军队合理医疗应注意的问题

军队医院的合理医疗,是军队医疗保障水平的重要标志。与地方医院相比,它具有自身的特殊性,除参与市场竞争外,还有一些应注意的问题。本文着重从坚持为军队服务。坚持以医疗质量为核心,坚持以伤病员为中心,坚持医疗保险和医疗服务协调发展,重视经济管理、加强成本核算、控制医疗费用不合理增长,适当创收、弥补经济补偿不足、坚持高效低耗的路子等方面,对军队医院合理医疗的要求与注意事项进行了讨论,以期真正达到合理医疗的目的。     

军队护理操作装备箱模块化设计的应用研究

目的 为提高未来战争护理保障水平,将护理操作装备箱作为一个复杂系统,研究能够充分发挥功能的护理操作装备箱的模块化结构。方法 采用模块化方法,确定护理操作装备箱的三级模块化结构方案。采用Delphi法,评价方案各级模块的可行性和重要性。结果 初步获得军队护理操作装备箱的三级模块化结构。结论 模块化是处理复杂问题的有效方法之一,模块化结构是提高护理操作装备箱保障效能的有益尝试,模块化结构使装备箱的配置具有前瞻性和可扩展性。     

开拓创新做好为兵服务工作

为做好为兵服务工作,本文提出：一是要更新观念,在为兵服务的思想认识上要有新提高,树立为兵服务是医院根本职能的观念、树立为兵服务是为了“打得赢”的观念、树立为兵服务是个人事业的观念。二是要完善机制,在为兵服务的形势和内容上要有新发展,把为兵服务的绿色通道规范化、“三送”活动经常化、医疗服务标准化、延伸医疗多样化、伤病员管理严格化。三是要强化服务,在为兵服务的组织领导上要有新办法,加大为兵服务在党委议事中的份量、加大为兵服务在落实工作中的力量、加大为兵服务在宣传教育中的力度。     

军队医院实施标杆管理探讨

标杆管理是20世纪90年代西方兴起的三大管理方法之一．因为具有强大的系统性、执行化、价值化和指标化优点而被许多跨国公司纳入了日常管理工作之中,但在我国尚处于起步阶段。本文创新地将其引入医疗管理中,阐述了标杆管理的基本内涵．指出标杆管理是部队医院实现跨越式发展的科学捷径,是部队医院适应新军事变革的根本需要、是克服部队医院弊端的有力工具．是保持部队医院持续先进的强大基石．并结合标杆管理在军队医院的实际应用,阐述了在医院开展标杆管理的具体做法和取得的初步成效。     

机动卫勤力量信息化建设的设计与实现

文章针对军队医院机动卫勤力量的信息化建设进行了探索,主要从系统设计、功能实现以及系统特点方面加以阐述。系统设计主要包括网络设计、数据库设计等内容。系统功能包括卫勤组织指挥、卫勤医疗管理、卫勤物资管理等。其中,卫勤组织指挥功能主要由人员管理、文书编辑、参谋作业、可视化通讯等子系统组成;卫勤医疗功能主要由单兵医疗、分类后送、医学影像、远程医疗、统计上报等子系统组成;卫勤物资管理主要由卫勤装备管理、卫勤耗材管理、医疗物资管理等子系统组成。在文章末尾对本系统的特点加以简要说明。     

解放思想开门办院推进军区医院快速发展

本文回顾了兰州军区医院实施“开门办院”四年来,主动适应医疗市场竞争和国家医疗卫生体制改革,努力提高军事斗争卫勤准备能力的基本做法。深刻分析了只有坚持解放思想,走“开门办院”的路子,才能推进军区医院健康快速发展。坚持以观念更新为先导,解放思想,用与时俱进的思想方法谋求医院发展的新思路。坚持姓“军”为兵,面向社会,以开放促发展的观念谋医院发展之路。坚持以科技进步为核心,大力发展特色技术,把加强重点学科建设、发展特色技术放在主体建设首位。着力打造设备优势,夯实医院发展基础。全力提高人才队伍的整体素质,形成有利于医院可持续发展的人才队伍结构。坚持以规范管理为手段,建立和完善管理机制,医疗质量管理工作要走上重质量、重服务、重绩效、重法治的健康发展轨道。加强卫生经济管理,理顺医院内部经济管理运行体系。搞好医院信息化管理,初步实现医院管理网络化、自动化目标。坚持以服务部队为根本,把握医院“姓军为兵”的发展方向,把发展效益体现在提高官兵医疗保障水平上,把发展水平体现在提高军事斗争卫勤准备质量上,把发展成果体现在提高卫生工作整体进步上。     

医院开展高新技术存在的问题及对策

阐述了高新技术在临床上开展的主要项目、基本运作形式和主要管理模式．指出了开展高新技术中设备配置、技术引进和管理模式存在的主要问题。对高新技术的时限性和局限性、高新技术与单纯科研项目的区别、高新技术与基础技术的关系和高新技术对道德和伦理的影响作了深入分析。提出了主要对策：加快卫生立法建设．把握关键环节．实行严格的质量监控。     

