县域服务网络应按医联体理念构建

我国目前的县域卫生服务网络,缺乏整合性。因此,应当对县域作出整体制度安排,按整合型服务体系的理念进行规划运行,将县域作为按医联体理念构建的重点,加强整合型农村卫生服务体系建设。首先,应将现有县域内不同层级医疗机构分区域进行规划和设置,组成若干区域医疗联合体,对居民实行契约式服务,慢病管理纳入基本医疗。同一区域可以鼓励和发展不同医联体,鼓励竞争,鼓励患者向医联体签约,自由选择。改革管理机制,     

我国贫困地区县域内健康扶贫工作进展与政策建议

通过健康扶贫政策梳理、定量分析卫生健康统计数据和典型案例分析,研究我国县域内健康扶贫工作的进展、成效及问题,提出后脱贫期县域内医疗卫生服务改革与发展的建议。整体上看,我国健康扶贫工作成效显著:医疗卫生机构"三个一"和医疗服务能力"三条线"目标基本实现;卫生技术人员配置基本达到"三个一"要求;贫困县床位和设备配置达到或接近全国平均水平;通过新建临床专科、开展新技术和新项目等,贫困县专科服务能力得到提升;此外,部分贫困地区积极探索县域内医疗卫生综合改革。今后,新脱贫地区面临的主要挑战是县域内卫生服务体系建设仍需加强,基层卫生人才队伍差距和财政投入与卫生改革协同不足三大主要问题。建议中央财政继续支持县域内卫生服务体系建设;以人才建设为抓手,提升县域内医疗服务能力;强化保障措施,推进县域内医疗卫生综合改革。     

县域医共体:要打通“关键路径”

正县域医共体建设是县域范围的一项综合医改,其生命力在于改革单元与医保筹资单元、行政管辖单元匹配,能在县域主要领导重视下纵向整合医疗资源,横向联合配套政策,并基于"医保驱动,医疗、医药联动"机制,立足存量改革和激励相容,构建连续型、一体化的医疗服务,重建我国的健康维护组织(HMO)体系。实践证明,县域医共     

连木成林 构建优质高效服务体系

<正>3月8日,国家卫生健康委主任马晓伟在全国两会"部长通道"回答记者提问时说:"分级诊疗制度是医改以来推行的一项重大制度。从某种意义上说,分级诊疗制度实现之日,乃是我国医疗体制改革成功之时。"3月9日,健康报社、《中国卫生》杂志社举办"两会精英汇",围绕"推进县域医共体,构建优质高效的医疗卫生服务体系"主题,邀请全国人大代表、政协委员座谈。如何通过推进县域医共体,将单项改革的"树木"连成综合改革的"森林"?     

分级诊疗如何开往“下一站”

建立分级诊疗制度,是合理配置医疗资源、促进基本医疗卫生服务均等化的重要举措,是深化医药卫生体制改革、建立中国特色基本医疗卫生制度的重要内容。根据国家卫生健康委近日发布的消息,"十三五"期间,分级诊疗制度建设取得了阶段性成效。我国县域医疗服务能力显著提升,医联体建设实现了跨越式发展。接下来,分级诊疗该如何推进落实?近日,由《中国卫生》杂志社、健康报社共同主办,强生医疗公益支持的"两会精英汇"线上座谈会召开,到会的全国人大代表和政协委员围绕这个话题进行了探讨和交流。     

复旦大学药物经济学研究与评估中心举办“2014复旦医疗保障论坛”

<正>本刊讯健全全民医保体系是深化我国医药卫生体制改革的重要内容,提高基本医疗保险制度的保障水平、完善城乡医疗救助制度、加快发展商业健康保险是当前我国医疗保障制度建设的战略目标。为追踪国内外医疗保障制度的改革方向和实践探索,复旦大学药物经济学研究与评估中心近日举办了"2014复旦医疗保障论坛"。本次论坛围绕"中国医疗保障体系改革展望"主题,交流完善社会医疗保险制度、医疗救助和商业医疗保险制度     

