金华市农村创建社区卫生服务示范区初探

以创建示范区为目标,在农村开展社区卫生服务是新时期农村卫生工作的重要内容,是加快乡镇卫生院建设发展的必由之路。文章对农村创建社区卫生服务示范区工作进行了论述,分析存在问题,提出建议措施。     

IMPROVING ACCESS TO HEALTH SERVICES IS STRATEGIC PRIORITY OF PRODUCTIVITY DEVELOPMENT

As one of the basic human rights, health is an important guarantee for productivity. The authors introduce the Andersen's behavioral model of health service use,as well as the conception and classification of access to health services based on the model. Meanwhile,the relative guidelines and the impact on the health reform of China are discussed, compared with America's and China's. This paper propounds three strategic priority of productivity development.     

地段医院转为社区卫生服务中心后的工作思路

论述了地段医院转为社区卫生服务中心后的工作思路:适应形势,转变观念,将工作重点放在加快硬件建设,强化人才培养,进行科室重组。同时还要合理设置社区卫生服务点积极开设家庭病床,实行上门服务,推广户籍医生制度,逐步建立家庭健康基础档案。     

以人为本的医院总务保障体系

邵逸夫医院的总务工作在借鉴国外先进管理模式,改变传统观念,建立强有力的后勤保障体系方面做了大量卓有成效的工作。从医院建筑平面布置、确保医院设施正常运作,营造整洁舒适医院环境和引进全程服务机制等方面介绍了建立以人为本、以病人为中心的总务保障体系的做法。     

基于Kano模型的养老机构老年人护理服务需求属性分析

目的 分析养老机构老年人护理服务需求属性,为制订针对性干预措施提供参考.方法 基于Kano模型设计养老机构老年人护理服务需求调查问卷,对天津市7所养老机构共687名老年人进行调查.结果 养老机构老年人护理服务需求34个条目中,魅力属性需求10条(29.4％),均位于保留区Ⅳ;期望属性需求10条(29.4％),其中7条位于优势区Ⅰ;必备属性需求11条(32.4％),其中7条位于待改进区Ⅱ;无差异属性需求3条(8.8％),均位于次要改进区Ⅲ.生理健康与医疗需要维度中,魅力属性2条,期望属性4条,必备属性5条,无差异属性1条;安全需要维度中,期望属性1条,必备属性4条,无差异属性2条;尊重需要维度中,魅力属性1条,期望属性3条,必备属性2条;爱与归属需要维度中,魅力属性4条,期望属性2条;自我实现需要维度的3条均为魅力属性.结论 养老机构老年人必备、期望属性护理服务需求主要集中在生理健康与医疗、安全及尊重需要,魅力属性需求主要集中在爱与归属、自我实现需要.养老机构应在维持和完善必备、期望属性需求的基础上,发展和创新魅力属性需求,客观分析和优化改造无差异属性需求.     

The reimagination of sustainable integrated care in Ontario,Canada

Purpose/settingTo encourage clinical and financial efficiency, the Canadian province of Ontario initiated an integrated care program – Integrated Funding Models (IFMs) that required collaboration and coordination across acute and post-acute care sectors. This research shows how program implementers went beyond policy-makers’ original designs, to make integrated care sustainable for chronic diseases.MethodsForty-five interviews were conducted with program participants at three chronic disease programs, as well as with policymakers. Interviews were conducted over two phases; during early implementation in 2016, and as programs matured in 2018. Data were analyzed through a cultural constructivist lens to understand how participants shaped programs.FindingsParticipants desired greater accountability and control. Participants in the first program wanted localized control over decision-making. In the second, participants initiated greater control over financial uncertainty. In the third program, hospital participants sought greater control over community care. Participants across programs simultaneously wanted integrated care to be expanded holistically, spatially, and temporally for patients, extending the length of care, and expanding the spaces in which care was provided. Findings also suggest a gap between program implementers’ and policymakers’ conceptualizations of integrated care.ConclusionThis work shows how IFMs were reimagined in ways that transcended their original conceptualization as spatially and temporally delimited initiatives aimed at improving coordination and efficiency. It has practical implications for those facing sustainability challenges in other contexts.     

Addressing alcohol and other drug use among young people from migrant and ethnic minority backgrounds: Perspectives of service providers in Melbourne,Australia

Young people from migrant and ethnic minority backgrounds are recognised as emerging priority populations for reducing alcohol and other drug (AOD)-related harms in Australia. Limited research has investigated how service providers address AOD challenges in migrant communities. In this qualitative study, we interviewed 15 service providers from AOD, migrant support, community and other health services in a diverse region of Melbourne. Interviews explored the challenges that service providers faced and the strategies they implemented to engage with young migrants in relation to AOD use. Thematic analysis was used to generate four themes: stigma as a barrier to service delivery, intergenerational differences between young people and parents, the need for outreach and establishing trust and understanding over time. Service providers believed that stigma prevented many young people from migrant backgrounds having open conversations about their AOD use with family members and professionals. Participants perceived that some parents had less AOD-related knowledge and lower English language proficiency than their children creating challenges for effective communication. Service providers recognised the importance of engaging with young people in settings where they felt comfortable rather than expecting them to approach their service. Participants also acknowledged the need to invest time in establishing trust and understanding with young migrants so they could facilitate conversations about AOD use as relationships evolved. Although service providers had a strong understanding of young people's needs, they found it challenging to build relationships in the context of funding and time constraints. Our results indicate the need for long-term funding and timelines that enable service providers to build strong relationships with young migrants, their families and their broader cultural communities to facilitate access to AOD support.     

北京市社区卫生服务中心微信公众平台建设及运营现状

目的了解北京市社区卫生服务中心微信公众平台建设及运营现状,为促进微信公众平台更好地发挥卫生服务功能提供参考依据。方法于2019年1—3月利用"北京市社区卫生服务"官方网站收集北京市344家社区卫生服务中心基本情况,同时利用手机微信APP收集社区卫生服务中心微信平台开通时间、微信认证、更新时间、信息推送数量及影响力等情况并进行分析。结果北京市开通微信平台的社区卫生服务中心数量由2014年的11家增长至2018年的231家,增长了20倍;截至2019年3月1日,北京市共239家(69.5%)社区卫生服务中心开通了279个微信平台,其中236个(84.6%)平台进行了微信认证,171个(61.3%)平台更新时间<30 d,54个(19.4%)平台近1年信息推送量>150篇;2019年1月1—31日北京市28个微信平台共推送信息756篇,其中健康科普类信息420篇(55.6%),医院新闻194篇(25.7%),信息公告65篇(8.6%),党政建设43篇(5.7%),其他信息34篇(4.5%);北京市不同地区比较,城区、近郊区和远郊区社区卫生服务中心在平台开通、平台认证、信息更新、信息推送数量、阅读量和点赞量方面差异均有统计学意义(均P<0.05)。结论北京市社区卫生服务中心微信平台建设良好,发展迅速,但仍存在地区发展不均衡、后期维护缺乏、影响力不足等问题,有待进一步改善。