妇幼保健院住院部医生配置标准研究

目的:确定深圳市妇幼保健院住院科室住院医生的配置标准。方法:通过调查表咨询各住院科室正副主任、管床医生、卫生管理的相关专家等获得关键指标数据,并且对其进行统计学处理。结果:"每管床医生平均担当病床数"为10.40张;"二线医生与管床医生比例"为0.53;还获得住院部各临床科室相应的指标数值。结论:此研究方法科学有效,研究结果合理可靠,可以为深圳市妇幼保健院住院医生的配置标准提供依据,并且为其他地区住院医生配置标准的研究提供借鉴。     

三级综合医院门诊医生配置标准研究

目的:确定深圳市三级综合医院及各门诊科室门诊医生配置标准。方法:通过调查表咨询各门诊科室正副主任、卫生管理的相关专家等获得关键指标数据,并且对其进行统计学处理。结果:"每门诊医生每小时门诊诊疗人次"、"中夜班医生日诊疗人次弹性系数"和"效率系数"等关键指标的平均数值分别为:6.39±4.43、0.330、1.123±0.218;还获得门诊部各临床科室相应的指标数值。结论:本研究方法科学有效,研究结果合理可靠。可以为深圳市三级综合医院门诊医生的配置标准提供依据,并且为其他地区医生配置标准的研究提供借鉴。     

妇幼保健院门诊医生配置标准研究

目的:确定深圳市妇幼保健院各门诊科室门诊医生配置标准。方法:通过调查表咨询各门诊科室正副主任、卫生管理的相关专家等获得关键指标数据,并且对其进行统计学处理。结果:"每个门诊医生每小时门诊诊疗人次"、"中夜班医生日诊疗人次弹性系数"等关键指标的平均数值分别为:5.10±3.14和0.19,还获得门诊各临床科室相应的指标数值。结论:此研究方法科学有效,研究结果合理可靠;研究可以为深圳市妇幼保健院门诊医生的配置标准提供依据,并且为其他地区医生配置标准的研究提供借鉴。     

三级综合医院临床科室门诊及病房医师人力资源配置测算方案的设计

目的设计三级综合医院临床科室门诊及病房医师人力资源配置测算方案。方法通过文献研究法及关键人咨询法确定三级综合医院临床科室门诊及病房医师人力资源配置测算方案设计思路;通过问卷调查法确定方案中涉及的相关指标及对其取值初值进行确定;通过德尔菲专家咨询法最终确定测算指标及其相关取值。结果设计出科学合理的三级综合医院临床科室门诊及病房医师人力资源配置测算方案。结论该方案能够为三级综合医院科学合理配地置临床科室门诊及病房医师人力资源提供依据。     

四所城市医院医生数供需分析

本文依据某城市１９９８年９月至１９９９年９月财务活动资料 ,采用标准劳动定额法 ,作分析如下 :一、四所城市医院医生人数供需现状分析(一 )定量分析 (见附表 )附表门诊住院年门诊人次（万）门诊医生数（名）实际每门诊医生日均门诊量（人次）实际门诊医生需要数（名）标准门诊医生需要数（名）门诊医生供需差（名）门诊医生过剩率（ %）年实际占用床日（万）住院医生数（名）实际每住院医生日均管床数（张）实际住院医生需要数（名）标准住院医生需要数（名）住院医生供需差（名）住院医生过剩率（ %）医生总剩余率（ %）医院甲４４．１…     

某大型综合医院护理人力资源配置研究

目的 从目前护理人员承担的工作量出发,探讨临床科室护理人员配置理想床护比,为医院护理人力配置提供依据.方法 以工作量测算法作为核心研究方法,采用工现场观察法对西安市某大型综合医院42个临床科室护士的工作量进行测算,并使用Excel、SPSS 17.0统计软件进行公式运算和统计分析.结果 (1)临床科室护理人员的工作时间超过标准工作时间6小时; (2)所调研科室现有床护比仅为1:0.46,缺编41.50％; (3)依据目前的工作量需要,内科病房的床护比应为1:0.62,外科病房床护比应为1:0.63,监护科室为1:2.08,平均床护比1:0.78.结论 临床科室医师人员配备亟待补充,医院应根据实际工作量进行合理测算后配置护理人员,通过工时测定提出的理想床护比可为其他医院提供参考.     

山东省医院卫生技术人员配置标准研究

医院管理中 ,卫技人员配置一致都很重视[1 3 ] 医生和护理及医技人员的配置标准是共同关心的问题 ,我们对此作了研究。一、基本思路医生提供的卫生服务主要有两种 :一是门急诊服务 ;二是住院服务。而且这两种服务分别可用门急诊人次数和住院床日数来测量。因此 ,医生配置标准的编制方法宜从各区域卫生机构实际提供的门诊人次数和住院床日数这两个指标入手 ,并把二者按照一定比例折合成一种工作量 ,即工作总量。然后对历史年限工作总量进行定量分析并做出预测 ,借助调整系数对预测工作总量进行调整 ,利用医生年标准工作量这一关键概念 ,即可…     

基于DRG与绩效导向的病床分配模型研究

目的通过构建病床资源分配模型, 为优化公立医院病床资源配置提供参考。方法本研究基于ReLU激活函数, 结合DRG和公立医院绩效考核要求, 纳入出院人次、平均住院日、病床使用率、手术占比、四级手术占比、病例组合指数和平均床日收入等指标, 构建病床资源分配模型, 当医院现有开放病床数大于首次分配的病床数时, 可采取二次分配。以某三级甲等综合医院为例, 进行模型实例分析。结果经模型分析, 某医院2 729张开放病床首次分配后结余110张, 可进行二次分配。医院40个住院科室的病床分配结果为15个科室加床, 3个科室加床并缩短住院日, 2个科室不变, 1个科室缩短住院日, 4个科室减床以及15个科室减床并缩短住院日。结论该病床资源分配模型丰富了指标内涵, 体现了专科特性, 能够结合医院发展规划和预算管理灵活调整指标, 有利于公立医院病床资源的精细化管理。     

基于指数调整的单床住院服务效能评价模型研究

目的 探索DRG指标在医院单床住院服务效能评价中的应用,为医院床位管理和绩效评价提供参考.方法 运用病例组合指数(CMI)、时间消耗指数和费用消耗指数等指标构建单床住院服务效能评价模型,绘制科室效能分布图,分析2019年某三级甲等综合医院科室效能水平的不同类型和特征.结果 基于指数调整的单床住院服务效能评价模型结合了科...     

