中华医院管理杂志最新文献

{"title":"Public health service delivered by public hospitals in China: function analysis and policy advices","authors":"Xiao-ling Yan, Xinchao Li, F. Bie, Shufeng Li, Y. Meng, A. Mao, Kun Wang, Qing Wang, Hai Wen, W. Qiu","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.004","url":null,"abstract":"Hospitals, especially public hospitals, are an important part of the public health service system. To clarify public health functions of secondary and tertiary public hospitals in China and provide evidences for related health policy decisions, this article introduced the public health services of hospitals in the United States, Britain, Australia and Canada, and then analyzed public health functions of secondary and tertiary public hospitals in China through literature review and case study. The authors summed up eight kinds of public health service functions, and put forward policy advices to promote the performance of public health functions of public hospitals in China. \u0000 \u0000 \u0000Key words: \u0000Hospitals, public; Public health; Functions; Policy advice","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"723-727"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69749710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major findings from the 4th Evaluation of the National Healthcare Improvement Initiative","authors":"Jing Sun, F. Jiang, Linlin Hu, Yu Jiang, Jing Ma, Li Luo, Y. Mao, Guo Zhang, Jinliang Hu, Bingjie Shen, Yinuo Wu, Peiwen Zhang, Jialin Ji, Ran Guo, Meicen Liu, Shichao Wu, Shiyang Liu, Zijuan Wang, Yuanli Liu","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.001","url":null,"abstract":"Objective \u0000To carry out the 4th round of third-party evaluation on the implementation and effect of the 1st year of the 2nd Phase National Healthcare Improvement Initiative(abbreviated as Initiative)since 2015. \u0000 \u0000 \u0000Methods \u0000The 4th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations. \u0000 \u0000 \u0000Results \u0000The 4th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces(autonomous regions, municipalities directly under the Central Government)and Xinjiang Production and Construction Corps.Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1%, 96.7%for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved. \u0000 \u0000 \u0000Conclusions \u0000The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction. \u0000 \u0000 \u0000Key words: \u0000Healthcare Improvement Initiative; Third party evaluation; Hospital Survey; Doctor-patient satisfaction","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"705-711"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47362370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study on nursing workload measurement based on relative value","authors":"Yuchi Shen, Qiufen Zhu, W. Jian","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.012","url":null,"abstract":"Objective \u0000To test the applicability of the relative value used to measure Chinese nurses′ workload, and measure part of single workload of nursing procedures. \u0000 \u0000 \u0000Methods \u0000Time, physical effort, mental effort and medical risk were used as the four dimensions to evaluate nurses′ workload. Based on these dimensions, a set of questionnaires covering 117 common nursing procedures were designed and 58 nurses form 58 hospitals were surveyed. Establishing three different regulation modals, of which the applicability and stability were evaluated through the good of fit. \u0000 \u0000 \u0000Results \u0000Median of the relative value of different dimensions was used to indicate the average level of the various nursing procedures′ workload. The results showed that the median of relative value between 100 to 199 accounted for the largest share, up to 88.89% of 104 items. The median of relative value between 200 to 299 accounted for 7.69%(9 items). The median of relative value between 0 to 99(3 items)and more than 300(1 item)accounted for a small proportion. The lowest point of workload was blood pressure measuring, having a relative value of 90(70, 100) while the PICC catheterization accounted for the highest point of workload, being 370(200, 500) Three kinds of modals were valid(Model Ⅰ, F=10 626.16, P<0.001; Model Ⅱ, F=17 108.22, P<0.001; Model Ⅲ: F=6 694.16, P<0.001), while the good of fit of these regulation modals was between 0.8 to 0.9. Time, physical effort, mental effort and iatrogenic risk were the key variables of nurses′ workload. \u0000 \u0000 \u0000Conclusions \u0000The applicability of the relative value to measure nurses′ workload is fairly satisfactory, and the relative value points based on multi-dimension will enjoy a promising future. \u0000 \u0000 \u0000Key words: \u0000Nursing care; Workload; Measurement; Relative value; Questionnaire survey","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"761-765"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45373537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current situation and reform path of nursing alliances in China","authors":"Shan Han","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.013","url":null,"abstract":"In order to deepen the connotation of nursing service, accelerate the construction of nursing discipline and promote the industrialization of nursing service, nursing alliances are mushrooming rapidly. However, the construction of nursing alliances deserves rational consideration, while policy guidance should be strengthened, functions and positioning be clarified, and personnel training be standardized. These