Computer use and undergraduate education for computer use in Canadian health care foodservices

Surveys were conducted to assess the computer use in 50 selected Canadian health care foodservice facilities and to determine the educational preparation for computer use in seven selected Canadian post-secondary education institutions which educate potential foodservice personnel. Both the foodservices and post-secondary educational institutions selected were represented at two workshops on computer-assisted foodservice management held in June 1980 and in May 1981. Only seven facilities used a computer for foodservice functions; nine foodservices planned to use a computer within the next two years. A list of applications in use, being planned and of future interest showed the priority areas for these foodservices. Only one post-secondary educational institution actually had an educational foodservice application for student use. The other six educational foodservice facilities covered the subject matter content by readings, lectures and discussions.     

我国地市级妇幼保健机构儿童保健服务能力基础调查

目的 对我国地市级妇幼保健机构儿童保健人员及设备投入水平、服务开展状况和管理情况历史数据进行分析,为比较我国儿童保健发展变化水平提供基础数据。方法 对2013年5-7月的历史调查数据进行收集分析。采用容量比例概率抽样方法,在有全国代表性的13个省中随机抽取1/3的地市,对地市级妇幼保健机构的儿童保健服务情况进行问卷调查。结果 实际调查的51所地市级妇幼保健机构中,每万名儿童有1.64名地市级妇幼保健机构儿保人员。机构平均开展9项儿童保健服务,生长发育服务的开展比例最高(98.0%),其次是营养咨询指导(94.1%)、耳及听力保健(92.2%)和心理行为发育测验(90.2%)。儿童康复服务的开展比例最低(62.7%)。平均设置儿童保健门诊6个。70%以上的机构设置了生长发育、心理行为发育测验、眼保健、听力保健门诊,高危儿随访门诊、口腔保健、儿童康复和早期发展指导门诊设置率均低于60%。2012年平均为下级医疗卫生机构举办培训班4次,举办托幼机构卫生保健人员培训班3次。结论 我国东、中、西部地区地市级妇幼保健机构儿童保健服务能力差异逐步缩小,但儿童保健服务设备与人员投入仍不足,科室设置和相关服务的开展需进一步提高。     

Computerized nutrient analysis for foodservice

The need for computerized nutrient analysis does differ depending on the type of foodservice institution. Variation in the menu cycles, type of funding, experience with computers, number and type of clientéle fed, and the limited number of respondents affiliated with various institutions make it difficult to recommend a standard nutrient analysis software system. Additionally, the researchers frequently noted two obstacles to computerization of foodservice and nutrition departments: (a) respondents believe their institutions or departments are too small for computers, and (b) there is limited knowledge about computers and nutrient analysis. It is hoped that foodservice personnel can use the information from this study to learn of features available in nutrient analysis programs and that professionals can use it in designing and marketing nutrient analysis software.     

妇幼保健机构专科建设研究

目的 研究并制定妇幼保健专科建设与管理指南,为开展全国妇幼保健机构专科建设提供依据.方法 通过文献研究、现场调查、专家研讨、机构试行等方法,制定妇幼保健专科建设与管理指南.结果 开发27个妇幼保健专科建设与管理指南,包括孕产保健专科5个,儿童保健专科11个,妇女保健专科8个,计划生育技术服务专科、信息专科和健康教育专科各1个.结论 制定妇幼保健专科建设与管理指南,规范妇幼保健服务,为全国开展妇幼保健机构专科建设打下基础.     

营利与非营利医疗机构的判定和监测

任何医疗机构有向居民提供基本医疗和执行国家定价的权利，机构营利与非营利的性质主要应由机构自己决定并由其经营行为体现。医疗服务营利具有自发性和隐蔽性，政府必须进行严格的判定和监测，以保证消费不受欺诈和医疗市场的公正和公平。监测利用服务价格、财务收支、基本医疗服务比重、人均工资、奖金、福利等各项指标。进行医疗机构的分类管理应该做好几项基础工作，包括核算服务项目的标准成本，进行合理定价，进一步界定基本医疗，确定非营利机构的合理奖金福利水平，建立医疗管理信息系统，建立专业审核监测组织，确立管理机制和决策程序等。     

