从护理收费过低现象看我国综合医疗服务项目价格调整的必要性

我国护理服务价格一直处于较低水平,难以真正体现护理人员的劳务价值.同样,其他综合医疗服务项目的价格也不尽合理,不利于医疗机构的经济运行和发展.文章基于对上述现象的分析提出调整综合服务项目收费价格的一些建议.     

ApoE与SLCO1B1基因多态性与老年脑梗死患者颅内动脉粥样硬化狭窄的相关性

目的 分析ApoE与SLCO1B1基因在老年脑梗死患者颅内动脉粥样硬化狭窄中的分布情况,及动脉狭窄程度与血脂的关系.方法 选取2018年2月至2019年2月北京中医药大学东方医院脑动脉粥样硬化患者200例为脑梗死组,以北美症状性颈动脉内膜剥脱术研究法分级标准划分动脉粥样硬化狭窄分级,其中无狭窄患者26例、轻度狭窄患者4...     

Cardiovascular consequences of expressing anger in a mutually-dependent relationship

Twenty males were harrassed by a confederate of the experimenters while solving anagrams. Following this experience they played a mixed-motive, interpersonal game with the confederate. In comparison with non-harrassed controls the harrassed subjects expressed more anger at the end of the task. While solving anagrams they also exhibited greater increases in systolic blood pressure and heart rate and greater decreases in finger pulse amplitude and pulse wave transit time. The post- harrassment adjustment of cardiovascular behavior during the interpersonal games was contingent upon the subject's aggression guilt, level of exploitativeness, and uncertainty concerning the consequences of exploiting the confederate. The greater the subject's aggression guilt the less anger he expressed at the end of the anagrams task and the less he exploited the confederate. The more a subject exploited the confederate the lower his diastolic blood pressure at the end of the game. The greater the uncertainty of consequences of behavior the faster the transmission of pulses and the smaller the drop in blood pressure during the game. The potential utility of interpersonal games for studying behavioral and biological adjustments during post-anger interpersonal transactions in a mutually-dependent relationship is illustrated.     

Inadequacy and indebtedness: no-fee psychotherapy in county training programs

The nature of the fee arrangement has significant influence on the psychotherapeutic process even when there is no fee. Given the large number of psychiatrists who receive at least some part of their training in the public system, understanding the no-fee arrangement is vital to the psychodynamic training of future psychiatrists. Following a brief overview of the meaning of money and the fee arrangement, various scenarios are considered under the headings of "inadequacy" and "indebtedness. "Although similar dynamics may be present in other public and private settings, attention is given to the county training program, with the intent to assist psychiatry residents and supervisors in their awareness and understanding of the psychodynamics of psychotherapy without fee.     

某医院门诊楼宇物业管理费用分析

目的:了解物业费支出的结构状况,找出控制物业费上涨的因素,合理支付物业费。方法:综合运用文献研究及分析法,对某医院物业费的构成及费用上涨因素分析。结果:人工成本和物耗成本的增加是使物业费用增高的主要因素。结论:加强物业服务质量的监管力度,控制物业从业人员数量,按项目需求实行委托物业管理费用包干,达到物有所值。     

从改变支付方式入手,求得医改的突破(1):上海市医疗费用“总量控制、结构调整”政策15年来效果及其启示

为验证总额预算下、按项目付费方式且合理化收费标准是实现医改突破的有效途径,研究以上海市上世纪九十年代中期出台的医疗费用"总量控制,结构调整"政策作为案例,引用政策实施前后近30年的全国卫生财务年报资料,通过纵向和同期不同地区横向比较发现,医疗费用从政策实施前的年均32.8%高速增长骤降至实施期间的12.5%,略低于期间GDP增长(14.7%),纳医疗费用在社会可承受范围之内,十年间为社会减少了2161.6亿元医疗费用负担,控费效果远超全国和同类城市平均水平。政策所取得的斐然成绩提示研究者和决策者,欲实现医疗费用的有效控制总额预算必不可少。但按项目付费方式下的高额医疗费用风险、物价部门难以协调又使得医疗机构潜在损失难以弥补等问题,均成为了现今看病贵等问题依然存在的桎梏。启示:合理设计总额预算指标以确保费用稳定增长,并需改现有按项目付费方式为预付制。