基于工作流程的医院员工绩效评价体系研究

长期以来,医院对医护人员的绩效评价不是凭硬性指标,而是更多依靠评语或概念式量化形式,且这些评价的内容往往笼统含糊,缺乏足以说明这些行为的事实和数据基础,同时常常受到许多人为因素的干扰,无法准确反映医护人员的实际工作情况.     

做好医疗设备使用统计的要点与意义

介绍了在医疗设备使用管理工作中,从确定统计对象、采集渠道、定额标准、量化评判、备案周期等要点入手,加强和做好医疗设备的使用统计,指出了做好医疗设备使用统计在医疗设备应用考核、使用评判、配置论证、量化管理、各级考评等方面的意义。     

多属性效用理论在医院物资采购中的应用

医院物资采购是医院管理中重要而又敏感的问题.该文将决策分析中多属性效用理论应用于医院物资采购,力求避免人为因素和盲目性,以量化、科学、合理的方法为医院物资采购的正确决策提供有力的依据.     

医疗设备安装位置与设备间干扰应注意的几个问题

医疗卫生单位在安装新设备的时候，无论是新建机房还是改造原有的医用房间，除了考虑温度、湿度、放射辐射、污染因素外，还考虑电磁辐射、震动及相互之间干扰等问题，但一些人为因素对医疗设备的干扰往往被忽视。人为因素引起局部温湿度的骤然改变，在南方许多地方经常会遇到，只有设备使用和维护人员注意日常工作细节，经常加强设备维护和保养，才能减少故障的发生率。     

军队医院绩效量化考评指标体系构建思考

随着我国医疗体系的不断改革和完善,近几年,军队医院的发展迅猛。如何评判军队医院运营成果,充分有效地利用卫生资源,最大限度地实现为兵服务的战略目标,成为管理职能部门十分关注的问题。本文从医院评价层面出发,通过分析选取军队医院绩效量化考评指标应遵循的原则和构建军队医院绩效量化考评指标体系的工具,提出了构建军队医院绩效量化考评指标体系的基本设想和建议。     

模糊数学在公共场所卫生管理中运用

目的 :通过量化综合评价 ,加强公共场所卫生管理。方法 :消毒、布局、备品、卫生制度四个方面 ,对管内旅店、理发、娱乐、浴室业四类 10 6家公共场所连续 4年检查情况进行综合评判。结果 :公共场所卫生管理水平年度综合评比为逐步提高。各类场所各年度评比结果均为逐年上升 ,但同一年度得分显示 ,旅店业、娱乐业较高 ,理发业、浴室业较低。结论 :该方法与其它评比方法相比较 ,模糊综合评判可以根据权重有重点地对有关因素作出总的贴近实际的量化评价 ,充分利用信息 ,取得满意效果。     

应用模糊综合评判法评价住院患者满意度

患者住院时,对医疗效果、医院环境等各方面的工作是否满意,直接影响到医院的社会信誉和医院的发展,随机调查了解住院患者的满意度并正确分析评价,从中找出该院工作存在的薄弱环节,为有针对性的改进工作,加强医院管理很有必要.但在评价住院患者满意度时,需要考虑的因素很多,并且满意度评价等级是一个非常模糊的概念,难以量化,这时候就可以应用模糊综合评判模型.模糊综合评判法就是对受众多因素综合影响的模糊现象做出综合评价的一种量化的数学方法[1].     

医用滤线栅物理性能微机测试仪的研制及应用

为快速、准确地检测医用X线滤线栅的质量和使用效果，我们研制了滤线栅物理性能微机测试仪。该仪器在微机控制下，对各个性能参数实现自动测量，测试结果精确，测量效率高，排除了人为因素的干扰。实用表明，效果很好。     

基于模糊综合法的高校食堂食品安全风险评价

目的 运用模糊综合法对某高校食堂食品安全风险水平开展量化评判实证研究,为高校食堂风险预警及防控提供借鉴和参考。 方法 基于高校食堂食品安全风险评价指标体系,组织专家对评价对象进行现场考核评分,应用模糊综合法完成某高校食堂风险水平的量化评判。结果 评价对象的风险水平总体处于“极低风险”等级,隶属度为0.6844,一级评价指标“极低风险”的隶属度由高到低依次为采购0.7344、加工0.6725、销售0.6252、贮存0.5808,但内部指标有所差异,5个二级评价指标呈现出明确的“低风险”或“中等风险”隶属等级。 结论 模糊综合法契合高校食堂食品安全风险评价的需要,其评价过程清晰明了,评价结果客观可靠,在高校食堂的风险预警和防控中具备实际应用价值。     

