基于物资供应链的医用高值耗材二级库管理模式

该研究分析了医用高值耗材传统管理模式存在的主要问题，提出通过医院物资供应链管理系统和医院信息系统（HIS）全面对接、实时共享，建立针对医用高值耗材的二级库管理模式。二级库管理模式实现了医用高值耗材申领、供应商管理、零库存管理、预警、全流程追溯等功能，弥补了传统一级库管理模式的不足，为财务预算提供了真实准确的数据，为全成本核算奠定了基础。     

医用耗材二级库管理的应用实践与效果分析

为加强医院医用耗材的监督和管理,该研究使用信息化手段对重点医用耗材进行了二级库管理的探索和实践,形成了完整的医用耗材二级库管理流程和模式,实现了重点医用耗材从准入、入库、使用、出库、结算全流程可追溯的信息化管理。实践结果表明,二级库管理模式显著提高了医用耗材的管理质量,也提高了医院的精细化管理水平。     

北大医院高值医用耗材系统管理概述

本文描述了高值医用耗材的特性,并针对医院管理中普遍存在的问题及医院对高值医用耗材强化管理的必要性和可行性进行了分析,阐述了北大医院针对高值医用耗材建立二级库管理、核实收费情况、提高信息化管理的方法、手段、意义和效果。     

二级库管理在医用耗材信息化管理与监控中的应用

目的：建立医用耗材二级库,通过医院资源规划（HRP）运营系统推进医用耗材的精细化管理与监控。方法：利用信息化技术设计基于HRP运营系统的医用耗材二级库管理系统,医用耗材二级库管理系统入库验收、移库、出库、库存查询、使用统计、结算查询等多项功能。二级库管理系统能有效转变一级库“以领代销”发展模式,从多路径出库,通过实用实销核算支出,确保“进”“销”“存”数据的准确,确保财务数据准确。结果：2021年1月～6月与2019年同期相比半年出库金额对比较之前下降约12%,可精确耗材成本核算,实现耗材的使用消耗与对应收入同步,建立“实用实销”的管理模式。结论：医用耗材二级库管理便于实现多重物流配送信息联动发展,全面提升管理成效。通过使用追溯及流程控制,为医用耗材全面精细化管理奠定基础,可保证耗材使用的全流程监控。     

高值医用耗材规范管理的探讨

作者对医院高值医用耗材的管理各环节进行探讨,包括严格使用准入审批、加强高值耗材集中采购管理、确保仓库管理、规范临床使用、全流程监督等,规范高值医用耗材的采购与临床使用行为,保障医院的医用耗材质量和医疗安全。     

基于条形码收费和核销的医用耗材管理模式的探讨

随着医用耗材在大型医院中取消加成,卫健委对其监管的越来越严格,以及从医院管控成本的角度来看,医用耗材特别是高值耗材的全闭环可追溯管理在现代医院的精细化经营管理中占有重要地位。文章探讨了基于条形码的医用耗材管理模式,将条形码技术应用在医用耗材的收费和核销环节,可实现高值耗材的全流程追溯管理,以及低值耗材的便携式扫码收费核销,既可节约人力成本又可规约科室对材料的使用,加强对收费过程的管理。同时探讨了医用耗材二级库管理模式下的难点和解决方案。     

精细化管理在医用耗材二级库的实践

医用耗材二级库是医用耗材的直接供应部门,对医用耗材的合理使用及安全保证承担着重要的责任。在保障临床医疗需求的前提下,可通过建立健全二级库耗材计划、领用、消耗、计费四要素的关联关系,采取流量流向管理技术,实现对医用耗材二级库的精细化管理。     

新冠肺炎疫情常态化防控期间的医用耗材二级库10S管理

目的:在新冠肺炎疫情常态化防控期间,针对二级库房耗材使用频次变化,应用10S管理策略,提高医疗护理质量和医院运作效率。方法:对医院各病区二级库进行10S管理,实施并逐步完善整理、整顿、清扫、清洁、素养、安全、节约、服务、学习、满意各个步骤,加强医用耗材的使用核查和各病区间的统筹协调,促进医用耗材管理精细化。结果:10S策略能保证医疗资源配置和管理的最优化,促进工作效率、服务质量提高,在新冠肺炎疫情常态化防控期间对二级库医用耗材实施10S管理后,耗材领用金额下降、住院患儿满意度提高。结论:医用耗材二级库10S管理,能降低耗材成本支出、提高患儿满意度、规范员工行为,是一种科学的管理模式。     

医用耗材二级库与流量流向管理

医用耗材的合理使用和有效监控是各级医院普遍存在的管理难题。以流量控制和流向监管为方向,建立医院耗材二级库管理模式,探索科学、合理、规范、精细的耗材使用管理新办法。     

高值医用耗材精细化闭环管理平台的设计与实现

目的 构建高值医用耗材精细化闭环管理平台,保证高值医用耗材的使用安全和规范管理,提升管理效率,控制医疗费用不合理增长。方法 分析目前存在的管理问题,研发高值医用耗材管理平台,实现与医院的业务信息系统、集采平台的信息互联互通,实现高值医用耗材的闭环管理和全程追溯。结果 实现从申请、审批、采购、配送、使用、记账、监测到评价等环节的信息化管理,改善了管理模式,提高了工作效率和高值医用耗材使用的安全性。结论 高值医用耗材管理平台能实现高值医用耗材全流程信息化监管,有效地控制医疗费用不合理增长,规范医疗服务行为,降低医院运营成本。     

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.     

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.     

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.     

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.     

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.     

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.     

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.