医疗机构利用网上招标进行设备采购的几点体会

利用网上招标采购系统，不仅使设备采购方便快捷、高效经济，而且做到公开透明，公正公平。同时阐述了医疗机构参加网上招标要注意的事项。     

医疗卫生装备网上招标系统的应用

医疗卫生装备网上招标是现代计算机技术、通讯技术和电子商务技术相结合的产物，是一种新的招标方式。在使用网上招标系统时除了应注重标书制作的全面、规范外，还应注意以下问题：正确打开下栽视频会议插件网页，适当调节视频音响．正确调试视频图像等，才能顺利完成网上招标工作。     

网上医疗设备招标的问题与对策

基于互联网的招标采购作为一项新事物,进一步拓展并深化了招标所倡导的“三公”原则。从实践出发,分析了网上设备招标的特点,结合在招标工作中所出现的问题,提出了以招标中心为主体的网上招标,并完善、优化了招标流程。使得网上招标工作更加高效、严密,招标结果更加令人信服,并维护了各方利益。     

参加医疗设备网上招标的实践

2004年6月，南京军区卫生部在全军卫生系统率先开展了医疗设备网上招标工作，经过半年多的运行，取得了显著的成绩。截至04年底，先后50余次成功地为全区30多家医院招标采购各类医疗设备265台件，价值近一亿元人民币，收到所属医院和有关供应商的欢迎。笔者有机会多次参加了医疗设备网上招标的具体工作，从电子标书制作、网上标书审核到网上评标。也曾多次参加军内外有关部门组织的传统集会式医疗设备招标。实践证明医疗设备网上招标相对于传统集会式医疗设备招标方式，确实有其独特的优势，有利于加强管理、提高效率、方便医院、节约经费，在此谈谈个人的一点认识。     

推行药品网上采购工作的探索

药品网上招标采购是利用电子商务平台进行药品招标、投标、竞价、采购、配送和结算，实现药品采购的公开、公平、高效，对于纠正医药购销中的不正之风，规范药品购销行为，控制药品的虚高定价等，有着非常积极的意义，有利于药品采购的监督管理，也有利于建立一种新的药品购销秩序。     

医疗器械网上招标采购过程中供应商的信用管理

结合军区医疗器械网上招标采购的工作实践．分析了在医疗器械网上招标采购过程中出现的各种供应商违规行为及其危害，剖析了导致这些行为的原因，提出了加强医疗器械网上招标采购供应商信用管理的建议。     

安徽大医院年内全部网上购药

安徽省卫生厅近日出台了《安徽省医疗机构网上药品集中招标采购工作实施方案》，提出力争到今年年底前，全省公立三级医院、省直医院全部实行药品网上集中招标采购；明年6月底前，全省公立二级以上医院将全部实行药品网上招标采购。     

崇尚荣誉管理,进一步加强供应商信用管理

根据军区开展医疗设备网上招标采购工作的实践经验,通过实行供应商诚信动态管理,进一步激励企业诚信守法经营,维护军区采购制度的严肃性,有力确保了上级赋予各项应急与日常采购任务的高效完成,推动了军区医疗设备网上招标采购工作的健康发展。     

医院开展网上招标投标的做法与体会

网上招标投标实施使公开、公平、公正的原则在更广泛的范围，更深的层面得到体现，尤其象地域广阔，无规律，集中不便，随机性的购买活动带来了前所未有的方便快捷。标书在网上进行公布，招标时间在网上预告，是公开的最佳形式；所有应标的厂家都处于同一起点，反映了公平性的原则；专家选择的来源多而优，体现了公正性。收到了较之以往集中采购，实施时间、地域限制。人员集中困难，无法达到的良好效果，给用户带来了节约费用的经济利益和及时、高效社会效益,其优势正越来越显示出来。     

信息技术在药品集中招标采购中的应用

为了纠正药品购销中的不正之风,上海金山区药品配置中心自1996年起实行药品集中招标采购,从初始的传真操作,到2000年采用Internet技术网上招标。具体方法：确立招标模式、规范医院公司的准入制度,并依照有关法规对公司实施年检,对其它医药公司也可实行随时验证制度。在做好上述准备的基础上,确定招标中心计算机网络架构和系统模型及数据交流数据,依其进行网上招标。网上招标实现了医疗机构的药品零库存管理,保证了药品及时供应,有利于公平竞争,缩短了交易周期。     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

对《医疗事故处理条例》的几点认识--学习《医疗事故处理条例》的一点体会

国务院颁布的《医疗事故处理条例》（以下简称《条例》）在吸收、总结原《医疗事故处理办法》（以下简称《办法》）实施十几年以来正反两方面经验教训的基础上，对《办法》作了许多重大的修改：《条例》扩大了医疗事故的主体与范围，提出了防范医疗事故的一些重要措施，授权医学会独立担纲医疗事故技术鉴定工作，赋予了患者更多的权利，规定医疗事故民事责任争议可以“私了”，制定了更为规范的医疗事故的赔偿制度等。《条例》作出的这些新规定必将使医疗事故得以更加科学、客观、公正、公平、合理的解决。认真学习、把握《条例》的这些新规定，很好地透视《条例》的立法宗旨与原则，必将极大地提高学习、宣传《条例》的主动性与积极性，更好地推进《条例》的贯彻执行工作。     

