优势医院在医院重组和集团组建中作用的研究

目的:研究优势医院在医院重组和集团化中的作用;方法:借鉴优势企业理论,从医疗、科研、领先学科和人才等因素分析,确立优势医院;结果:三级医院尤其是大学附属教学医院是当之无愧的优势医院;结论:发挥优势医院在医院重组和集团化以及建立“小病进社区,大病到医院”两级医疗服务模式改革中的作用,才能带动区域内医疗水平的提高。     

临床医师处方抗菌药物前需思考的几个问题

2001年和2003年卫生部全国医院感染监测网调查结果均显示,医院横断面抗菌药物的平均使用率在54%以上,联合用药较为普遍.国内监测结果也表明细菌耐药性日益严重.针对上述问题,提出临床医师在面对病人开处方抗菌药物之前,须思考的问题:是否有使用抗菌药物的适用症?是否了解选用的抗菌药物,选用何种药物?是否有联合使用抗菌药物的指征?采用何种给药途径、给药剂量、给药时间?是否属于特殊宿主或针对特殊病原体的感染使用抗菌药物?密切观察抗菌药物治疗是否有效?针对局部感染是否需要穿刺或外科手术引流病灶?是否已出现抗菌药物的不良反应?是否存在药物相互作用?是否存在不合理使用抗菌药物情况?并且针对每个问题提出了建议.     

The hospital as an enterprise: management strategies

After introducing the context in which health systems exist in developing as well as in industrialized countries, the author describes the role that hospitals are expected to play as 'enterprises'. The rationale behind such a role is explored and the experience so far available discussed. Evidence from several developing countries suggests caution and tends to discourage radical and indiscriminate introduction of market‐oriented reforms, which international donors seem to be spearheading in Africa's health systems. It is likely, however, that a limited, gradual introduction of selected elements of these reforms (such as some aspects of contracting out, managerial decentralization, the split between purchasing and providing functions) may find its place and eventually have a positive impact on the performance of the health systems. But the 'mystique of markets' must not be allowed to deprive public hospitals of the sense of social utility and of the caring ethos which are essential requisites of a meaningful and effective public health system.     

我院平均住院日状况的调查分析

目的：通过对医院平均住院日情况的简要分析，以探索缩短平均住院日的有效途径。方法：从统计室提取数据，与病案核对，计算相对指标。结果：我院的平均住院日呈下降趋势，但与卫生部颁布的标准还有差距，中医各科和康复科科别的平均住院日更长一些。结论：我院的平均住院日还有潜力可挖，术前住院日多数病种都较长，应在医疗质量和护理质量上狠下功夫，加强科室间的协作，降低平均住院日，减少无效住院日。     

提高住院分娩率和产科质量是降低孕产妇死亡率的关键

本研究以河北省４个妇幼卫生项目县为现场，对１９９０年１月１日～１９９２年１２月３１日三年间全部死亡孕产妇与其有关的卫生服务及死因进行了调研。结果表明：调研地区孕产妇死因前两位为产科出血、产褥感染。可能与其大部分在家分娩，由未经培训过人员接生、接生质量低劣等有关。从而提出，提高住院分娩率和产科质量是降低孕产妇死亡率的关键。还提出，全社会重视妇女受教育的问题，提高妇女的社会地位，使其拥有生殖权力是提高住院分娩率的重要条件。     

对《2007年医院管理年活动方案》的认识与思考

针对新出台的2007年医院管理年活动方案，文章归纳了2007年管理年活动的主要内容和重点要求，并针对当前我国医院实际，紧密结合《医院管理评价指南（试行）》，从理念、质量、服务和管理4个方面着重分析了医院管理者应当关注的问题，以更好地贯彻落实管理年的有关精神和要求，科学制定出适合各级医院特点的更为具体和更具操作性的实施细则，促进我国公立医院管理水平不断提升。     

Serum digoxin and beta-methyldigoxin in elderly patients on hospital admission: correlation with home compliance and clinical variables

Summary Serum digoxin and beta-methyldigoxin (BMD) were measured in 165 elderly patients (age >60 years) admitted to hospital, of whom 109 had been treated at home with digoxin and 56 with BMD.The mean BMD level was significantly lower than that of digoxin (1.1 vs. 1.4 ng/ml). Creatinine clearance and daily dose were the variables most strongly associated with digoxin level, and the prescribed dose and serum albumin were the best predictors of the BMD concentration. Compliance was assessed by a compliance index (CI), namely the ratio of the measured glycoside concentration, corrected for creatinine clearance, over the expected steady-state dose, calculated from a hospitalized reference group. Compliant individuals in both treatment groups, i.e. those with a CI > the median value, were characterized by a lower daily dose and dosage frequency.Toxicity, whether clinical or electrocardiographic, was present in 9% of the patients and was associated only with a significantly higher mean serum level of the drug.     

中医医院内部审核的策划与实施

通过对所在中医医院ISO9001族质量管理体系实施过程中历次内部审核的总结,探索既符合中医医院实际工作又满足标准要求的内部审核模式,形成科学化的内审流程。