社区卫生服务站工作建议探讨

随着卫生体制改革的深入和国家对卫生投入的调整,社区卫生服务站如何履行公共卫生服务职能以及政府投入的资金如何监管成了一项重要的工作.就社区卫生服务站如何强化其职能以及资金监管方式提出建议.     

北京两家定点医疗机构被摘牌

2001年12月5日,北京市朝阳区潘家园街道松榆里社区卫生服务站和西城区新街口社区卫生服务中心因     

基层医疗卫生机构的文件和档案管理工作

中山市东凤镇1998年率先在全市实行镇村医疗卫生一体化管理,于2000年成立东凤镇社区卫生服务中心,由东凤人民医院对13个社区卫生服务站实行一体化管理,社区卫生服务中心与东凤人民医院属一个机构,挂两块牌子。随着社区卫生服务体制的创新和工作方式的变革,基层医疗卫生机构的文件和档案管理工作表现出明显的过渡性特点:1.由于社区卫生服务中心下设站点多且分散,文件的形成、传递、收集以及归档、利用等遇到诸多问题。2.在     

农民看病首选社区医院

从大年初一开始，江苏省汪阴市云亭镇花山村的社区卫生服务站里一直有医生值班，为农民量血压、看小病，为行动不便的老人或病人上门就医。坐在窗明几净的服务站里等待看病的村民掏出心里话：“现在我们都首选在家门口的社区医院里看病，既方便快捷，又省钱省心。”     

农村医疗机构计量器明年可免费检定

2009年1月1日起,福建省16411家村级卫生所和322个社区卫生服务站的在用血压计、浮标式氧气吸入器等全部实行免费检定,其中血压计一年2次免费检定。对922家乡镇卫生院、172家社区卫生服务中心的在用血压计也实行一年2次的免费检定。此外,福建省647家集贸市场的电子计价秤和台案秤也将会享受一年两次的免费检定     

一名基层村医的困惑

我是山东临沂的一名乡村医生,在一家社区卫生服务站工作,既是医生,也是站长。我的辖区有近万名居民,我和所在卫生服务站的五六位医生,每天除了要给居民看病,还有11项公共卫生管理要做,并进行各种各样的随访     

用活卫生资源发展养老服务

湖北省襄阳市樊城区突出“老有所医”的服务特色，逐步形成以居家养老为基础、社区卫生服务站为依托、社会福利机构为补充的养老服务体系，使老年人能及时、方便、快捷地享受医疗救助、生活照料等多方面的服务。     

双程联控规范行为阳光采购预防腐败——句容市药品招标纪实

江苏句容市卫生局下属医疗机构有3家二级医院，16家社区卫生服务中心（卫生院），114个农村社区卫生服务站（村卫生室）。二级医院药品采购统一参加镇江市的招标。基层医疗单位每年的药品采购金额约4600万元，疏于管理，极易产生腐败。为此，句容市卫生局实行统一管理，全面实施药品集中招标采购，有效降低了药品供应商利润空间，使做临床、给“回扣”等不规范行为得到较好遏制。     

徽县：完善卫生院设施方便群众就医

近年来，甘肃省徽县大力加强县、乡、村三级医疗卫生基础设施建设，着力改善群众的就医环境，以县级医疗机构为龙头、乡镇卫生院为枢纽、社区卫生服务站和村卫生室为基础的三级医疗卫生服务网络功能日趋完善，使城乡群众就医更方便。     

当代中国的信贷配给

<正>所谓信贷配给,是指商业银行在面临对贷款的超额需求时,不是通过提高利率的途径来增加存款供给,同时抑制贷款的需求来实现信贷市场的均衡;而是通过实行配给,来部分的满足借款人的信贷需求、或者只满足部分借款人的信贷需求的这样一种金融现象。信贷配给现象和对信贷配给的研究由来已久,近年来,新凯恩斯主义者基于信息不对称角度对信贷配给所做的解释得到了广泛的认同。     

新医改背景下,基于SWOT分析法的南京市社区卫生服务中心可持续发展研究

新医改背景下,南京市社区卫生服务中心得到了大力发展。通过介绍南京市社区卫生服务中心的现状,运用SWOT分析法对目前南京市社区卫生服务中心的内部优势和劣势以及外部环境存在的机会和威胁进行探索性地分析,并就南京市社区卫生服务中心的可持续发展提供了相关的建议。     