学术期刊硕士研究生文稿质量的评判

以学术期刊上硕士研究生论文的60份专家审稿单为调查样,60份非研究生的论文审稿单为对照样,应用模糊评判原理对研究生的论文质量进行了量化评判。结果显示：研究生组综合评分稍低于对照组,差异率-5．38％,差异不显著。说明该刊的研究生论文质量基本达到了该刊质量水平的要求。     

医务人员对不同品牌医用防护口罩的主观感受与适合性测试结果

 目的 了解医务人员对不同品牌医用防护口罩密合性感受和舒适度感受的差异。方法 选取发热门诊的工作人员,包括医生、护士、医技、工勤人员,对四个品牌的折叠形医用防护口罩进行定量适合性测试,调查不同动作时医务人员主观感受密合性情况,并调查测试时和佩戴4h后医务人员鼻梁区压迫感、皮肤痒、颜面部皮肤损伤、内表面磨嘴、勒耳廓、面部压迫感等不适感受,以及佩戴4h后口罩变形等特殊情况。结果 共对发热门诊98名工作人员进行了医用防护口罩佩戴适合性测试和舒适度调查,与定量适合性测试结果相比,主观感受真正密合的符合率为77.42%;主观感受真正非密合的符合率为56.86%。不同测试动作中,除大声说话动作之外,其他动作主观感受真正密合性符合率均在90%以上,而真正非密合符合率各项动作均较低,均在30%以下。口罩佩戴主观感受反映的主要问题为大小不合适、头带拉力不舒适、鼻梁区压迫感,整体不适感受人员比率在40%左右。佩戴4h后,头带拉力不舒适、鼻梁区压迫感人员比例所有增加。结论 选择医用防护口罩时,除考虑适合性测试数据外,还需综合考虑舒适度等主观感受,可提高医用防护口罩佩戴的依从性和正确性,并提高医务人员满意度。     

Patient- and hospital-related determinants on subjective evaluation of medical treatment outcome of severely injured patients

Aim The importance of subjective evaluation of medical treatment has been neglected so far. Therefore, the objective of this study is to identify determinants of subjective evaluation of medical treatment outcome in terms of severely injured patients. Subjects and methods A written questionnaire was sent to 121 seriously injured patients, who were hurt predominantly by traffic or work-related accidents and were treated between 1996 and 2001 in two hospitals in North Rhine-Westphalia. Using bi- and multivariate analysis, significant determinants on a dichotomized index of subjective evaluation of medical treatment outcome were analyzed. Results Logistic regressions identified one significant determinant on subjective treatment outcome of severely injured patients: trust of patient in physician. Conclusion This finding confirms the importance of psychosocial aspects in physician-patient interactions concerning the subjective evaluation of medical treatment outcome. Therefore this result emphasizes the importance of social sciences in medical education especially for surgeons.     

基于博弈论分析如何减少主观医疗缺陷

目的 探索主观医疗缺陷产生的原因，研究如何避免主观医疗缺陷。方法 将医疗缺陷产生分为主观医疗缺陷和客观医疗缺陷。针对主观医疗缺陷建立博弈模型，对医务人员和医院管理者之间的利益关系进行了分析，以阐述主观医疗缺陷产生的内在原因。结果 当医院当局对医务人员违规和不违规的预期收益无差异时，可得到医院在博弈均衡时医务人员违规的最优概率和医院监管的最优概率。 结论 当医院监管概率不变的情况下，提高惩罚力度或者提高查出违规的概率都可以提高医疗质量水平。     

Subjective quality of life measures for evaluating medical intervention

Medical interventions are usually evaluated in terms of mortality and morbidity data, but there is recent interest in going beyond medical data to assess the impact of the therapy on the objective and subjective quality of the patient's life. Objective quality of life measures such as employment and functional status are relatively straightforward, but measuring subjective quality of life is a more complex task. This article reviews psychometric issues relevant to using subjective quality of life scales developed by Bradburn and by Campbell, Converse, and Rodgers for research with patient populations. The evidence indicates that these relatively brief scales assess both affective and cognitive aspects of subjective quality of life, that they are measuring something more stable than mood but less enduring than personality, and that they can be as sensitive as physiological measures in distinguishing among treatment groups. It is concluded that these scales offer a useful complement to more objective measures of patient status for research evaluating medical interventions.     

