整合照料视角下的老年家庭照护床位政策研究

作为嵌入式养老的创新模式，家庭照护床位是解决当前养老服务困境，推动养老服务体系高质量发展、精细化治理的重要举措。然而，当前的试点仍存在需求不足、供给乏力的双重困境。究其原因，主要在于对家庭照护床位认识不清、理解错位；政策实施中尚未有效解决社区居家养老服务资源碎片化问题，资源整合定位不准、整合层次低。基于此，本文提出回归家庭照护床位政策本色，强调其准市场化服务属性，明确其补充、协调、整合的功能定位，探索以街镇-社区为基点、以“养老管家”为媒介、以智能科技为支撑、以老年人住所为场域、以老年人个体为中心的服务终端功能性整合路径，完善配套激励相容机制、支付保障机制，推动实现 “医-养-康-护”一体化居家养老。     

我国老年护理人员从业现状及应对策略

随着我国的老龄化快速发展,老年人口的高龄化、空巢、失能趋势明显,老年护理从业人员的需求增加,目前老年护理人员供求严重失衡,护理人员素质较低,地区分配不平衡对老年护理业的发展带来极大的困扰。我国应从建立适合我国老龄化严峻形势下的老年护理人员制度,开展老年护理人员教育,加强职业态度培训,加大老年护理人员的政策扶持以及提高护理人员的社会地位等方面来建立一支专业素质强,职业素质高的老年护理人员队伍,促进我国的老年护理业更好地发展,从而让每个老年人拥有一个积极、健康、有爱的晚年生活。     

我国长期护理保险制度试点成效、问题和建议

全国长期护理保险制度试点在减轻失能老年人家庭经济负担、优化医疗资源配置、改善老人生存质量、促进康养产业发展、扩展就业渠道、解放社会劳动生产力等方面发挥了重要作用,但仍存在需完善的短板。扩大试点工作,应本着扎实稳步推进的总基调,着眼于建立独立制度,重点完善筹资、待遇政策体系;建立统一的护理需求认定和等级评定等标准体系;完善服务质量评价、定点机构协议管理和费用结算等办法;深化管理服务规范和运行机制。     

Implementation of quality programs in health care organizations

Any organization??s efforts to achieve continuous quality improvements must involve applying various quality related programs and tools. Such efforts are important for improving quality of products and/or services and increasing business performance. It is especially important for health care organizations as quality of care and service is a top priority. The focus of this study is on the implementation of quality programs which are based on tools, awards criteria, or standards to improve quality of care in the health care industry. Two hundred fifty-four hospitals with more than 100 beds that have quality programs were used to collect data for this study. Two of the most widely used quality programs were quality control (61.8?%) and total quality management (60.6?%). As widely known quality programs have shown to play a role in improving quality of care in the global health care market, some hospitals implement a combination of various quality programs to get certification or an award that helps them enter the international market such as medical tourism.     

城乡老年人医疗消费行为及其影响因素分析——以泰州市海陵区为例

论文为了了解影响老年人医疗消费行为的多层次原因,并据此对老年人医疗消费改善提供针对性的建议,随机抽取泰州市海陵区416名常住老年人,进行医疗消费行为及影响因素的调查,同时采用SPSS软件进行描述分析、卡方检验等分析。结果显示,泰州市海陵区老年人去医疗机构就诊占60.6%,去药店买药占34.4%,先不治疗占5%。卡方检验结果显示影响因素主要有户籍、年龄、收入以及受教育水平、市场环境。因此,泰州市海陵区老年人医疗消费行为以去医疗机构就诊为主,医疗消费行为主要受户籍、年龄、收入、受教育水平等因素的影响。老年人的身体健康状况较差,患慢性病的老年人较多,对医疗保健的需求较大,应大力发展老年医疗服务行业,提高老年医疗资源的有效供给。     

居家养老服务体系财税政策空间及顶层设计--基于上海市的实证研究

财税政策是养老服务财政责任的重要工具变量;政策路径与财力支持能力是核心,直接关系服务体系建设与发展。上海是中国老龄化最突出的地区。本文以问题为导向,基于实际调查与老龄人口服务需求预测;通过居家养老服务财税政策空间及财政支持能力关联分析,从“财税、社保、民政福利”财力统筹及“养、医、康、护、住”服务融合的全局,设计与经济社会发展相适应、满足老年服务需求以及发挥财税政策效能三者相协调的财税支持政策顶层框架,并进行政策效果模拟,制定财税政策分步实施路线。     