Do quality perceptions of health and social services vary for different ethnic groups? An empirical investigation

The United States is now more ethnically diverse than any other time in its history. In 2000, minority ethnic groups comprised 26% of the US population; by 2010, they comprise 35%, and in 2080 they will form the majority of American citizens. And among these ethnic groups, African Americans (12.4%), Hispanics (15.4%) and Asians (4.4%) were the most predominant in 2000. The growth of this segment of the population is not only in terms of numbers but also in terms of economic development. Minority groups are showing marked improvement in income and education levels leading to greater purchasing power. As a result, for‐profit companies are increasingly targeting minority populations with products and promotions specifically designed for specific minority groups. Even non profit organizations such as educational programs, social service and healthcare agencies are striving to design specific services and culturally competent outreach models in order to serve this increasingly diverse marketplace. But despite the strides made by non profit agencies, several studies note the tremendous disparities between the ethnic and racial groups in the seeking and the receipt of health‐care and social services. Additionally, there is limited empirical information about the perceptions of minority consumers. In order to effectively serve minority groups, it is essential to understand their experiences with the non profit service industry and to assess their ongoing concerns. In this study, we focus on two critical components of the non profit world – healthcare and social services. We conducted a survey to compare and contrast the social service and health‐care quality perceptions of three ethnic groups: Caucasians, African‐Americans and Hispanics. Our study, undertaken in collaboration with community health centers, reveals distinct differences in perceptions between the three ethnic groups. Based on our findings, we outline a set of implementable strategies for social service and community health organizations. Copyright © 2010 John Wiley & Sons, Ltd.     

BACK TO THE FUTURE: TOWARDS A BETTER STATE OF HEALTHCARE

In 1948, the government nationalised more than 3,000 independent hospitals, homes and clinics to create a National Health Service that was supposed to deliver 'all medical, dental and nursing care'- free at the point of delivery. Demonstrating that the service failed to do this and instead substituted rational pricing signals with numerous forms of rationing, the authors examine the re-emergence of a sizeable independent health and social care sector today and its implications for the future.     

A new vaccine supply chain network under COVID-19 conditions considering system dynamic: Artificial intelligence algorithms

With the discovery of the COVID-19 vaccine, what has always been worrying the decision-makers is related to the distribution management, the vaccination centers' location, and the inventory control of all types of vaccines. As the COVID-19 vaccine is highly demanded, planning for its fair distribution is a must. University is one of the most densely populated areas in a city, so it is critical to vaccinate university students so that the spread of this virus is curbed. As a result, in the present study, a new stochastic multi-objective, multi-period, and multi-commodity simulation-optimization model has been developed for the COVID-19 vaccine's production, distribution, location, allocation, and inventory control decisions. In this study, the proposed supply chain network includes four echelons of manufacturers, hospitals, vaccination centers, and volunteer vaccine students. Vaccine manufacturers send the vaccines to the vaccination centers and hospitals after production. The students with a history of special diseases such as heart disease, corticosteroids, blood clots, etc. are vaccinated in hospitals because of accessing more medical care, and the rest of the students are vaccinated in the vaccination centers. Then, a system dynamic structure of the prevalence of COVID -19 in universities is developed and the vaccine demand is estimated using simulation, in which the demand enters the mathematical model as a given stochastic parameter. Thus, the model pursues some goals, namely, to minimize supply chain costs, maximize student desirability for vaccination, and maximize justice in vaccine distribution. To solve the proposed model, Variable Neighborhood Search (VNS) and Whale Optimization Algorithm (WOA) algorithms are used. In terms of novelties, the most important novelties in the simulation model are considering the virtual education and exerted quarantine effect on estimating the number of the vaccines. In terms of the mathematical model, one of the remarkable contributions is paying attention to social distancing while receiving the injection and the possibility of the injection during working and non-working hours, and regarding the novelties in the solution methodology, a new heuristic method based on a meta-heuristic algorithm called Modified WOA with VNS (MVWOA) is developed. In terms of the performance metrics and the CPU time, the MOWOA is discovered with a superior performance than other given algorithms. Moreover, regarding the data, a case study related to the COVID-19 pandemic period in Tehran/Iran is provided to validate the proposed algorithm. The outcomes indicate that with the demand increase, the costs increase sharply while the vaccination desirability for students decreases with a slight slope.     

