实施区域卫生规划合理配置大型医用设备

大型医用设备是卫生资源的重要组成部分,是医、教、研的重要物质基础,也是衡量医疗卫生单位科技水平的重要标志之一。国家计委、财政部、卫生部颁布的《开展区域卫生规划的指导意见》明确指出,大型医用设备配置规划是区域卫生规划的一项重要内容。如何合理配置大型医用设备,充分发挥其综合利用效益,引起了医疗卫生机构和全社会的极大关注。 一、我省大型医用设备的配置现状 福建省有３３００万人口,改革开放以来,全省卫生事业取得长足的进步,大型医用设备数量快速增长,医疗装备水平明显提高。以ＣＴ机为例,从１９９０年的３台,增…     

大型医用设备在医院的使用效益分析

大型医用设备工作为卫生资源的重要组成部分，是医疗教学、科研的重要物质基础，也是衡量医疗卫生单位科学技术的重要标志。如何适应市场经济需要，进一步强化和完善大型医用设备的配置与管理，使大型医用设备等重要卫生资源既能充分发挥其效能，更好地满足广大人民群众的基本医疗需求，又不造成卫生资源的浪费，是目前需要解决的重要问题。笔者通过对某院设备的有关资料进行使用效益分析估评，建立设备使用管理机制，对促进大型设备的使用，提高使用效益，缩短设备投资回收周期起到了重要作用。     

对大型医用设备现状的调查与思考

大型医用设备作为卫生资源的重要组成部分，是医疗、教学、科研的重要物质基础，也是衡量医疗卫生单位科学技术水平的重要标志?如何适应市场经济需要，进一步强化和完善大型医用设备的配置与管理，使大型医用设备等重要卫生资源既能充分发挥其效能，更好地满足广大人民群众的基本医疗需求，又不造成卫生资源的浪费，是目前需要解决的重要问题。     

东营市大型医用设备分布公平性研究

近年来 ,随着医学科技水平的提高 ,高、精、尖大型医用设备的数量明显增多 ,设备质量和性能有了进一步提高 ,进而提高了医疗质量 ,带动了当地医疗技术水平的发展 ,并已渐渐成为三级医院和部分二级医院生存和发展不可缺少的物质基础。随着经济发展和人民生活水平提高 ,患者对医疗质量的要求也越来越高 ,又进一步促进了医院对大型医用设备的需求。由于种种原因 ,大型医用设备出现了分布不均、重复配置、盲目引进等诸多问题 ,造成了有限卫生资源的浪费 ,因此如何加强大型医用设备的配置与管理 ,提高其使用效益 ,是卫生决策和管理者必须重视和亟…     

日照市大型医疗设备现状及分析

目的评价我市大型医疗设备使用效益。方法选取二级以上医院资料,对大型医疗设备进行综合评价。结果使用效果不理想,卫生资源浪费。结论购置大型医疗设备,必须进行充分的调查论证,卫生行政主管部门应切实加强大型医疗设备的监管。     

济宁市卫生资源现状及配置分析

随着卫生体制改革的进一步深化、各级医疗机构迫于竞争压力，大多从眼前利益出发，争先超标准购置大型医疗设备。导致部分地区出现卫生资源配置不合理、卫生投入产出效益不高等现象。实践证明，卫生资源的合理配置，是充分发挥现有卫生资源效能、保证医疗保健服务顺利进行的前提条件。合理配置卫生资源的原则应是，既要符合国家的有     

大型医用设备配置公平性研究方法分析

大型医用设备在医疗工作中具有高技术水平、大型精密、贵重的特点,是重要的卫生资源.由于文革期间的停滞不前,改革开放以来,以前所未有的速度急剧增加.短时间内的大量引进,势必造成宏观调控乏力,重复购置造成浪费,也会因与大型设备配套之人才匮乏造成设备效率不能充分发挥的问题.所以其配置利用直接影响着卫生服务的效率,也是我国经济体制转轨后卫生事业管理的重要课题.特别是目前各地都在制定区域卫生规划,大型医用设备配置规划是其中一项重要内容.     