华东卫生经济研究协作会第29次年会征文通知

为贯彻落实党的十八大报告精神,深化"十二五"医改,结合华东六省一市卫生改革和卫生经济管理的实际,拟将第29次华东卫生经济研究协作会学术年会的主题定为"推进公立医院改革"。现将征文选题及有关事宜通知如下。一、征文参考选题1.医疗卫生体制改革监测、评估体系研究;2.县域范围内基本医疗卫生制度评价方法研究;3.政府对医疗服务补助方向、范围、实施途径及其对全社会医疗机构发展的影响研究;4.医疗服务支付方式改革在公立医院综合改革中的作用研究;5.基层医疗卫生机构实施绩效工资后的得失研究;6.分级医疗和双向转诊的实现途径研究;     

如何加快县域内临床检验中心的实施设想

县级及以下医疗结构承担着我国大部分患者的接诊任务，县域内医疗检验水平和相关资源整合利用程度，决定着我国整体医疗服务水平，加快县域内临床检验中心的建设对医共体组织形式的顺利形成起到积极推动作用，为深化公立医院改革，推进医疗资源纵向整合、完善城乡医疗服务体系、同步提高县乡两级医疗服务能力提供有力保障。本文对加快建设县域内临床检验中心的必要性进行了阐述，并对如何加快县域内临床检验中心的实施设想进行了探讨，以期为完成深化医疗体系改革的重要使命提供借鉴。     

医共体 县域强才是真的强

<正>县域医疗共同体是农村开展医联体建设的主要模式,可以实现医疗技术和专家资源的下沉,提升县域医疗服务能力,促进分级诊疗制度建立。然而,在各地的探索实践之中,医共体却显现出"跑偏"迹象,有些县级医院院长甚至乘机"跑马圈地"。县域医共体的建设目标到底是什么?县级医院在医共体中应处于怎样的地位?近日,在国家卫生计生委指导,《中国卫生》杂志社和《健康报》社共同主办的"烽火行动,品质无边界——县级医院改革与管理创     

国际卫生改革经验对我国卫生体制改革的借鉴

通过对国际卫生改革经验的研究,作者建议,我国的基本卫生保健制度改革要立法先行;体现"公平优先、兼顾效率"的原则,确保人人享有公共卫生服务和基本医疗服务;基本卫生保健内容要与具体国情和财力相适应;正确认识政府和市场的作用,实现政府主导与市场机制的有效结合;做好卫生发展规划,发展社区卫生服务,建立健康"守门人"制度;建立社会化的老人照顾体系;拓宽卫生筹资渠道等。     

Trends in medical microbiology--gene probes in medical microbiology

At first the principle of nucleic acid hybridisation, some important technics used heretofore, and methods to label nucleic acids are described. The advantages and disadvantages regarding to the application to microbiological diagnostics are discussed. The advantage, before all, is the high specificity of the test which allows to detect the presence and the properties of genes which are not expressed. The methods known up to now can only be applied if the probe is labelled radioactively, since under these conditions the sensitivity is high enough to identify bacteria contained in clinical isolates without prior cultivation. The comparable complex methods are restricted, presently, to special mostly epidemiological problems. To improve these technics regarding increased sensitivity, to the use of non-radioactively labelled probes, to higher speed, and to the automation of the test internationally much work is carried out with great intensity. The solution of these problems will create conditions for a wide application of DNA probes in the general microbiological laboratory.     

