Effects of the North Carolina Prematurity Prevention Program among public patients delivering at New Hanover Memorial Hospital.

Twelve per cent of the 847 women who delivered in one hospital prior to implementation of the North Carolina Prematurity Prevention Program had low-birthweight births compared with 9.5 per cent of the 748 women who delivered during the program. Controlling for known risk factors, both low- and very-low birthweight births among Whites (Odds Ratio 2.0 and 3.7 respectively) and very-low-birthweight births among Blacks (OR 2.9) were reduced.     

The evolution of surgery at the New York Hospital.

Surgery evolved from colonial times through many innovations and developments. During this time it was transformed from a dangerous practice to a delicate and scientific art. Many of these early developments continue to be a part of modern surgical therapy. Although European discoveries have had a profound effect on this evolution, American advances solidified the link between the laboratory and the operating room. The New York Hospital-Cornell Medical Center, like other medical centers around the country, made important contributions to this evolution. Because the hospital has spanned American history, it also has paralleled surgical development in the United States.     

The role of a paediatric day surgery unit at the Royal Hospital for Sick Children, Glasgow between 1993 and 2006

A retrospective analysis was carried out on all day surgery admissions at Glasgow's Royal Hospital for Sick Children between 1993 and 2006. The aim of the study was to analyse the total number of operations per day, month and year; specialties involved; and age range of the children admitted, to examine how these factors changed over the 13-year study period. We also studied the specific operations performed in 2006 by each specialty.     

Functional gain and length of hospital stay at a medium-stay geriatric care unit at the Central Red Cross Hospital in Madrid, Spain

BACKGROUND: The medium-stay or convalescent care geriatric units were defined by the Spanish National Health Institute in 1996 as being the level of geriatric hospital care aimed at recovering those functions, activities or sequelae having undergone changes as a result of different prior processes. This study is aimed at evaluating the characteristics of patients related to functional gain and stay in medium-stay geriatric units. METHODS: A study was made of all those patients admitted throughout the May 2000-December 2001 period. The weekly and overall functional gain was evaluated using the Barthel Index (BI), the hospital stay and the effectiveness (BI at discharge-BI at admission/during stay) having been evaluated. An improvement in the weekly gain of BI>5 points was set at the effectiveness threshold. RESULTS: A total of 459 patients averaging age 80.56 (+/-7.45) admitted for functional recovery from sequelae of ictus (48.4%), orthopedic disorders (26.3%) and immobility due to other ailments (23.5%) were evaluated. The total functional gain was 29.71 (+/-16.75) Barthel Index points, entailing an average stay of 24.93 (+/-12.94) days and a 1.44 (+/-1.02) effectiveness. The weekly functional gain was above the threshold set during the first three weeks, independently of the age and disorder for which admitted. In the multivariate regression analysis, the age, admission due to ictus, functional impairment prior to admission, cognitive impairment at admission, comorbility and delay in admission were related to a lesser functional gain. Admission due to ictus and a better functional condition prior to admission and better cognitive condition at admission were related to a longer stay. CONCLUSIONS: Hospital stays in medium-stay geriatric units is adequate, at least during the first three weeks. A comparison of the results among units should be adjusted by age, the disorder for which admitted, comorbility and functional and cognitive condition of the patients.     

试论医院任期经济责任审计

任期经济责任审计的出现，是我国经济体制、政治体制改革以及社会主义市场经济发展对领导干部任期经济责任监督的客观需要。我院从2000年开始对设备部、总务科、基建、工会、营养部等部门负责人实行任期责任审计，也配合医科大学对其他所属医院院长进行任期责任审计，几年来我们发现些问题。有的单位存在转移收入，私设“小金库”现象；有的盲目决策，导致购入的医疗设备利用率不高或闲置；有的对所属“三产”监督管理不够，造成所属单位财务管理混乱，违规套取现金等问题的发生。因此，加强领导干部任期经济责任审计，正确评价领导干部在经济方面的功过，为领导及组织部门考核评价干部提供依据．是审计工作的一项重要任务。     

Feasibility and utility of mapping disease risk at the neighbourhood level within a Canadian public health unit: an ecological study

Background  

We conducted spatial analyses to determine the geographic variation of cancer at the neighbourhood level (dissemination areas or DAs) within the area of a single Ontario public health unit, Wellington-Dufferin-Guelph, covering a population of 238,326 inhabitants. Cancer incidence data between 1999 and 2003 were obtained from the Ontario Cancer Registry and were geocoded down to the level of DA using the enhanced Postal Code Conversion File. The 2001 Census of Canada provided information on the size and age-sex structure of the population at the DA level, in addition to information about selected census covariates, such as average neighbourhood income.     

The impact of the observation ward on acute admissions at Guy's Hospital

This paper describes an evaluation of the short-stay ward at Guy's Hospital Accident and Emergency Department. It includes an audit of the operational policy, the care provided to patients, and the impact of the short-stay ward on hospital admissions. The results indicate that by concentrating patients in a short-stay ward, the quality of care is improved, delays are reduced, and the pressure on inpatient beds is relieved.     