efforts ought to promote the healthy and orderly development of nursing alliances along the initial purpose of its establishment. in the end, the alliance should give full play to its unique role in safeguarding people′s health and meeting the needs of primary medical care. \u0000 \u0000 \u0000Key words: \u0000Nursing care; Nursing alliance; Nursing staff; Current situation; Reform path","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"766-769"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42720371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of health technology assessment in value-based management of total health expenditure","authors":"Ningze Xu, K. Zhu, Lizheng Shi, Xiaoguang Yang, Yingyao Chen","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.003","url":null,"abstract":"Unreasonable growth of total health expenditure at various extent has been found to be prevalent among many countries for a long time. Thus how to deal with this global public health challenge has become a hot topic among the consumers, providers, and payers alike. Echoing the global trend of value-based healthcare, value-based management of total health expenditure could be a direction of cost containment in the future. Through promoting the rational development of healthcare industry, assisting the decision-making of health insurance authority, improving health authority′s supervision of health technology allocation and utilization, maximizing resource utilization efficiency at hospitals, standardizing physician practices, guiding patients′ medication preferences and behaviors, health technology assessment could mobilize stakeholders′ participation in the value-based management of total health expenditure and serve as an important decision-making tool to optimize the allocation and utilization of scarce health resources, reducing and avoiding waste in healthcare sector, and promoting high-value and sustainable development of total health expenditure. \u0000 \u0000 \u0000Key words: \u0000Technology assessment, biomedical; Health technology assessment; Value-based healthcare; Total health expenditure; Health insurance","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"719-722"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42792071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American neurology fellowship setup and its enlightenment to specialized training in China","authors":"Min Qian, L. Cui, Qin Lan","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.019","url":null,"abstract":"In view of the recent advancements in the standardized neurology residency training in China, standardized neurology fellowship training has become a crucial next step for China′s graduate medical education. The design of the fellowship and development of relevant norms and standards to ensure quality training constitute key areas in need of further consideration. The United States has established a standardized neurology fellowship training for nearly 30 years and has been successful in ensuring high quality physician training. Currently there are 9 accreditation council for graduate medical education (ACGME) accredited neurology fellowship programs in the USA, including clinical neurophysiology, pain medicine, neurodevelopmental disabilities, vascular neurology, neuromuscular medicine, sleep medicine, endovascular surgical neuroradiology, epilepsy and brain injury medicine. Among them, the number of fellowship training programs in vascular neurology, clinical neurophysiology, and epilepsy are relatively stable or show continuous growth, while neurodevelopmental disabilities and brain injury medicine remain stagnant or even retrogressive. It indicates that design of the neurology fellowship training calls for full weight of a wide array of factors, taking into account the number of subspecialty patients, clinical applications, prospects for future development of the subspecialties, and lessons learned from the United States. We can start with ACGME accredited steady growth fellowship programs and then add others in the future accordingly. \u0000 \u0000 \u0000Key words: \u0000Neurology; Sub-specialty; Fellowship; United States","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"789-792"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45150060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of 2019 version tertiary hospital performance evaluation indexes and the impact on hospital management","authors":"Yongqin Zhang, Q. Guo, Yue Yang, Yangyun Chao","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.015","url":null,"abstract":"The authors compared and analyzed the guidelines and the index system of public hospitals as stated in such papers as \" State Council′s Opinions on Performance Evaluation of Tertiary Hospitals\" (No.4 Document of State Council, 2019)and \" Guidance on Strengthening the Performance Evaluation of Public Hospitals\" (No.94 Document of Guo Wei Ren, 2015). Based on their studies, this paper summarized the commonness and law of development of the two editions of the indexes. They proceeded on such basis to collect data from over 3 600 medical institutions of tertiary hospitals in Beijing and the rest of China before and after the drug-clinic-separation reform in Beijing, National tertiary public hospitals and analyzed key indexes to learn the guidelines and impacts of the 2019 edition on hospital management. The performance indexes of the 2019 edition highlight the public welfare of public hospitals, strengthen the functional orientation of tertiary public hospitals, and point out the