Issues of effectiveness, efficiency and value for money are increasingly becoming the central issues for the 1990s and beyond. The article examines the development of the Turkish health system. Within a framework of health care reform proposals emerging from a major development project in the Ministry of Health itself, the text explores current initiatives and future needs in developing human resource planning if the health care reforms are to be successful in meeting the health needs of the population.