新形势下加强医院文化建设的思考

<正>当今医院文化已经成为医院生存和发展的重要战略资源和宝贵的物质及精神财富,成为提高医院整体素质和核心竞争力的重要内容,成为构建和谐医患关系的关键因素。谁掌握了先进的医院文化,谁就能够掌握医院建设的主动权,为医院的振兴和发展创造最根本的条件。如何加强医院文化建设,笔者认为,医院文化建设应主要从医院文化教育、医院文化活动、医院文化制度三方面着手,使医院文化建设实现正常化、规范化、系统化、制度化。     

中心酸化水系统在海军总医院新建内科医疗楼的应用

酸化水是一种具有高氧化还原电位(ORP)、低pH、含低浓度有效氯的水,具有较强的氧化能力和快速杀灭微生物作用,是消毒领域中一种新型的环保型消毒剂,在我国的正式名称为"酸性氧化电位水"。新建的内科医疗大楼引进了中心酸化水系统,是建设绿色医院的重要内容。文章对中心酸化水系统安装的施工要求及安装后的经济性分析做了详细的阐述。     

Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital

IntroductionIn response to the COVID-19 pandemic, health systems quickly implemented changes in care delivery with a goal of balancing patient-focused obstetric care with the need to protect pregnant persons and health care providers from infection. Yet, there is no consensus within the scientific community on the impact these measures have on obstetric outcomes in vulnerable populations. We aimed to assess the impact of the COVID-19 pandemic on rates of obstetric procedures and severe maternal morbidity (SMM) among births at an urban safety net institution.MethodsWe used an interrupted time series design to calculate risk ratios (RRs) and 95% confidence intervals (CIs) comparing monthly rates of labor induction, cesarean births (overall and among nulliparous, term, singleton, vertex births), operative vaginal births, and SMM among births occurring at a public hospital before (March 1, 2016, to February 29, 2020) and during (March 1, 2020, to May 31, 2021) the COVID-19 pandemic.ResultsThere were 10,714 and 2,736 births in the prepandemic and postpandemic periods, respectively. Overall, the rates of obstetric interventions and SMM were constant over the two time periods. There were no significant differences in rates of labor induction (42% during prepandemic period vs. 45% during pandemic period; RR, 1.12; 95% CI, 0.93–1.34), operative vaginal births (5% vs. 6%; RR, 1.24; 95% CI, 0.88–1.76), cesarean births (28% vs. 33%; RR, 1.10; 95% CI, 0.94–1.28), or nulliparous, term, singleton, vertex cesarean births (24% vs. 31%; RR, 1.27; 95% CI, 0.92–1.74). Rates of SMM (7% vs. 8%; RR, 1.19; 95% CI, 0.86–1.65) were also unchanged.ConclusionsOur findings indicate that the rapid implementation of measures to reduce viral transmission in the labor and delivery setting did not materially affect routine clinical management or rates of serious maternal complications.     

新形势下医院档案信息资源的开发与利用

医院档案是医院历史全貌的真实记录，它内容丰富、门类齐全，集文书档案、病历档案、财务档案、科研档案、设备档案、声像档案、基建档案等各种门类于一身。切实管好、用好医院档案，对于改善医疗服务，提高医院管理水平，具有十分重要的作用。开发利用医院档案信息，强化档案信息服务，是医院档案部门和档案工作者的主要任务和义不容辞的责任。如何开发利用现有档案信息资源，提高馆藏档案的利用率，更好地为医院现代化建设服务，为临床、教学、科研活动服务，为领导决策提供各种信息资料，是档案管理者应深入研究和解决的课题。就此笔者提出几点看法。     

某医院新农合按病种付费实施情况探析

2011年,北京市率先在全国启动按病种付费试点改革,随后该支付方式被推向全国。实施按病种付费确实有利于减轻新农合患者的医疗经济负担,但具体的政策执行却需要医疗机构的积极配合和落实。通过对某三甲医院新农合按病种付费方式实施情况的研究,了解医疗机构在实际执行按病种付费制度中取得的成效及存在问题,为合理改善医院新农合按病种付费管理工作提供依据。     

Hospital care at home; a review of the literature on the effects of a form of transmural care

OBJECTIVE: To evaluate the effects of hospital at home on health outcomes and quality of life of patients and carers; to evaluate the costs of this form of care and the experiences of the (para)medics involved. DESIGN: Literature study. METHOD: Using Medline, EMBASE-Excerpta Medica, Sci-search and Cinahl, a search was carried out for Dutch- and English-language studies from 1990-2001 which compared hospital at home with conventional inpatient care. RESULTS: Twenty-seven (randomised) controlled trials and cross-over studies from seven different countries were found, which resulted in 37 publications. No differences were found in health outcomes between patients allocated to hospital at home and inpatient care, providing there was careful patient selection and the home met a number of basic conditions. Patients and their carers rated hospital at home positively. The expected reduction in costs to the health services was disappointing. Good organisation, communication and funding were essential boundary conditions to the success of this form of care. Health benefits appear to be primarily attained with schemes designed to avoid admission to hospital for the elderly.     

The problems of collecting the K?rner minimum data set at a District Psychiatric Hospital.

The K?rner report recommends that there should be an annual census of all in-patients in psychiatric units who have been there in excess of one year. A study involving the collection of the 'K?rner Minimum Data Set' at a district psychiatric unit found that the current patient information system does not always provide adequate or accurate information. It is also found that seeking these data is time-consuming if the census enumerator is not involved with patient care. It is therefore suggested that the most accurate information on long stay psychiatric patients might be obtained if such a census were conducted and coded by DHSS collectors using a special census form to be completed by the ward doctor. The accuracy of medical records might also be improved if the completion of the front sheet of the case notes were made the responsibility of the ward doctor.