新公共管理视野下卫生领域政事分开的理论与实践探讨

新公共管理理论为中国卫生领域政事分开奠定了理论基础。按照其掌舵而非划桨的思想,卫生领域改革应该正确处理好政府和事业单位的关系。文章简述了卫生领域政事分开不彻底和政府过度放权而监督不力两种相反方向的政府失灵现状,提出卫生领域政事分开改革需要处理好的医院管理法人选择和政府职能定位两个关键问题。     

Pediatric sedation in North American children's hospitals: a survey of anesthesia providers

BACKGROUND: Information about the existence and organization of pediatric sedation services in North America is not available. We conducted a survey to collect this information from anesthesiologists at pediatric institutions and to identify factors perceived as limiting the development of sedation services. METHOD: We electronically mailed a confidential survey about pediatric sedation practice to an attending anesthesiologist involved in pediatric sedation at 116 children's hospitals in the United States and Canada. We identified the institutions using Internet resources. Electronic mailing addresses were obtained from departmental websites, society membership directories and departmental administrators. Our follow-up for nonresponders was by a second e-mail and a telephone call. RESULTS: A total of 54 completed questionnaires were received, a response rate of 47%. Forty-nine (91%) were received from US hospitals, and the remainder from Canadian. Fifty percent of hospitals had a formal pediatric sedation service. Fifty-four percent utilized a 'mobile' provider model. Hospital credentialing for nonanesthesiologist providers varied between 66 and 76% for 'deep' and 'conscious' sedation, respectively. A nurse-physician provider combination was the most common, utilized in 59% of hospitals. Anesthesiologists were the sole sedation providers in 26% of institutions. Propofol was used regularly by nonanesthesiologists for sedation of nonintubated (42%) and intubated (63%) patients. Eighty-seven percent of institutions reported barriers to development of pediatric sedation services. The most common barrier was a shortage of providers, particularly anesthesiologists. CONCLUSIONS: Propofol use by nonanesthesiologists is common. Addressing the shortage of providers, and allocating resources for credentialing providers will encourage further development of pediatric sedation practice.     

我国省级健康教育机构能力建设现状调查分析

目的了解我国省级（除台湾、香港、澳门以外）健康教育机构能力建设现状及其影响因素，为各级健康教育机构的能力建设及相关政策的制定提供依据。方法采用问卷调查方式，对我国31个省、自治区、直辖市及新疆生产建设兵团的省级健康教育机构（共计32个机构）在能力建设中经费投入、工作设备配置、队伍建设、机构建设等9个方面进行了调查。结果全国31个省、自治区、直辖市及新疆生产建设兵团都设置了健康教育机构，其中独立法人机构13个，非独立法人机构19个，59．00％以上机构隶属于省级疾病预防控制中心的业务主管部门；85．00％以上机构拥有现代办公设备；业务人员占77．35％，年龄构成以中青年为主，学历以本科为主，研究生以上学历仅占4．68％；78．00％以上的省有完整的应对突发公共卫生事件预案；31．00％的省级机构开设了健康教育／健康促进专业网站，年访问量近10万人次；75．00％的省有完整的考核评价体系。结论省级健康教育机构网络健全，但管理部门不统一，常规工作经费不足，高层次专业人员缺乏，队伍建设亟待提高，信息网络建设有待加强。     

维护公立医疗机构公益性质的制度选择

利用制度经济学原理．结合有关文献资料和访谈资料，分析了部分发达国家和发展中国家公立医疗机构的制度安排和运行机制．提出了维护公立医疗机构公益性质的几种制度选择，为建立科学规范的公立医院管理制度提供可以借鉴的政策建议。     

农村患者就医流向的变化趋势分析

根据国家的卫生统计提要数据以及有关国家卫生服务调查数据,对农村患者就医流向的变动趋势进行描述性统计分析,指出了有关的现状和原因,并提出了相应的政策建议。     

省级医学信息机构综合服务能力提升探讨

分析了省级医学信息机构面临的困难及挑战,以广西医学科学情报研究所改革实践为例,从信息资源保障体系建设、人才队伍建设、科学研究工作三方面,探讨了提升省级医学信息机构综合服务能力的有效途径。     

社区卫生服务机构作业成本法成本核算方法研究

本研究结合目前卫生服务机构成本核算方法和社区卫生服务机构的特点,提出作业成本法应用于社区卫生服务机构成本核算的基本思路和实施步骤,为社区卫生服务定价、政府补偿和提高社区服务效率提供依据。     

Factors Related to Recidivism Among Juvenile Sexual Offenders

This recidivism study retrospectively examined the juvenile court case records of 170 first-time juvenile sexual offenders in a 5-year observation period. Cox regression, a model of event history analysis, was used to test hypotheses and to build multivariate competing risk models predictive of criminal recidivism. The multivariate analyses found that nonsexual offense recidivism was significantly (p < .01) associated with (a) prior nonsexual offenses and (b) failure to complete treatment. Sexual offense recidivism was significantly associated with larger numbers of female victims, but results were inconclusive due to the small size (n = 13) of the sexual reoffending sample.     

The social skills of six-year-old Turkish children: a comparison by gender

The purpose of this study is to analyze the social skills of six-year-old children living in institutions and six-year-old children living with their family with respect to the variable of gender. The sample group of the study consists of 57 children in need of protection and 57 children living with their family, all dwelling in Istanbul or Ankara. The social skills of the children were evaluated through the Social Skills Form for Six-Year-Old Children. The form was developed by the researcher. In addition, the Personal Inquiry Form was used to collect demographic data about the children. Group leaders completed the Social Skills Form for the children living in institutions and nursery school teachers completed it for the children living with their family.

The data obtained were evaluated by Chi-Square, Fisher's Exact Chi-Square, and Likelihood Ratio Chi-Square. The findings of the study show that the variable of gender generally does not have an impact on the frequency of using social skills among six‐year-old children.