上海市某医院医疗器械库存状况分析

分析了上海市某医院医疗器械库存的状况,对卫生材料中库存金额、库存数量和平均年消耗量较大的3种医疗器械建立了经济批量订购模型,并对模型构建的要素进行了敏感性分析。通过分析,提出了医院应控制医疗器械库存,利用库存模型减少医疗器械订购与库存的总成本,探索医院与供应商合作管理医院医疗器械库存。     

国内关于缩短平均住院日的影响因素及对策研究

平均住院日是衡量医院医疗质量与管理水平的综合指标。医院合理提速运行的基础是控制平均住院日的影响因素,这些因素可分为可控因素和不可控因素。相应可通过宏观协调转化不可控因素,引入的新的管理思想,制定适宜的平均住院日标准,配以微观措施以降低医院的平均住院日。     

影响医院平均住院日的因素及对策

为找出缩短平均住院日的对策，本文通过对合肥市二院进行各方面因素的调查分析，得出影响平均住院日的两大类因素，即相对于医院的＂可控因素＂和＂不可控因素＂。可控因素主要包括检查、诊断、治疗、医疗设备、医技科室与临床科室的配合程度以及领导者的管理思想等；不可控因素主要包括病种、年龄、职业、病人来源、医疗费用支付形式和文化等因素。不可控因素对平均住院日的影响大于可控因素。     

国内关于缩短平均住院的影响因素及对策研究

平均住院日是衡量医院医疗质量与管理水平的综合指标。医院合理提速运行的基础是平均住院日的影响因素,这些因素可分为可控因素和不可控因素。相应可通过宏观协调转化不可控因素,引入的新的管理思想,制定适宜的平均住院标准,配以微观措施以降低医院的平均住院日。     

医疗设备合作经营中存在的问题及对策

大型医疗设备价值较高，医院如果以自有资金购买，一次性付现压力较大，再加上对设备产生的经济效益不能确定等原因，因此很多医院往往通过与设备供应商合作分成的方式进行经营。即由医疗设备公司提供设备，由医院提供场地及人员，双方按一定比例对该设备产生的收益分成。但是，在合作经营中医院往往处于被动地位，合作利益往往向设备供应方倾斜，而经营风险则向医院倾斜，使医院的收益与实际投入不匹配。     

运用指数体系对医院效益进行分析

本文利用指数体系对我院2004—2005年业务收入的总额进行因素分析,测定工作量、单位平均费用各个因素变动方向对医院收入总额影响程度,以探讨医院如何适应社会医疗改革;促进合理创收,加强对影响业务收入可控因素的管理。*1资料与方法1.1资料来源于我院2004—2005年医院工作统计     

应用综合指数法分析我院医疗业务收入

医院的业务收入受多种因素的影响,本文对我院2006年和2007年业务收入额进行因素对比分析,测定工作量、单位费用等因素的变动方向对医院收入的影响程度,分析在收入总体的变动中,各构成因素变动所起的作用,以探讨医院如何适应市场竞争,促进合理创收,加强对影响业务收入可控因素的管理.     

基于灰色关联法分析平均住院日影响因素

平均住院日是一种衡量医院利用医疗资源,评价医院医疗质量、工作效率和管理水平的综合性指标.影响平均住院日的因素很多,一般分为可控因素和非可控因素,前者如等待检查结果时间、术前住院日;后者如病种、年龄、付费方式等.本文采用灰色关联法,从患者住院日的时间长短和医疗质量、床位利用等方面综合评价其对平均住院日的影响,为控制平均住院日提供参考信息,为医院管理决策提供理论依据.     

