How to Effectively Implement an Indicator System to Improve Performance from a Management Perspective: The Case of Taiwan Healthcare Indicator Series (THIS) System

This study uses the Taiwan Healthcare Indicator Series (THIS) system as an example to examine which determinants would improve performance by sharing indicators from a management perspective. This study population included all 227 hospitals participating in the THIS system in 2006. A structured questionnaire was sent to the director who was responsible for the THIS system via electronic mail. A total of 111 responses were returned by February 10, 2006. Questions included current implementation and impacts of the system. Hierarchical regression models were performed to identify which variables were significantly associated with performance improvement, adjusted for hospital characteristics. Four variables significantly associated with implementing the THIS system to improve performance were ‘senior management support,’ ‘benchmarking,’ ‘making departments improve the underperforming indicators and report the improvement results in performance management meetings,’ and ‘integration with the National Health Insurance payment regulations’. This study contributes substantially to the evidence base about what works to improve performance by information sharing. Although information sharing is the basis of efforts to improve performance, senior management support and how to effectively apply the information are the most important determinants of performance enhancement.     

论以服务对象为中心的医院管理道德原则

以服务对象为中心，就是医院管理者在医院工作管理过程中，从维护病人和服务对象的利益出发，将以为服务对象服务，满足服务对象合理医疗保健需求作为医院各项工作的中心，把服务对象至上、一切为了病人和服务对象的医院管理道德要求落实到各项管理措施之中。     

联勤后我分部医院开展优质服务的做法

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。     

贫困山区育龄妇女健康状况调查分析

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。     

特需医疗服务机构中护士工作满意度的调查分析

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。     

再论医院后勤服务社会化的可行性

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。     

武汉市武昌区精神发育迟滞卫生服务调查

目的 了解武汉市武昌区精神发育迟滞的卫生服务利用和需求以及满意度。方法 对108例一胎精神发育迟滞与正常儿童进行1：1对照入户调查。结果 就诊医院以附属医院和省级医院为主；就诊科别集中在儿科。最需要的服务机构是专科门诊、特殊教育学校。遗传咨询比例约50％。自费比例为37．96％，没有医疗保险。对医院满意度调查中一般57．41％，不满意26．85％，很满意15．74％。结论 有必要对高危人群宣传遗传咨询。要加强专科门诊建设和特殊教育发展规划，并从社会保险、医疗保险和商业保险以及社会救助中重视这一以前忽略的领域。     

Monitoring maternity mortality in Botswana

This paper describes the maternity monitoring system in Botswana, developed in 1998, and the main methods used: maternal death and morbidity reviews at service delivery level, analysis by the National Maternal Mortality Audit Committee of data from the reviews as reported on two forms, perinatal reviews and surveys using process indicators. We carried out a study of these findings to examine whether the system was working well. Surveys using process indicators in 2001 and 2006 were analysed. Other data examined were from 2004-2006 and early 2007. The Maternal Death Notification Form was found to be comprehensive but not all health facilities were submitting them and some gave incomplete information. In 2001, 70% of pregnant women attended antenatal care but access to emergency obstetric care was uneven. In 2006, 28 facilities with maternity services surveyed were providing 24-hour delivery care, but laboratory, theatre and blood supplies were more limited, and only 50% of doctors and 67% of midwives had life-saving skills. Antibiotics were widely available, but there were shortages of magnesium sulphate, diazepam, oxytocics and manual vacuum aspiration kits. Recommendations for improvements have been made, training for skilled attendants is ongoing and a medical school has just opened at the University of Botswana.     

潍坊市出境劳务人员艾滋病防治知识需求分析

目的为了解外出劳务人员对艾滋病知识的需求和接受程度。方法对外出劳务人员艾滋病防治知识知晓率进行抽样调查。结果艾滋病防治知识平均知晓率为60.75%。讨论调查对象对艾滋病知识及检测有很大的需求,对艾滋病防治知识和无偿献血基本知识相当缺乏,有待于继续加强宣传教育工作。     

医院门诊药房与医院分离的理性探讨

介绍了医药分业的定义、国外医药分业的目的和少数医院无门诊药房的原因。指出门诊药房从医院分离出去弊大于利,认为门诊药房从医院分离,难以达到预期目的,反而有损于医疗卫生事业的公益性;医药分离削弱、甚至取消了医院对医师不当处方和合理药物治疗等医疗行为的行政和技术监管与干预;医药分离不适合我国的国情,不符合我国卫生体制改革的精神,不利于医疗质量的提高,不利于病人安全、有效、经济用药,不利于调动医院广大药学技术人员的积极性,不利于医院药物治疗管理自动化的实现与信息的传递。建议医药结合的模式必须加强;保留门诊药房,加大监督力度;建立药品配送中心,完善社会化物流机制;加速非处方药药品的发展;在条件成熟后实施处方调剂费;高薪养廉,较大幅度提高医师职业的收入;解决当前医疗体系中分配不合理问题,适当提高挂号、手术、诊疗等收费标准,降低药品收入在医院总收入中所占的比例。