中药葛根研究现状分析及展望

从药材种植、产地初加工、药效物质基础、炮制工艺、质量标准研究、新药和功能性食品开发现状等方面对葛根产业链过程进行综述,认为目前研究在葛根的种植、产地初加工、药效物质基础、炮制和开发利用方面取得了一定成效,但为了使葛根饮片更好地应用于临床,以及葛根深加工产品的进一步开发利用,应对葛根药材、饮片和提取物的质量标准再加以研究和完善.     

依据公平与效率并重式发展战略促进医药卫生体制改革

目标:公平与效率并重式发展是新时期医药卫生体制改革的价值取向。方法:依据公平与效率的并重式发展理念重构医药卫生体系运行机制。     

喜炎平注射液在某院儿科住院患者中的使用调查

目的：了解喜炎平注射液在某院儿科住院患者中的使用情况。方法：回顾性分析2012年10-12月儿科出院病例,对使用喜炎平注射液患儿的性别、年龄、诊断、住院天数、用药天数、药品的用法用量、费用等进行统计分析。结果：298例患儿中有280人使用了喜炎平注射液;涉及呼吸系统的169例、诊断不清的31例;162例患儿的药物用量未达到治疗剂量;人均喜炎平费用338．0元。结论：临床儿童使用喜炎平注射液中存在不合理情况,应加强中药注射剂的规范使用与管理,细化药品说明书中儿童的用药剂量。     

我院2011-2012年住院患者基本药物使用情况分析

目的:促进基本药物在临床的合理使用。方法:从我院信息管理(HIS)系统中调取2011-2012年住院患者的药品使用数据,对其中的基本药物使用情况进行统计、分析,并计算用药频度(DDDs)和日均费用(DDC)。结果:2011-2012年,我院住院患者使用的基本药物金额分别占全院住院患者用药总金额的15.74%和14.56%。使用金额排序前10位的基本药物类别中,调节水、电解质及酸碱平衡药、心血管系统用药和消化系统用药连续两年均排名靠前。而基本药物品种排名中,化学药品与生物制品类以氯化钠注射液为首,中成药类以红花黄色素注射液为首。DDDs排名靠前的化学药品类基本药物有维生素C、多烯磷脂酰胆碱、非洛地平缓释片等,但其DDC较低;而中成药类基本药物中,红花黄色素注射液的DDDs和DDC均排在首位。结论:基本药物在我院住院患者中的使用总体符合云南省的要求,但其应用水平尤其是中成药类基本药物还有待进一步提高。     

土家医药半结构化数据的功效挖掘及可视化研究＊

目的 利用数据挖掘技术对半结构化数据的土家族医药进行品种规范和常用功效的可视化发现。方法 收集整理《中国民族药辞典》、《土家医方剂学》等土家族代表性医药文献，建立土家族医药原始数据库，包含药物拉丁学名、药用部位、性味、毒性、功效、主治疾病等。借助Visual FoxPro 9.0软件对土家族医药特性进行频次统计和品种规范，主要以法定标准收录；借助TCMISS (V2.5)、Cytoscape3.6.1、Gephi0.9.2等软件对土家药“药物-功效-主治”间的语义关系，进行功效挖掘和可视化展示。结果 筛选土家药共1453味，方剂共771首，其中土家药主要以“寒（凉）、平”性偏多，苦味药频次最高，其次是辛味药、甘味药；清热败毒、赶风除湿等功效出现频次最高；皮肤疮癣、妇科疾病等是关联程度较大的主治病症。结论 土家族医药的品种规范和“药性-药味-功效-主治”隐形关系可视化分析，可为完善土家药信息化研究奠定基础。     

天津青年流动人口健康知识和卫生服务利用调查

目的了解天津市经济技术开发区(简称泰达)青年流动人口的健康状况、健康知识知晓,以及卫生服务的利用情况。方法采用整群抽样方法 ,通过自填式问卷,对在泰达居住满3个月但不足3年的976名年龄为15～24岁的流动人口进行调查。结果超过80%调查对象自认为比较健康,最近2周患病率为13.7%;调查对象在结核病、健康饮食和生殖健康方面的知识知晓率低,均不足50%;70%调查对象近一年内患病主要为感冒,患病后未就诊率为51.2%,就诊医院以社区卫生服务中心和服务站为主。结论有必要采取措施提高天津泰达青年流动人口的卫生知识知晓率和自我保健意识,以改善他们的卫生服务利用情况。     

Disparities in physical access and healthcare utilization among adults with and without disabilities in South Africa

Background

In South Africa barriers to accessing health services by persons with a disability would appear to be exacerbated by the overburdened state of public healthcare.

Assessment of efficiency levels of training and research hospitals in Turkey and the factors affecting their efficiencies

ObjectivesThis study's aim was to compare the efficiency levels of training and research hospitals in Turkey during 2014–2017 and find the factors affecting their efficiency scores.MethodsTo achieve the above objective, input oriented and variable returns to scale (VRS), data envelopment analysis (DEA), and Tobit regression model were used. The number of beds (BD), the number of intensive care beds (IBD), and the number of specialist doctors (SD) were used as the input variables of DEA while the number of polyclinic admissions (PA), number of inpatients (InP), and number of A, B, and C type surgeries as the output variables. The Tobit regression model was created by using some control variables as independent variables and transformed DEA scores as dependent variables. Average length of stay (ALS), bed turnover rate (BTR), bed occupancy rate (BOR), surgery number per specialist doctor (SNSD), polyclinic admission number per specialist doctor (PANSD), and metropolitan city status (MCS) were used as control variables.ResultsStatistically significant control variables of BTR (p < 0.001), SNSD (p = 0.001), and MCS (p = 0.015) affect the transformed DEA score while ALS, BOR, and PANSD do not (p > 0.05).ConclusionsThe research revealed that efficiency increased as BTR and SNSD increased, and that MCS also had a positive effect on efficiency. Policy makers should therefore consider the province's MCS status while allocating resources to relevant educational research hospitals for improving their efficiency. Likewise, policy makers should pay more attention to increasing BTR and SNSD compared to other variables.     

A gap in formal long-term care use related to characteristics of caregivers and households,under the public universal system in Japan: 2001–2010

We investigated whether the universal provision of long-term care (LTC) under Japan's public system has equalized its use across households with different socio-economic characteristics, with a special focus on the gender and marital status of primary caregivers, and income. We used repeated cross-sectional data from national household surveys (2001, 2004, 2007, and 2010) and conducted multiple logistic regression analyses to obtain odds ratios of caregiver and household characteristics for service use, adjusting for recipients’ characteristics. The results showed that the patterns of service use have been consistently determined by caregivers’ gender and marital status over the period despite demographic changes among caregivers. The gap in service use first narrowed, then widened again across income levels after the global economic recession. The results indicate that the traditional gender-bound norms and capacity constraints on households’ informal care provision remained influential on decisions over service use, even after the universal provision of formal care. To improve equality of service utilization, the universal LTC system needs to meet diversifying needs of caregivers/recipients and their households, by overcoming barriers related to gender norms and economic disparity.     

建设“公平与效率相统一的资源节约型”医疗卫生事业的措施和方法

以建设“公平与效率相统一的资源节约型”医疗卫生事业为目标,结合国情,系统地提出了“诊疗就地区域化、转诊双向梯度化、服务基本适宜化”的原则和尽快制定《卫生法》、《初级卫生保健法》等8项相互关联、不可分割的具体措施。