社区医院药品核算与管理有关问题探讨

国家为了解决老百姓"看病难、看病贵"的问题,在很多社区设立了社区医院,社区医院主要为居民提供低价、就近、方便、快捷的医疗服务,让患者可以不用排队就近看医,药品是社区医院为了开展正常医疗工作,用于诊断和治疗疾病的特殊商品,药品种类繁多、功能不一、价格也多种多样、使用领域也很宽广,是医务人员进行工作能够完好进行的物质保证。因此,社区医院要对医院内部的药品进行管理,减少积压且建立科学完善的药品管理制度和科学核算方法,以保证医疗和科研能够正常运行,是社区医院财务管理的重点之一。     

弱势群体医疗救助实施效果评估——基于“城乡困难家庭社会政策支持系统建设项目”调查数据的分析

基于2015年"中国城乡困难家庭社会政策支持系统建设项目"的调查数据,本文对接受医疗救助家庭的基本特征及其对医疗救助的满意度、重特大疾病医疗救助满意度及其影响因素进行了分析,结果发现困难家庭遭受疾病风险高,抗疾病风险能力弱,医疗救助水平总体偏低,大病家庭受助有限,但大部分城乡困难家庭认为医疗救助作用较大,满意度高,医疗卫生服务对提高医疗救助的满意度正向作用显著;进一步通过对受助困难家庭对重特大疾病医疗救助满意度的分析,发现困难家庭对重特大疾病救助满意度不及医疗救助满意度,重特大疾病救助在涵盖病种、救助标准、审核手续、费用结算方面均有较大的可提升的空间。本文为此提出的建议是:实施精准救助和早干预措施,对于不同家庭的不同医疗需求,实施分类救助;同时要突出重点,加强大病救助;推进分级诊疗,普及基本医疗卫生服务。     

公立医院绩效考核的现状与对策探讨

随着医疗改革的不断深入,对医疗行业的要求越来越高;随着社会进步,居民对医疗资源的需求越来越大,但医院的发展无法满足居民的医疗资源的需求。因此,加强医院精细化管理,提升医院服务能力显得尤为重要。本文分析了绩效考核的重要性,并针对医院绩效考核的现状,提出了相应的对策。     

医共体模式下社区医院运营管理模式转变探讨

在县域医共体改革背景下,社区医院作为公立医疗体系的终端,为区域老百姓提供健康保障服务。如何在新形势下,找准区域医疗中的定位,发挥社区医院职工能动性,通过科学管理提高运营管理效能和效率,促进社区医院服务能力提升,改变目前绝大多数社区医院亏损的局面,实现国家分级诊疗体现真正落地。     

广州地区商业银行服务质量调查与思考

根据调查，客户对广州地区商业银行的服务质量总体满意度不高。对商业银行的服务满意度不高主要体现在服务效率和服务水平方面。因此，对于广州地区的商业银行来说，提高效率是改善服务的当务之急，提高服务水平、催生消费者剩余和赢得客户满意是提升商业银行服务质量的长远之计。     

政策支撑 智能医疗可望快速发展

医疗物联网通过物联网技术可以大幅度降低成本，使医疗监护设备无线化，最终的目标是使有限的卫生资源得到充分地利用，从而使患者能够得到更加方便快捷、低成本高质量的服务。掬联网给医皖带来翻面问题但是，医疗资源配置的不合理制约着分级医疗的开展。目前我国每1万人中只有14名医生，这个比例还不到发达国家的一半，医疗资源十分匮乏。同时，大量优秀医生集中在大医院，不愿意去社区医院，也造成医疗资源配置不合理，改革推进举步维艰。     

医疗卫生保障满意度调查研究——以辽宁省沈阳市为例

目的:对医疗卫生保障满意度进行研究,为构建公平、可持续发展的医疗保障制度提供科学依据。方法:根据调查目的,设计一套完整的问卷,运用计算机辅助电话调查方法(CATI),抽取2300各样本进行医疗卫生满意度调查。结论:有效样本中,34.5%的居民选择满意和比较满意,44.4%的居民选择一般,21.1%的居民选择不太满意和不满意。医疗卫生保障满意度为59.4分。     

内蒙古基层医务人员医改满意度的调查研究

新医改实施以来,了解内蒙古基层医务人员对新医改的满意度,以促进医改总体目标的实现.利用现场调查数据,对内蒙古基层医务人员医改满意度进行分析.结果表明内蒙古基层医务人员对新医改的总体满意度为69.6％,即接近七成的医务人员对新医改持满意态度,说明新医改的实施取得了一定成效.要提高医务人员的满意度,建议医院及相关行政部门应完善医院补偿机制,建立健全激励机制,实行多种分配制度、加大政府投入以及完善基本药物目录等,以提高医务人员的积极性,进而促进医疗服务质量的提高.     

