医疗卫生机构综合审计指标体系的建立

经济责任审计核心是对领导干部经济责任的绩效评价,要提高经济责任审计质量和控制风险,必须建立绩效审计评价指标体系,通过财务绩效定量评价和管理绩效定性评价两方面内容进行综合评价.并提出要在国家层面上制定绩效评价准则和行业指标评价体系,充分发挥绩效审计的评判、引导和诊断作用.     

音乐结合强制性使用运动疗法治疗脑梗塞上肢运动障碍疗效观察

目的：探讨音乐疗法结合强制性使用运动疗法治疗脑梗塞上肢运动功能障碍的疗效及机理。方法：将120例脑梗塞亚急性期上肢功能障碍患者随机分为观察组（50例）和对照组（50例）,两组患者在入院后均接受常规康复训练及内科治疗;2周后,对照组在常规康复训练、治疗基础上给予强制性使用运动疗法治疗,观察组则给予音乐疗法结合强制性使用运动疗法,干预14天后观察两组患者上肢动作研究量表（ARAT）评分、Fugl．Meyer量表（FMA）评分、汉密尔顿焦虑量表（HAMA）评分的改善情况。结果：干预14天后,观察组ARAT评分、FMA评分均显著高于对照组（P〈0．01）,HAMA评分显著低于对照组（P〈0.01）。结论：音乐结合强制性使用运动疗法可有效改善脑梗塞亚急性期上肢功能障碍及焦虑状态,值得临床推广应用。     

加强报账员管理 提高会计信息质量

报账员在会计集中核算中是一个十分重要的财务岗位,加强报账员管理是提高集中核算会计信息质量的重要手段之一。对此,笔者介绍了浙江省衢州市财会中心通过建章立制、严格考核、重视培训、加强沟通来提高集中核算会计信息质量的做法。     

加强报账员管理提高会针信息质量

报账员在会计集中核算中是一个十分重要的财务岗位,加强报账员管理是提高集中核算会计信息质量的重要手段之一.对此,笔者介绍了浙江省衢州市财会中心通过建章立制、严格考核、重视培训、加强沟通来提高集中核算会计信息质量的做法.     

医院固定资产管理的实证研究

目的:合理配置医院固定资产,提高医院固定资产的使用效率,提升医院固定资产的管理水平。方法:对2009—2011年衢州市公立医院固定资产管理现状全面调查,主要采用文献法及观察法,进行专家访谈;结果 :资产配置不合理、大型设备利用率不高,资产收益率较低;结论:大型专用设备应实行专业化集中管理,全面实行固定资产管理信息化管理,运用ABC管理法对医院固定资产进行分类管理,建立分层次的资产管理责任制。     

医院管理会计体系创新

目的:推进管理会计体系在医院的创新发展。方法:充分运用全面预算管理、成本管理、绩效考评、内部审计和内部控制的方法,并将它们相互融合,相互渗透。结果:资产使用效益提高、科室核心竞争力增强、职工个人能力得到提升、降本增效,医院优质高效发展。结论:为医院管理会计体系的建设提供实务支持,该套体系可以在各级各类医院推行。     

加强财会中心服务质量管理的探讨

服务对象感知的质量是由服务技术质量和服务功能质量两方面构成。财会中心要提高服务质量，只有通过提高服务过程中的技术质量和功能质量，并且两者双管齐下、缺一不可，才能最终形成一种良好的服务质量，使服务对象、员工、社会三者满意。     

完善财务管理提高医院综合实力

财务管理的目的是以较少的投入获得较大的产出 ,取得社会效益和经济效益的双丰收。这不仅是医院自身的要求 ,也是病人所希望的。首先是资金管理 :资金投入应遵循三个原则 :一是控制资金投放时间 ;二是研究投资方向 ;三是提高投资效果。重点抓好两个方面 :一是加强流动资金的管理 ,核定日常所需的周转金 ,加快资金回笼 ;二是提高投资效益 ,确定资金规模和投资项目 ,选择最优的投资方案 ,加强设备使用过程的管理 ,促进医疗设备的服务效果。提高医院综合实力。其次是预算管理。预算管理是以经营决策为基础编制的经营预算和财务预算 ,包括业务工…     

