医院服务质量管理

提高医院服务质量是新形势下加强医院内涵建设,提高医院竞争力的有效方法。通过阐述与运用服务质量与顾客满意的管理理念和原则,对医院医疗服务质量概念、提高医院服务质量认识以及将服务质量作为医院质量发展战略等内容进行了探讨。     

Utilization of hospital emergency services in Andalusia (1987)

A study out the inter-hospital information system (INIHOS) of the Servicio Andaluz de Salud has been carried for 25 hospitals, during 1987. One out of four inhabitants in Andalucía have utilized the emergency rooms of hospitals. An analysis of variance has permitted to find statistically significant differences (p less than 0.05) among three groups of hospitals, as classified according to the total number of emergencies attended. Biger hospitals attend more emergencies by inhabitant from its catchment area (0.426) than the intermediate (0.285) and the smaller (0.223). The latter perform more complementary explorations (0.76 Rx studies by patients) than the bigger ones (0.525). However, there are no inter-group differences for the proportions of patients hospitalized of those admitted in emergency rooms (global mean of 18.3%). After a multiple regression analysis, it can be concluded that the number of hospital beds explains up to 95% of the variance of the 4 subgroups of hospital as defined by their size (big/small hospitals) and by their location (Mediterranean coast/elsewhere). Thus, it can be explained the biger rate of emergency room admissions/inhabitant found in Granada and Málaga. It is concluded that the utilization of emergency rooms increases when more services are offered. (Gac Sanit 1989; 3(10): 313-9).     

Equity,access and resource allocation: Planning hospital services in New Zealand

The desire to limit the growth of expenditure in the Western world has seen increased attempts to reallocate resources in the name of equity and efficiency. This paper reviews recent moves in New Zealand to achieve an equitable financing and distribution of hospital resources. While a more equal distribution of resources is likely to result from the recent reforms, redistributive policies of the type being implemented in New Zealand, which leave the basic structure of the health care system intact, may have only a marginal impact on improvements in access to care and health status.     

Markets for hospital services in Zambia

Hospital reforms involving the introduction of measures to increase competition in hospital markets are being implemented in a range of low and middle-income countries. However, little is understood about the operation of hospital markets outside the USA and the UK. This paper assesses the degree of competition for hospital services in two hospital markets in Zambia (Copperbelt and Midlands), and the implications for prices, quality and efficiency. We found substantial differences among different hospital types in prices, costs and quality, suggesting that the hospital service market is a segmented market. The two markets differ significantly in their degree of competition, with the high cost inpatient services market in Copperbelt relatively more competitive than that in the Midlands market. The implications of these differences are discussed in terms of the potential for competition to improve hospital performance, the impact of market structure on equity of access, and how the government should address the problem of the mine hospitals.     

Health services system for seafarers and fishermen in Iran

The maritime health services system is presented in this review article. The national Iranian shipping line IRISL owns the largest commercial fleet in the Middle East and it operates 137 ships. This company and several other national shipping companies employ over 5900 seafarers. There are 11,000 fishing ships and boats and the number of Iranian fishermen reaches 124,000. Seafarers and fishermen are regularly medically examined and issued health certificates, according to the national regulations. The health services system for them is linked to the port authorities throughout the country. Observations, data and relevant statistics on the health problems of the national maritime workers have been regularly collected.