医师多点执业利弊分析

随着2009年新医改政策的实施,探索医师多点执业成为医改的一大亮点,有关其利弊的争论众说纷纭。在现行的医疗环境下,实施医师多点执业势必会带来诸多积极影响,然而也存在不利因素。立足于我国执业医师现状,对医师多点执业利弊进行了综合分析,为政策的贯彻落实提供参考依据。     

医师多点执业中的法律问题探讨

本文从医师多点执业的定义、背景和该政策实施现状等出发,分析医师在现有法律体制下进行多点执业存在的身份合法性、可能承担"非法行医"责任、多点执业医师与各执业地点医疗机构之间的法律关系问题、竞业问题、法律监管问题等现实存在和可能出现的问题,针对这些问题,提出对《执业医师法》等法规进行修订、完善相关的规章制度等建议。     

我国实施医师多点执业的政策分析与思考

医师多点执业试点工作正在各地逐步推开.文章依据国家新医改政策,以医师多点执业为基点,对医师多点执业现状和对医疗卫生系统的运行管理可能带来的影响进行综合分析,结合医疗单位的实际,提出意见建议.     

广东省医师多点执业的现状分析——基于“广东医师多点执业2.0版”

从多点执业医师的人事管理,医疗质量,医师的收入分配、社会保险及法律责任承担等方面,对"广东医师多点执业2.0版"进行利弊分析,并借鉴国外医师多点执业的经验,为推进广东省医师多点执业提供建议和对策。     

医师多点执业改革的利与弊

卫生部出台《卫生部关于医师多点执业有关问题的通知》近3年,由此多点执业改革的试行和管理工作积累了一定经验,本文即对执业医师管理工作中的“多点执业”改革的概念和试行背景进行了阐述,分析管理中遇到的利与弊,并提出相应建议.     

关于医师多点执业的几点思考

医师多点执业是卫生部所作出的医改重要内容之一,本文对实行医师多点执业带来的困惑进行了分析,同时提出了思考和对策,包括应尽快出台多点执业的配套法规、要尽快进行人事制度改革、要充分市场引导作用、要积极推行医疗赔偿第三方支付制度、要全面提升医务人员法律意识。     

关于医师多点执业的思考

医师多点执业是当前社会热门话题之一,对其利弊的讨论众说纷纭。从医师多点执业的积极意义和可能带来的问题这2个方面进行了分析。     

公立医院医师多点执业制度探讨

回顾了我国医师多点执业的制度背景,从微观层面分析了制约我国公立医院医师多点执业行为选择的原因,并以此为基础,探索促进医师多点执业行为选择的措施,包括先行设计多点执业制度、健全多点执业的医疗质量及安全机制、完善医师多点执业激励机制、实行强制医疗责任险以分担医师多点执业风险,期望对推进我国医师多点执业提供帮助.

Abstract：

A review of the system background for the multi-institution physician practice in China,and an analysis for the specific constraints for physicians of public hospitals to embrace such a practice On this basis, the paper probed into the measures to encourage the physicians for doing so. The measures recommended include advanced design, improvement of the quality of care and safety mechanism,incentives mechanism, mandatory enforcement of medical liability insurance to minimize risk exposure of such a practice, aiming at advancement of this practice.     

医师多点执业问题刍议

新医改方案提出了探索注册医师多点执业的要求,这对于更好地统筹调配医疗卫生资源,调动医务人员积极性,促进区域间、机构间人员和技术的交流,提高基层医院诊疗技术水平,方便人民群众特别是基层群众看病就医,减轻群众就医负担等方面都具有积极作用,但这其中也存在着一些问题.对此,我们有必要制定相应的政策和措施对其进行鼓励与规范.     

医学院校医疗保险专业实践教学探讨——以昆明医科大学为例

医疗保险专业是医学院校新开设的一个跨学科专业。该专业以培养应用型人才为目标定位,实践教学是实现这一目标的重要途径。通过介绍昆明医科大学医疗保险专业十年的建设情况,分析"四位一体双实习"的实践教学体系的特点和不足,探讨完善途径,为医科大学非医学类专业的健康发展,提供借鉴。     

重庆市个体诊所非法行医情况分析

目的了解重庆市个体诊所执业现状,切实加强诊所管理,确保医疗安全。方法收集整理重庆市2011年主城9区个体诊所的机构执业情况、执业分类情况和违法情况,根据经济情况不同分为好、中、差三类,通过描述性统计方法和x^2检验进行统计分析。结果经济水平不同的地区执业情况存在差别,无证诊所中口腔和其他类专科诊所比例相对增加,违法行为中以聘用非卫生技术人员的情况居多。结论通过政府、社会各界及诊所自身共同力量使得个体诊所健康发展。为群众提供安全有效的卫生服务。     

