医院后勤服务社会化、产业化改革的探索

医院后勤服务改革是医院综合改革的突破口,近年来,通过后勤服务社会化改革的实践和探索,逐步形成了上海市医院后勤服务改革的目标和倡导模式,取得了一定进展。     

浅谈医院分级管理与改革

当前,医院分级管理由试点逐步展开,在改革大潮中,由于相当部分同志不能正确认识医院分级管理与改革的关系,把医院分级管理与改革割裂开,甚至对立起来,影响医院分级管理工作的开展。为此,笔者略谈医院分级管理与改革关系,与同行们商榷。一、改革促进了医院分级管理制度的形成新中国成立后,我国虽早在50年代就制定和颁布了一系列医院管理法规,使医院医     

对医院统计改革的思考与对策

近年来,医院改革不断深入,管理水平日益提高,使医院统计改革取得了明显的成效。但就整体而言,医院统计与医院改革所形成的反差仍较大,医院统计还远远不能适应改革中医院管理的需要。各种统计报表在信息的广度和深度方面与医疗卫生事业的发展需要还不相适应。统计工作仍面临种种困境,如何跟上改革的步伐,与深化医院改革同步、接轨,是统计改革的热点。     

医院如何巩固和完善已有的改革措施

在宏观控制的情况下,医院如何巩固和完善已有的改革措施,这是继续推进医院改革需要探讨的重要课题。一、医院改革要有一个验证和完善的过程近年来,在以城市为重点的全面经济体制改革中,医院吸取了其他行业的改革经验,也推行了内部改革,主要表现在领     

医院分配制度改革有关问题探讨

为了深入贯彻十六大会议精神，提高职工的积极性和创造性，各大医院都因地制宜地进行了分配制度改革。本文回顾和总结了医院分配制度改革的形式，分析了医院分配制度改革的难点，并提出了医院分配制度改革的措施。     

谈当前医院的改革

深化医院改革已成为新形势下推动卫生事业发展的重要课题。潍坊市坚持从实际出发,在总结经验的基础上,推出了深化医院改革的新举措,医院管理体制与运行机制不断创新,取得了明显的社会效益和经济效益。一、主要做法(一)总体设计。医院要改革,必须设计好改革方案,形成较完善的改革思路和框架。１９９９年,市政府制定了《潍坊市医院改革试点意见》,市县两级卫生行政部门和试点医院制定了相关配套措施,与物价、财政部门制定了《潍坊市医药费用“总量控制、结构调整”试点方案》,以行政规章指导医院深化改革。(二)分步实施。为保证医院改革顺利实…     

医院发展影响因素分析

阐述了我国医院医疗服务所面临的严峻形势,指出了医院管理体制和运行机制的误区,分析了医院改革滞后的根本原因。对医院改革的理论和政策进行了研讨,提出了医院改革的目标。指出了医疗发展的关键、途径和原则,即提高医疗水平,保证医疗质量,增强服务意识,注意经营管理。     

对医院经营策略的几点思考

当前,以实行承包为主体的多种形式的医院改革,在经过一个时期的理论探讨和实践之后,进入了一个日趋完善和审慎发展阶段。尽管人们对医院改革众说纷纭,褒贬不一,但医院改革所取得的巨大成就是有目共睹的。目前,摆在医院面前的突出任务是,如何在现有改革成果上进一步把医院改革引向     

深化劳动人事制度改革 实现医院全员效率管理

分析了医院劳动人事制度改革的现状和潜力,论述了医院深化劳动人事制度改革的内容和措施,提出了深化医院劳动人事制度改革的原则和工作要求,即坚持从实际出发,因地制宜;坚持效益分流;坚持改革与队伍稳定的高度统一。     