direction for further healthcare reform. These papers have a far-reaching impact on hospital strategy and management mode, guiding public hospitals to change their concepts and take on dual responsibilities of public welfare and self-development. \u0000 \u0000 \u0000Key words: \u0000Hospitals, public; Performance evaluation; Index; Tertiary hospitals; Management","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"774-777"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43881364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey on the self-rated health of doctors and nurses at China′s 144 tertiary public hospitals","authors":"Yinuo Wu, M. Cao, Shichao Wu, Yang Liu, Huanqiang Wang, Xinyue Chen, Jing Sun, Yu Jiang, Juan Zhang, Jing Ma, Yuanli Liu","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.002","url":null,"abstract":"Objective \u0000To establish comprehensive understanding of the self-rated health of the Chinese doctors and nurses and probe into their influencing factors. \u0000 \u0000 \u0000Methods \u0000Data were drawn from a hospital performance survey, which was conducted by the Peking Union School of Public Health from March 18th to April 9th, 2019, among the 144 tertiary public hospitals in 31 provinces, autonomous regions, and municipalities. The survey included a cell-phone based questionnaire filled out by the sampled doctors and nurses, in which they were asked to rate their health using a 5-level Likert scale(from \" very poor\" to \" very good\" ). Mann-Whitney U test was used to analyze the differences in self-rated health between doctors and nurses. Chi-square test and two-class multivariate logistic regression were performed to analyze factors affecting self-rated health of the providers. \u0000 \u0000 \u0000Results \u0000Among the 144 sample hospitals, the proportion of doctors, who rated their health as \" healthy\" , was 20.30%(4 979/24 529), that of nurses was 28.92%(8 361/28 910). It was worse than that in some developed countries and lower than the general population in China. Multi-variate analysis showed that adequate sleeping time, satisfaction with the work and with the doctor-patient relationship, were positively associated with the level of self-rated health of the sampled doctors and nurses(P<0.05). It was also found that the longer the average weekly working time, the higher the recognition of \" the work load is too heavy\" , the lower the proportion of doctors and nurses who rated their health as \" healthy\" (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Sleep time, job satisfaction, workload and doctor-patient relationship are important factors affecting self-rated health of the Chinese doctors and nurses. \u0000 \u0000 \u0000Key words: \u0000Health status; Self-related; Medical staff; Influencing factors; Third party evaluation","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"712-718"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41927916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and the effectiveness analysis of a comprehensive management system for preventing and curing venous thromboembolism within hospital","authors":"Hongfei Wang, L. Tang, Jiao-hua Yu, Yu Hu, Hui Sun","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.011","url":null,"abstract":"Venous thromboembolism(VTE)is an important etiology for unexpected deaths and perioperative deaths of inpatients. Early diagnose and early prevention are main measures to reduce the incidence and mortality of VTE. Herein, we have established a comprehensive management system of VTE prevention, treatment and research. On one hand, we implemented the in-hospital VTE prevention management and improved the implementation status of VTE prevention and treatment. As a result, the number of diagnosed VTE cases and related medical disputes decreased by years. On the other hand, we have built up the VTE monitoring platform, providing useful statistical data for the clinical use of anticoagulants and further reducing the incidence of VTE. The VTE monitoring platform also revealed some significant differences of the VTE incidence between the medical patients and the surgical patients, which could provide reference for further revision of VTE guidelines. \u0000 \u0000 \u0000Key words: \u0000Venous thromboembolism; Management system; Multi-disciplinary team; Effectiveness","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"757-760"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47454839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional certification system of infection prevention and control in the United States and its enlightenment to China","authors":"Qiao-jing Tong, T. Lo","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.018","url":null,"abstract":"The United States Certification Board of Infection Control and Epidemiology(CBIC)provides standardized measurements for all infection prevention and control professionals. It pursues a professional standard of excellence and aims to continuously improve their skills to ensure safe medical care of high quality for patients. We should learn from their certification system of infection prevention and control to accelerate the development and maturity of professional certification of infection prevention and control in China. \u0000 \u0000 \u0000Key words: \u0000Infection control; Professional certification system; United States; Enlightenment","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"785-788"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41472528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}