医院项目投资决策应予考虑的相关因素

医院发展离不开医疗项目投资，为了减轻投资风险，把握投资机会，笔者就医院项目投资与相关市场变化、项目成本和技术因素进行讨论，强调项目的社会效益、医院的整体和长远利益。     

清洁发展机制下垃圾填埋气发电项目的分步式建设

大多数投资人在决策投资垃圾填埋气发电项目时,会面临两大难题：一是投资收益率低,二是初投资门槛高,前者在CDM机制的参与和国家政策的扶持下,得到了很好的解决。而初投资的门槛,却让很多填埋气项目进展缓慢、本文以北京某垃圾填埋场填埋气利用项目为例,探讨了在初投资短缺的情况下,如何合理利用CDM机制进行项目的分步式建设。     

医院项目投资决策应考虑的相关因素分析

医院发展离不开医疗项目投资，为了减轻投资风险，把握投资机会，笔者就医院项目投资与相关市场变化、项目成本和技术因素进行讨论，强调项目的社会效益、医院的整体和长远利益。     

关于政府投资的医院建设项巨绩效评价实践与思考

为了提高政府投资的效益，规范政府投资项目的预算管理，强化政府投资项目资金全过程监管，根据财政部《关于开展政府投资项目绩效评价工作的指导意见》，我们组织开展了政府投资的医院基本建设项目绩效评价工作。本文主要介绍了政府投资的医院基本建设项目开展绩效评价的做法，通过对评价结果的分析、比较，提出思考和建议。     

国家体改委负责人指出今年改革重头戏 建立投资新体制

国家体改委副主任张皓若透露,建立政企分开的投资体制是当前改革中一项非常紧迫的任务。今年将把投资体制改革放到突出位置,重点抓好三项工作。第一,进一步明确政府、企业、银行在投融资体制中的职责范围,建立投资风险约束机制。政府主要投资于公益性项目和部分基础设施项目,一般不对竞争性项目直接投资。按照这一框架,今年要扎扎实实推进以下工作,一是政府要通过向社会转让股份,将部分竞争性项目和基础性项目中的国有资本转向科技,教育等公益性项目投资。二是政府一般不对竞争性项目投资,对政府没有投资的项目,政府不审批,用登记备案制代替现行的审批制。三是积极推进投资主体多元化。四是切害加快国有专业银行商业化改革步伐。     

论投资决策审计

一、投资决策审计的意义 投资决策审计,是一种在某项目投资方案实施之前,对该项目投资的经济效果结论及其测算过程进行的经济监督行为。它与工程招标、签约行为和工程预算方案审计等,完整地构成项目投资经济效益事前审计环节。 在社会主义市场经济条件下,对于盈利型投资,必须要求     

工程项目"代建制"模式全过程的投资与管理

一个项目从前期决策、可行性研究、勘察设计、施工准备、施工、竣工验收、审计决算、项目运行乃至拆除报废是一个全寿命周期.项目在建设过程中,对内管理涉及众多的参建单位,对外与政府监管部门、社会环境等相关联,如何在项目建设过程中建立一个投资控制体系,采取有效投资控制措施,是控制"三超"现象的关键.文章主要介绍了上海市市级医院项目实行"代建制"管理模式中的投资控制实践方法.     

县卫生防疫站对乡镇企业卫生审核初探

随着经济体制改革的进一步深入,工业生产得到了迅速发展,特别是乡、镇、村办企业越来越显示出强大的生命力,它们对推动和促进经济的搞活和发展起着重大的作用。 由于这些企业本身的经济特点,往往承接一些生产设备投资少,手工操作程度大,职业危害较严重的生产项目。这就对县一级卫生监督部门提出了一个新的课题:如何既保证这类企业的迅速发展,又有利于     

上海市级医院基本建设项目投资控制分析与管理

以上海市级医院的多个新建及改扩建项目为样本,分析引起医院建设项目超投资的主要因素,包括项目综合管理水平较弱、项目方案频繁变更、设计缺陷、建筑材料价格波动、政策因素以及概算编制不合理等。针对这些主要影响因素,对于从项目立项阶段至项目审价阶段的全过程投资控制提出建议,旨在为上海市级医院建设项目投资的科学性决策提供参考,最终提高医院建设项目的投资控制水平以及政府资金效益。     

医疗单位固定资产投资理论在更新改造决策中的应用

阐述了医疗单位固定资产投资理论在更新改造中的应用,分别采用项目投资中的投资回收期、净现值法比较2种方案回收期的长短、增减的现金净流量,计算出投资回收期短、项目的净现值大于零的方案为最优的方案,最终使固定资产投资发挥最大效能,对于提高医院固定资产的创收效益也具有重要的应用价值。     

