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目的:通过研究澳大利亚医保支付方式演变过程以及改革主要特点,以期为我国医保支付方式改革提供有价值的建议。方法:通过文献研究的理论方法分析了澳大利亚医保支付方式的演变过程以及改革的特点。结果:澳大利亚医保支付方式改革主要分为三个阶段,主要是按服务项目付费、总额预付制以及按病例组合付费方式。同时其医保支付方式改革的特点主要是由后付制转变为预付制、建立精细化分类管理、关注医疗服务质量安全。结论:澳大利亚的医保支付方式改革对我国具有重要借鉴意义,但仍需结合本国国情,探索具有中国特色的复合型医保支付方式。 相似文献
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目的:对比实施总额预付和按项目付费的县级公立医院住院患者的用药差异,探讨总额预付改革对住院患者合理用药的影响,为科学推进医保支付方式改革提供建议。方法:针对样本医院儿科和呼吸科主要诊断为社区获得性肺炎的医嘱用药信息,使用单因素分析法探究两种支付方式在住院指南推荐用药符合率、抗菌药使用率、抗菌药联合使用率以及激素使用率四项指标上的差异。结果:相比按服务项目付费,总额预付制下的指南推荐用药符合率更高,抗菌药使用和联用率均更低,激素使用率更低,但呼吸科的结果存在一定差异。结论:总额预付对促进合理用药有一定效果,但合理用药水平仍有待加强,建议实施多种促进合理用药的策略来提升合理用药水平。 相似文献
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将传统中医住院治疗纳入疾病诊断相关分组(DRG)医保支付方式改革范围内,利用信息化系统使医保付费改革探索范围向纵深推进。建立数据仓,通过对中医病案首页数据进行样本分析,结合西医CHS-DRG1.1分组方案进行研发。该研究研发了符合中医诊疗服务特点的中医DRG分组器,支持发挥中医药治疗部分疾病的独特优势,稳步推进以DRG付费为主的医保支付方式改革持续深入。分析研发意义,从社会效益层面,通过中医疗效价值付费改革体现了中医医务人员的技术劳务贡献,支持了中医药事业的发展,实现了“患者少花钱、医院增收入、医保减支出、中医特色得体现”的多方共赢改革效果。 相似文献
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按疾病诊断相关分组付费(diagnosis-related groups,DRG)和按病种分值付费(diagnosis-intervention packet,DIP)两大医保费用支付方式已开始在我国多地试点实施,住院患者医保费用支付方式改革对医保基金管理和医疗机构运营将产生重要影响.药品费用作为医保费用的重要组成部分... 相似文献
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The prevention of histamine-induced gastric and duodenal ulceration in the guinea-pig has been examined using a series of undegraded and degraded carrageenans. Undegraded carrageenans were active at lower doses than degraded carrageenans. The high viscosity of the undegraded carrageenans in solution prevented their use in larger doses. Degradation of carrageenan without serious loss of sulphate, gives a product which allows the dose to be increased to an extent that its effect more than offsets the slight loss in activity caused by the degradation. No single feature of carrageenan structure can be related to anti-ulcer activity although degradation, and hence reduction of molecular size, generally reduces activity. Sulphate contents over 30% have little apparent effect on activity; κ-carrageenans were not consistently different in anti-ulcer activity from Λ-carrageenans. This contrasts with the antipeptic activity of carrageenans where κ-carrageenans are less active than their Λ-counter-parts. As with antipeptic activity, the degree of anti-ulcer activity is probably determined by a combination of structural features which includes molecular size and polyanionic properties. 相似文献
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Larks and owls and health, wealth, and wisdom 总被引:1,自引:0,他引:1
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《Journal of addictive diseases》2013,32(3):73-87
Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder. 相似文献
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Z J Witczak 《IDrugs : the investigational drugs journal》1998,1(1):30-31
The American Chemical Society Symposium "Glucosidase and fucosidase inhibitors" took place on 1 April 1998 and was organized by Professors Zbigniew J Witczak (UConn, School of Pharmacy, CT, USA), Kuniaki Tatsuta (Waseda University, Tokyo, Japan) and Waldemar Priebe, MD (Anderson Cancer Center, University of Texas, USA). Professor Witczak provided introductory remarks including the status of existing glucosidase inhibitors, and chaired the morning session, which consisted of six lectures. The symposium was well received, and was particularly attractive for those interested in networking, as attendance was about sixty. In addition, some participants and attendees presented posters on the subject during the regular poster session organized by the Division of Carbohydrate Chemistry. 相似文献