河南省乙类大型医疗设备配置规划研究

目的:为使卫生资源的供给与医疗卫生服务需求相一致,按照科学、合理、公平和效益的原则,在现状调查分析的基础上,制定河南省乙类大型医疗设备配置标准,以提高卫生资源的使用效益。方法:采用普查法和抽样调查法相结合,对河南省乙类大型医用设备的相关资料进行了调查。并采用目标服务法,综合考虑河南省社会经济发展、医疗服务需要等因素,对河南省2005年和2007年CT和MRI等乙类大型医用设备的控制总量和增量准入标准进行探讨。结果:CT、MRI数量分布和医院数量所占比例大致吻合。平均每所医院的CT拥有量为1.08台,MRI为1.00台。省市县级医院2004年CT平均检测次数分别为8818人次、8788人次和6677人次,MRI分别为4863人次、3050人次和2247人次;省级医院MRI的年工作量是县级的2倍。CT阳性率分别为84.00%、76.00%和69.00%,MRI阳性率分别为91.00%、81.00%和81.00%。结论:CT的拥有量基本上已经满足需求;有些单位MRI的使用率较低,存在较大的潜力。MRI出现了过剩现象。     

磁共振成像安全性和有效性评价

目的　评价MRI安全性和有效性 ,为制定大型医用设备发展政策提供重要依据。方法　应用流行病学中描述性方法评价MRI安全性 ,应用循证医学中疾病诊断标准评价体系评价MRI有效性。结果　MRI科室工作人员有轻微的自觉症状 ,患者在MRI检查、治疗过程无意外事件发生 ;MRI门诊诊断阳性率和住院诊断阳性率较高 ,分别达 83 6 0 %和 78 0 0 % ;MRI诊断与门诊前诊断和入院前诊断一致性较低 ,与“金标准”(出院诊断 )相比较一致性较高。结论　MRI是一种比较安全的大型医用设备 ,具有较高的临床诊断价值 ,对身体各部位疾病的诊断价值均高于CT。     

山西省磁共振成像成本-效益分析

以山西省全部拥有磁共振成像(MRI)的19所医院为研究对象,应用卫生经济学中净现值模型技术对MRI成本 效益进行分析。采用定基比和还基比的方法分析各等级医院MRI经济效益增长速度,并预测今后3年发展趋势,其结果对MRI经济性评估具有重要意义。一、资料来源与研究方法1.调查内容:通过流行病学调查表,收集了山西省截止2 0 0 2年6月拥有的2 1台MRI的成本 效益相关资料,其中有2台因相关数据不完整,未做分析。资料包括:MRI年检查总收入、MRI购机费、MRI年维修费、MRI年材料费、MRI检查的年水电费和MRI科室人员年总费用。为了保证资料…     

6~18岁学龄儿童生长发育评价指标综述

国民营养与健康状况是反映一个国家社会经济发展和卫生保健水平的重要指标,定期开展国民营养与健康状况调查,制定和评价相关政策,对于推动社会经济的发展具有重要意义.     

医院设备维修工作综台评价模式的探讨

一、概述医院建设一支高水平的医学工程技术队伍，为其提供高质量的维修技术支持，是维持现有医院医学技术装备水平和运行质量，保证医院临床医疗、教学和科研工作顺利进行的必要条件。由于诸方面的原因，目前医院的维修工作现状未尽人意。因此做为设备管理部门，应首先研究并制定工程技术人员维修工作的评价标准，为下一步制定相关的改革措施和激励政策提供条件。评价医院设备维修工作是一个多参数的复杂系统问题。首先，由于医院维修工作不直接创造经济效益，因此不能用经济标准单独衡量维修工作；第二，由于医院维修工作涉及设备种类多、…     

对大型医疗设备调整的浅见

先进医疗设备的大规模引进,大大提高了卫生服务的档次,迅速地改善了医疗条件,但也存在很多不可忽视的问题:(1)大型医疗仪器的配置与当地的经济发展水平不匹配。(2)缺乏必要的、科学的宏观调控。(3)设备在区域、城乡等方面,存在着巨大的差异。(4)设备配置缺乏科学性和合理性。我们应该根据本地区国民经济发展水平和区域卫生规划的要求,综合卫生工作的实际需要,并充分考虑所在地区服务人群的经济承受能力,缩小城乡差别,合理制定高、中、低档医疗服务的配置比例,力求尖端设备与常规设备相辅相成。     