论医疗卫生机构的医疗废物管理

医疗废物是一类危险性大、社会影响广泛、来源及危害性明确的特殊危险废物,是指医疗卫生机构在医疗、预防、保健以及其他相关活动中产生的具有直接和间接感染性、毒性以及其他危害性的废物,《中华人民共和国固体废物污染环境防治法》将医疗废物归类为危险废物。为了加强对医疗废物的安全管理,防止其对人体的危害及环境的污染,国务院制定的《医疗废物管理条例》和卫生部制定的《医疗卫生机构医疗废物管理办法》中明确要求对医疗废物必须进行无害化处理。     

医疗救援卫生耗材的保障策略

目的:加强医疗救援卫生耗材的应急保障。方法:分析日常医疗耗材的供应基础和要求,明确应急医疗耗材供应的管理要素。结果:应急医疗耗材的供应保障需要更多的经验积累和科学统筹的管理。结论:应该充分重视应急医疗救援的耗材供应,克服管理混乱的弊端,才能保障应急救援工作更快捷、更顺利、更精细。     

某院109例医疗纠纷中医方缺陷分析

医疗纠纷是指患者或其亲属认为医疗单位或者医护人员提供的诊疗护理服务有过错并造成患者人身、财产、精神的损害,而与医疗单位或卫生行政主管部门或医疗事故鉴定机构之间产生的争执[1]。近年来,医疗纠纷日渐增多,医患冲突不断升级,已成为困扰医院发展的严峻问题。作为医疗中主     

建立军队医疗机构医学计量管理体系的实践与思考

介绍了建立军队医疗机构医学计量管理体系的必要性,提出基于GB/T 19022-2003《测量管理体系测量过程和测量设备的要求》建立军队医疗机构医学计量管理体系的原则和思路.分析了该医学计量管理体系在某院实际计量管理实践中的实用性和可操作性,从标准化、精细化、信息化3个方面进行了进一步的探索和改进,逐步建立了一套适合军队医疗机构的医学计量管理体系.该计量管理体系的建立,对实现军队医学计量管理的规范化、程序化和系统化具有重要意义.     

Role of state medical boards in continuing medical education

The evaluation of physician competency prior to issuing an initial medical license has been a fundamental responsibility of medical boards. Growing public expectation holds that medical boards will ensure competency throughout a physician's career. The Federation of State Medical Boards (FSMB) strongly supports the right of state medical boards to require physicians to demonstrate continuing qualification for medical licensure. The FSMB views continuing medical education (CME) as an important component of any maintenance-of-competence initiative. Most medical boards require CME as part of their license renewal process. Learner-focused CME with measurable outcomes enables the medical profession's emphasis on core competencies, training, and assessment, and the general public's expectation for maintenance of physician competence. To effectively move their licensee populations toward the most effective CME tools and structure, medical boards must recognize physicians' educational needs and preferences. Medical boards can be proactive by fostering educational consortia involving medical boards, medical societies, and academic medical centers and featuring educational sessions that represent the best in current CME practices.     

The underrepresented in graduate medical education and medical research

There is a perception that the career options open to medical school graduates who are members of minority groups are restricted. This perception relates especially to those postgraduate medical training programs that have not traditionally encouraged or had significant minority participation. Data were therefore sought to determine whether this perception was well founded. Recent reports show the strikingly low numbers of minorities on medical school faculties and in administrative positions in spite of efforts to fill such positions. Information on the specialties of practicing minority physicians is limited, but accurate figures are available on the participation of minorities in various specialty postgraduate training programs. For instance, during recent years, 50 to 60 percent of all black residents have been trained in internal medicine, pediatrics, general surgery, and obstetrics and gynecology. Further studies are needed to document or disprove the conception that minority physicians have less access than other physicians to certain careers in the delivery of health care and education. In the interim, efforts should be continued to encourage minority physicians not only to seek preparation for community primary care practice, but also for professional participation in academic careers of other specialties (and subspecialties), in biomedical and clinical research, and in health care administration. The ability to enter these diverse careers is most often determined by the opportunities available at the time of completion of medical school education. Therefore, those involved in graduate medical education should address the challenge of providing opportunities for the proportionate representation of minorities in all aspects of medical care and medical education.