加强人才队伍建设促进卫生事业发展的途径探索

在卫生事业的发展过程中,应该注重人才队伍的建设,强化人才队伍建设的创新改革力度,转变传统的人才管理工作思维与模式,遵循健康发展、协调发展的基本原则,借助人才队伍的建设促使卫生事业良好发展和进步,形成新时期背景下的卫生事业发展动力,彰显人才队伍的积极作用。该文就当前卫生事业人才队伍的现状,提出加强人才队伍建设促进卫生事业发展的指导思想,并且归纳总结卫生事业发展过程中人才队伍的建设经验、对策,争取可以采用有效的措施建设人才队伍,提升卫生事业发展过程中的核心力量,增强服务工作效果,满足当前的时代发展需求,达到预期的工作目的。     

运用品管圈提高血药浓度监测及个体化服务项目的认可度

目的提高血药浓度监测(TDM)及个体化服务项目的认可度。方法2019年1—7月,针对TDM每月监测例数较低,针对医生进行问卷调查,按品管圈的10个步骤实施各项活动,并对活动成果进行评价。结果明确了影响TDM监测例数低的因素,通过品管圈活动拟定了一系列对策,有形成果方面,每月监测例数逐步提高;无形成果方面,圈员的品管手法、解决问题能力、责任心都有不同程度的提升。结论品管圈活动显著提高了血药浓度监测及个体化服务的认可度。     

“四方联动”医疗卫生服务模式初探——以深圳市宝安区人民医院集团为例

深圳市长期以来一直沿用“院办院管”的社区卫生管理运作模式,但随着社康中心的发展,该模式的弊端逐渐显现。为推动医院院本部与下属社康中心深化合作,促进专科、全科高度融合发展,落实国家分级诊疗政策,宝安区人民医院集团创新探索“居民-社区-社区健康服务中心-医院(集团)”专病健康管理模式的四方联动,实现医院和社康中心共同管理患者,提高社区居民健康水平。通过对“四方联动”模式的概念、建设方案、实施效果进行介绍,为进一步完善“四方联动”发展模式提出政策建议。     

DRGs视角下某医院医疗服务半径分析

目的通过分析某三甲医院的医疗服务半径及其变化趋势,为医院的科学发展规划提供决策依据。方法获取2016年至2019年的病案首页资料和DRGs运行指标,按患者现住址的行政区域统计分析各项业务指标的变化情况。结果医院各区域出院人次和DRGs组数均逐年增长,市本级患者构成比呈逐年下降趋势(χ趋势^2=441.74,P<0.001);区域CMI值表现为外市患者高于外县市高于市本级;MDCY(烧伤)、MDCN(女性生殖系统疾病及功能障碍)、MDCQ(血液、造血器官及免疫器官疾病和功能障碍)等MDC和整形烧伤科、神经外科、心胸外科等临床学科的区域辐射能力在增强。结论该院医疗服务辐射范围整体上有逐年扩张的趋势,未来需通过持续提升医疗质量和效率,积极推行分级诊疗,加强学科建设等措施,为本地市及周边区域的患者提供更加高质高效的医疗服务。     

信息交流视角下国内外科技期刊的知识服务模式

【目的】在信息交流视角下,探讨我国科技期刊知识服务转型发展的突破路径。 【方法】通过文献调研和对比分析法,探讨面向科技期刊知识服务的科学信息交流模式框架,对国内外科技期刊知识服务模式进行分析。 【结果】分别从正式交流和非正式交流视角,归纳总结国内外科技期刊所开展的知识服务。通过对比国内外科技期刊在服务模式、手段和渠道的差异,提出我国科技期刊知识服务的发展策略。 【结论】我国科技期刊应从集团化经营模式、自动化出版流程、基于微信矩阵拓展服务项目等方面入手,完善自身的知识服务体系,实现知识生产向知识服务的创新转型。     

Effectiveness of Comanagement Model: Geriatric Medicine and Vascular Surgery

ObjectivesOlder surgical patients frequently develop postoperative complications due to their frailty and multiple comorbidities. Geriatric medicine consultation helps to optimize risk factors and improve outcomes in patients with hip fracture. This study aimed to evaluate patient outcomes before and after comanagement model implementation between geriatric medicine (Geriatric Surgical Service) and vascular surgery services.DesignThis was a case-control study involving emergency vascular surgical patients who were comanaged by vascular surgery, geriatric medicine, and geriatric nursing services.Settings and ParticipantsThis study was conducted in a tertiary hospital in Singapore from 2015 to 2018 with acute vascular surgical patients aged older than 65 years.MethodsA retrospective cohort of 135 patients from 2013 to 2014 (control group) who fulfilled the criteria for the comanagement model was compared with a prospective cohort of 348 patients who were comanaged by a geriatric surgical service from 2015 to 2018, and a further subgroup analysis of patients between 2015 and 2016 (n = 150) (early intervention group) and between 2017 and 2018 (n = 198) (late intervention group) was performed.ResultsComanaged patients had a significantly shorter length of hospital stay (11.6 vs 20.8 days, P = .001), reduced nosocomial infections (3% vs 12% for urinary tract infection, P = .003) and decreased 30-day readmission rates (22% vs 34%, P = .011). A trend of a decreased incidence of fluid overload was noted in patients comanaged with the geriatric surgical service (3% vs 7%, P = .073). Subgroup analysis showed progressive reductions in the length of stay (15.4 vs 11.6 days, P = .001), 30-day readmission rate (35% vs 22%, P = .01), and nosocomial urinary tract infection (8% vs 3%, P = .003) between the early intervention group and the late intervention group. Although they were not statistically significant, reductions were also observed in the delirium rate (13% vs 11%) and other postoperative medical complications in the early intervention group and the late intervention group.Conclusion and ImplicationsDespite having increasing comorbidities, older vascular surgical inpatients had a significantly shorter length of stay, reduced nosocomial infections, and decreased 30-day readmission rates through a comanagement model with vascular surgery and geriatric medicine services. Improvements in outcomes were observed over time as the model of care evolved. Geriatric medicine intervention in the perioperative period improves the outcomes of older acute vascular surgical patients.     

社区卫生服务信息系统之健康档案研究

建立一套标准、规范、电子化的城市社区家庭个人健康档案模式及可接通互联网络的电脑管理信息系统,为社区工医生提供完整的、系统的居民健康状况数据,是社区医生掌握居民健康状况的基本工具,进行社区诊断的主要依据,是进行社区卫生管理的重要前提,也是我国卫生事业发展必然趋势。     

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.