风流闲雅《珠玉词》

晏殊《珠玉词》之艺术特色,前人公认为风流闲雅,这一风格的形成主要得益于清新淡雅的意象、华美明丽的色彩、珠圆玉润的声韵、和谐动听的词调。     

Performance of French intensive care units: A directional distance function approach at the patient level

By using a novel adaptation of the free-disposable hull analysis of productivity, we assess the medical and technical efficiency of patient care in 25 Parisian intensive care units (ICUs) during 2000. The robust free disposable hull (RFDH) as defined by [Cazals et al., 2002. Nonparametric frontier estimation: a robust approach. Journal of Econometrics 106, 1–25] reduces the impact outliers may have on findings by employing Monte-Carlo techniques and repeated sample selection. Among our key findings, there was no overall significant correlation between medical and technical efficiencies for all the ICUs, therefore performing well in one does not guarantee good performance in the other. We also found that over 80% of inefficiency is concentrated in less than 20% of the sampled patients.     

私人部门在满足医疗需求方面的作用（上）

本文就私人部门在满足医疗需求方面的作用进行分析,认为如果私人部门能够得到有效监管,并按照社会道德认同的方式进行运转,一国医疗体系就能够受益于私人部门。本部分探讨了医疗体系的基本功能及其目标,介绍了绝对平均主义、两阶层医疗体系和多阶层医疗体系三种分配医疗服务的观点,指出当前用货币价值衡量医疗产出价值是次优选择;而衡量医疗服务分配效率也存在争议。     

黄山市城乡养老服务体系建设情况调研

21世纪的今天,发展已经成为时代的主题,随着经济与社会的快速发展,人口老龄化的步伐也随之加大。养老是民生之本,养老问题已成为政府和全社会关注的焦点,"十二五"规划提出要坚持把完善社会养老服务体系放在经济社会发展的优先位置,因此,应把城乡养老服务体系建设作为推动社会福利事业建设的重点。城乡养老服务体系建设在加强政府的主导作用同时要引导社会力量积极参与,实现城乡养老服务体系建设的科学发展。本文以黄山市为例,分析城乡养老服务体系建设实施的现状以及所面临的问题,并根据调查结果提出相关建议。     

Audit as Leviathan: Constructing Quality Registers in Swedish Health Care

This paper explores the rise of an audit practice: the national quality registers in Swedish health care. Based on actor‐network theory, the study tells the story of an actor‐network formed by physicians in the 1970s who mobilized themselves around a common object; to develop the knowledge‐base of medical professionals. However, over time more actors became persuaded of the potential of the network and associate themselves with it, resulting in reformed registers. The study shows how the network develops into a macro‐actor, a Leviathan in health care, how this macro‐actor comes to affect health care practices and how it contributes towards maintaining a new governance regime.     

Accounting and Medicine: An Exploratory Investigation into Physicians’ Attitudes Toward the Use of Standard Cost-Accounting Methods in Medicine

Research studies demonstrate wide variation in how physicians diagnose and treat patients with similar medical conditions and suggest that at least some of the variation reflects inefficiencies and unnecessary medical costs. Health care researchers are actively examining ways to reduce variations in practice through standardization of medicine to reduce the cost of treatment and ensure the quality of outcomes. The most widely accepted form of this standardization is Evidence Based Best Practices (EBBP). Furthermore, financial health care providers such as hospitals and managed care organizations are investigating methods to tie resource usage to medical protocols in their efforts to monitor and control health care costs. Such proposals are contentious because they report on physicians’ medical practice behaviors (such as the number of tests ordered, use of specific therapies, etc.) and such reports could potentially be used to influence their clinical behaviors. The intent of this exploratory study was to examine physicians’ perceptions about linking a standard costing system to EBBP guidelines. The authors interviewed nine practicing physicians asking each physician to respond to the question, ‘As a physician working in a hospital environment, what are your reactions to and concerns with combining standard costing techniques with EBBP?’ The interviews were in-depth and free form in nature. The physicians’ responses were recorded and analyzed using Grounded Theory Methodology. Using this methodology the field data was categorized into two major themes. The most important theme centered on ethics and the second theme was concerned with the implementation and use of a standard cost system in regard to EBBP. If physicians’ worries about ethical dilemmas and implementation issues are not resolved, then it is likely that doctors would be unwilling to participate in any efforts to develop or use a standard cost-reporting system in medicine. While this study was exploratory in nature, it should provide future guidance to accountants, health care researchers and health care providers about physicians’ issues with the use of standard costing methods in medicine.     

Representational Approaches Matter

This paper raises the question of how ethical issues arising out of social inequities involving international business in developing countries can be represented, and articulates a conceptual framework that identifies and maps four different approaches to representing or making sense of such issues. A fieldwork-based case study on the child labor issue in Pakistan’s soccer ball industry illustrates the argument that representational practices do matter, and that when representational approaches go awry, they end up savaging the well-being of the poor in the developing world. Farzad Rafi Khan holds a Ph.D. in Management from McGill University. He is currently an Assistant Professor at the Suleman Dawood School of Business, Lahore University of Management Sciences, Pakistan.     

An evaluation of consumer participation in hospital breast services

Community expectations and research demonstrate that consumers play an important role in shaping services for women with breast cancer. Consumer contribution has been mandated recently in Victoria, Australia, to ensure the inclusion of consumer involvement in the planning and decision‐making processes within health organizations. As part of the redevelopment of breast services in Victoria, Southern Health has been funded to plan local improvements to care co‐ordination for women diagnosed with breast cancer in the southern metropolitan area of Melbourne. The establishment of effective consumer participation in breast services is an integral aspect of this project and a range of initiatives has been undertaken to achieve meaningful consumer involvement including the appointment of a consumer advisor; appointment of staff with extensive knowledge in women's health and community development to the project; establishment of a consumer reference group; and plans made to improve the receptivity of health service systems to consumer input. A preliminary evaluation of this ongoing project has indicated that a productive role for consumers in service practice review and policy and planning activities has been established and some change and engagement of staff has occurred. There is still work to be done to promote the involvement of a wider range of health professionals and to increase the level of trust between consumers and staff.     

非理性就医对医保费用管理的挑战及应对策略

目的分析参保患者非理性就医现象,积极探索应对策略,为控制不合理增长的医疗费用提供参考。方法结合我院医保工作中对医保基金正确合理使用的管理及参保患者的就医情况,分析近年来参保患者非理性就医的现象、原因及结果,探索应对策略,总结规范化管理的措施。结果小病大治、大病贵治、无病保养等是非理性就医的主要表现,严重影响医保费用的管理,助推了过度医疗和医疗费用的不合理增长。结论应落实国家医药卫生体制改革,完善配套的医疗保险政策,深化医院医保费用管理,科学控制基本医疗付费总额,控制医疗费用不合理增长,从而保障医保基金的安全使用。