国企医院改制中的利益平衡制度

国企医院改制过程中在医院、职工、国家三个主体间形成的医院与职工、医院与国家间的冲突最为明显.医院与职工的冲突主要表现为医院聘用与职工就业间的冲突及职工经济利益与医院成本控制间的冲突.医院与国家的冲突主要体现在医院改制与国有资产保护间的冲突及医院自主经营与国家发展规划间的冲突.我国现行对于上述冲突的利益平衡制度存在忽视医...     

香港的医院和医疗服务

目前香港有政府医院14间,政府补助医院20间,自负盈亏的私人医院11间。全港有病床24,078张(其中精神病床近4,000张),平均每千人有4.5张。较大的医院有玛丽医院、伊丽莎白医院、威尔斯亲王医院、玛嘉烈医院、浸会医院、圣母医院、广华医院、粉岭医院、长洲医院以及九龙、新界等区医院。此外,还有350多个注册诊疗     

术中核磁手术间的感染控制

目的 探讨神经外科核磁手术间安全有效的管理措施,加强核磁手术间各环节管理,预防和控制医院感染.方法 通过加强组织领导,规范手术间环境、手术物品、手术人员等各个环节管理,建立健全核磁手术间医院感染控制体系.结果 加强了神经外科核磁手术间医院感染的管理体系,有效地预防和控制了医院感染,提高了术中核磁手术间的医疗护理质量.结论 采取严格规范化的术中核磁手术管理措施,可以有效地控制医院感染的发生,对加强医院规范化管理,控制医院感染具有积极的意义.     

军队医院与体系部队间管理体制优化

为合理利用军队医院的优质医疗资源,满足体系部队医疗的多方面需求,优化医院与体系部队间的管理体制至关重要.通过对医院和部队间的管理体制开展问卷调查,并针对卫勤管理体制的优化措施进行利弊分析.调研结果显示,优化体系部队与军队医院间管理体制是解决部队医疗技术水平低最有效的措施,而优化医院与部队间管理体制的最好方式是将部队人员纳入医院管理中.     

组建医院集团的宏观设想——兼谈赴美国考察的启示

<正> 中国医疗卫生改革面临的一个重大问题,是如何建立医院集团。笔者在2002年4～5月间到美国洛杉矶加利福尼亚州州立大学卫生科学系学习并考察了当地医疗机构,对医院集团这种经营模式有了较深入的了解。美国有6000多间医院(近4000间是私人医院,约占60％),绝大多数医院都组成不同类型的医疗(企业)集团。主要有两种类型,一是集医疗提供与医疗保险于一体的集团,如KASA公司;另一类是纯医院集团。现在就我市如何建立医院集团的问题,谈一些看法。 1 医院集团的组织形式 医院集团是由多个具有法人资格的医院平等自愿组成的医疗联合体,其中应以一间或多间     

四家医院手术室内空气中麻醉气体浓度调查

目的 了解某市部分医院手术室内麻醉气体污染情况.方法 检测某市4家医院的40个手术间内空气中异氟烷和七氟烷的浓度,测定方法为溶剂解吸-气相色谱法.结果 甲医院16个手术间中,5间检出异氟烷,其中1间浓度超出最低参考值;14间检出七氟烷,其中2间浓度超出最低参考值,合格率为81.25％(13/16).乙医院6个手术间均检出七氟烷,其中3间的浓度超过最低参考值,合格率为50.00％(3/6).丙医院13个手术间均未检出异氟烷及七氟烷,合格率为100％.丁医院5个手术间均检出七氟烷,其中1间的浓度超过最低参考值,合格率为80％(4/5).4家医院总合格率为82.50％( 33/40).结论 在使用七氟烷和异氟烷的手术间内,其空气受到不同程度的污染.     

梅州市医疗单位消毒状况调查

1990年8月份,我们对梅州市二间市级医院、二间县级医院、三间乡镇级卫生院和五间集、个体医疗门诊进行消毒监测调查,现将结果报告如下: 项目及方法     

主成分回归在医院目标管理中的应用

目的 将主成分回归应用于医院目标管理,以便医院管理者更清晰各指标间的相互关系及影响程度,服务于医院目标管理.方法 引入某三甲医院目标管理的历史数据,对原始数据进行整理、分析各指标间的特性,分别拟合基于多元线性回归和主成分回归的指标分析模型.结果 由于指标间的相关性,适合应用主成分回归来建立指标分析模型.结论 针对医院目标中指标间的相关性,主成分回归能保留更多原始指标,并拟合出指标间的相关性,是医院管理者实行目标管理中的一种有效数据分析方法.     