被动吸烟儿童呼吸健康状况与血清免疫球蛋白含量的相关性

目的:探讨被动吸烟儿童呼吸健康状况与血清免疫球蛋白含量的相关性。方法:对泰安市6个县市区采用简单随机抽样的方式对3～6岁儿童进行调查,内容包括不同年龄儿童的被动吸烟量及吸烟年限;近1年呼吸道健康状况;血清免疫球蛋白含量。结果:被动吸烟儿童感冒、肺炎、支气管炎、哮喘发病率均高于无被动吸烟的儿童(P<0.01)。随被动吸烟量的增大、家庭成员吸烟年限的延长,儿童患呼吸系统疾病的次数逐渐增加(P<0.01)。被动吸烟组儿童血清免疫球蛋白低于无被动吸烟组,随被动吸烟量的增加,免疫球蛋白明显下降,各组有显著差异,而被动吸烟儿童免疫球蛋白含量降低者反复呼吸道感染的几率增高(P<0.01)。结论:被动吸烟对儿童呼吸健康及免疫功能有不良影响,应采取措施减少儿童被动吸烟的暴露。     

护理人员对血液透析患者自体动静脉内瘘使用的健康教育

目的 :分析血液透析患者自体动静脉内瘘使用健康教育的护理。方法 :选取我院2011~2012年64例维持血液透析患者,通过健康指导对动静脉内瘘使用情况和效果。分析如何有效的避免由各种原因导致内瘘闭塞或失能的诱因,延长动静脉内瘘在透析中的使用年限。结果 :通过有效的健康教育,增加了医患之间的沟通和信任,使患者由原来的被动变为积极主动参与。结论 :医患合作程度优良,延长了内瘘使用年限及减少并发症,为安全有效的透析做好持久战。     

医疗服务产业投资分析

与医疗机构加强战略合作是医疗保险供方控制的根本途径,对医疗机构进行投资在医疗保险和医疗机构间建立了资本纽带,是双赢的举措。该文分析了医院投资的政策意义和商业机会,并进一步对投资回报和投资前景进行了系统性的分析。其中论述的一系列要点强调了可操作性。     

Supply Chains in Healthcare Organizations: Lessons Learned from Recent Shortages

This paper examines the need for better management of supply chains in healthcare facilities. Recent shortages have highlighted the need for better supply chain systems. The reasons for the shortages are false scarcity, natural disasters, medical lawsuits, production process problems, and group purchasing organizations (GPO). These problems have occurred with increasing frequency. There are three possible solutions available to handle the shortages. First, better use of supply chain management, including multiple suppliers and safety stock. Second, there needs to be better cooperation between suppliers, consumers, and government entities. Finally, healthcare facilities should develop teams of individuals responsible for monitoring critical areas and developing contingency plans.     

Information needs of workers

In Britain, the law places duties on employers and suppliers to provide information to ensure health and safety of employees, so far as is reasonably practicable, and there are regulations for the appointment of employees' safety representatives which employers are required to consult. A recent survey by HSE has shown that suppliers are the most important source of information on substances. However, the flow of information is often obstructed by barriers between the suppliers and the companies, and within organisations. Safety representatives, where they exist, are often better informed than employers, and in companies with safety representatives accident rates are lower. Information from suppliers can be inappropriate for the end use, and the goal-setting approach which has dominated in recent years may not help the non-expert employer. We welcome HSE's move to more specific control guidance for chemicals.     

在医院医疗用楼改建中医学装备部门的工程配合

目的：随着越来越多的医院通过新建或改建、扩建现代化医疗用楼来改善就医环境和提升医院综合实力,国内各大口腔医院口腔诊椅数量逐年递增。在这些口腔椅位增加的医疗用楼改建、扩建中,应重视医学装备部门的紧密配合。方法：介绍在口腔医院医疗用楼改扩建中4个阶段医学装备部门如何做好配合,即前期参与医疗用房需求探讨;中期确定对水电气及环境有特殊需求医学装备供货商;后期完成设备安装、调试及验收;休整期办理货款支付、资产上账及成本核算事宜。结果：通过医学装备部门在4个阶段的配合,使医疗用楼顺利投入使用。结论：在医疗用楼改扩建过程中,医学装备管理部门的紧密配合至关重要。医学装备管理部门要根据医学装备的类型、对安装技术的要求,在不同的基建工程阶段予以针对性的配合。     