浅析医院绩效改革的难点及应对策略

近年来,随着新医改的深入,医院的竞争压力越来越大。为了提高医院的核心竞争力,必须提高医疗质量和医疗服务满意度。同时,继取消药品加成后,取消卫材加成势在必行,药品和卫材逐步转化为成本。医院应当以绩效为切入点,抓内部管理;以绩效为导向,引导科室关注医疗质量、成本管理、满意度等等。大收大支下如何实现向精益化管理转变,绩效改革势在必行。改革必然会触痛部分群体的利益,本文针对医院绩效工资改革中所出现的难点进行分析,并就其中的问题提出几条有效解决的途径。     

就医秩序何以形成？

就医无序引发重提分级诊疗 如今大医院人满为患,社区医院门可罗雀,原有的逐级就医的秩序荡然无存;大医院医生忙得四脚朝天,每天看上百门诊;社区医生则是看病成为了辅业,更多地在拓展非医疗服务技能。对此,这些年来,从上到下一直在努力尝试推行分级诊疗和双向转诊,以重新建立良好的就医秩序。分级诊疗是按照疾病的轻重缓急及治疗的难易程度分级,不同级别的医疗机构承担不同疾病的治疗,各有所长,     

METHODOLOGICAL ASPECTS IN EFFICIENCY EVALUATION OF PUBLIC HOSPITALS

The specific characteristics of the public health care sector prevent the normal working of the market and the trend toward the efficient provision of services. The present study was carried out to offer the Audit Office of the Basque Country and Navarra an objective point of reference from which to measure the efficiency of clinical services. This study consists of an evaluation of the efficient production and utilization of the resources—intermediate services—that hospitals provide to medical staff for carrying out the diagnosis and treatment of patients, together with the efficient use of these intermediate services by the aforementioned medical staff.     

Do non-profit hospitals provide more charity care when faced with a mandatory minimum standard? Evidence from Texas

Policymakers often question whether not-for-profit (NFP) hospitals provide enough charity care to justify tax advantages. In 1993, Texas enacted legislation requiring NFP hospitals to provide certain community benefits at levels set forth in specific criteria to retain tax-exempt status; this paper focuses on the effect of the legislation’s requirement that NFP hospitals spend a minimum of 4% of net patient revenue on charity care. We also study a modification of the law passed in 1995, which allows the deduction of bad debts expense when calculating net patient revenue. This change effectively lowers required charity care spending, and our study considers whether Texas hospitals responded by reducing charity care spending.     

Management of frontline financial sales personnel

The employee turnover rate within the financial services industry is one of the highest among all industries. Studies demonstrate that a salesperson’s organizational commitment and propensity to leave are impacted by job satisfaction and emotional exhaustion. This study examines the relationships among emotional exhaustion, organizational commitment, propensity to leave and the facets of job satisfaction. Findings support that: (i) financial services salespeople’s propensity to leave is influenced by emotional exhaustion, (ii) emotional exhaustion is mediated by multi-faceted job satisfaction in predicting organizational commitment and (iii) the facets of job satisfaction are, in part, mediated by organizational commitment in predicting propensity to leave.     

微观经济个体参保行为对医疗费用支出的影响效应研究

本文根据2016年中国家庭追踪调查数据,运用面板数据回归方法和倾向得分匹配法(PSM)研究微观经济个体参保行为对医疗费用支出的影响。研究表明,城镇职工医疗保险参保行为显著提高了医疗总费用和自付费用,城乡居民医疗保险参保行为对降低医疗总费用和自付费用具有一定的积极作用,新农合参保行为显著降低了医疗总费用,对自付费用的降低具有一定的积极作用。运用PSM法解决内生性问题和消除选择性偏差后得到的净效应结果与上述发现基本一致。参保行为与医院等级的交互分析表明,选择社区诊所等基层诊疗机构就诊可显著降低医疗总费用和自付费用,选择综合医院就诊则显著提高医疗总费用和自付费用。此外,参保行为对医疗费用支出的影响具有个体和区域异质性。据此,建议增强基层医疗卫生服务能力,进一步提高统筹层次,推进公共卫生服务均等化。     