上海郊区卫生资源配置和利用的公平与效率分析

目的 :通过对上海郊区卫生资源配置和利用的分析 ,指出卫生资源配置和利用中存在的公平和效率问题 ,并提出政策建议。方法 :对上海郊区不同经济发展时期和不同经济发展水平地区的比较分析。结论 :1.上海郊区政府对卫生事业经费的投入采取了一定的倾斜政策 ,公平性得到了相应提高 ,但三类地区人均卫生事业经费仍然较低 ;2 .上海郊区每千人口医生数和每千人口护士数较低 ,均低于全市的平均水平 ,尤其是三类地区 ;3.三类地区平均每人每年诊疗次数及每千人口每年住院次数相对较低 ;4 .上海郊区尤其是经济发展水平较低的地区医疗卫生服务利用效率较低。政策建议 :1.建立健全多种形式的医疗保障制度 ,提高医疗保障的社会化程度 ;2 .开展社区卫生服务 ,改革上海郊区医疗卫生服务功能 ;3.实施区域卫生规划 ,合理配置卫生资源 ;4 .大力加强卫生人才建设 ,提高医疗卫生服务质量     

赵平：借机查缺补漏才是明智之举

许多国家的医院都有等级之分。医院等级有助于合理配置医疗资源,保证医院医疗技术水平和医疗质量。中国医院的等级之分已推行多年,促进了中国医院的建设与发展。尤其在推行医院三级评审时恰逢上一轮医改,国务院的松绑政策使中国的医院从建筑水平、床位数目、设备档次与数量、技术人才与水平都发生了翻天覆地的变化。中国的三甲医院方阵形成了历史上最强大的阵容。不容置疑,医院三级评审对于促进中国医院升级换代发挥了很难否认的作用。     

某医院2007~2009年放射诊断工作场所辐射防护监测与分析

目的 掌握医院放射治疗工作人员个人剂量水平和工作场所防护现状,进一步开展质量控制工作。方法 依据国家的相关规范和标准分别开展设备质量控制检测、机房防护和个人剂量监测。结果 放射工作人员年有效剂量均低于年剂量均低于年剂量限值的1/10;放射诊断设备质量控制检测指标满足规范要求;机房外周围剂量当量率保持在本底水平。结论 该医院医疗照射设备的质量控制及辐射防护达到要求,但应进一步加强患者防护。     

弘扬中医传统文化 做好康复管理事业

山西省医院协会康复管理专业委员会成立暨首届康复学术论坛会,于2012年11月18日上午8点在太原市经贸宾馆召开。此次会议由山西省医院协会主办,太原市中医医院承办。出席此次会议的领导有:山西省医院协会会长赵震寰、山西省中医药管理局局长张波、太原市卫生局局长郝宝清等。会议还特邀了中国健康教育中心、卫生部新闻宣传中心     

The world economic crisis. Part 1: Repercussions on health.

The widespread economic crisis has resulted in a fall in living standards in the western hemisphere of over 9% (1981-83) and in Sub-Saharan Africa they have fallen to the level of 1970. Food production in the African countries most seriously affected by drought dropped by 15% between 1981 and 1983. Living standards also fell in some countries in Europe and in some of the poorest countries of Asia. The high cost of fuel, the heavy burden of interest payments and unfavourable terms of trade in Africa and Latin America led to serious unemployment, devaluation of national currencies and formidable austerity policies. While some countries have succeeded in protecting their health services from cuts in public expenditure, in many others cuts in health budgets have been substantial. The effects of the crisis in some countries have amounted to the virtual disintegration of rural health services. There are limited data available to show what has been happening to levels of expenditure on health, but those presented here demonstrate that levels of health expenditure per head have fallen in many countries. The cumulative effects on health of increased poverty, unemployment, underemployment and famine, and the reduced capacity of health services to respond to health problems can be documented with facts for a number of countries in Latin America and Africa. Malnutrition has increased and improvements in infant mortality have been checked or reversed. The economic crisis has placed at risk the health of the most vulnerable.     

Neoliberalism as a class ideology; or, the political causes of the growth of inequalities.