中国疾病预防控制中心公共职能的界定

目的　明确中国疾病预防控制中心公共职能的落实程度。方法　采用分层随机抽样法,在全国范围内抽取16 1个疾病预防控制中心,调查样本机构公共职能项目开展比例以及开展项目的操作程度。结果　(1)疾病预防控制中心公共职能项目的平均落实程度为4 2. 9% ,其中省级为5 6. 0 % ,市级为4 3. 7% ,县级为4 1. 3% ;东部地区为4 9. 3% ,中部地区为4 5 . 4 % ,西部地区为35. 3%。(2 )疾病预防控制中心七项公共职能中,疾病预防与控制落实程度职能落实程度为5 4 3%、突发公共卫生事件应急处置为6 5 . 8%、疫情报告及健康相关因素信息管理为35 . 0 %、健康危害因素监测与控制为31 .3%、实验室检测与评价39 .1%、健康教育与健康促进为36 .4 %、技术指导与应用研究为5 6 . 7%。结论　中国疾病预防控制中心各项公共职能落实程度普遍不高,并随地区和级别的变化而变化;各项公共职能中,突发公共卫生事件应急处置职能落实程度最高,健康危害因素监测与控制职能落实程度最低。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

北京市2010年流行性腮腺炎流行病学分析

目的 开展流行性腮腺炎监测,对制定疾病控制策略、评价疫苗免疫预防效果有重要意义.方法 对北京市腮腺炎个案数据库进行流行病学分析.结果 北京市2010年共报告2 935例病例,发病率为16.72/10万;发病主要集中在5～8月份;远郊发病率最高,其次是近郊,城区最低,与人口流动相一致;发病以小年龄为主,15岁以下病例占总数82.59％;外来人口发病率高于本市人口.结论 提高接种率仍是腮腺炎防控的关键,同时应保持和提高对学校等集体单位的监测敏感性,科学评价疫苗的效果.     

The quality of life of women of Chinese origin

This paper draws upon qualitative data to explore the quality of life of Chinese mothers with preschool children in the central part of Manchester. In doing this it considers their own self-reported health conditions. Both semi-structured and conversational face-to-face interviews were used with mothers in their homes. The names of Chinese mothers were drawn from the immunization records of the Health Authority and Hospital Trust of Central Manchester. The final interview sample of 30 had a Chinese surname in the record. 'Lee' as a surname was excluded because it was used both by Chinese and English people. The mothers' socio-economic background and their quality of life in terms of work conditions and leisure, housing and residential environment, marital support and life satisfaction were examined. The findings indicate that since they settled in the United Kingdom, the women have been under great psychological stress from a variety of sources. These sources included hardship and overwork, poverty and deprivation, poor social support and social isolation, unhappy family relationships, gambling husbands and domestic violence, together with language and cultural difficulties. All of these contributed to poor quality of living standards as well as indirectly causing negative psychosocial health outcomes. The unsatisfactory self-reported health conditions and poor quality of life of Chinese mothers were naturally interrelated and might be determined by the disadvantages of migration. However, the mothers themselves expressed little satisfaction with the health services and it may be that improvements are necessary in this area to ameliorate some of the disadvantages of migration.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

医院院长职业化概念的探讨

医院院长职业化随同新医改方案“管办分开、法人治理”精神的出台再度引起业内的广泛关注,但何为院长职业化、何为职业化院长等基本的概念仍尚未厘清,难免导致研究和实践的迷误。因而对现存代表性的模糊认识进行剖析,并结合国内外相关概况研究评述。最后得出中国特色的院长职业化的概念,以期为相关研究和实践提供参考。     

78例宫内节育器断裂事件分析

目的探讨高血压与男性性功能障碍发病风险的关系。方法采用前瞻性队列研究方法,随机抽取2015年中国人民解放军联勤保障部队第九二三医院进行健康体检的30~40岁已婚男性1000例进行基线调查,实际调查892人,有效应答率89.2%,剔除不符合调查条件者78例,最终可纳入研究对象为814例。按基线调查有或无高血压情况分为高血压组和正常血压组。随后开展3年随访,并剔除在随访中新发影响性功能的器质性疾病者、随访期服用降压药者、失访者,共135例。最后可纳入数据统计分析共679例。采用Cox模型分析高血压与男性性功能障碍发病风险比及95%可信区间(95%CI)。结果高血压组177例(26.07%),正常血压组502例(73.93%)。开展3年随访发现高血压组患者的性功能障碍发生率为48.58%,明显高于正常血压组的15.54%,差异有统计学意义(P<0.05)。Cox回归单因素结果显示,高血压组性功能障碍发病风险是正常血压组的2.056倍;调整高血压患者的年龄、BMI、饮酒、吸烟、职业类型、夫妻关系、高血脂症史和糖尿病史因素后,Cox回归多因素分析结果显示,高血压组性功能障碍发病风险是正常血压组的3.133倍。结论高血压是增加男性性功能障碍发生风险的危险因素,临床中应密切关注男性高血压患者的情况,并及早采取措施预防或避免性功能障碍发生。     

医院物业社会化服务质量控制实践

医院物业社会化是医院后勤发展的趋势,加强物业监管可满足医患人员及院感对医院环境的高要求。通过对物业公司实行质量控制举措,成立后勤质控组,严格准入退出机制,细化合同服务条款和考核,建立物业服务测评体系、双向沟通机制,严格执行质控巡查制度等,物业社会化服务质量明显提升。主要表现在:加强了对物业中层管理者的考核,提升了管理力度和质量;2012年-2018年物业综合服务满意度从71.53%提升至97.24%。医院物业社会化需要持续考核、追踪、监管、改进,以不断提升医院环境卫生及物业保障水平。