Consumer evaluation of hospital foodservice quality: an empirical investigation

PURPOSE: The purpose of this article is to estimate the relationship between acute care consumers' satisfaction with hospital foodservices, foodservice characteristics, demographic and contextual variables. DDESIGN/METHODOLOGY/APPROACH: The acute care hospital foodservice patient satisfaction questionnaire was administered to 2347 patients in Queensland, Australia from 1996-2001. Regression analysis was conducted to measure the influence of 21 foodservice attributes and seven contextual/demographic items on overall foodservice satisfaction. FFINDINGS: Foodservice satisfaction was strongly associated with variety, flavour, meat texture, temperature, meal taste, and menu staff (p < 0.01). Consumers aged 70 years or more rated their overall satisfaction significantly lower than younger consumers (p < 0.01), but no statistically significant differences in overall ratings existed for other contextual or demographic groups. RESEARCH LIMITATIONS/IMPLICATIONS: This new foodservice instrument and the methods of analysis may be generalisable, but application is likely to be context-specific. Further applications of the instrument are required to produce greater confidence in its validity and reliability across different foodservice settings. PRACTICAL IMPLICATIONS: Global statements often used in health service satisfaction surveys (e.g. a single rating of "food quality") provide insufficient information to allow managers to adapt foodservices to suit consumers' preferences. ORIGINALITY/VALUE: Detailed information of the kind produced here is required for the formulation of managerial and sectoral policies to improve the quality of health and consumer nutrition care. The findings are noteworthy and, as far as the literature review showed, no previously published study has produced this level of detail on consumer preferences across foodservice attributes or their relationship to overall foodservice satisfaction.     

我国医疗卫生机构儿科服务现状研究

目的通过调查了解全国不同地区不同级别医疗卫生机构儿科服务提供现状、变化趋势以及儿科服务能力,发现我国儿科服务中存在的问题。方法在全国随机抽取44个城市,对提供儿科住院服务的医疗卫生机构进行问卷调查。结果县区级医疗卫生机构儿科出院人次占辖区儿科总出院人次的比例最高（51．2％）;2008—2010年不同级别的机构儿科出院人次均呈逐年上升趋势,以县区级机构增长幅度最大,2010年增长幅度达到16．1％。能提供综合性新生儿科服务的机构中,以市级及以上机构比例最高（70．O％）,其次是县区级机构（64．9％）,乡级机构最低（16．0％）。23．6％的乡级机构尚不能提供基本新生儿科服务。新生儿死亡病例以发生在县区级机构比例最高（46．3％）,其次是乡级机构（32．6％）。新生儿死亡原因以早产和低出生体重、出生窒息死亡比例最高。结论县区级医疗卫生机构在我国儿科医疗服务中发挥了重要作用;提高儿科服务能力．需重点关注基层医疗卫生机构;加强儿科适宜技术在基层医疗卫生机构的推广,提高其服务能力。     

Computer use and educational needs in selected Canadian health care food services

A survey was conducted to assess the computer use in 27 selected Canadian health care food service facilities and the educational needs in computerization of the corresponding foodservice administrators. The foodservices selected were represented by foodservice administrators at a workshop on computer-assisted foodservice managements held in June 1980. Only three facilities used a computer for foodservice functions: seven foodservices planned to use a computer within the next two years. A list of applications in use, being planned and of future interest showed the priority areas for these foodservices. The foodservice administrators identified their educational needs in computerization and demonstrated that a one to two day workshop was their preferred educational program format.     

耒阳市乡镇卫生机构现状分析及改革对策探讨

乡镇卫生机构是农村三级医疗预防保健网的枢纽，是农村医疗卫生服务体系的重要“基石”。为了解乡镇卫生机构的发展现状，给政府宏观调控提供决策依据，该文回顾调查了耒阳市2001年乡镇卫生机构的内部管理、业务开展、经济运行等方面的现状，针对实际存在的问题，分析了其产生的原因，并提出了改革的对策及建议。     

Health information management using optical storage technology: case studies

All the health care facilities examined in the case studies addressed several important organizational issues before and during the installation of their systems. All the facilities examined employee commitment. The prudent managers considered how easily their employees adapt to changes in their jobs and work environment. They considered how enthusiastic cooperation can be fostered in the creation of a liberated and reengineered office. This was determined not only by each individual's reaction to change, but also by the health care facility's track record with other system installations. For example, document image, diagnostic image, and coded data processing systems allow the integration of divergent health care information systems within complex institutions. Unfortunately, many institutions are currently struggling with how to create an information management architecture that will integrate their mature systems, such as their patient care and financial systems. Information managers must realize that if optical storage technology-based systems are used in a strategic and planned fashion, these systems can act as focal points for systems integration, not as promises to further confuse the issue. Another issue that needed attention in all the examples was the work environment. The managers considered how the work environment was going to affect the ability to integrate optical image and data systems into the institution. For example, many of these medical centers have created alliances with clinics, HMOs, and large corporate users of medical services. This created a demand for all or part of the health information outside the confines of the original institution. Since the work environment is composed of a handful of factors such as merged medical services, as many work environment factors as possible were addressed before application of the optical storage technology solution in the institutions. And finally, the third critical issue was the organization of work. "Organizations that understand their business processes are having no trouble whatsoever justifying the cost of optical storage-based information management systems," said Thornton May, director of imaging research at Nolan Norton Institute. "It is only confusing to organizations that do not have a feel for what is happening in the flow of work in the company. If an organization has on-line performance measurements with regard to time, cost, quality, error rates, and customer service, the move to optical image and data management technology is a no-brainer."(ABSTRACT TRUNCATED AT 400 WORDS)     

