中国部分贫困地区孕产妇保健服务提供质量状况分析

利用卫Ⅵ项目终末现场调查资料，重点围绕乡村级孕产妇保健服务提供的内容，数量，拥有相关的知识技能情况进行了分析。分析显示：产前检查，住院分娩，产后访视服务提供的数量及内容基本达到了项目要求，乡村妇保人员的基本知识与技能掌握良好，服务态度令被访妇女满意，但分析也反映出，乡村妇保人员对于产后血的紧急处理和护送转诊处理，妊高征（尤其是先兆子痫）的处理等相关知识还存在不足，分析结果提示，今后应加强贫困地区乡村级孕产妇保健服务质量的提高。     

武汉市部分老年人长期照护需求研究

介绍了老年人长期照护需求的意义和国内外概况,对老年人对社会性长期照护服务需求的总体情况进行了详细分析,并进行了讨论,提出了政策性建议。     

农村医疗保障制度建设研究

基于我国城乡分治、二元经济的国情，我国农村医疗保障体系的建设要与农村的经济水平相适应，只有通过政府职能的转换和市场机制的运作。大力发展农村经济，培育和扩大农村市场，才能培育起多元化的农村医疗保障体系；只有通过市场优化配置农村医疗资源，才能缓解因病致贫现象。     

农村基本护理服务项目人力成本测算及补偿方法研究

目的:为适应农村卫生服务的发展,更好满足农村基本护理服务的需求,增强农村护理人力资源配置的合理性.方法:建立了农村基本护理服务评估内容体系,通过对大兴、昌平、顺义社区服务站的现场调查,从服务内容和人力资源配置方面增强了对农村基本护理服务的了解.结果:提出了现阶段农村基本护理服务项目内容体系共计17项,涉及范围主要包括基础护理技术、生命指征观测、诊疗护理技术和健康教育等,测算了农村基本护理服务项目人力成本,提出了护理服务补偿的基本建议.     

对农村医疗卫生服务方式的调查

医疗卫生服务方式决定着医疗卫生资源的配置和利用,也决定着人们的就医行为,及就方式.为了更好的发展农村卫生事业,不断满足农村居民的医疗卫生保健需求,2001年5月8 日国务院体改办转发了五部委《关于农村卫生改革与发展的指导意见》.《意见》明确指出,“在有条件的农村地区可以试行社区卫生服务”,为此,不少农村卫生部门积极响应,采取措施,推行农村社区卫生服务,并取得了一定的成效.     

整体护理对老年多病共存患者的住院干预

目的 探讨整体护理对提高老年多病共存(以下简称:共病)患者护理效果的影响.方法 将468例老年多病共存患者分为干预组和对照组,每组分别为234例.干预组在住院期间实施整体护理,包括心理疏导、健康评估与教育;对照组住院期间实施传统护理.对比两组患者出院时的Barthel指数得分、住院期间不良事件发生率并统计其住院死亡率、治疗依从性和护理满意程度.结果 干预组患者的Barthel指数得分、住院期间不良事件发生率、住院死亡率以及治疗依从性与对照组相比,差异均具有统计学意义(P＜0.05);干预组患者的护理满意度要高于对照组,差异具有统计学意义(P＜0.05).结论 整体护理对提高老年多病共存患者的日常生活能力效果显著,同时能够降低患者住院期间的不良事件,改善其治疗依从性,提高护理满度度.     

践行优质护理 提升护理服务质量

结合神经外科ICU实施优质护理的实践,从建立健全规章制度并严格执行;强化培训,积极转变观念;落实护士分层管理;简化护理文书书写;落实基础护理,强化细节服务;明确标识,落实差错管理等6方面,总结了优质护理的主要经验。     

贫困农村地区妇女的产时保健：问题与对策

本文对云南贫困农村地区产时保健存在的问题进行了分析,结果表明,贫困地区住院分娩率低,新法接生率低,且短期内难以大幅度提高;产时并发症发生率高;贫困妇女不愿意住院分娩。针对上述情况,可考虑提供住院分娩,在家由受训人员接生分娩和在家由家人接生分娩三级服务,并采取其他相应的配套措施以加强贫困地区的产时保健工作。     

The Effectiveness of a Rural Nursing Center in Improving Health Care Access in a Three-County Area

The purpose of this article is to describe an innovative nurse-managed health center that has been effective in improving access to primary health care for residents of a Midwestern three-county rural area. Penchansky and Thomas's (1981) framework for evaluating health care access was used to analyze client satisfaction and utilization data. Findings clearly indicate success in improving access. Client satisfaction surveys consistently show a high level of satisfaction across all framework dimensions, including overall satisfaction with the health care received. Utilization data indicate a steady increase in the number of clients served, especially those who are uninsured or underinsured. This article demonstrates that key dimensions of access can be effectively measured using the Penchansky and Thomas framework and concludes with recommendations for enhancing the model.     

Primary Care Service Areas: A New Tool for the Evaluation of Primary Care Services

Objective. To develop and characterize utilization-based service areas for the United States which reflect the travel of Medicare beneficiaries to primary care clinicians.
Data Source/Study Setting. The 1996–1997 Part B and 1996 Outpatient File primary care claims for fee-for-service Medicare beneficiaries aged 65 and older. The 1995 Medicaid claims from six states (1995) and commercial claims from Blue Cross Blue Shield of Michigan (1996).
Study Design. A patient origin study was conducted to assign 1999 U.S. zip codes to Primary Care Service Areas on the basis of the plurality of beneficiaries' preference for primary care clinicians. Adjustments were made to establish geographic contiguity and minimum population and service localization. Generality of areas to younger populations was tested with Medicaid and commercial claims.
Data Collection/Extraction Methods. Part B primary care claims were selected on the basis of provider specialty, place of service, and CPT code. Selection of Outpatient File claims used provider number, type of facility/service, and revenue center codes.
Principal Findings. The study delineated 6,102 Primary Care Service Areas with a median population of 17,276 (range 1,005–1,253,240). Overall, 63 percent of the Medicare beneficiaries sought the plurality of their primary care from within area clinicians. Service localization compared to Medicaid (six states) and commercial primary care utilization (Michigan) was comparable but not identical.
Conclusions. Primary Care Service Areas are a new tool for the measurement of primary care resources, utilization, and associated outcomes. Policymakers at all jurisdictional levels as well as researchers will have a standardized system of geographical units through which to assess access to, supply, use, organization, and financing of primary care services.