公立医院政府采购存在的问题和对策研究

随着公立医院价格综合改革的开展，在政府补贴少的情况下，医院政府采购是一个涉及采购资金管理、采购过程管理、国有资产管理等多方面的复杂的系统工程，如何真正实现医院政府采购的“公开、公平、公正”，规范医院的政府采购行为，使医院资金的使用效益达到最佳状态，已成为公立医院亟待解决的问题。文章基于财务管理角度对政府采购过程中存在采购成本难控制，政府预算管理不力，信息化程度低，监督机制不完善等问题进行具体阐述，并提出了创建供应商及其价格挡案，实行政府采购绩效评价工作，建立统一采购服务平台，完善内部监督管理的解决对策。     

我国财政公共卫生支出政府间负担结构分析

文章介绍了我国目前公共卫生支出在各级政府间的负担结构,通过与部分国家的比较,发现了我国财政公共卫生支出在各级政府间负担结构的不合理.造成财政公共卫生支出在各级政府间负担结构不合理的体制原因有公共卫生事权划分模糊不清、公共卫生财政拨款体制的不完善以及公共卫生财政转移支付制度存在缺陷.最后提出了相应的政策建议.     

推行政府采购制度 加强医疗设备管理

为加强医疗设备管理,节约有限的行政经费,郑州市卫生局在充分调查摸底的基础上,日前成功地召开了一次医疗设备采购招标会,对全市卫生系统由专项经费购置的万元以上的医疗设备实行政府集中采购。这在河南省尚属首次。来自省内外40多个商家以公开竞标的方式参与了招标,一批价值百万余元的医疗设备被医疗单位择优选购,从而为郑州市正式引入政府采购制度拉开了序幕。 政府采购是指以政府及其所属机构为主体,在财政监督下,以公开招标为主要形式,在国内外市场上统一购买商品或劳务的经济活动,它属于一种政府行为。政府采购制度在国外作为一种公共支出的管理手段,早已开始实行。美国在建国初期就有了这种制度,迄今已有200多年     

政府采购对中国经济的影响

从政府采购制度及其理论依据入手，从公共财政理论和新公共管理理论等方面分析了政府采购制度的利与弊。提出政府应利用行政、法律等手段加强对政府采购制度的宏观管理和监督，并逐步淡出微观管制。在政府采购制度与采购行为中，政府的作用不是取代市场，而是为市场保驾护航，让市场更好地发挥作用。     

高校实行政府采购制度尚需解决的几个问题

自我国推行政府采购制度以来，政府采购的实践在国家机关和不少省市高校取得了明显的经济效益和社会效益，这说明政府采购制度是一种市场经济条件下政府加强财政支出管理和国有资产管理，提高资金使用效率和采购质量，促进廉政建设，强化政府宏观调控能力的重要手段。本文就高校实行政府采购中需解决的几个问题进行探讨。     

浅谈政府采购工作中的质疑与投诉

随着我国《政府采购法》的出台，近几年我国形成了相对完善的政府采购法律体系，经过这些年来的工作实践，政府采购工作也取得了一定的成果。集中采购机构作为政府集中采购活动的法定代理机构，根据采购人的委托，遵循公开、公平、公正和诚信原则，按照法定的方式和程序负责政府集中采购活动的组织工作。在实际采购活动中，由于采购活动是以利益为纽带，其间充满了各方当事人的竞争与冲突，而集中采购机构是采购活动的关键点，也是各方矛盾的聚焦点。集中采购机构既要合法的开展采购活动，又要巧妙规避、化解各方冲突、矛盾，更要以服务质量赢得双方美誉，因此，如何在政府采购活动中切实维护供应商、采购人的合法权益，减少质疑、投诉的发生，已成为当前集中采购机构面临的一大课题。     

试论药品实行政府采购

政府采购也称政府统一采购或公共采购,是指各级政府为了开展日常的政务活动,或为公众提供服务,在财政监督下,以公开招标为主要形式,从国内、外市场上购买商品和劳务的行为。在我国,政府采购还处于起步阶段,药品又有它的特殊性,因此,药品实行政府采购不同于其他物品,现就这一问题谈谈自己的一点看法:     

医疗设备政府采购验收遇到的法律难点

医疗设备政府采购是政府采购中重要的一项。医疗设备政府采购验收应该是政府采购的一个重要环节。本文通过探讨政府采购验收制度及监督管理机制中存在的问题,建议尽快出台政府采购验收制度的具体实施条例或细则,完善政府采购流程,引入第三方参与验收的制度。     

试论大型医疗设备招标采购管理中急需解决的问题

1现状随着政府采购管理的逐步规范和医疗体制改革的逐步深化,大型医疗设备的招标采购正在我国逐步全面展开。目前,我国绝大多数大中城市和大多数中央、部队所属大医院对大型医疗设备采购实行了集中管理和统一招标,在很大程度中实现了民主、科学决策,体现了公开、公正原则,并在很大程度上避免了“暗箱”操作及腐败现象。2存在问题由于缺乏经验,缺乏法规和标准,现有的大型医疗设备招标采购管理还存在许多不尽完善、亟待解决的问题,主要表现在如下3个方面:2.1没有规范的招标管理体制目前,我国部分城市和单位,采用常设招标采购中心的办法组织采…     

当前卫生系统政府采购的若干思考

我国的政府采购历经十多年时间的发展,已日益成熟和完善,取得可喜成绩.但当前卫生系统政府采购执行的过程中还存在采购周期过长、采购结果满意度低等问题.为提高卫生系统政府采购效率与效益,应法治建设注重“完”字,采购制度尝试“变”字,计划执行强调“前”字,从业人员加大“培”字,采购信息坚持“集”字.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.