新生儿局部脑组织氧检测的多中心研究

Objectives To understand the value of measuring neonatal cerebral regional oxygen ‘saturation(rSO2)using near infrared spectroscopy (NIRS) in assessing cerebral oxygenation,to establish the normal range of neonatal cerebral rSO2,and to collect data of the changes of cerebral rSO2 under certain disease status.Methods Nine large hospitais participated in the multicenter randomized clinical trial from Jan 2007 to Apr 2008.Using the NIRS human tissue oximeter(TSAH-100)independently developed in China.tIle cerebral rSO2 of 223 normal full-term and 95 otherwise healthy preterm neonates without any stmcial disease,Was detected at 1.2 and 3 days after birth,respectively.The cerebral rSO2 of 102 neonates with diseases which may affect the cerebral oxygenation.Was also detected during the severe phases.The pulse oxygen saturation(SpO2)measured at the finger tip,and also the arterial oxygen saturation(SaO2) measured by blood gas analysis,which could indicate the oxygen supply of the whole body,were obtained simultaneously.The correlations among cerebral rSO2,putse SpO2 and arterial SaO2 were analyzed.Results (1)The cerebral rSO2 of the normal full-term neonates wag(62±2)%.Cerebral hypoxia Was deftned as rSO2 lower than 58%. The cerebral rSO2 of the normal full-terms was steady at 1, 2 and 3 days after birth respectively, without any significant differences among them (F = 0. 610, P >0. 05 ). The cerebral rSO2 of the neonates with diseases was ( 55 + 7 ) %, which was significantly lower that that of the normal full-term neonates (t = 15.492,P <0. 05). (2) The cerebral rSO2 was positively correlated with the SpO2(r =0. 74,P < 0. 01 ) and the SaO2 ( r = 0. 71, P < 0. 01 ). ( 3 ) Under some special diseases, the changes of cerebral relatively low hemoglobin concentration, the cerebral rSO2 was significantly low (50%～58% ), but the cerebral rSO2 was lagged as compared with that of pulse SpO2. Especially, during the severe phases of 6 cases with multi-organ failure, the SpO2 and the cerebral rSO2 were both significantly low (55%～80% for SpO2, and 44%～50% for cerebral rSO2 ) ; when the diseases were alleviated, although the SpO2 recovered phases of serious hypoxic-ischemic encephalopathy (HIE), the cerebral rSO2 significantly increased to 70%～72%, which was significantly higher than the normal value (62%). Condusions The range of cerebral rSO2 of the normal full-term neonates was (62 + 2) %. Cerebral oxygenation can be externally indicated by the rSO2 noninvasively and continuously measured by NIP, S, which was positively correlated with traditional pulse SpO2 and arterial SaO2. In some special diseases, the rSO2 measured by NIRS can be helpful for clinical diagnoses and treatments.     

新生儿局部脑组织氧检测的多中心研究

Objectives To understand the value of measuring neonatal cerebral regional oxygen ‘saturation(rSO2)using near infrared spectroscopy (NIRS) in assessing cerebral oxygenation,to establish the normal range of neonatal cerebral rSO2,and to collect data of the changes of cerebral rSO2 under certain disease status.Methods Nine large hospitais participated in the multicenter randomized clinical trial from Jan 2007 to Apr 2008.Using the NIRS human tissue oximeter(TSAH-100)independently developed in China.tIle cerebral rSO2 of 223 normal full-term and 95 otherwise healthy preterm neonates without any stmcial disease,Was detected at 1.2 and 3 days after birth,respectively.The cerebral rSO2 of 102 neonates with diseases which may affect the cerebral oxygenation.Was also detected during the severe phases.The pulse oxygen saturation(SpO2)measured at the finger tip,and also the arterial oxygen saturation(SaO2) measured by blood gas analysis,which could indicate the oxygen supply of the whole body,were obtained simultaneously.The correlations among cerebral rSO2,putse SpO2 and arterial SaO2 were analyzed.Results (1)The cerebral rSO2 of the normal full-term neonates wag(62±2)%.Cerebral hypoxia Was deftned as rSO2 lower than 58%. The cerebral rSO2 of the normal full-terms was steady at 1, 2 and 3 days after birth respectively, without any significant differences among them (F = 0. 610, P >0. 05 ). The cerebral rSO2 of the neonates with diseases was ( 55 + 7 ) %, which was significantly lower that that of the normal full-term neonates (t = 15.492,P <0. 05). (2) The cerebral rSO2 was positively correlated with the SpO2(r =0. 74,P < 0. 01 ) and the SaO2 ( r = 0. 71, P < 0. 01 ). ( 3 ) Under some special diseases, the changes of cerebral relatively low hemoglobin concentration, the cerebral rSO2 was significantly low (50%～58% ), but the cerebral rSO2 was lagged as compared with that of pulse SpO2. Especially, during the severe phases of 6 cases with multi-organ failure, the SpO2 and the cerebral rSO2 were both significantly low (55%～80% for SpO2, and 44%～50% for cerebral rSO2 ) ; when the diseases were alleviated, although the SpO2 recovered phases of serious hypoxic-ischemic encephalopathy (HIE), the cerebral rSO2 significantly increased to 70%～72%, which was significantly higher than the normal value (62%). Condusions The range of cerebral rSO2 of the normal full-term neonates was (62 + 2) %. Cerebral oxygenation can be externally indicated by the rSO2 noninvasively and continuously measured by NIP, S, which was positively correlated with traditional pulse SpO2 and arterial SaO2. In some special diseases, the rSO2 measured by NIRS can be helpful for clinical diagnoses and treatments.