从公共服务的角度看社区卫生服务的发展

社区卫生服务是一种面向社区的整体化服务模式,以个人为中心,以家庭为单位,在我国,社区卫生服务是为了解决看病贵、看病难而出现的,是我国卫生改革发展的一项重要举措,本文从公共服务的角度对社区卫生服务的发展进行分析。     

A grant rationing model for a health care system.

Most public health programs are created through a political process and the health administrator's resource allocation decision is influenced not only by the relative performance of the subunits but also by political considerations. This paper presents a goal programming model for rationing available grants to competing health care subunits on the basis of performance subject to resource and political constraints. Performance is defined in terms of output adjusted for non-compliance on the identified quality of care and administrative efficiency criteria. The quality and efficiency criteria are those specified by the Federal agency as amended by local funding authorities and subunit administrators through a Delphi process. The model has the advantage of flexibility and can be easily adapted to suit prevailing financial and political conditions. In particular, it can be used as a viable analytical tool in health care and other public service agencies where political considerations are important in resource allocation decisions.     

Modeling mobile health service delivery to Syrian migrant farm workers using call record data

A significant number of Syrian refugees under temporary protection in Turkey work in agriculture seasonally in various rural areas during several months a year. These migrant farm workers and their families are deprived of access to the regular health care system and preventive services due to their remote locations. The government supports the delivery of different types of mobile health care services, such as vaccination for children, reproductive health and screening services. While planning the mobile health care service delivery, it is critical to know where the refugees will work during what time frame; hence the demand for the services. By analyzing the call record data of a major mobile network operator in Turkey, we quantify the increase in the volume of calls made by Syrian refugees in various agricultural areas during the harvesting season of local crops. This information helps us to forecast spatial and temporal distribution of demand for mobile health care services at a fine granularity. Taking demand over multiple periods as input into a mathematical programming model, we optimize the routing of mobile clinics that visit locations close to where refugees are concentrated over the given planning horizon. We consider three hierarchical objectives. Given the availability of a number of mobile clinics at community health centers in the districts, the first objective aims to maximize the percentage of refugees that can benefit from each service type within pre-defined close distances. The second objective minimizes the number of clinics needed while covering the maximum percentage of refugees. The third objective minimizes the total travel distance of the clinics, while keeping the maximum coverage level using a minimum number of clinics to achieve this level. We quantify the benefits of centralized planning (by the province directorate) over decentralized planning (by each district separately). We also show the trade-off between the required number of clinics and coverage of potential patients.     

论在高校社区进行中医医疗服务的可行性

随着新医改的深入,高校社区中医药服务是必须的也是可能的。坚持开展中医特色的高校社区卫生服务工作对弘扬祖国医学、促进高校社区卫生服务可持续发展,提高高校师生员工的健康素质具有重要的现实意义;对丰富高校社区卫生服务的中医内涵,促进高校社区卫生服务向多元化方向发展也起到积极的作用。     

中国医疗卫生事业效益分析之系列研究——2010年社区卫生服务中心(站)社会效益分析

研究社区卫生服务中心(站)情况,总体发展迅速,发挥良好社会职能与效益,应培养全科医生,紧密联系社区,增强资产利用率,提升管理水平和医疗水平,加强成本核算,控制成本支出。     

The measurement of rationing and the treatment of structural change in the uk mortgage market

UK mortgage markets have undergone major structural changes in the past few years, resulting in mortgages no longer being rationed. The ending of rationing has implications for the specification of empirical models of housing demand. Housing models have never adequately resolved how to incorporate unobservable mortgage rationing. Conventional proxy methods are particularly unsuitable, when rationing ceases. In this paper, we propose a new way of measuring rationing directly, which incorporates regime switching. The model of rationing is extensively tested and estimates of rationing for the period 1963–1988 are provided; these may be easily incorporated into housing demand studies.