医院多通道冗余信息网建设

本文首先介绍了浙江大学医学院附属妇产科医院的概况与网络建设需求,然后提出了大中型医院信息网建设的设计原则。依据这些设计原则,提出了医院多通道冗余信息网建设的技术实现方案。经过长时间的运行,证明多通道冗余信息网是稳定可靠的。     

抑郁症患者就诊机构的选择及其相关因素分析

目的：了解抑郁症患者选择就诊机构的影响因素，以及不同的选择对疾病的影响。方法：随机选择在北京安定医院住院和门诊治疗的抑郁症患者共计94例，采用自行设计的调查表进行调查。结果：①有63．80％的抑郁症患者首诊选择非精神科医院进行诊治；②有55％患者认为自己患的是躯体疾病不是精神疾病；③具有以下症状者往往首诊选择精神科医院如抑郁情绪、自责自罪、消极观念、自杀企图、幻觉妄想、非真实感；而躯体症状明显、家人对患者病情较关注者往往选择非精神科医院；④选择在非精神科专科医院就诊的患者其病程明显长于在精神科专科医院的患者。结论：影响抑郁症首诊机构选择的主要因素为症状特点及家人的态度；提示以精神症状为主诉的抑郁症患者往往首先选择到精神科医院就诊。     

在医院图书馆中开展医学继续教育

阐述了医院图书馆开展医学继续教育(CME)的必要性，介绍了医院图书馆进行CME的3种方式，并提出医院图书馆应关注的问题。     

Determinants of interest rates on tax-exempt hospital bonds

The aim of this paper is to examine the determinants of interest rates on tax-exempt hospital bonds. The results highlight the potential and actual roles of Federal and state policy in the determination of these rates. The shift to a Prospective Payment System under Medicare has subsidized the borrowing costs of some hospitals at the expense of others. The selection of underwriters by negotiation rather than by competitive bidding results in higher interest rates. The Federal tax act of 1986 raised the cost of hospital debt by encouraging bond issues to contain call features.     

基层医院如何开展临床药学工作

临床药学是现代药学的重要组成部分,临床药学工作在各级医院开展极不平衡,特别是基层医院开展较差。本文论述了在基层医院应从人才的选择入手开展临床药学工作。     

An overview of hospital accreditation in Taiwan, Republic of China

This paper examines the hospital accreditation system in Taiwan, Republic of China. The paper describes the historical evolution of accreditation; preliminary teaching hospital accreditation; hospital and teaching hospital accreditation; issues and problems; and perspectives and challenges.     

The incidence of alcohol-related problems and the risk of alcohol withdrawal in a general hospital population

A survey was carried out using the Canterbury Alcohol Screening Test (CAST) and clinical criteria for risk of alcohol withdrawal of 2000 randomly selected hospital in-patients in order to determine the prevalence of alcohol-related problems, the work-load for a specialist alcohol withdrawal service and the target group for early intervention. Patients at risk of alcohol withdrawal were followed prospectively.

The major findings were: 14.3% of patients had a positive CAST and 8% were at risk of alcohol withdrawal; the prevalence of positive clinical criteria was greatest in men under the age of 30 years (OR 3.6) and very low (OR 0.34) in women over 60 years. In addition, patients who were too sick or refused to complete the questionnaire had high rates of being at risk for alcohol withdrawal. The prevalence of CAST positivity was greatest in men under the age of 40 years (OR 3.7) and lowest in women over 70 years (OR 0.2).

It is concluded that 15-20% of in-patients have alcohol problems and 8% are at risk of withdrawal; questionnaires will produce underestimates of the order of 25%; and female in-patients over the age of 60 years are extremely unlikely to have problems with alcohol.