矫正的病床综合工作效率指标的研制与应用

目的 针对传统的病床工作效率评价方法的缺陷,提出矫正的病床工作效率指标,为医院病床资源的合理配置提供技术支持。方法 资料来源于唐山市某综合医院2008年的医疗统计报表和绩效考核方案。用标准住院天数对病床综合效率指标进行矫正,并测算各科室的开放床位的可信区间。结果 各科室的病床工作效率存在较大差异,口腔科、ICU和儿科的效率最高。20个科室中病床设置合理的有6个科室,14个科室需要调整,其中需增加床位的有6个科室,需减少床位的有8个科室。结论 矫正的病床工作效率指标具有更广泛的适用范围,应探索应用单病种或病例分型的标准平均住院天数矫正病床工作效率。     

Glycemic management in the inpatient setting

Hyperglycemia occurs frequently in hospitalized patients and affects patient outcomes, including mortality, inpatient complications, hospital length of stay, and overall hospital costs. Various degrees of glycemic control have been studied and consensus statements from the American Diabetes Association/American Association of Clinical Endocrinologists and The Endocrine Society recommend a target blood glucose range of 140 to 180 mg/dL in most hospitalized patients. Insulin is the preferred modality for treating all hospitalized patients with hyperglycemia, as it is adaptable to changing patient physiology over the course of hospitalization. Critically ill patients should receive intravenous insulin infusion, and all noncritically ill patients with hyperglycemia (individuals with and without diabetes) should be managed using a subcutaneous insulin algorithm with basal, nutritional, and correctional dose components. Hypoglycemia remains a limiting factor to achieving optimal glycemic targets. Similar to hyperglycemia, hypoglycemia is an independent risk factor for poor outcomes in hospitalized patients. Improvement in glycemic control throughout the hospital includes efforts from all health care providers. Institutions can encourage safe insulin use by using insulin algorithms, preprinted order sets, and hypoglycemia protocols, as well as by supporting patient and health care provider education.     

Minimising undernutrition in the older inpatient

Background Malnutrition among elderly hospitalised patients is widespread and has been shown to lead to adverse health outcomes. The effectiveness of interventions to minimise undernutrition in elderly inpatients is not well documented. Objectives To identify the best available practices, in the hospital setting, that minimise undernutrition or the risk of undernutrition, in the acute care patient especially for the older patient. The review will assesses the effectiveness of a range of interventions designed to promote adequate nutritional intake in the acute care setting, with the aim of determining what practices minimise malnutrition in the elderly inpatients. Search strategy English language articles from 1980 onwards were sought using Medline, Premedline, Cinahl, Austrom-Australasian Medical Index and AustHealth, Embase and Science Citations Index. Selection criteria For inclusion the study had to include an intervention aiming to minimise undernutrition in hospitalised elderly patients aged 65?years or older. All study designs were included. Data collection and analysis Two independent reviewers assessed the eligibility of each study for inclusion into the review, critically appraised the study quality and extracted data using standardised tools. For each outcome measure results were tabulated by intervention type and discussed in a narrative summary. Results from randomised controlled trials were pooled in meta-analyses where appropriate. Main results Twenty-nine studies met the inclusion criteria, with a total of 4021 participants. The focus of 15 interventions was the supplying of oral supplements to the participants, six focused on enteral nutrition therapy, four interventions made changes to the foods provided as part of the hospital diet, one included the services of an additional staff member and three incorporated the implementation of evidence-based guidelines. Ten meta-analyses were conducted from which the main findings were: significant improvements in weight status and arm muscle circumferences with an oral supplement intervention, P?相似文献   

Measuring the quality of inpatient health care

A validated case mix and severity adjusted performance measurement system and methodology are presented. Using this methodology in a user-friendly interactive interface, those who are interested in the performance of a hospital or providers within a hospital can easily identify areas for quality improvement.     

Comparing the economy of outpatient versus inpatient rehabilitation

This article outlines the findings of a project comparing the economic effects of outpatient and inpatient rehabilitation in Mecklenburg-Vorpommern. The study statistically covers the total population of applicants for orthopaedic-traumatologic rehabilitation who are suitable for outpatient rehabilitation. As a randomised and controlled study, it compares outcome parameters of the two variants of rehabilitation. Because the results are approximately equal, analysing the differences between amounts and periods of payments and costs for the pension insurance agency do not result in disadvantages for the patients. The results obtained from the investigation confirm that, in suitable patients, outpatient rehabilitation can achieve approximately the same outcomes as inpatient rehabilitation--but at distinctly lower cost.     

普通外科临床常见手术病种住院流程重组研究：概述

2000年1－12月,在北京市某综合性三级甲等教学医院普通外科对临床常见手术病种进行了“住院流程重组”的研究。研究结果表明,住院流程重组可以在医疗服务资源基本不变的条件下,提高医疗服务的质量和效率,增加医院的医疗业务收入。