卫生系统内部审计工作规定

《卫生系统内部审计工作规定》已于2006年6月13日经卫生部部务会议讨论通过,现予以发布,自发布之日起施行。部长高强二○○六年八月十六日第一章总则第一条为加强卫生系统内部审计工作,建立健全各单位内部审计制度,完善内部监督制约机制,规范收支管理,促进卫生事业健康发展,根据《中华人民共和国审计法》和《审计署关于内部审计工作的规定》,结合卫生系统具体情况,制定本规定。第二条卫生系统内部审计是指卫生系统内部审计机构和审计人员,对本单位及所属机构的财务收支、经济活动的真实、合法性进行独立监督审核的行为。第三条本规定适用于…     

卫生系统内部审计工作规定

第一章 总则 第一条为加强卫生系统内部审计工作，建立健全各单位内部审计制度，完善内部监督制约机制。规范收支管理，促进卫生事业健康发展，根据《中华人民拭和国审计法》和《审计署关于内部审计工作的规定》，结合卫生系统具体情况，制定本规定。     

现阶段卫生系统内部审计存在的问题及对策

卫生系统的内部审计工作，在促进卫生资金的合理使用，加强廉政建设方面，发挥了重要作用。中华人民共和国卫生部第51号令即《卫生系统内部审计工作规定》以及《江苏省卫生系统内部审计实施办法》都明确规定，二级乙等以上的医院、财务收支数额较大的预防保健机构和财务收支数额较大或者所属单位较多的国家事业单位和社会团体，应当设立独立的、与本单位财务机构相同级别的内部审计机构，     

新制度下医院内审的侧重点

一、新形势下内部审计的意义医院内部审计是审计人员依照国家的政策、法令和财经制度,按照一定的程序和方法,独立地对本单位的财务收支及经济活动全过程进行监督、评价、鉴证的一种活动。目前医院的内部审计制度是根据1989年卫生部颁布的《卫生系统内部审计工作规定》和《综合医院分级管理标准》中对审计任务和标准建立的,曾为促进医院事业发展发挥了重要作用。随着社会主义市场经济体制的建立,医疗市场的形成,医院的资金主体结构发生改变,医院的经营活动内容不断扩大,医院会计模式和核算方法也跟着发生变化,这些都使内部审计任务更显重要。内审工作应跟上卫生改革的步伐,针对医院经济活动特点,发挥其监督管理评价职能,以达到完善自我约束机制、维护财经律、改善经营管理、提高两个效益的目的。     

卫生防疫机构内部审计的地位及工作重点

<正> 《审计法》和卫生部《卫生系统内部审计工作规定》颁布后,我国卫生系统内部审计已把财政审计作为职责写进规定,这对卫生事业的财务收支,财经法纪和经济效益进行监督,促进了社会效益、经济效益和管理水平的提高。但是,内审工作也有出现流于形     

加强医院内部审计 促进医院经营管理

俗话说：“没有规矩，则不成方圆”，为了规范内部审计工作，明确内部审计机构和人员的责任，根据《中华人民共和国审计法》、《审计署关于内部审计工作的规定》及相关法律法规制定了《中国内部审计准则》，可以说，它的出台进一步完善了我国审计监督体系。     

做好医院内部审计工作的几点思考

国家卫生部2006年颁布的《卫生系统内部审计工作规定》明确规定,年收入3000万元以上或拥有300张床位以上的医疗机构,应当设置独立的内部审计机构,配备审计人员。医院内部审计机构作为医院管理的重要职能部门,其职能范围不仅局限于查错防弊,而是已经从以真实性、合规性为导向的财务审计向与内部控制和风险管理为导向的管理审计并重的方向发展。因此,做好医院内部审计工作对推进医院可持续发展显得尤为重要。     

加强卫生内审 促进事业发展

卫生审计是保障卫生经济活动在国家法规的范围内正常运作,提高卫生经济效益,促进事业发展的重要工作。1988年,云南省卫生厅成立审计室,根据《中华人民共和国审计条例》、《审计署关于内部审计工作的规定》和卫生部《卫生系统内部审计工作规定》的要求,本着“一审二帮三促进”的精神开展卫生系统内部审计工作。把服务寓于监督之中,纠风治乱,防弊堵漏,几年来共审计15个单位,42个项目,查出违纪收费133.02万余元,贪污受贿24人,37.84万元。在厅党组的重视支持下,在省审计厅的指导下,卫生内审工作已进入规范化。     

医院内部审计存在的问题与建议

内部审计是一种独立、客观的保证和咨询活动,其目的在于为组织增加价值并提高组织的运作效率。它采用系统化、规范化方法对风险管理、控制和治理程序进行评估和改善,从而帮助组织实现它的目标。长期以来主管部门一直强调医院外部审计的重要性,随着我国医疗体制改革的不断深化和医院间日益激烈的市场竞争,医院内部审计工作在医院经营管理中的作用越来越受到关注。卫生部于2006年颁布了《卫生系统内部审计工作规定》,根据规定,     

医院内部审计机构:专项审计项目的选择和审计方法

自从卫生部制定下发《卫生系统内部审计工作规定》以来,大中型医院均设置独立的内部审计机构。然而配备的专职审计人员,不是由原来纪检部门“转业”过来的，就是由财务科“分离”出来的。他们对日常审计还可以适应，但对专项审计却缺乏经验,影响内部审计作用的发挥。下面介绍医院内部专项审计项目的选择和审计方法。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.