不同等级医院间血常规项目差异的研究

目的比较不同等级医院间血常规项目的偏差,为血常规结果的互认提供依据。方法采集新鲜血常规标本(20份)分别在不同等级医院检验科进行检测,对血常规结果 [包括白细胞(WBC)、红细胞(RBC)、血小板(PLT)、血红蛋白(Hb)、红细胞比容(HCT)、平均红细胞体积(MCV)]进行统计学分析。结果血常规项目中HCT、MCV、PLT在不同等级医院间有统计学意义(P<0.05),三级医院间所有项目均无统计学意义(P>0.05)。结论不同等级医院间血常规检验质量有明显差异,还需提高不同医院间检验结果的可比性和准确性。     

台山市甲等与非甲等医院消毒质量监测结果分析

为了更好地贯彻落实卫生部1992年颁发的《消毒管理办法》，提高医院消毒质量，预防医院内交叉感染。笔者于1995年7月至1996年5月对台山市甲等与非甲等医院消毒质量进行随机抽样监测工作。现将监测结果报道如下。材料与方法1监测对象15间甲等医院（其中13间为华侨捐建医院，2间为非华侨捐建医院）和14间非甲等医院（其中3间为华侨捐建医院，11间为非华侨捐建医院）。2监测内容空气细菌污染、医护人员手的污染，病房物体表面的污染，灭菌医疗用品的污染，使用中消毒剂的污染状况，紫外线灯强度测定，压力蒸气灭菌效果检测。3方法3．1手污染采…     

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.     

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.     

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.     

Estimating the effect of the run-in on the power of the Physicians' Health Study

In the Physicians' Health Study, a randomized, placebo-controlled, double-blind trial of aspirin in the reduction of cardiovascular mortality and beta-carotene in decreasing cancer incidence, 33,223 subjects were eligible and willing to enter the trial. Instead of randomizing this group immediately, all participants received identical calendar packs that contained active aspirin and beta-carotene placebo. Following an 18-week run-in, only 22,071 subjects who remained eligible and willing and had taken at least 2/3 of their pills were randomized. We estimated the effect of the run-in as follows: pill taking compliance increased 20-41 per cent; sample size decreased 34 per cent; duration of follow-up decreased 7 per cent which resulted in a 7 per cent decrease in the expected event rate for the placebo group. To estimate these changes, we made assumptions about compliance and outcome risk for those excluded by the run-in. Our conclusion, however, about the net effect of the run-in on the power of the study remains constant across variations in a number of those assumptions. The power with the run-in, with 22,071 good compliers was typically higher, and never more than negligibly lower, than the power without the run-in, with 33,223 good and poor compliers. In addition, savings from enrolling 11,152 fewer subjects in the trial resulted from the use of the run-in.     

Plundering the poor: the role of the World Bank in the Third World

The World Bank, the most important so-called development assistance agency, annually dispenses billions of dollars to Third World governments, ostensibly to "develop" their economics through a variety of loan projects. But even a superficial analysis reveals that the Bank is the perfect mechanism to help (i.e., subsidize) the large transnational corporations from the industrial countries to expand their industrial, commercial, and financial activities in the Third World, at the expense of the latter and particularly at the expense of the rural and urban proletariat. This article discusses Cheryl Payer's recent book, The World Bank: A Critical Analysis, in which she analyzes the Bank's role in the Third World and sets forth the major reasons why poverty, hunger, and malnutrition, as well as unemployment, and all the adverse social phenomena associated with them, are on the increase.     

氢化物发生—原子荧光光谱法测定牙膏中的铅

目的:建立了一种测定牙膏中微量铅的方法——氢化物发生—原子荧光光谱法。方法:采用硝酸—高氯酸消解,氢化物发生—原子荧光光谱法测定。结果:线性范围为0~100μg/L,检出限为0.23μg/L,样品加标回收率为91.7%~102.1%,用标准物质茶叶(GBW10016)对该法验证,验证结果与推荐值一致,相对标准偏差为1.18%。结论:该法检出限低,线性范围宽,精密度好,准确性高,适合牙膏中微量铅的检测分析。     

新形势下对医院文化建设的思考

随着我国卫生医疗事业近年来飞速的发展和民众日益增长的需求,如何从容面对外部严峻的挑战以及如何抓住自身发展的机遇成为医院改革和发展不得不面对的问题,而医院文化建设正是推动医院发展、提高医院综合竞争实力的核心内容。同时,医疗改革的不断深化更是对医院的管理提出了新的要求,这就使得管理者必须科学地运用医院文化这一现代化的医院管理理论提高医院的管理水平,增强医院的综合实力。     

优化结构提高效率实现医院可持续发展

随着我国医疗保险的大范围实施，医院只有优化结构、提高效率，才能实现可持续发展。以财务管理为出发点，分析了目前大型医院所面临的现行国家医疗政策、外部环境以及内部约束等条件，提出强化医疗业务管理．建立科学合理的医疗业绩考核指标体系：平均住院天数、出院人数、手术量、门诊预约率，促进医疗业绩的提高：强化财务管理，建立现代医院财务考核指标体系：结余率、人均结余、病人人均费用，对各个科室的经济效益进行考核，促进医院经济效益的提高。