提升文化管理铸造品牌医院

1用医院文化铸造服务的品牌 现代医院的服务和核心价值就是落实以病人为中心的服务理念。以病人为中心,最大的挑战就是观念的真正转变。这种思想应贯彻于医疗工作全过程。我院推行机关干部门诊值班巡视制度,     

上海病人就医需求特征研究

我们于１９９３年５月至８月就上海病人就医行为特征进行了调查研究。调查对象为上海４个区和２个县的１３６９名门诊和住院病人。调查结果表明：上海医疗消费者的购买力较低；医疗消费人群以中、老年为主；就医行为以注重方便和质量为主；医疗消费者对医院的选择性较小；医疗消费者需求具有层次性；病人认为医疗保健功效比较好。我们认为，卫生行政管理部门和医院管理者应引起重视和采取的相应对策是加强对老年病人的服务；合理收取病人的费用；发展层次性服务；医院应确定适宜的服务方向。     

军队医院实施ISO 9001体系认证的思考

现代医院均强调“以病人为中心，以质量为核心”开展医疗工作。军队医院实施ISO9000体系认证的目的是想引进现代质量管理的科学理念和先进方法，建立较为完善的医院质量管理体系，使医疗服务工作的各个环节都处于受控状态，减少质量缺陷，将“以病人为中心”的医疗理念真正融人医疗工作的每一环节，提高医疗保健水平，打响医疗服务牌。     

病人选择医生应注意的问题

病人选择医生是当今医疗行业内部管理机制的重大改革。本针对军队医院病人选择医生工作的特殊性，提出了应注意的问题，重点讨论了如何体现军队享有同等“选择”权力，如何合理利用人、财、物及正确理解按劳取酬等问题。     

军队医院提高病人满意的新举措

军队医院坚持姓军为兵、为部队战斗力的服务正确方向,从新时期病人需求特点出发,对医疗服务工作进行了改革和发掘。在“真实的瞬间”发掘医院与病人之间的“共同利害”,按照病人需求,从根本上修订医疗服务的立足点;选拔优秀人才,充实急救第一线;积极开展高新技术,满足不同病人的需求,从诊治颖难病人入手缩短平均住院日;改革工作制度科学安排医疗服务力量;转变护理模式,积极开展整体护理。把各项工作落到实年,使病人满意     

从单病种成本分析看军队医院补偿模式对医疗服务的影响

本文主要研究解放军某医院(以下简称L医院)消化性溃疡病种医疗成本核算方法及结果,并利用病种医疗成本,试图定量分析预算补偿与经营补偿对病种及项目医疗服务的影响程度,为深入研究军队医院病种成本核算,评价军队病人病种医疗服务水平,供军队卫生管理决策机关和军队医院管理者参考。     

医院门诊不同时间段各服务环节病人流量测定

门诊病人的诊疗过程包括了挂号、交费、检查、治疗、取药等诸多服务环节。保证每一服务环节优质、高效的运行，是提高门诊医疗服务质量和病人满意度的基本保障。本文通过门诊不同时间段各服务环节病人流量测定，以期找出病人流量特点，为门诊管理提供决策依据。     

新形势下提高军队医院门诊量的策略

为探讨新形势下提高军队医院门诊量的策略，本阐述了该院采取了以病人为中心，增强服务意识，重视技术水平，提高诊疗质量。严格医疗管理，提高工作效率，拓宽服务范围，扩大医院影响等措施，使社会效益和经济效益都得到了提高。     

专家门诊现状评估和质控探讨

以问卷形式对门诊患者和专家进行了有关专家门诊质量、医德医风、收费标准及对专家挂号费档次的选择等问题进行了调查。结果提示目前专家门诊的医疗质量是肯定的，绝大多数的专家服务认真热情，大多数病人认为专家门诊收费合理，患者在挂号费档次的选择上以高档次者居多，笔者提出：应加强检查，适度定额，以利于专家门诊的质量保证；限制专家出诊次数，要求专家参加普通门诊医疗答疑，以利于住院医师的培养和防止普遍门诊医疗服务质     

人均费用比指标应用于医院管理的探讨

由于军队医院国防卫生事业经费投入不足，使医院在确保为兵服务上难度加大．本作采用人均费用指标．从医院收治的军队和地方病人疾病分类医疗费用、临床科室医疗费用两方面进行统计分析．旨在为提高自我补偿能力，促进医院全面发展提供参考。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.