Neoliberalism is the dominant ideology permeating the public policies of many governments in developed and developing countries and of international agencies such as the World Bank, International Monetary Fund, World Trade Organization, and many technical agencies of the United Nations, including the World Health Organization. This ideology postulates that the reduction of state interventions in economic and social activities and the deregulation of labor and financial markets, as well as of commerce and investments, have liberated the enormous potential of capitalism to create an unprecedented era of social well-being in the world's population. This article questions each of the theses that support such ideology, presenting empirical information that challenges them. The author also describes how the application of these neoliberal policies has been responsible for a substantial growth of social inequalities within the countries where such policies have been applied, as well as among countries. The major beneficiaries of these policies are the dominant classes of both the developed and the developing countries, which have established worldwide class alliances that are primarily responsible for the promotion of neoliberalism.     

陕西省乡镇卫生院运行情况分析及对策研究

目的通过对陕西省30所乡镇卫生院的基本运行情况进行分析,针对目前乡镇卫生院存在的问题,提出政策建议,为政府制定相关政策提供决策依据。方法采用描述性分析方法对乡镇卫生院的基本情况进行分析,用EpiData 3.0软件录入数据并建立数据库,用STATA 10.0对数据进行清洗和分析。结果陕西省乡镇卫生院存在功能定位不准确、人才匮乏、技术力量薄弱、政府财政投入不足和管理基础薄弱等问题。建议针对存在的问题,提出准确定位、完善乡镇卫生院基本功能,引进人才、强化人才队伍建设,加大财政投入力度,夯实工作基础,科学管理,规范行业行为等一系列政策建议。     

Accessibility to general hospitals in rural Bendel State, Nigeria

The concern is growing in Nigeria as in many other developing countries that the rural population, in spite of its size, is the most neglected in the distribution of social facilities. Even in the rural areas the spatial disparity in the location of the few available facilities aggravates the problem of some segments of the population. The case of accessibility to general hospitals in rural Bendel State of Nigeria is examined in this paper because general hospitals are crucial to the success of the free medical delivery system being attempted in the state. Using some surrogate measures of accessibility the study attempts a classification of all the rural Local Government Areas in the state according to their relative accessibility to general hospitals. Finally, the paper discusses some implications of the findings for social services planning in Nigeria and other developing countries.     

Is globalization good for your health?

Four points are made about globalization and health. First, economic integration is a powerful force for raising the incomes of poor countries. In the past 20 years several large developing countries have opened up to trade and investment, and they are growing well--faster than the rich countries. Second, there is no tendency for income inequality to increase in countries that open up. The higher growth that accompanies globalization in developing countries generally benefits poor people. Since there is a large literature linking income of the poor to health status, we can be reasonably confident that globalization has indirect positive effects on nutrition, infant mortality and other health issues related to income. Third, economic integration can obviously have adverse health effects as well: the transmission of AIDS through migration and travel is a dramatic recent example. However, both relatively closed and relatively open developing countries have severe AIDS problems. The practical solution lies in health policies, not in policies on economic integration. Likewise, free trade in tobacco will lead to increased smoking unless health-motivated disincentives are put in place. Global integration requires supporting institutions and policies. Fourth, the international architecture can be improved so that it is more beneficial to poor countries. For example, with regard to intellectual property rights, it may be practical for pharmaceutical innovators to choose to have intellectual property rights in either rich country markets or poor country ones, but not both. In this way incentives could be strong for research on diseases in both rich and poor countries.     

Welfare state, labour market inequalities and health. In a global context: an integrated framework. SESPAS report 2010

Since the nineteen seventies, high- and low-income countries have undergone a pattern of transnational economic and cultural integration known as globalization. The weight of the available evidence suggests that the effects of globalization on labor markets have increased economic inequality and various forms of economic insecurity that negatively affect workers' health. Research on the relation between labor markets and health is hampered by the social invisibility of many of these health inequalities. Empirical evidence of the impact of employment relations on health inequalities is scarce for low-income countries, small firms, rural settings, and sectors of the economy in which "informality" is widespread. Information is also scarce on the effectiveness of labor market interventions in reducing health inequalities. This pattern is likely to continue in the future unless governments adopt active labor market policies. Such policies include creating jobs through state intervention, regulating the labor market to protect employment, supporting unions, and ensuring occupational safety and health standards.     