黑龙江省物流企业服务质量探析

黑龙江省物流产业正处于起步之后的上升态势,各类商品物资外运数量庞大,物流业市场需求较旺,有较好发展潜力和空间,然而要发展物流则服务需先行。以顾客感知物流服务质量为主线,结合前人对相关内容研究的理论和调查结果,分析出影响黑龙江省物流服务质量的五个维度,且这五个维度之间为并列关系。黑龙江省物流企业可以从订购质量、定制化服务质量、回应质量、交付质量、误差处理质量等方面增强物流服务质量,从而满足多样化的物流发展服务。     

An integrative model of customers' perceptions of health care services in Taiwan

As the health care service gets more competitive, health care practitioners and academic researchers are increasingly interested in exploring how patients perceive the quality and value of their care before building up their satisfaction levels and generating behavioural intentions. Drawing some theories from marketing and health care service literature, this study tries to propose an integrative model of customers' perceptions of health care services based on the established relationship among four key constructs (service quality, perceived value, satisfaction, and behavioural intentions). Structural equation modelling is then used to validate the model. As Taiwan's universal health insurance offers every citizen equal financial access to all health care providers, Taiwan offers a good opportunity to study how the patients' perception model is structured. The findings reveal both perceived quality and value as antecedent variables in this model illustrating direct and indirect paths from perceived quality and value to patient satisfaction and behavioural intentions.     

Forecasting intermittent demand for inventory management by retailers: A new approach

The forecasting of intermittent demand is a complex task owing to demand fluctuations and interval uncertainty. Intermittent demand is essentially random demand with a high percentage of zero values. In the retail industry, there are many products which face intermittent demand and this poses a problem of inventory management. This study proposes a Markov-combined method (MCM) for forecasting intermittent demand, which takes into account the inventory status and historical sales of products. We divide the prediction process into two stages. In the first stage, the transition probabilities of the four basic states of demand and inventory are calculated. In the second stage, the corresponding and appropriate prediction method is selected according to the predicted state. Further, using two large datasets from the two biggest e-commerce companies in China, we verify our results and show that the MCM forecasts more accurately than the Single Exponential Smoothing (SES), Syntetos-Boylan Approximation (SBA), and Croston (CR) methods. The MCM can be as an alternative method for forecasting intermittent demand because it is easy to compute and typically more accurate than the classical forecasting methods.     

Kapazitätsauslastung im Ausland als Indikator für die deutschen Investitionsgüterexporte

The German export industry has traditionally specialised in the supply of capital goods. For this reason, forecasting the exports of capital goods is not only useful for fi rms operating in this sector but also for forecasting total German exports. An important determinant of the demand for capital goods from a theoretical point of view is capacity utilisation. We present an indicator of capacity utilisation in countries that import German goods and show its usefulness for forecasting German capital goods exports. Thus, this indicator is a valuable complement to the set of indicators available for forecasting German exports.     

Selecting an Optimal Region by Fuzzy Group Decision Making: Empirical Evidence from Medical Investors

Since China opened its medical services market in 1989, its health care industry has become the focus of international investment. This study employs the fuzzy analytic hierarchy process to establish an evaluation model of optimal region selection for joint-venture hospitals or clinics in China. On the basis of the combined perspectives of thirty experts, this study adopts six criteria and nineteen sub-criteria for selection. It considers the Surrounding Bohai Bay (SBB), Yangtze River Delta (YRD), Pearl River Delta (PRD), and other economic zones as potential locations for the establishment of medical institutions. The findings reveal that government policies, demand conditions, and investment strategy are relatively highly weighted criteria. The order of priority for economic zone selection is as follows: YRD, PRD, SBB, and other economic zones. These results can help foreign investors in selecting appropriate investment regions.     

奢华养老？

很难将这里同传统的“养老院”联系在一起：位于寸土寸金的京城CBD南区，甫一走进便是宽敞的酒店式大堂，影音室、书画室、图书馆、健身房、康复室、电脑室、艺廊等一应俱全，这些公用面积约占到总面积的40％－50％。房型有单人间、双人间、卧床老人间等，均是为老人量身打造。     

The Impact of Demand Management on Service System Performance

Reports of overbuilding in the lodging industry, closings of hospitals, bankruptcies of fast-food chains, and acquisitions of debt-ridden airlines are strong signals that demand management problems exist in service industries. The phenomenal growth experienced by the total service sector has masked these problems somewhat. When the differential between lagged demand and service capacity supply becomes significant, efficiency, productivity, utilisation, service quality, and profitability decline.     