院长最关注的改革重点:基于三级公立医院的调查

目的:了解我国大型公立医院院长对公立医院改革主要措施的关注情况及态度。方法:随机抽取200名三级公立医院院长进行横断面调查。结果:公立医院院长最关注的问题是增加政府投入(83.7%),对推行临床路径关注比例最低(19.7%)。院长认为政府平均投入应占医院总收入的50.8%,且55.1%的院长认为政府应该按项目对公立医院进行投入。82.0%的院长认为收入未提高是影响医务人员参与医院改革积极性的主要因素,并且仅14.5%的院长对自己目前的收入水平是满意的。结论:三级公立医院院长最关注医院运营相关的改革措施,其次是薪酬制度和院长责权改革。因此,公立医院改革应建立科学合理的医疗服务价格体系以及长效的政府投入机制。建立符合医疗行业特点的岗位绩效薪酬制度,调动医务人员积极性。明确院长责权,落实公立医院经营管理自主权。     

Consider a microcomputer

Although computers have proven to be effective tools in managing the administrative aspects of a medical group practice, many groups are hesitant to invest in this new technology. They are concerned about huge capital expenditures for equipment, the consequences of the implementation period, and failures that many groups are reported to have experienced in this endeavor. Microcomputers are a low-cost method through which a medical group can experiment with computerized information systems without taking the risk of total conversion from a manual to an automated system. The experience of the Sterling Heights Center in implementing a microcomputer is helpful to any group considering such a system.     

Research on Food in Brazil: sustaining the autonomy of the Food and Nutrition field

Based on Bourdieu's thoughts about the scientific fields, we visited the Research Groups Directory of the National Council for Scientific and Technological Development (CNPq), seeking to invest in critical and reflective approach on the segment of Brazilian research work concerned with "food". We identified a stable and growing set of research groups whose visibility is compromised, once its name is not included in the institutional taxonomies within the agencies that support research and researchers' formation. Its epistemological foundations, its theoretical and methodological bases are located in the sphere of Humanities and include a wide range of interacting disciplines, forming a significant complexity around its central object: food. The study of feeding phenomena calls for interdisciplinarity and makes the challenge of facing the tensions inherent to democratic life in which we have a glimpse in which the growing and collaborative coexistence among different epistemic references must take institutional place.     

Lay discourses and beliefs related to food risks: an Australian perspective

Much publicity has been given to risks associated with food in Western countries. This article draws on an Australian research study using qualitative interviews to investigate discourses and beliefs related to food risks among lay people. It was found that the interviewees were most concerned about dietary fat as a risky substance related to overweight, both because of health reasons and physical appearance. A secondary concern they identified was the processing of foodstuffs and 'unnatural' additives. The dominant discourses which were commonly used to organise people's ideas included those concerning 'trying' to consume the 'right' kinds of foods, the importance of 'balance', the notion of food as 'functional' for bodily health, the 'blame' that often accompanied moral judgements about the diet of people with serious illnesses such as cancer and the 'battle' and need for 'control' that people with children referred to in relation to making sure that their children consumed a healthy diet. Most people were willing to invest their trust in government bodies and health professionals to provide accurate information about food risks, as well as trusting their own judgement. The relevance of the Australian cultural context for these findings is discussed.     

Clinical researchers and the pharmaceutic industry. The research contract is not an addendum]

The relation between a pharmaceutical company and a clinical investigator combines a certain form of entrepreneurship with scientific endeavour. Both parties are concerned with the content of the clinical study as well as with its business aspects. A good contract is essential for the project to succeed. In three cases based on actual experience the contract failed. In the first case, dosage miscalculation in the hospital pharmacy led to side effects in patients as a consequence of which the study was stopped. The pharmaceutical company sued the investigator. In the second case the investigator published data in a congress abstract, which prevented a patent by the company. In the third case scientific information was published by the company with the principal investigator featuring in the acknowledgement section of the article only. Investigators should have their own standard contract ready, and they should invest time and energy in understanding the contracts of the research they are carrying out.     

Personalised medicine and the state: A political discourse analysis

The last decade has seen a range of health policy initiatives relating to personalised medicine. There is an emerging body of studies that demonstrates the continued importance of states in the development of personalised medicine. This paper contributes to this literature by focusing on how political discourses construct the role of states in personalised medicine. Based on a case study of the introduction of a national programme in Denmark, the analysis identifies specific discursive mechanisms in this construction. The material consists of documents from key national stakeholders, media coverage and interviews with experts at the national level. The analysis found three types of discursive mechanisms. Firstly, mechanisms can relate to problem definitions, and these were concerned with a number of salient problems of health services. Secondly, mechanisms can relate to underlying assumptions, and these were about the possibility of engineering healthcare improvement through data and by extension personalised medicine. Thirdly, mechanisms can relate to discursive effects, and here the state emerged as a highly influential governor. These mechanisms are likely to be highly relevant for other countries, but future research needs to test this. Health policy practitioners and health administrators thus need to invest effort into influencing political discourses around personalised medicines, in addition to the formulation of policies itself.     