Modern aspects in managing the quality of medical care provided to the male teenagers of the pre-conscription and conscription age

A topical issue of medical care provided to the teenagers and an introduction of a new technology of rendering such care to them under the conditions of pediatric out-hospital clinical institutions are discussed. The establishment of a multi-level system of the medical care management, as described in the article, will enable to detect, timely, pathologies in teenagers for the purpose of improving their health and for the purpose of exempting the male teenagers with physical defects and with psychosomatic disorders from the military service in the army and fleet. The designing and successive implementation of the general scheme of promoting the management of medical care of teenagers with regard for a modern state-of-art of health care institutions and with regard for the health condition of the growing generation would insure a rational usage of the material-and-technical, personnel and financial resources of health care and military commissariats.     

欠发达地区门诊患者就诊机构选择及影响因素——基于我国西部地区县级医院及乡镇卫生院的实证研究

目的:调查西部农村地区医疗机构门诊患者治疗常见病的就诊机构选择,并分析其影响因素。方法:研究收集我国西部11省的县级医院和乡镇卫生院门诊患者常见病就诊机构选择情况,采用非条件无序多分类logistic回归和卡方检验分析就诊选择的影响因素。结果:共纳入4 233名样本,其中45.5%选择乡镇卫生院。样本来源机构、省份和受访者性别、教育程度、职业、月收入、医保类型等自身因素对患者的选择意愿有显著影响。就诊机构的"距离"、"收费的合理性"、"医务人员服务态度"及"医务人员技术水平"是就诊选择的主要外部原因。结论:男性、务农务工群体、教育程度较低、收入较低的患者,倾向于在级别较低的医疗机构就诊;农村居民对村卫生室的医疗需求多为方便、及时,对较高级别的医疗机构(如县级及以上医院)的需求则定位于更好的服务态度和技术水平,因此村卫生室、乡镇卫生院应更注重提高基本医疗服务的可及性,而县级及以上医疗机构应着眼于提升医疗服务水平、改善患者的可负担性及满足患者较高层次的卫生服务需求。     

安徽省不同区域县区级妇幼保健机构能力综合评价比较

目的通过对安徽省妇幼保健机构综合情况的调查,了解安徽省区域间妇幼保健机构综合能力现状和差异,为制定相关政策提供依据。方法应用全国统一的＂妇幼保健机构资源与运营情况调查表＂和《全国妇幼卫生机构管理信息网络报告系统》调查101家县、区级妇幼保健机构。根据建立的保健机构综合评价模型计算各单位综合得分。按照安徽省行政区划,将其分为皖南、皖中、皖北三个地区,使用统一问卷进行调查;采用定量与定性相结合的方法对三地区妇幼保健机构综合能力进行评价。结果各区域妇幼保健机构综合评价得分中,皖中地区得分最高（64.46分）,皖北地区得分最低（59.89分）,三个地区妇幼保健机构综合评价总分,差异无统计学意义（P〉0.05）;皖南、皖中地区妇幼保健机构综合资源、人力资源、设备资源等指标得分较皖北地区高。结论安徽省县级妇幼保健机构发展不平衡,应基于各地区社会发展水平,加快人才队伍建设,全面提升服务能力和水平。     

The Use of Public Mental Health Services by Older Californians and Complementary Service System Effects

Older adults with mental disorders are less likely to use specialty care than any other population group. In this study, we created a multisource secondary data file and examined the use of public mental health services by older adults across California’s county-based community mental health systems. We specifically considered complementary service system effects relative to compositional effects representing individual service users and more general contextual effects. Service use was defined in terms of treated prevalence rates, repeat service use, and intensity of service use. Differences across 49 county-based systems were evaluated by regressing the 3 service use measures onto compositional characteristics including client age, diagnosis, and insurance status; variables reflecting complementary service systems including mental health, health, long-term care, and aging services; and other contextual effects such as the size of the county population and average education level. The analyses were adjusted statistically for regional, yearly, and seasonal differences, and for longitudinal clustering within the 49 counties over 12 quarters of observation. Results suggested that older adults’ service use varied significantly from one county to the next, and differences were associated with both compositional and contextual effects. As the aging population continues to grow and place an increasing demand on public mental health service systems, this research may help policy makers and program administrators understand some of the critical elements that affect service use patterns among older adults.     