江苏医疗保障制度改革试点城市医院改革的调查与思考

医疗保障制度改革对医院产生了四个方面的影响：医院业务收入增长幅度明显下降;医院工作效率有所提高;医院服务结构有了变化;医院服务行为进一步规范。医疗保障制度改革必须地带动了医院内部改革向前发展：一是更新了思想观念;二是强化了经营管理;三是优化了内部资源配置;四是提高了工作效率;五是改进了医疗服务。由于国家改革政策不配套,当前医院改革面诸多困难和问题,如政府财政投入不足,医疗服务价格体系不合理,影响医     

再论城市大医院的功能定位

实现城市大医院的功能定位,必须立足于我国正处于社会主义初级阶段这一现实。即我国人口多,患者基数大;底子薄,国家对卫生事业投入不足;地区间经济发展不平衡;管理体制不健全,人员素质不高,还要健康地把握当前,恰当地筹划未来。即实事求是,因地制宜,逐步完善,渐进到位。实现城市大医院的功能定位,必须遵循“持续、协调、健康”的发展方针。     

医疗人才培养适应社会需求的探讨

通过对南方地区医疗人才培养与社会需求状况的调研,从政府,用人单位及医学生个人三个层面,分析了形成总需求未满足而毕业生难求职这一现状的原因。认为医学院校除适时调整医学专业外,应从战略高度抓好在校生和职医生的素质教育,以适应卫生事业发展的需要。     

关于医疗服务产业化的探讨

医疗服务产业化是医疗服务行业自身发展的内在要求：医疗保健制度改革是医疗服务产业化的直接动力;政府财力有限、医疗服务业的属性要求医疗服务必须产业化。医疗服务产业化的形式可为：组建集团医院;开办连锁医院;推行股份制医院;开办中外合资、合作医院;实行后勤服务社会化。     

职业院校医学生基层医疗机构就业意向分析

高等职业教育要服务区域社会发展需求。巴中市是"三区叠加"地区,社会经济发展相对滞后,卫生资源缺乏,卫生人力严重不足,是当地卫生事业发展的重要制约因素。为促进革命老区振兴发展,提高当地医疗卫生服务水平,对当地唯一一所高等职业院校医学生进行就业意向调查,了解医学生生源与就业意向,分析就业意向影响因素,探讨促进高职医学生在当地就业的有效途径,实现职业教育服务地方经济的人才培养目标,促进巴中地区卫生事业健康发展。     

Building the infrastructure for primary health care: an overview of vertical and integrated approaches

In the past four decades there has been a succession of different approaches to the development of infrastructure for the delivery of health services. There have been striking similarities among these approaches in both direction and timing in many different countries, particularly in the developing world. While the general trend has been strongly in the direction of a more comprehensive, integrated health infrastructure, there have been important regressions from this path. It is suggested that the recent attention given to the delivery of 'selective' packages of interventions has often diverted energy and resources from the essential task of developing comprehensive, efficient and effective health services. This paper begins with an historical review of trends in the development of health services infrastructure in recent decades. It proceeds to analyse the implications for the organization of health services and for resource allocation when the health services infrastructure is viewed as part of a health system based on primary health care. Finally, we maintain that district health systems based on primary health care provide an excellent practical model for health development, including an appropriate health system infrastructure. Within this model the concerns with accelerating the application of known and effective technologies and the concerns with strengthening of community involvement and intersectoral action for health are both accommodated. The district health system provides a realistic setting for dialogue and planning involving both professionals and non-professionals concerned with health and social development.     

医院减员增效的现实思考

探讨了医院减员增效的必要性和艰巨性；如何实现减员增效以及医院减员增效的几条原则：１减 员是手段，增效是目的；２新生卫生事业发展的规律；３相信群众，依靠群众；４坚持民主集中制，正确决策；５留住人才，促进发展。     

