Health economics analysis of prospective payment systems in medical rehabilitation

The forthcoming introduction of the DRG-system as a new hospital funding system in Germany reinforced the discussion about a reform of the already existing funding system in medical rehabilitation. Experience and concepts from acute medicine, however, cannot be transferred directly to rehabilitation. The development of a patient classification system is a presupposition for prospective payment systems. Initial attempts in rehabilitation-specific patient classification systems already exist, even though a comprehensive approach is not yet noticeable. International patient classification systems scarcely seem to be transferable due to the specific German case-mix. The specific differences between acute medicine and medical rehabilitation relevant for the valuation of funding systems are analyzed. Particularly a reduction of the length of stay as a primary aim for the introduction of the DRG-system does not seem appropriate for medical rehabilitation. The existing funding system in medical rehabilitation is analyzed from an economic point of view. The cost management of the German pension insurance, being one of the rehabilitation providers in Germany, has achieved high quality standard of treatment as well as cost restriction. This funding system has been further developed during the last couple of years. Future developments are shown.     

医学专业与非医学专业大学生死亡态度的比较

[目的]比较医学专业与非医学专业大学生对待死亡的态度。[方法]选用死亡态度描绘量表（修订版）（DAP—R）对523名大学生的死亡态度进行调查,比较医学生与非医学大学生一般资料中影响死亡态度的因素。[结果]医学生与非医学生在死亡恐惧和趋近接受两个维度得分差异无统计学意义（P〉0．05）;而死亡逃避、自然接受及逃离接受3个维度得分差异有统计学意义（P〈O．05）。[结论]医学知识的获取可以帮助医学生正确看待死亡这一独特的社会现象,避免对死亡的逃避和逃离,对死亡更易持自然接受态度。     

医学检验技术专业学生实验室生物安全教育情况调查分析

目的 了解医学检验技术专业学生实验室生物安全认知现状，为医学检验技术专业开展有效的实验室生物安全教育提供依据。方法 2019年4月，利用问卷星平台在线发布问卷，对西南医科大学医学检验技术专业全日制本科在校大学一至四年级共414名学生进行实验室生物安全认知情况的问卷调查。结果 发放414份试卷，回收有效问卷389份；大学一至四年级学生的实验室生物安全基本知识得分逐级增高（43.68±15.78 vs.62.66±22.40 vs.70.82±18.05 vs.77.53±16.75）分；学生实验室生物安全操作行为正确率总体偏低，不同年级学生生物安全操作行为在安全事故、防护设施、废弃物处理、正确洗手、安全检查、清洗实验服六个方面存在明显差异（P＜0.05）。结论 医学检验技术专业学生实验室生物安全认知情况不容乐观。对医学检验技术专业，应从低年级开始开展系统、全面、深入的生物安全课程教育。     

Teaching medical students rehabilitation medicine

Purpose.?The principles of rehabilitation medicine will become ever more important across many medical and surgical specialties in view of the rising prevalence of chronic and disabling conditions. Yet rehabilitation medicine has traditionally been unpopular with medical students. This article aims to review the existing evidence of problems in teaching medical undergraduates in rehabilitation medicine and provide published recommendations and practical approaches from our own experience.

Method.?A literature review was carried out to search for publications relating to teaching rehabilitation medicine to undergraduates in order to identify problems that potentially affect undergraduate education in rehabilitation medicine and its future as a medical speciality.

Conclusion.?The lack of consistent undergraduate curriculum, knowledge of rehabilitation medicine and academic opportunities contribute to the inadequate perception of the speciality to the undergraduates. The attitude of medical students towards rehabilitation medicine is important for its future development as a specialty. Further standardisation of teaching rehabilitation medicine at a national level, promoting research activity in this area and increasing the profile of rehabilitation medicine are warranted.     

Smoking among medical students.

A survey of smoking habits of medical students was done using basic medical science graduate students at the same institution as a comparison group. Smoking status was not significantly related to sex, race, or academic classification. Knowledge of adverse health consequences of smoking was related to time spent in medical school and to whether or not the respondent smoked (ie. probable denial of knowledge of the adverse consequences among smokers). The respondent's smoking status was significantly related to familial and peer group smoking status and to peer group attitude. The most common reason given by quitters was "the media influence." The nonsmoker most frequently never began the habit because of fear of health consequences. Because of the finding that a small percentage of medical students still are not convinced of the dangers of smoking, it was suggested that increased educational emphasis on these dangers be included in the medical curriculum.