Diagnostic utility of CT for abdominal injury in the military setting: A systematic review and meta-analysis

Background:It is critical to accurately identify patients with abdominal injury who truly need to undergo laparotomy during the war in timely fashion. The diagnostic utility of computed tomography (CT) for evaluating abdominal injury in the military setting remains uncertain.Methods:PubMed, EMBASE, and Cochrane Library databases were searched. Meta-analyses were performed by using a random-effect model. We pooled the area under the summary receiver operating characteristic curves with standard errors, the Q indexes with standard errors, the sensitivities with 95% confidence intervals (CIs), the specificities with 95% CIs, the positive likelihood ratios with 95% CIs, the negative likelihood ratios with 95% CIs, and the diagnostic odds ratios with 95% CIs. The heterogeneity among studies were evaluated by the I² and P value.Results:Overall, 5 retrospective studies were included. The area under the summary receiver operating characteristic curve was 0.9761 ± 0.0215 and the Q index was 0.9302 ± 0.0378. The pooled sensitivity was 0.97 (95% CI = 0.92–0.99) without a significant heterogeneity among studies (I² = 0%, P = .4538). The pooled specificity was 0.95 (95% CI = 0.93–0.97) with a significant heterogeneity among studies (I² = 90.6%, P < .0001). The pooled positive likelihood ratio was 10.71 (95% CI: 2.91–39.43) with a significant heterogeneity among studies (I² = 89.2%, P < .0001). The pooled negative likelihood ratio was 0.07 (95% CI = 0.02–0.27) with a significant heterogeneity among studies (I² = 57.5%, P = .0516). The pooled diagnostic odds ratio was 177.48 (95% CI = 18.09–1741.31) with a significant heterogeneity among studies (I² = 75.9%, P = .0023).Conclusion:Diagnostic accuracy of CT for abdominal injury is excellent in the military setting. Further work should explore how to shrink CT equipment for a wider use in wartime.     

某军校大学生CPI测量结果分析

目的探讨军校大学生的人格特征。方法对192名某军校大学生采用加利福尼亚心理调查表在专业人士的指导下进行测评分析。结果军校大学生自我实现水平较国内常模高,进取心、表达沟通能力、灵活性强,性格果敢。但同时又易冲动,自我控制能力差,自我关注程度高,对环境的限制有较强的不适应感。不同年级、专业的学生具有一定的特征性。结论军校大学生群体自我确认程度较高,人际适应较好,,但社会价值内化程度较差,成就潜能表现不明显。     

High Work-Related Stress and Anxiety as a Response to COVID-19 Among Health Care Workers in South Korea: Cross-sectional Online Survey Study

BackgroundThe COVID-19 outbreak had a severe impact on health care workers'' psychological health. It is important to establish a process for psychological assessment and intervention for health care workers during epidemics.ObjectiveWe investigated risk factors associated with psychological impacts for each health care worker group, to help optimize psychological interventions for health care workers in countries affected by the COVID-19 pandemic.MethodsRespondents (n=1787) from 2 hospitals in Korea completed a web-based survey during the period from April 14 to 30, 2020. The web-based survey collected demographic information, psychiatric history, and responses to the 9-item Stress and Anxiety to Viral Epidemics (SAVE-9), 9-item Patient Health Questionnaire (PHQ-9), and 7-item Generalized Anxiety Disorder-7 (GAD-7) scales. We performed logistic regression to assess contributing factors as predictor variables, using health care workers’ depression as outcome variables.ResultsAmong 1783 health care workers, nursing professionals had significantly higher levels of depression (PHQ-9 score: meannurse 5.5, SD 4.6; meanother 3.8, SD 4.2; P<.001), general anxiety (GAD-7 score: meannurse 4.0, SD 4.1; meanother 2.7, SD 3.6; P<.001), and virus-related anxiety symptoms (SAVE-9 score: meannurse 21.6, SD 5.9; meanother 18.6, SD 6.3; P<.001). Among nursing professionals, single workers reported more severe depressive symptoms than married workers (PHQ-9 score ≥10; meannurse 20.3%; meanother 14.1%; P=.02), and junior (<40 years) workers reported more anxiety about the viral epidemic (SAVE-9 anxiety score; meannurse 15.6, SD 4.1; meanother 14.7, SD 4.4; P=.002). Logistic regression revealed that hospital (adjusted odds ratio [OR] 1.45, 95% CI 1.06-1.99), nursing professionals (adjusted OR 1.37, 95% CI 1.02-1.98), single workers (adjusted OR 1.51, 95% CI 1.05-2.16), higher stress and anxiety to the viral infection (high SAVE-9 score, adjusted OR 1.20, 95% CI 1.17-1.24), and past psychiatric history (adjusted OR 3.26, 95% CI 2.15-4.96) were positively associated with depression.ConclusionsPsychological support and interventions should be considered for health care workers, especially nursing professionals, those who are single, and those with high SAVE-9 scores.