认真实施区域卫生规划加强大型医用设备管理

国家计委、财政部、卫生部在《开展区域卫生规划的指导意见》中明确指出：“大型医用设备配置规划是区域卫生规划的一项重要内容”。如何实施区域卫生规划,合理配置和有效利用大型医用设备,发挥卫生资源综合效益,是卫生行政管理部门面临的重要课题,在此,笔者结合区域卫生规划,就河南省大型医用设备管理的现状和问题,提出今后工作的对策和措施。     

大型设备使用效益评估结果随机性的检验

大型设备使用效益的评估是各医疗单位效益评估的一个重要方面，它从大型设备侧面反映出总体投资的效益。评估方案如何，是能否正确评估大型设备使用效益的重要环节。评估结果则是评估方案全部实践过程的最终体现。所以对评估结果与实际情况的拟合度进行合理检验，即是对评估方案正确与否的检验。     

大型医疗设备检查费用面临"瘦身"风暴

价格永远是政府调控与部门调控的最直接最见效的手段。大型医疗设备的配置和使用所产生的费用,需要消耗大量的社会卫生资源,在我国现阶段卫生资源不够充足的情况下,如果不对大型设备的配置和使用进行管理,势必造成卫生资源的浪赞;长期以来我国对包括大型设备在内的新技术和新项目实行高标准收费,由于很大程度上的逐利驱动,医疗机构盲目购置大型设备,比如彩超、CT等,资源配置极不合理。医疗机构为了收回投资成本和追求大型设备检查带来的高收益,另一方面也直接加重了患者和医疗保险基金的负担,成了“看病贵”的一大原因之一。国家发文要求各地降低大型医疗设备检查的费用,直接从终端上调节了卫生资源的不合理配置与惊人浪费现象,同时也直接从源头上控制了百姓医疗费用的节节升高。     

From the end of the world to the top of the world

I've been on the road a bit this summer. Because of the kind generosity of my London broker, Lloyd and Partners, Ltd., I've been allowed the unique opportunity to have an insider's view of the London market. I observed an interesting renewal situation and sat with underwriters in their boxes amid the hallowed (at least to us insurance geeks) trappings of Lloyd's. I spent several lovely days in Hanover with my long‐time lead reinsurer, Hanover Re, while trying desperately to keep up with my own work back home. It's been stimulating and thought‐provoking, and I know I won't ever view the purchase of insurance in the same way.     

社区医院脑卒中康复模式效果评估

目的探讨社区医院开展脑卒中康复、提高脑卒中患者的运动功能和日常生活活动能力（ADL）的模式。方法选择2006年8月-2008年8月住院脑卒中患者63例,采用随机对照研究方法,分为强化组32例,对照组31例,强化组采用系统的综合康复治疗;常规组给予临床基础药物治疗。分别于入选时、治疗1、2及3个月后对运动功能和日常生活活动能力（ADL）进行功能评定。结果两组患者在治疗前运动功能和日常生活活动能力（ADL）差异均无统计学意义（P〉0．05）,在治疗后3个月时强化组的运动功能和日常生活活动能力（ADL）与对照组相比较,差异有统计学意义（P〈0．01）。结论社区医院利用适宜技术开展脑卒中康复,对提高脑卒中患者运动功能和日常生活活动能力（ADL）有着极其重要的意义。     

从医方视角探解医患关系困境

目的：从医方视角探解医患关系困境。方法2013年10月-2013年11月,从本市几所主要医院中随机选择600例住院患者及医务人员进行研究。利用问卷调查法,对医患关系相关情况进行调查。结果调查发现,医务人员中有34.3％认为医患关系紧张,患者中有8.6%认为医患关系紧张。患方对医方不满的原因主要有沟通交流障碍和态度问题以及医疗质量问题等方面。结论面对医患关系的困境,医方需要积极的采取患者-医生-医院三位一体的应对策略,不断提高整体医疗质量,为患者提供人性化的医疗服务,努力改善医患关系。     