Primary Care Pediatrics and Public Health: Meeting the Needs of Today’s Children

The proportion of children suffering from chronic illnesses—such as asthma and obesity, which have significant environmental components—is increasing. Chronic disease states previously seen only in adulthood are emerging during childhood, and health inequalities by social class are increasing. Advocacy to ensure environmental health and to protect from the biological embedding of toxic stress has become a fundamental part of pediatrics. We have presented the rationale for addressing environmental and social determinants of children’s health, the epidemiology of issues facing children’s health, recent innovations in pediatric medical education that have incorporated public health principles, and policy opportunities that have arisen with the passage of the 2010 Patient Protection and Affordable Care Act.In pediatrics, the acknowledgment of child development as a transactional process and ultimate determinant of adult capacity has important implications for the development of systems, practice models, and training. If we are to ensure children’s health and, ultimately, overall population well-being, childhood service systems must become responsive and coordinated on many levels; practitioners must develop multiple skills outside the traditional medical model; and training strategies must become innovative. Promoting access to effective health and health-related services is essential for achieving Healthy People 2020 objectives (the US Department of Health and Human Services’ set of health-promotion and disease-prevention goals to be achieved nationwide by 2020). There are many examples of shortfalls in adequacy of available services, effectiveness of care provided, organization of services, and focus on primary prevention. Up to 50% of developmental problems in children are not identified until school entry,1 more than 8 million children remain without health care coverage in the United States, and a much larger number have no regular source of health care except in emergencies.2 In addition to inadequate funding for appropriate services, the network of programs serving children is increasingly fragmented, difficult to navigate, and unresponsive.A major challenge for children’s and youths’ services is to develop more effective and efficient service integration models. In the present system, pediatricians tend to avoid asking parents about matters for which they feel inadequately trained and for which they are not aware of patient resources, including child development, obesity, breastfeeding, family violence, environmental health, and mental health. The system will not respond without adequately prepared clinician–advocates who recognize and understand these issues and their relationship to ultimate outcomes.     

医药经济核算与我国医药总费用初步分析

为了按照市场经济规律,正确地分析医药消费的宏观经济形势,制定符合我国国情的基本药物政策,本文试图对目前世界卫生组织推荐的医药费用核算体系和医药总费用指标体系作简要介绍,并利用卫生总费用测算结果所得数据,对我国医药总费用进行概略测算与初步分析,以便建立医药费用核算体系和医药总费用指标体系,开展医药总费用测算与分析。     

A partnership approach to health promotion: a case study from Northern Ireland

In recent years there has been a renewal of interest in community development and partnership approaches in the delivery of health and social services in Northern Ireland. The general thrust of these approaches is that local communities can be organized to address health and social needs and to work with government agencies, voluntary bodies and local authorities in delivering services and local solutions to problems. Since the Ottawa Charter was launched in 1986, government in Northern Ireland has stressed that community development should no longer simply be added on to key aspects of Health and Social Services, but should instead be at the core of their work. There is increasing consensus that traditional approaches to improving health and well-being, which have focused on the individual, are paternalistic and have failed to tackle inequalities effectively. Partnerships within a community development setting have been heralded as a means to facilitate participation and empowerment. This paper outlines the policy background to community development approaches in health promotion and delivery in Northern Ireland. Drawing on evidence from a case study of a community health project it highlights the benefits and difficulties with this approach. The findings suggest that partnerships can positively influence a community's health status, but in order to be effective they require effective planning and long-term commitment from both the state and the local community.     

Disadvantage and discontent: a review of issues relevant to the mental health of rural and remote Indigenous Australians

OBJECTIVE: To provide an overview of the mental health of Aboriginal and Torres Strait Islander residents of rural and remote Australia and to identify associated factors. FINDINGS: Indigenous Australians have higher rates of serious mental disorders and of mental health problems associated with social disadvantage. This disadvantage is greater for Indigenous Australians living outside metropolitan centres. Contrary to romanticised constructions of remote Aboriginal Australia, those living in such settings are not immune to such hardship - which is often unrelenting. The psychological and behavioural problems that emerge as a result are compounded by narrowly focused and inadequate mental health services, with children being particularly vulnerable. CONCLUSION: Indigenous residents of rural and remote Australia experience high levels of mental disorder. Although addressing the predisposing social disadvantage will demand significant whole-of-government investment, ensuring equitable access to effective mental health services is an immediate priority.