Profits with a purpose: an interview with Tom Chapman. Interview by Nancy A. Nichols

Greater Southeast Community Hospital is located in the center of one of Washington, D.C.'s most troubled and isolated neighborhoods. Like so many inner-city hospitals, it serves a population struggling with high rates of poverty, crime, and illiteracy. As a result, the area suffers from the highest rates of infant mortality, cancer, and coronary disease in the D.C. area. When Tom Chapman joined the hospital in 1984, it was giving away roughly 11% of its care-or about $11.5 million worth of medical services to indigent residents. If things continued at that rate, the hospital would soon go out of business. His challenge: to keep Greater Southeast solvent while shoring up the community that surrounds it. Chapman, who grew up in a housing project himself, understands the problems of inner cities innately. Working in tandem with community residents, Greater Southeast has developed a broad range of preventive and supportive programs, such as housing, day care for children and the elderly, nursing home services, and literacy training. Last year, Chapman was promoted to CEO of Greater Southeast Health Care, a broad network comprising two hospitals, three nursing homes, a physician care network, and over 50 community programs. He remains true to his original mission: "I want to create a network of participants, stringing together various organizations and players, each of whom have something special to contribute to urban problems.... What we are really doing is creating a community."     

The effects of big-bank presence on the profit efficiency of small banks in rural markets

Because big banks could impact competition in rural markets, we investigate the effects of big-bank presence on the performance of rural, small banks. When competing against a big bank, rural one-county banks operate at lower levels of proit efficiency, but with higher ROA and increased levels of interest and fee income from loans. Lower profit efficiency and higher returns in the rural markets suggest that big banks possess market power in rural markets and that they can extract rents to earn higher returns with lower than average profit efficiency. Therefore, small banks in rural markets should not fear large competitors. Conversely, customers who rely on loans from rural, small banks are negatively impacted by higher rates and fees on loans when a big bank is present in the market.     

农村社会养老服务需求现状及对策的实证研究

当前我国农村社会养老服务体系建立健全问题已经成为政府和理论界普遍关注的热点问题。对河南省六个地市的抽样调查显示,在农村社会养老服务需求层次中,经济保障是农村老年人最为迫切的需求,其次是生活照料需求,医疗卫生服务需求位居第三,最后是精神服务需求。在此情况下,要建立健全的农村社会养老服务体系,就必须大力发展农村老年经济保障、加快发展农村社区居家养老、充分发挥农村基层医疗卫生机构的功能、完善农村社区卫生服务体系、加快农村社区文体活动基础设施建设。     

社保基金资产对社区医疗服务机构建设及运营的投资研究

随着我国社会福利保障制度的不断完善及参加医疗保险人数快速增加，为广大医疗参保人员提供有效基本医疗卫生服务，成了社会医疗保险基金必须解决的客观现实问题。对此，广州市政府通过在行政区范围内，设置社区医疗卫生服务组织机构，为市民提供公共卫生和基本医疗服务，满足社区居民健康需求。然而，少子化政策实施及老年人口的迅速增加，面对目前养老机构条件严重不足情况下，必须发挥社区卫生服务机构的有效综合医疗作用。因此，本论文在设计社区医疗卫生综合服务机构运营体系模式基础上，提出加强社保基金资产对社区医疗卫生综合服务机构建设及运营的科学投资。     

Evolve and integrate: a new imperative for ambulatory care

A highly evolved ambulatory care delivery system possesses four key attributes: high-quality care, exceptional levels of access, outstanding patient and staff satisfaction, and cost-effective delivery of care. Such a system seeks to ease management of the patient care continuum by delivering as many services as possible under one umbrella. High-quality, cost-effective care is achieved through improved care coordination and cost management, resulting from a tight connection between physicians and hospitals and between inpatient and outpatient settings. Improved access is an important means to improving patient satisfaction.     

Delivering patient choice in English acute hospital trusts

The role of the patient within the NHS has changed from supplicant to consumer to active participant. A demand-side patient-led approach is combining quasi-consumerism and participative democracy to inform and facilitate patient choice. On the supply-side funding and incentives coupled to reform and performance will deliver additional hospital capacity and patient choice. This paper argues from both a demand and supply-side perspective that there is a large gap between the rhetoric and reality of delivering patient choice in acute hospitals.