Short term locum tenens for rural practice: a trial of a Japanese medical school

ABSTRACT: This study investigated locum tenens dispatch to rural practices organised by a medical school. Locum tenens has not been studied previously in rural general practice, and little has been reported about locum dispatch from an academic institution. Since 1990, Jichi Medical School (JMS) has sent faculty members as locum tenens to rural practices where its graduates have been working. The details of all locum dispatches between 1990 and 1996 were reviewed and analyzed. Locum dispatches were performed 486 times for a total of 1233 days from April 1990 to March 1996. Locum relief was supplied to 15 group practices and 42 solo practices which are located throughout most of Japan. Most locum reliefs (98.1%) were short and less than one week. There was a wide variety of reasons for requesting a locum, ranging from official to personal. The three main reasons were practice support (30.5%), continuing medical education (13.8%) and physician absence (13.8%). These reasons were different between solo and group practices. Solo practices had a more diverse range of inquiries than group practices. In group practices, practice support amounted to over half of the inquiry reasons. Rural practices face a wide range of circumstances which necessitate locum dispatch. Organised locum dispatch by a medical school can provide practical support of rural practices through locum tenens dispatch.     

医师多点执业监管体系的构想

医师多点执业是我国2009年新医改中提出的一项新制度,已陆续在全国部分地区试点推行,引起了医药卫生行业乃至全社会的广泛关注.本研究介绍了医师多点执业的概念,探讨了对其进行监督管理的必要性,阐述了相关主体在监管过程中的职责和作用,提出按照“社会管理”的思路构建医师多点执业监管体系,构想了一个“精细化、信息化、动态化、社会化”的监管模式,旨在为我国构建医师多点执业的监管体系提供一个参考路径.     

医学生参与社区卫生服务对社区全科医疗建设的作用

目的　了解杭州市社区全科医疗现状和居民的需求 ,探索医学生社区志愿服务在完善社区全科医疗 ,推动全科医疗服务发展中的作用。方法　通过对杭州市社区全科医疗服务提供和需求情况进行调查。结果　杭州市社区全科医疗服务存在全科医学人才缺乏 ,卫技人员学历层次低 ,医疗卫生服务单一等问题 ;杭州市居民慢性病发病率较高 ,对社区全科医疗服务需求意识不足 ,对“健康使者”社区卫生服务表示支持。结论　医学生参与社区卫生服务对社区全科医疗建设的作用在于①缓解社区全科医疗人力资源的不足。②改善当前社区全科医疗服务单一的情况。③提高居民对社区全科医疗的认识。④促进全科医学人才的培养     

县域医共体建设试点医院的实践与成效分析

目的评价浙江省县域医共体建设某试点医院的综合改革实施效果。方法通过搜集县域医共体建设试点医院成立一年来的相关医疗业务、财务运行及上下转诊等数据,对比医共体总院和医共体分院的发展趋势。结果自医共体成立以来,2018年医共体分院的门急诊人次、门诊总收入、出院人次、出院总收入增长率均高于医共体总院。门诊均次费用、住院均次费用增长率均低于总院。结论县域医共体的建设提升了乡镇卫生院的整体医疗卫生服务能力,有力地推动了医疗卫生工作重心下移、关口前移,有效缓解了基层群众就医难的问题。     

有效预防实习护士引发医疗纠纷的探讨

近年来,医院的医疗纠纷逐年增多。在各类医疗纠纷中,由于实习护士护理服务质量差而导致的医患纠纷也占据相当的比例。文章分析了实习护士医患纠纷的差错因素,并针对这些差错采取了一系列措施,从而有效地防止了纠纷。     

医学院校二级学院绩效评价的实践与思考

大学二级学院是大学办学的主体部分,一所大学办学质量和综合竞争能力的高低,主要依靠二级学院的办学绩效来体现.开展二级学院办学绩效评估,可以在大学内部创造公平的竞争环境,引导二级学院围绕大学战略发展目标强化内部管理,不断提高办学效能.文章运用数理统计、运筹学等理论知识,以某医学院校二级学院为评价单元和研究的出发点,深入研究高校绩效评价的理论、探索高校绩效评价的方法、建立评价的数学模型、构建绩效评价指标体系,以其所属的14个二级学院为研究对象,开展高校绩效评价的实践研究,探讨了开展绩效评价的意义、方法、途径,并对有关问题进行了思考.     

A prospective randomized trial of an urban general practice attachment for medical students

A randomized controlled trial was undertaken to evaluate the effectiveness of a new model for providing urban general practice attachments for final-year medical students at the Flinders University of South Australia. All the student groups in that year were randomized prospectively to either the standard student attachment, as run by the university, or to an attachment organized by a project team from a local network of general practitioners. Students in the intervention group had their personal learning goals assessed and matched with their general practice preceptors, and the students were set a task that developed their contact with other health resources in the community. Results from an evaluation questionnaire completed by the students at the end of their terms showed that the students in the intervention group rated their general practice preceptors more highly, had more contact with allied health and community organizations, felt that they had met their own learning goals to a greater extent, and enjoyed their term more. Student examination results showed that the students in the intervention group did not perform as well in one of the four areas of their end of term examination as did the students in the standard attachment. The additional cost of providing the intervention was estimated to be A$340 per student. We conclude that long-term decisions about adopting this new model of organizing general practice attachments on a wider scale will need to balance the apparent benefits against the increased resources required.