类胡萝卜素与骨密度关系的观察性研究进展

随着人类寿命延长和老龄化社会的到来,骨健康越来越受到人们的关注。骨密度作为衡量骨健康的主要指标,受不可控因素与可控因素的影响,而营养是重要的可控因素。近年来植物化学物与骨健康的关系逐渐引起人们重视。本文按不同国家和地区对类胡萝卜素与骨密度的观察性研究进行总结,旨在为骨质疏松的防治提供新的视角。     

Drinking-water safety - challenges for community-managed systems

A targeted review of documented waterborne disease outbreaks over the past decades reveals some recurring themes that should be understood by drinking-water suppliers. Evidence indicates the outbreaks are often linked to some significant change in conditions that provides a sudden challenge to a water system. Severe weather events, such as heavy rainfall or runoff from snow melt, as well as treatment process and system changes, are common risk factors for drinking-water outbreaks. Failure to recognise warning signs and complacency are important contributors to drinking water becoming unsafe. Drinking-water suppliers must focus on competence and vigilance in maintaining effective multiple barriers appropriate to the challenges facing the drinking-water system. Understanding the risk factors and failure modes of waterborne disease outbreaks is an essential component for effective management of community drinking-water supplies and ensuring the delivery of safe drinking-water to consumers.     

Drinking-water safety: challenges for community-managed systems

A targeted review of documented waterborne disease outbreaks over the past decades reveals some recurring themes that should be understood by drinking-water suppliers. Evidence indicates the outbreaks are often linked to some significant change in conditions that provides a sudden challenge to a water system. Severe weather events, such as heavy rainfall or runoff from snow melt, as well as treatment process and system changes, are common risk factors for drinking-water outbreaks. Failure to recognise warning signs and complacency are important contributors to drinking water becoming unsafe. Drinking-water suppliers must focus on competence and vigilance in maintaining effective multiple barriers appropriate to the challenges facing the drinking-water system. Understanding the risk factors and failure modes of waterborne disease outbreaks is an essential component for effective management of community drinking-water supplies and ensuring the delivery of safe drinking-water to consumers.     

慢性疾病医保患者个人支付及统筹支付费用影响因素分析

调查2所三级甲等综合医院5种慢性疾病医保患者住院费用中的个人支付和统筹支付费用构成情况,分析影响医保患者住院费用的因素,探究控制医保患者住院费用增长的途径和方法。关注老年人的健康需求和慢性病年轻化趋,对影响医保患者住院医疗费用和个人、统筹支付费用的可控因素加以严格管理,积极促进非可控因素的转化,减少或杜绝低效或无效性医疗费用。     

基于非洲视角分析中非卫生合作现况及影响因素

目的:从非洲视角,探究中非卫生合作的态度、需求及主观影响因素,为深化中非卫生合作提供参考。方法:采用问卷调查法,对参加2018年中非卫生合作高级别会议的非洲政府官员、专家学者、医药企业代表等进行调查。结果:共回收有效问卷134份,接受调查对象来自35个非洲国家。超过90%的非洲代表对中非卫生合作表示肯定,81.5%的非洲代表所在单位具有合作意向,意向合作的重点领域是疾病防控(56.2%)、医学人才培养(55.2%)等;认为最有效的合作途径是通过政府协议或接洽(89.4%),影响中非卫生合作的主要因素是伙伴关系(87.3%);最容易开展卫生合作的国家依次为其他非洲国家、中国等(P0.001);影响合作难易程度的因素是政府和民众的支持(P=0.001)、安全风险(P=0.029)。结论:中非卫生合作影响因素多元化,政府作用占主导,可通过加强顶层设计,增进伙伴关系,畅通合作渠道,加强产品质量与认证,提升合作有效性。     

Uncertainties in retrospective radon exposure of glass: possible effects of hydration and of leaching

Embedded 210Pb in glass results from exposure to 222Rn and its prompt decay products and is used to estimate integrated, retrospective radon exposures for times up to the 32-y mean life of 210Pb. Certain established uncontrollable factors lead to rather large scatter in the results. We review briefly the known sources that contribute to this scatter and then point out that effects of water and, in particular, hydration layers on glass are probably further sources of error, possibly of major importance, but subject to straightforward checking to reject glass compositions that are unreliable.