Determinants of knowledge management system adoption in health care

The demand for efficient knowledge management (KM) in health care is increasing because the complexity and scale of the knowledge generated from medical research and clinical practices have resulted in challenges of information overload and medical quality. These critical issues can be improved through the adoption of knowledge management systems (KMS). However, the adoption of technological innovations in health care demands an enhanced understanding of the lagged technology adoption status in the health care sector. This study uses empirical methods to investigate the determinants of KMS adoption on the basis of a national survey. Results suggest that KMS adoption is affected by organizational characteristics, KM enablers, and KMS characteristics. We emphasize that KMS adoption in health care is considerably complex because it largely depends on KM enablers and organizational characteristics and not solely on system characteristics. The implications of the findings for research and practice are outlined in this work.     

农村市场信息供给失衡问题研究

文章从供给主体和需求主体的行为入手,分析了导致我国农村市场信息供给失衡的逻辑机理,从而得出我国自上而下的供给决策机制,导致的需求主体话语权缺失,需求评判机制失灵,供给主体动力不足,才是问题的根源。以此为逻辑起点,提出创立供求有效互动的服务模式,发挥需求评判的作用,真正建立起地方政府的内生动力,自觉地改善服务质量,从而促进农村市场信息供给失衡问题的有效解决。     

Effects of hospital leadership,organizational systems,and ESWOS on medical error reduction

One of the major elements of care quality provided by health care organizations is the reduction of medical errors. This study empirically examines the effect of leadership, organizational systems, and employee satisfaction with organizational support on medical error reduction. A set of hypotheses is tested based on data collected from 208 medical staff of hospitals with more than 300 beds in South Korea. Data were analyzed by confirmatory factor analysis and path analysis using SPSS 17.0 and Mplus 5.1. One of the major findings of this study was that medical error reduction could be achieved by effective leadership. Leadership and operational efficiency drive reduction in medical errors in the health care industry. The comparison between large- and small-sized quality assurance teams’ roles indicated that there was a significant difference in their effect on medical error reduction. The results of the study shed light on some practical implications for management professionals in hospitals.     

加快江苏现代服务业人才队伍建设的思路与建议

在服务业领域,人才素质决定着产业素质,人才层次决定着产业层次,人才密度决定着产业高度。围绕人才队伍规模、结构、层级等问题,文章对江苏省现代服务业人才队伍建设情况进行了实地调查和深入分析。研究表明,江苏现代服务业人才队伍建设已取得一定成效,但与现代服务业快速发展的需求相比,江苏省人才队伍建设存在着以下几方面的问题:人才队伍建设滞后于现代服务业发展,现代服务业人才队伍建设面临众多因素制约,人才结构不合理问题逐渐凸现,现代服务业人才的供给约束逐渐凸现。为此,应不断完善现代服务业人才队伍建设政策支持体系,促进现代服务业规模扩张与产业升级。     

How policy is shaping the macro healthcare delivery supply chain: The emergence of a new tier of retail medical clinics

The healthcare industry continues to face substantial pressure to simultaneously improve costs and patient centricity. Much of the focus to date has concerned policy interventions capable of improving these performance measures for traditional healthcare providers, such as hospitals. But recently, nontraditional healthcare providers like Walmart Health and Amazon have made forays into the industry by establishing retail medical clinics (RMCs). These efforts constitute a redistribution of how services are organized across the macro healthcare delivery supply chain. While RMCs stand to bring innovative models of service delivery to patients, the policy environment can both enable and inhibit their involvement in the industry. We develop a framework that explains how structural and conduct regulations have historically influenced demand for and supply of healthcare services. We then describe how these regulatory factors can support nontraditional healthcare providers as they launch innovative service delivery models aimed at efficiency and customer centricity.     

我国公立医院审计委员会制度构想

在建立以理事会为核心的公立医院法人治理改革框架下, 加强医疗卫生综合监督体系的顶层设计至关重要. 本文因循国外医疗机构审计委员会近40年的治理现实和我国上市公司引入审计委员会制度10多年的成功经验, 提出应在公立医院试行并推广审计委员会制度的设想. 论文构建了一个新医改前后公立医院审计供需均衡的基本经济学模型, 据此进一步分析了我国公立医院设立审计委员会的现实需求和可行供给, 并就我国公立医院施行审计委员会制度提出了相关建议.