阴道镜图文报告系统的开发

目的：开发一套具有良好的扩展性,可实现与医院信息系统接口的图文报告系统,恢复阴道镜的运行。方法：系统采用多层C／S结构,数据层采用Microsoft SQL Server数据库平台,应用服务层和客户应用程序采用Delphi开发。应用服务层采用ADO组件实现连接数据库．客户应用程序和应用服务层之间通过SOCKET协议通信。图像处理模块基于采集硬件设计,使用硬件商提供的开发包实现采集处理功能。结果：该系统实现了实时图像采集．具有灵活的报告生成功能。该系统不仅实现了菜单功能动态设置,甚至创新性地实现了报告内容的自定义设置．可以根据不同需求设置完全不同的报告内容和输出格式．可很容易地在不同科室中推广应用,结论：该系统符合设计要求,恢复了原阴道镜检查设备的使用．并在同类系统中实现了动态界面设计,具有良好的扩展性,可满足类似科室的使用需求,解决了基于硬件的个性化图像采集软件开发问题,可有效降低运维成本。     

四川省城乡居民就医行为现状及其影响因素分析

目的 了解四川省城乡居民就医行为的现状及其影响因素。方法 基于2018年四川省卫生服务调查数据描述四川省城乡居民两周内患病就诊及就诊机构选择的基本特征,采用多水平logistic回归分析居民两周内患病是否就诊以及就诊机构选择的影响因素。结果 居民两周患病率为41.7%,其中选择就诊的比例为46.4%;影响居民患病后是否就诊以及就诊机构选择的因素主要是居民是否患有慢性病、自感患病伤的严重程度、病伤的持续天数和患者受教育程度(均P<0.05);基本医疗保险类型是就诊机构选择的重要影响因素(P<0.05);居民选择就诊机构并无城乡差异,但少数民族地区的居民选择基层医疗机构就诊的可能性是非少数民族地区居民的2.627倍(P<0.001)。结论 四川省居民两周患病后就诊的比例较低,应进一步完善不同类型基本医疗保险制度,提高基层医疗机构服务水平并加强健康教育,合理规范居民就医行为。     

The reformation of information technology

During the last twenty years there have been major changes in European health services in the need for information, technology and the information user. The need for information for management purposes has been highlighted by the shift away from running institutions to providing health care for defined populations, and the diminution in financial growth available to health services. To provide comprehensive care in the current financial climate there is a requirement for relevant and timely information about the patients being treated, the population from which they come and the cost and effectiveness of the treatment being provided. Major changes have occurred in both the software and hardware available for information technology (IT) applications. Modern technology cannot only process statistical data but also acquire, process, store and disseminate vocal, pictorial, textual and numerical information. Among applications of interest to health service managers are quantitative data systems, planning systems, text management systems and communications both within the organization and with other organisations.(ABSTRACT TRUNCATED AT 250 WORDS)     

Continuity of care and the control of costs: can case management assure both?

Case management is increasingly extolled as a mechanism to improve services in both health and mental health settings. However, in mental health service systems, case coordination of services is at the client level, while in health services it is applied mainly as a means to manage care and control costs. This paper discusses the background of case management, the policy and management conflict that is arising between the goals of cost control and continuity of care, and a number of steps to reduce the negative effects of these competing policies and goals.     

安徽省县区级妇幼保健机构发展现状及对策研究

目的:了解安徽省县区级妇幼保健机构发展现状,为卫生管理部门制定妇幼保健机构能力建设方案和发展对策提供参考依据。方法:采取整群抽样的方法,应用全国统一的"妇幼保健机构资源与运营情况调查表"和《全国妇幼卫生机构管理信息网络报告系统》对全省101所县区级妇幼保健机构进行全面调查。结果:87.13%的县区级妇幼保健机构人员编制未达国家标准,卫生技术人员中以中、初级职称和大专及以下学历为主;妇幼保健常用仪器设备相对缺乏,服务项目拓展受到限制;73.27%的机构处于长期负债运营状态,后续发展力较弱;科研教学水平落后,制约机构全面发展。结论:应强化县区妇幼保健机构的能力建设、明确功能定位、进一步加大财政专项投入和政策支持、加强群体保健工作力度、加快人才队伍建设、全面提升服务能力和水平。     

推进城市社区卫生服务合理利用卫生资源

针对城市卫生服务体系改革与发展社区卫生服务,合理利用卫生资源,对盐城市社区卫生服务供需状况进行了系统的调查,对收集到的数据进行了分析和研究,并结合盐城市的实际情况,提出了相应的对策及建议。