Situational assessment of adult vaccine preventable disease and the potential for immunization advocacy and policy in low- and middle-income countries

By 2050, the number of adults over 65 years of age will be double the under-5 population, and heavily concentrated in low- and middle-income countries. Population growth and increasing life expectancies call for effective healthy aging strategies inclusive of immunization to reduce the burden of vaccine-preventable diseases, improve quality of life, and mitigate antimicrobial resistance. Based on a review of available literature on the pneumococcal disease, influenza, and herpes zoster epidemiology and economic burden, and the health systems and policy barriers for adult immunization, we identified evidence gaps and considerations for prioritizing adult immunization. The body of evidence for adult immunization and the health and economic burden of adult disease is heavily concentrated in high-income countries. The few countries reporting adult immunization policies generally focus on high-risk groups. Despite robust child immunization programs in most countries, adult immunization programs and policies lag far behind and there is a general lack of appropriate delivery platforms. Global adult disease burden and economic costs are substantial but evidence from low- and middle-income countries is limited. There is a need for a strengthened evidence base and political commitment to drive a comprehensive, global technical consensus on adult immunization.     

Population causes and consequences of leading chronic diseases: a comparative analysis of prevailing explanations

CONTEXT: The mortality numbers and rates of chronic disease are rising faster in developing than in developed countries. This article compares prevailing explanations of population chronic disease trends with theoretical and empirical models of population chronic disease epidemiology and assesses some economic consequences of the growth of chronic diseases in developing countries based on the experiences of developed countries. METHODS: Four decades of male mortality rates of cardiovascular and chronic noncommunicable diseases were regressed on changes in and levels of country income per capita, market integration, foreign direct investment, urbanization rates, and population aging in fifty-six countries for which comparative data were available. Neoclassical economic growth models were used to estimate the effect of the mortality rates of chronic noncommunicable diseases on economic growth in high-income OECD countries. FINDINGS: Processes of economic growth, market integration, foreign direct investment, and urbanization were significant determinants of long-term changes in mortality rates of heart disease and chronic noncommunicable disease, and the observed relationships with these social and economic factors were roughly three times stronger than the relationships with the population's aging. In low-income countries, higher levels of country income per capita, population urbanization, foreign direct investment, and market integration were associated with greater mortality rates of heart disease and chronic noncommunicable disease, less increased or sometimes reduced rates in middle-income countries, and decreased rates in high-income countries. Each 10 percent increase in the working-age mortality rates of chronic noncommunicable disease decreased economic growth rates by close to a half percent. CONCLUSIONS: Macrosocial and macroeconomic forces are major determinants of population rises in chronic disease mortality, and some prevailing demographic explanations, such as population aging, are incomplete on methodological, empirical, and policy grounds. Rising chronic disease mortality rates will significantly reduce economic growth in developing countries and further widen the health and economic gap between the developed and developing world.     

Challenges and options for animal and public health services in the next two decades

Trade in livestock and livestock products makes up approximately one sixth of global agriculture trade. This trade is demand driven, primarily by growing human populations, changing economies, and consumer preferences in developing countries. Different rates of population growth, economic growth, urbanisation, environmental sustainability, and technology transfer will determine which countries will reap the greatest benefits. Global trends in demand and supply for food, not terrorism, will drive the future of animal and public health service delivery. To benefit the greatest number of people and countries, animal and public health services should support policies that temper growing disparities among rich and poor countries, city and rural populations, and the sexes. Economic growth is critical to overcoming disparities between countries and best supported by integrated animal health, public health, labour, and foreign policies. Opportunities for job growth will be the greatest along the value added chain of food production and will require significant investments in science- (risk-) based education.     

Health care reforms and developing countries--a critical overview

Although health care reforms have been implemented in both developed and developing countries since the 1980s, there has been little discussion of the historical, social and political contexts in which such reforms have taken place. Health care reforms in developing countries, for instance, have been an integral component of structural adjustment policies, yet scant attention has been paid to these connections nor to their implications. The basic assumptions behind the reforms, and in particular, the ideological underpinnings of health care reorganization, need to be taken into account when considering long-term strategies and policies to provide health services in developing countries.