Evoked potentials in pediatrics: economic audit

In the present era of resource management, there is increasing emphasis on the need to make the best possible use of available resources. We therefore measured the productive factors directly involved in performance of 59 evoked potential examinations (brainstem auditory evoked potentials, BAEPs; flash visual evoked potentials, F-VEPs; and electroretinograms, ERGs) in different pediatric age groups. In order to ascertain the gap between the costs of instrumental examinations performed in our service on children and the fees reimbursed by the Italian national health service (NHS) a breakdown was made of the costs of tests and their scheduling in relation to the different age variables involved. It was found that the fees reimbursed do not cover the real costs, because they underestimate the actual consumption of resources. The findings recorded indicate that for pediatric tests the economic audit should be graded according to the ages of the children examined and should include an analysis of different test phases. The economic audit should also be considered a preliminary step in clinical audit. It is concluded that it is financially punitive to reimburse a pediatric service with a fee based on the examination of adults, because in pediatrics the variable ``age' influences the duration and complexity of tests and also their interpretation. Received: 20 June 1996 Revised: 30 October 1996     

西南马遗传资源研究

本文阐述了西南马的起源进化、分布数量、遗传研究现状、保种等方面,并对今后发展进行了展望。     

区域“医疗规模经济”和卫生资源配置理论假说

医疗规模经济的实质是谋求以最低成本提供特定质量的医疗服务。因此，政府及医院管理者就城要掌握关于“医疗规模经济”以及在竞争体系中达到效率的成本资料，在一个限定的区域内，大中小医院都存在着不同程度的“规模经济”。正确地引导和调控医疗经济规模活动的走势，能够推动区域卫生资源的合理配置。     

论医学图书馆学科化服务之核心要素

在学科化服务实践的基础上,结合信息技术发展现状,通过对图书馆的长远建设发展、可持续学科化服务的思考,将医学图书馆学科化服务的核心概括为资源建设是基础、泛在服务是未来、技术支撑是关键、特色服务是亮点4句话,并详细阐述了图书馆如何从这4个方面深入开展学科化服务.     

医学外文原版纸本期刊的采购模式

针对医学外文原版纸本期刊的采购种类逐年减少、价格不断上涨等问题,从期刊招标和联合采购两方面探讨了医学图书馆外文原版纸本期刊的采购模式。     

关于建立与完善以综合医院为依托的社区护理服务模式的探讨

目的：探讨适合当前中国国情的社区护理模式。方法：通过现状分析当前社区护理面临的问题及以综合医院为依托开展社区护理的优势。结果：开展社区护理可促进综合医院的发展。结论：建立与完善以综合医院为依托,借助其优质医疗护理资源推动社区护理服务的开展,促进全民卫生保健事业发展是适合当前中国国情的社区护理模式。     

秦岭高海拔“七药”的资源调查研究

目的:研究秦岭高海拔(大于2600 m)的"七药"资源种类及分布情况。方法:以"七药"分布最低海拔高度作为切入点,通过文献查阅、实地走访等形式调查"七药"的分布状况。结果:秦岭高海拔分布的"七药"资源共有8科9种植物。结论:秦岭高海拔"七药"作为抗风湿、活血化瘀药物开发具有巨大潜力。     

全面统筹 科学发展——完善神木医改的几点建议

以学者的视角来审视神木医改现象,并为完善神木医改提出几点建议,设计有效的救济制度;加强健康教育和健康促进;提高传染病和突发公共卫生事件的预防能力;加强慢性病和生活方式疾病的防控;加大职业卫生的投入和改善;关注弱势人群;重视环境保护和可持续发展;继续提高卫生领域专业人员的素质等。将神木县通过医改所展现的为政为民的现实做法展示给大家,把和谐的场景呈现给社会。     

Impact of urban health indicators in urban planning policy and decision making: a qualitative system dynamics study

BackgroundAt least 145 urban health indicator (UHI) tools exist internationally. Previous studies have shown that public health researchers and practitioners produce them to inform built environment policy and decision making. Little research exists on their use and how it affects policy. This study used qualitative system dynamics to investigate the benefit and use of UHI tools to promote health in the complex context of urban planning policy and decision making.MethodsThis qualitative system dynamics study involved semistructured interviews with indicator producers (typically public health professionals) and indicator users (typically urban planners) in case study settings of San Francisco (CA, USA), Melbourne (VIC, Australia), and Sydney (NSW, Australia) to ascertain experts’ understandings (or mental models) of the use (ie, direct reporting of) and value (ie, knowledge gained leading to policy changes) of UHI tools in urban planning policy and decision making. Exemplifying cases of UHI tools (ie, those designed with characteristics to support policy makers) were selected from the literature and we used purposive sampling to approach potential interview participants through departmental websites and the professional network of HP. We did a thematic analysis using collaborative rationality and systems theories. We constructed causal loop diagrams (CLDs) using system dynamics methods (CLDs represented participants’ mental models). We tested whether our preliminary CLDs corresponded to experts’ views through a participatory workshop.FindingsInterviews took place on April 5–7, 2016, with six participants in the USA, and March 13–22, 2018, with 16 participants in Australia, and the workshop was on Jan 16, 2019, with six participants in the USA. Indicator users and producers had overlapping mental models of the value and use of UHI tools, and workshop participants broadly agreed with the CLDs. The thematic analysis produced five themes that were represented in CLDs, summarised as follows. Developing and applying UHI tools increases knowledge of the social determinants of health and intersectoral relationships. This supports actors to better understand each other's perspectives and helps create new advocates for health in diverse organisations, supporting health-in-all-policies or whole-of-society approaches. Community involvement in UHI tools and having effective advocates for health reduces obstacles to health-promoting policy. However, the high number of available indicators can create confusion and reduce indicator use.InterpretationUHI tools influence local urban planning when they are embedded in policy processes, networks, and institutions, which often requires long-term funding. Indicator producers should consider such resource requirements and the potential for co-producing indicators to create intersectoral relationships and better respond to users’ information needs. Further research is needed to explore how UHI tools affect the power of different actors in governance processes, particularly of under-represented communities.FundingThe Building Research Establishment (BRE) and BRE Trust.     

浅谈用创新思维留住中小型公立医院知识型员工的做法和体会

目的 探究在21世纪的今天中小型公立医院如何尊重人才、引进人才,以人才立院,靠人才兴院,凭人才强院等,总结笔者所在医院的具体做法和体会,供同行参考.方法 将笔者所在医院5年来引进和辞职的高学历人才（硕士及博士毕业生）的来院意愿和离院原因进行对比研究.结果 来笔者所在医院的36名高学历人才中,5年来有5人因各种原因提出辞职离院.结论 在医疗市场的竞争中,最关键和最根本的是人才的竞争,只有牢固树立人力资源是第一资源,用创新思维来改革和完善人力资源管理机制,才能真正留住高学历的知识型员工,使医院得到发展.