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The public sector in Britain has been subjected to over a decade of major reform aimed at breaking up public service monopolies, at containing costs while at the same time opening services up to greater consumer choice. Health and social services have not been exempt from this revolution in the organization and management of public sector services. The long-standing policy of care in the community is being subjected to market principles and the introduction of a ‘contract culture’ very similar to the NHS reforms introduced in 1991. This paper reviews the origins of these developments in the doctrines of ‘new public management’, a movement which has proved attractive to policy-makers in many countries. Local authority social services departments have been identified as the lead agency for the development of a mixed economy of care following a review of community care policy by the government's health adviser, Sir Roy Griffiths, and a subsequent white paper. This paper examines the limited empirical evidence available on how managers and providers are meeting the challenge bestowed upon them, and concludes that most authorities are moving ahead cautiously if at all. Only a handful of authorities studied have embraced the reforms with any degree of enthusiasm. The paper concludes with an assessment of the reforms from two perspectives: a pessimistic one and an optimistic one. There are many worrying features of the reforms, not least among these being a lack of clarity over their intended purpose. Tensions and contradictions are plentiful, which places in jeopardy the certainty of the reforms in becoming user led rather than provider driven. A more optimistic scenario is that the changes are leading to a loosening up of services and practices which have often suffered from sclerotic tendencies, paternalism and sometimes complacency. If the reform process is skilfully handled and not rushed and if the ends are clearly established and communicated then users and carers could prove to be the principal beneficiaries. 相似文献
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联勤后我分部医院开展优质服务的做法 总被引:2,自引:2,他引:0
魏敦宏 《解放军医院管理杂志》2003,10(2):104-105
为探讨军队医院联勤后开展联勤优质服务工作的管理,本介绍了我分部所属医院开展优质服务的做法,即:端正服务态度,增强服务意识,狠抓内涵建设,提高服务质量,改善医疗设备,美化诊疗环境,完善制度措施,加强监督管理等落实联勤优质服务。 相似文献
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贫困山区育龄妇女健康状况调查分析 总被引:1,自引:0,他引:1
育龄妇女的健康状况。可以反映一个地区的社会经济发展水平,也可反映当地医疗保健服务的水平以及群众利用服务的能力。通过对贫困山区岳西县555名育龄妇女的健康状况及影响因素进行分析,发现常见病、多发病仍威胁贫困山区育龄妇女的健康,同时家庭经济状况直接影响农村育龄妇女对卫生服务的利用。 相似文献
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特需医疗服务机构中护士工作满意度的调查分析 总被引:18,自引:0,他引:18
目的:了解目前从事特需医疗服务工作的护士对自身工作的满意程度及其影响因素,探讨提高护士工作积极性及护理管理效率的途径和方法,为护理人力资源的有效管理提供依据,方法:采用自行设计的问卷对61名相关的临床护士进行问卷调查。结果:被调查护士的工作满意度为中等水平,影响满意度的原因由强到弱依次为个人发展机会少、福利待遇低、工作负荷过重、专业交流机会少等。此外,针对特需医疗服务的特点,对如何提高该领域护士工作满意度提出了建议。 相似文献
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再论医院后勤服务社会化的可行性 总被引:4,自引:3,他引:1
周兆明 《中华医院管理杂志》1997,13(4):251-253
目前,经济高速发展,服务体系和水准相对滞后,加上管理者素质的提高,现代管理技术的应用,以及后勤管理体制的改革,为医院后勤工作向社会分离提供了条件,也为推进医院后勤服务社会化提供了机遇。但规范卫生服务市场体系是后勤服务社会化的保障,故要建立:卫生物质流通、后勤人才流动、经济信息市场及卫生建设筹资机构。在推进后勤服务社会化时尚需解决:①支持条件;②实施集团联盟;③注意经营定位等问题。 相似文献
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During the years 1959 to 1983 a doubling in the rate of homicide took place in Copenhagen. This increase was exclusively due to an increasing number of male offenders. By comparing with another Danish material, the frequency of female homicide as well as that of homicide combined with suicide was found practically unchanged since 1946, indicating that both of these kinds of homicides seem to have a background different from those of other offences of fatal violence. During the years 1959 to 1983, the criteria of selection of the defendants for a psychiatric examination for the court were fairly consistent. Examinations were performed in practically all cases, where a charge of murder raised by the police was followed by a legal trial for homicide. Less and less of the defendants, however, were hospitalized for the examination, while more were examined in The Clinic of Forensic Psychiatry in Copenhagen. 相似文献