Health insurance and subjective health status: data from the 1987 National Medical Expenditure survey.

OBJECTIVES. The relationship between health insurance and subjective health status was investigated. It was hypothesized that persons without health insurance would have lower levels of subjective health status than those with health insurance and that this relationship would hold for both poor and nonpoor persons. METHODS. Data from the 1987 National Medical Expenditure Survey were analyzed to examine the relationship between health insurance and self-reported health status. The analysis controlled for sociodemographic and attitudinal variables and medical conditions. RESULTS. Persons without health insurance had significantly lower levels of subjective health status than did persons with insurance. This adverse effect persisted after adjustments were made for the effects of age, sex, race, income, attitude toward the value of medical care and health insurance, and medical conditions. The detrimental effect of lacking health insurance on subjective health status was present for persons at all income levels and was greater than the effect on subjective health status found for 2 of the 11 reported medical conditions. CONCLUSIONS. Lacking health insurance is associated with clinically significant lower levels of subjective health status in both poor and non-poor persons.     

Determinants of quality of life in primary care patients with diabetes: implications for social workers

Using a cross-sectional design of 400 primary care patients with diabetes, the authors evaluated demographics, health status, subjective health and mental health, health behaviors, health beliefs, knowledge of diabetes treatment, satisfaction with medical care, and quality of medical care as potential predictors of QoL and QoL in the hypothetical absence of diabetes. Those who reported difficulties meeting basic needs, diabetes-related complications, worse subjective health, and dissatisfaction with medical care were more likely to report worse QoL. Those who reported difficulties meeting basic needs, higher cholesterol level, and worse subjective health also were more likely to report better QoL in the hypothetical absence of diabetes. In addition, diabetes management played a major role in one's QoL in the hypothetical absence of diabetes: Engaging in stricter diabetes self-care and taking pharmaceutical treatment for managing diabetes were associated with better QoL in the hypothetical absence of diabetes. Providing psychosocial support geared toward diabetes self-management may improve patients' QoL. When doing so, social workers need to be aware of the potential trade-off between following medical recommendations that advocate for a strict lifestyle and patients' QoL.     

Subjective health and rehabilitation needs of LVA insured patients currently applying for medical rehabilitation

Unlike services paid through the Federal German Health Insurance, applications for medical rehabilitation are granted based on defined criteria. In some cases, rehabilitation is granted without apparent reason. Seeking to minimize this problem, this study integrates information on the subjective health status into the decision-making process of medical examiners. The return rate of the postal questionnaire (87%) as well as the evaluation of the examiners documented the practicability of the approach. The interviewed applicants described themselves as more limited in their abilities on several health dimensions (ICIDH) compared to a population of prestationary interviewed rehabilitation patients, whereby the standard deviations in both populations were similar. Furthermore, the applicants rarely utilized complementary treatments and sociomedical/legal advice. A surprising result lies in the mostly non-existent association between the subjective health status and the medical decisions. This constitutes a significant difficulty in legitimizing the decision-making process of the medical examiners.     

从一典型案例看医疗机构医疗事故防控机制的构建

医疗事故的频繁发生是我国当前医患冲突的最大隐患。事实上,医疗事故发生的主要原因在于医务人员在医疗活动过程中的主观过失。这种主观过失在客观方面表现为其医疗行为的违法性,正因为如此,医疗事故可以防控,并且重在防控。如果试图避免医疗事故的发生或将其降ILGWU最小限度,实现医患和谐,建立有效的医疗事故防控机制则是医疗机构的关键所在。     

我国现行婚检制度问题的政策学分析

文章以我国婚检制度的历次演化为立足点，利用新的政策学基本原理，从政策主体、政策客体、主客体间关系等几个角度分析强制婚检取消后婚检率急剧下降的原因，从而探讨改变婚检现状的机制，提出政策建议。     

某医学院毕业生幸福感及影响因素分析

目的探讨医学院毕业生主观幸福感水平及影响幸福感形成的社会学因素。方法采取问卷法,用自制的主观幸福感调查表调查某医学院校200名大学毕业生。结果医学院校大学毕业生总体幸福感为中等水平,平均分为65.4分。结论影响医学院校大学毕业生主观幸福感的因素主要是性别、健康状况、学校满意度、生活满意度、个人满意度、积极和消极情绪。