Metabolomics: an emerging post-genomic tool for nutrition

The post-genomic era has been driven by the development of technologies that allow the function of cells and whole organisms to be explored at the molecular level. Metabolomics is concerned with the measurement of global sets of low-molecular-weight metabolites. Metabolite profiles of body fluids or tissues can be regarded as important indicators of physiological or pathological states. Such profiles may provide a more comprehensive view of cellular control mechanisms in man and animals, and raise the possibility of identifying surrogate markers of disease. Metabolomic approaches use analytical techniques such as NMR spectroscopy and MS to measure populations of low-molecular-weight metabolites in biological samples. Advanced statistical and bioinformatic tools are then employed to maximise the recovery of information and interpret the large datasets that are generated. Metabolomics has already been used to study toxicological mechanisms and disease processes and offers enormous potential as a means of investigating the complex relationship between nutrition and metabolism. Examples include the metabolism of dietary substrates, drug-induced disturbances of lipid metabolites in type 2 diabetes mellitus and the therapeutic effects of vitamin supplementation in the treatment of chronic metabolic disorders.     

Elderly people from ethnic minorities in Liverpool: mental illness, unmet need and barriers to service use

The objective of the Health and Ethnicity Project was to identify unmet need and barriers to the use of psychogeriatric and welfare services by ethnic minority older people living in Liverpool's inner-city. The results presented here are the findings of Phase II of the project in which 71 ethnic minority older people aged 65 years and over were interviewed. These respondents had been diagnosed as suffering from dementia or depression earlier in Phase I. They include Black British, Afro Caribbean and Chinese older people. Findings show a low level of service use in spite of considerable unmet need. Only 8% were in institutions and 46% lived alone. For the 17% living alone in sheltered housing, there was evidence of violence towards wardens, wandering, neglect of rooms and occasional fires. Of the 27% living with a family nearly a half of cases also experienced physical disability. Those in institutions were finding language difficulties and problems in obtaining a suitable diet. Using Yeatts et al.'s typology (1992) ‘lack of knowledge’ barriers and ‘lack of intent’ barriers concerned the group as a whole most, i.e. they either did not know of services or perceived them as being culturally inappropriate. Implications for service providers are considerable: to ensure improved access it is necessary not only to invest more in general medical services but to work in partnership with ethnic minority groups to overcome barriers of mistrust and ensure cultural sensitivity in the services offered.     

Managing research evidence to inform action: influencing HIV policy to protect marginalised populations in Pakistan

Abstract Our aim was to demonstrate that an understanding of the process of how research may (or may not) influence policy and practice is crucial to leverage research findings and bring about evidence-informed policy and its implementation. We describe a process of research design and execution, based on theories of the relationship between evidence and public policy-making, which sought to improve the uptake of evidence into the HIV policy-making process in Pakistan. We designed and implemented specific strategies in research methods, management and dissemination to increase the policy influence by recommendations from a multi-disciplinary research project. Research to policy is complex, rarely linear and causal attribution is problematic. Nonetheless, we believe that, in part, some of the current changes in HIV policy and practice in Pakistan may be due to the managed process of research influence. We offer four key recommendations for those concerned with improving the chances of seeing their research incorporated into policy and practice - these are (1) involve stakeholders in research management; (2) set realistic expectations of research impact; (3) invest in long-term research-policy-maker relationships; and (4) build capacity of end users to use research to demand policy change.     

Managing research evidence to inform action: Influencing HIV policy to protect marginalised populations in Pakistan

Abstract

Our aim was to demonstrate that an understanding of the process of how research may (or may not) influence policy and practice is crucial to leverage research findings and bring about evidence-informed policy and its implementation. We describe a process of research design and execution, based on theories of the relationship between evidence and public policy-making, which sought to improve the uptake of evidence into the HIV policy-making process in Pakistan. We designed and implemented specific strategies in research methods, management and dissemination to increase the policy influence by recommendations from a multi-disciplinary research project. Research to policy is complex, rarely linear and causal attribution is problematic. Nonetheless, we believe that, in part, some of the current changes in HIV policy and practice in Pakistan may be due to the managed process of research influence. We offer four key recommendations for those concerned with improving the chances of seeing their research incorporated into policy and practice – these are (1) involve stakeholders in research management; (2) set realistic expectations of research impact; (3) invest in long-term research–policy-maker relationships; and (4) build capacity of end users to use research to demand policy change.