Relationship of the clinician and the pathologist at the turn of the millennium

The autopsy, once a fundamental and familiar component of medical practice based on the good cooperation of clinicians and pathologist, is now infrequently used. Recent data indicate that autopsies are performed only about one third of the cases in Hungary and less that 1 of 10 inpatients death in the united States. Explanation for this decrease is multifactorial, involving changing professional and patients attitudes, the advent of sophisticated antemortem diagnostic methods, socioeconomic factors, and medicolegal concerns as well. Teaching institutions need to reevaluate concerning the need and practice of the autopsy. "The final audit" not always reflect well on clinical diagnoses and management of patients. Many facts proves that our modern tools still not enough to reach always a correct and safe diagnoses. Errors are still common in medicine. About 10% of necropsies indicate a clinical managements different from what the patients received, 20% reveal additional diagnoses, and 60% of cases have teaching point. Though autopsy is expensive and time consuming, moreover the shortage of pathologist is evident, necropsy should remain the cornerstone of medicine in the new millennium as well. There are a broad range of different fields where pathologist and clinicians should work together in an everyday--setting--e.g. evaluate biopsy- or cytology-samples. Clinicopathological conferences are also important to discuss cases mainly for teaching purposes. Without maintaining the traditionally good cooperation neither clinicians nor pathologists will be able to give proper answers to the challenges and professional questions of the new era.     

Metrological aspects of the study of physical characteristics of the air on the objects in the vicinity of the habitat

The paper considers the problems of measurement of air ions for settle the tasks of medical and environmental monitoring the habitat of various objects. It discusses the metrological assessment of the physical characteristics of the environment and the reasons for the insufficient use of aeroionometry in public health. The paper also compares the characteristics and specific features of the use of devices intended for study of air ion spectra. It shows it necessary to design the devices that measure air ions, which satisfy with the requirements that they measure accurately, are easy-to-use, rapidly operate.     

The relationship of the aims of the theory of Peplau with the care of the diabetic patient

In the face of the contextual amplitude of nursing activity, its theories need to be mediatated so to we be able to access the real meaning of the ideas elicited by theorists, and thus making possible to the nurses, consider and incorporate them into practice professional. In this article, we described the nursing theory developed by Hildegard Peplau still looking for to establish a connection of this theory with the way of caring of diabetic patient. The building of this study was worth of reflexion and it provided not just knowledge of theoretical ideas but mainly the urgency to use it (or to use another theory) in the environment of our daily practice of diabetic patient care.     

Appealing to the ''experience'' of the patient in the care of the dying

The care of dying patients in hospital is characterized by the copresence of four different frames: practical, medical, lay and psychological. Within the psychological frame, the staff define the patient as an experiencing subject, exposed to the staff members' knowledge and involvement. The psychological frame is used in two different circumstances. First, it is used by the staff members when the patient deviates from an expected identity within some other frame. The deviation creates a threat to the working conditions and moral order at the ward. The threat is managed through a shift into the psychological frame. Second, the psychological frame is used spontaneously in the accounts of their work given by staff members to the sociological field researcher. The image of care associated with the field researcher is characterized by a special awareness of the psychological issues. Thus the field researcher is inevitably a part of the functioning of the new kind of surveillance working through the psychological frame.     

医院感染监控管理综合评估在医院管理中的应用

目的 对医院感染监控管理进行全面、综合的评估。方法 应用综合评估指标体系，对监控工作进行量化评估。结果 甲、乙、丙医院综合评定状态(SA)分别为78．0、21．7、12．9，甲医院感染监控质量高。结论 建立的医院感染监控管理综合评估体系具有较强的科学性和可行性。     

Complete rupture of the tendon of the biceps muscle of the thigh

Complete rupture of the tendon of the M. biceps femoris proximal to its insertion is a rare occurrence. Relatively few patients have been recorded. We describe a patient with a complete rupture sustained as a result of a water skiing accident, viz. a fall over the stern wave. The case history was in accordance with a theory about the cause of this lesion--sudden overstretching of the hamstrings. The diagnosis was made by physical examination in the acute phase. With the patient in supine, 90 degrees flexed knees position and with isometric contraction of his hamstrings it is easy to mark and palpate a defect of the tendon just proximal to the caput fibulae. After operative reconstruction, a plaster cylinder was used for five weeks' postoperative immobilization. Five weeks after surgery, physical therapy was started, first to regain knee motion, and later to regain strength. Twelve weeks after surgery, the patient resumed working and recreational sports.