项目地区孕产妇保健情况干预效果评价

[目的]评价“农村初级卫生保健项目”中母亲安全活动的干预措施的效果,为改善项目地区孕产妇保健状况提供科学依据。[方法]2001年和2005年的7～8月间,采用人口比例抽样法(PPS)在中国西部农村项目地区分别进行了基线和终线调查,用SPSS软件,选用χ2检验等方法。[结果]基线调查和终线调查的产前检查率分别为85.8%和98.0%,住院分娩率分别为46.2%和84.9%,项目执行后均有明显提高。[结论]项目的干预措施有效,使项目地区的孕产妇保健工作有了较大的改善。这些措施可以在一定程度上推广到类似的地区。     

新型住院医师培训模式初探

该文概述了我国住院医师培训工作的现状和实施过程中存在的问题。以“单位人”进入培训的机制,建立以“社会人”身份接受培训的住院医师规范化培训制度,引入竞争机制和淘汰机制。其主要目的是招收临床医学本科毕业生,经过3年全面、正规、严格的临床培训,使受训者在完成培训后达到三级甲等医院高年住院医师的水平,为社会提供合格的普通专科住院医师。     

急诊创伤救治模式及其效果分析

目的探讨一体化急诊模式在急诊创伤救治中的应用。方法在一体化急诊模式下,将院前急救、急诊科、创伤病房及ICU融为一体对创伤患者进行整体化治疗。结果2005年我院急诊科共收治创伤患者2007例,其中227例为多发伤,死亡84例,救治成功率为95.7%。结论合理的创伤救治模式对提高救治水平十分重要,一体化是创伤救治模式的基本发展方向。     

实现"病有所医"目标的初步探讨——也谈政府与市场、"补需方"与"补供方"

要实现党的十七大提出的“病有所医”目标，必须处理好医疗卫生领域中政府主导与市场机制的关系．政府投入的“补需方”与“补供方”的关系。     

住院患者欠费问题分析与控制措施

目的:通过住院患者欠费问题的调查,了解欠费发生的方式、特征和时间变化趋势,探讨控制患者欠费的措施。方法:以某军队医院2000-2006年欠费患者资料为本,建立数据库,利用Excel软件对患者身份、住院科室、住院时间和欠费原因等进行统计处理。结果:欠费多发生于外科患者、外地患者和全费患者。欠费方式主要以未结算出院和延期支付为主,且欠费现象有逐年上升的趋势。结论:建立健全预缴金支出的监测系统,强化科室监管制度,管理好特殊人群,以减少欠费现象的发生。     

HIS服务器及数据库升级前后性能的对比研究

目的：测试数据库服务器软硬件升级前后数据库性能的具体变化。方法：从硬件的扩展性、硬件处理能力与系统稳定性以及数据库性能表现等几个方面，测试了数据库及数据库服务器升级前后的变化。结果：通过具体数据分析了引起性能改变的部分原因，总结了升级的变化规律。结论：系统升级后，系统性能得到了极大提升。     

Telephone appointment visits for head and neck surgery follow-up care

OBJECTIVES/HYPOTHESIS: To test the hypothesis that patients with a variety of otolaryngologic diagnoses using telephone appointment visits would be equally as satisfied as patients receiving physician office visits, the study compared telephone appointment visits with physician office visits for health maintenance organization patients who needed routine follow-up care in a head and neck surgery clinic. STUDY DESIGN: Randomized, nonblinded cross-sectional study. METHODS: After their initial visit to either of two head and neck surgery clinics, new otolaryngology patients were randomly assigned into treatment and control groups. Patients in the treatment group (n = 73) received follow-up care in the form of telephone appointment visits, and patients in the control group (n = 80) received physician office visits for follow-up care. Study data were collected using telephone interviews and physician tracking forms. RESULTS: Patients receiving telephone appointment visits were significantly less satisfied with their visits than patients receiving physician office visits (chi2 = 25.4, P < .005). Patients who had physician office visits were significantly more likely than were patients in the treatment group to agree "somewhat" or "strongly" that 1) the physician addressed their questions and concerns (chi2 = 24.0, P < .005); 2) the physician provided personal care and attention (chi2 = 29.9, P <. 005); and 3) the physician provided high-quality care (chi2 = 34.5, P < .005). CONCLUSIONS: Patients who received telephone appointment visits were statistically significantly less satisfied with all aspects of their follow-up appointment than were patients who had physician office visits. The study findings indicate that telephone appointment visits may not be an ideal type of follow-up visit for all patients. Despite these findings, one third of patients in the treatment group would consider receiving a telephone appointment visit for future routine follow-up care, and 21.9% had no preference, perhaps a factor indicating willingness to receive a telephone appointment for a follow-up visit.     

CHN法骨龄测定的临床应用

CHN(中国人手腕骨发育标准CHN法)近几年来受到越来越多的重视。目前,主要应用在预测身高、初潮时间、小儿内分泌疾病的诊断、司法鉴定、口腔矫形等几个方面,对CHN法骨龄测定的临床应用进行了探讨,指出了CHN法骨龄测定存在的问题及研究对策。     

浅谈数字化手术室改造

本文介绍了积水潭医院数字化手术室项目改造的背景,详尽地阐述了数字化手术室的设计思路和建筑理念。总结提出了改造过程中的体会和手术室优化对医院发展的重要意义。     

Rites of passage to adulthood: traditional initiation schools in the context of HIV/AIDS in the Limpopo Province,South Africa

The HIV/AIDS epidemic and its disproportionate effect on the lives of young people has been a source of major concern in South Africa. Research has, until now, focussed on the broad cultural determinants of risky sexual behaviour among this group and on the barriers that impede the promotion of health seeking behaviour in the context of HIV/AIDS. Still missing is a dedicated investigation into the role of traditional rites of passage customs in influencing the sexual behaviour of young people. This article presents the findings from a study investigating the perceptions of young people from Venda, a former South African homeland under apartheid, of the cultural and educational importance of traditional initiation schools. The results of the study suggest that traditional initiation schools remain both an important rite of passage and source of sexual information for many young people. However, it is also discovered that initiation schools are not currently providing young people with the relevant information to adopt health-seeking behaviour in the era of HIV/AIDS.