收费全文 | 2038443篇 |
免费 | 161602篇 |
国内免费 | 7618篇 |
耳鼻咽喉 | 27296篇 |
儿科学 | 66195篇 |
妇产科学 | 56999篇 |
基础医学 | 282736篇 |
口腔科学 | 56456篇 |
临床医学 | 179639篇 |
内科学 | 413593篇 |
皮肤病学 | 46865篇 |
神经病学 | 166019篇 |
特种医学 | 83744篇 |
外国民族医学 | 616篇 |
外科学 | 320929篇 |
综合类 | 46921篇 |
现状与发展 | 2篇 |
一般理论 | 636篇 |
预防医学 | 158468篇 |
眼科学 | 44816篇 |
药学 | 145028篇 |
5篇 | |
中国医学 | 3608篇 |
肿瘤学 | 107092篇 |
2018年 | 20516篇 |
2016年 | 18582篇 |
2015年 | 21015篇 |
2014年 | 29688篇 |
2013年 | 44979篇 |
2012年 | 56948篇 |
2011年 | 60896篇 |
2010年 | 37733篇 |
2009年 | 36481篇 |
2008年 | 57461篇 |
2007年 | 61391篇 |
2006年 | 62402篇 |
2005年 | 60837篇 |
2004年 | 58024篇 |
2003年 | 56370篇 |
2002年 | 54222篇 |
2001年 | 96433篇 |
2000年 | 99236篇 |
1999年 | 83183篇 |
1998年 | 23272篇 |
1997年 | 20735篇 |
1996年 | 21458篇 |
1995年 | 22338篇 |
1994年 | 21020篇 |
1993年 | 19646篇 |
1992年 | 68155篇 |
1991年 | 65972篇 |
1990年 | 63893篇 |
1989年 | 61034篇 |
1988年 | 56650篇 |
1987年 | 55621篇 |
1986年 | 52881篇 |
1985年 | 50822篇 |
1984年 | 38535篇 |
1983年 | 32550篇 |
1982年 | 20091篇 |
1981年 | 17863篇 |
1980年 | 16900篇 |
1979年 | 34983篇 |
1978年 | 25052篇 |
1977年 | 21129篇 |
1976年 | 19601篇 |
1975年 | 20916篇 |
1974年 | 24799篇 |
1973年 | 23670篇 |
1972年 | 22232篇 |
1971年 | 20480篇 |
1970年 | 18993篇 |
1969年 | 17884篇 |
1968年 | 16830篇 |
A positive relationship between treatment volume and outcome quality has been demonstrated in the literature and is thus evident for a variety of procedures. Consequently, policy makers have tried to translate this so-called volume–outcome relationship into minimum volume regulation (MVR) to increase the quality of care—yet with limited success. Until today, the effect of strict MVR application remains unclear as outcome quality gains cannot be estimated adequately and restrictions to application such as patient travel time and utilization of remaining hospital capacity are not considered sufficiently. Accordingly, when defining MVR, its effectiveness cannot be assessed. Thus, we developed a mixed integer programming model to define minimum volume thresholds balancing utility in terms of outcome quality gain and feasibility in terms of restricted patient travel time and utilization of hospital capacity. We applied our model to the German hospital sector and to four surgical procedures. Results showed that effective MVR needs a minimum volume threshold of 125 treatments for cholecystectomy, of 45 and 25 treatments for colon and rectum resection, respectively, of 32 treatments for radical prostatectomy and of 60 treatments for total knee arthroplasty. Depending on procedure type and incidence as well as the procedure’s complication rate, outcome quality gain ranged between 287 (radical prostatectomy) and 977 (colon resection) avoidable complications (11.7% and 11.9% of all complications). Ultimately, policy makers can use our model to leverage MVR’s intended benefit: concentrating treatment delivery to improve the quality of care.
相似文献This paper describes the design of a theory-informed pragmatic intervention for adolescent perinatal depression in primary care in Nigeria.
MethodsWe conducted Focus Group Discussions (FGDs) among 17 adolescent mothers and 25 maternal health care providers with experience in the receipt and provision of care for perinatal depression. The Consolidated Framework for Implementation Research (CFIR) was used to systematically examine the barriers and facilitators affecting adolescent mothers' use of an existing intervention package for depression. The Theoretical Domain Framework (TDF) and the Capability, Opportunity, Motivation, Behaviour (COM-B) model were used to analyze the results of the data across the five CFIR domains.
ResultsFGD analysis revealed that care providers lacked knowledge on approaches to engage young mothers in treatment. Young mothers had poor treatment engagement, low social support, and little interest in parenting. A main characteristic of the newly designed intervention is the inclusion of age-appropriate psychoeducation supported with weekly mobile phone calls, to address treatment engagement and parenting behaviours of young mothers. Also in the outer setting, low social support from relatives was addressed with education, “as need arises” phone calls, and the involvement of "neighborhood mothers”. In the inner settings, care providers’ behaviour is addressed with training to increase their capacity to engage young mothers in treatment.
ConclusionA theory-based approach helped develop an age-appropriate intervention package targeting depression and parenting skills deficit among perinatal adolescents in primary maternal care and in which a pragmatic use of mobile phone was key.
相似文献