我国公立医院固定资产管理中存在的问题与对策研究

医院固定资产管理对医院的生存和发展起着非常重要的作用，由于现行的医院财务制度和固定资产管理制度已经不适应当前社会的发展，致使公立医院的固定资产管理工作存在很多问题。针对我国公立医院固定资产管理的现状和问题进行了分析，并针对问题的解决提出了相应的政策。     

基于HRP构建医院固定资产全生命周期管理体系

借助于医院资源规划（Hospital Resource Planning,HRP）可以实现医院固定资产全生命周期管理。以北京大学人民医院HRP系统为案例,对从资产采购申请至报废处理的全流程优化改造的特点和效果进行研究。通过企业资源规划（Enterprise Resource Planning,ERP）系统、OA系统与设备维护管理系统的整合,可以提高固定资产管理效率,为医院发展奠定坚实的物质基础。医院可以借鉴此模式实现固定资产精细化管理。     

新财务会计制度下医院成本核算的探讨与实践

卫生部和财政部于2010年对原有的《医院财务制度》和《医院会计制度》进行了全面修订,实现了与企业会计准则部分接轨。与此相对应的是,已经开展全成本核算工作的医院,需要根据新的制度对成本核算的相关内容与细节进行相应的调整与完善。原有的《医院财务制度》和《医院会计制度》对成本核算的相关规定非常笼统,只是初步提出了医院需要进行成本核算,成本对象的划分不够科学,对医院开展成本核算工作缺乏现实指导意义。新的《医院财务制度》对医院开展成本核算工作起到了明确的指导作用,充实了成本分析和控制的内容。通过分析新的《医院财务制度》和《医院会计制度》在成本核算方面所涉及的变化与调整,结合成本核算的实践经验,对相关问题进行了深入的研究与探讨。     

医院经营管理若干问题的思考

该文对目前医院经营管理中存在的模糊观念进行了一些理论探讨。包括医院的经营目标、关于卫生服务需求弹性、关于医院产权制度改革、关于医院经营管理的思路,对于医院在不追求利润最大化的前提下,如何最大限度地满足广大人民群众健康的需求提出了粗浅意见。     

医院经营管理若干问题的思考

该文对目前医院经营管理中存在的模糊观念进行了一些理论探讨。包括医院的经营目标、关于卫生服务需求弹性、关于医院产权制度改革、关于医院经营管理的思路,对于医院在不追求利润最大化的前提下,如何最大限度地满足广大人民群众健康的需求提出了粗浅意见。     

泌尿外科手术后引流袋更换时间的研究进展

<正>泌尿外科手术后患者常需留置导尿管、肾或膀胱造瘘管以及腹腔引流管,连接这些管道的引流袋应该间隔多久更换,一直是困扰医院感染管理者与临床护理人员的一个难题。目前关于引流袋更换频率的结论不统一,护理教材及各医院规定更换引流袋的时间也不尽相同[1~4],因此,许多研究者对引流袋的更换时间进行了探讨。现作者就泌尿外科术后常见引流管连接的引流袋更换时间的研究进展综述如下。1留置尿管集尿袋更换时间     

促进药物科学管理的策略分析

近年来,随着我国医药事业的发展,很多新医药进入市场和各大医院,随着药物种类的增多,安全用药和药物科学管理的重要性随之凸显,因此,加强医院的药物科学管理,合理使用临床药品,是保证医药安全的重要措施。医护人员和药品管理人员作为药物的使用人员和储存人员,是药物管理的重要人员,笔者以自身在医院的多年工作经验,结合《中华人民共和国药品管理法实施条例》的相关规定,提出医院药物科学管理的方法及策略,希望对医院的工作人员有所帮助。     

基于杜邦模型的非营利性医院财务状况宏观分析

目的 通过对我国非营利性医院财务状况的分析,评估非营利性医院资金运营状况。方法 运用经典财务分析系统——杜邦模型对全国非营利性医院2002—2007年财务年度指标进行计算和分析。结果 非营利性医院固定资产快速增加,业务收支结余为负,净资产收益率大都为负值,医院基本处于亏损经营状态。结论 现阶段非营利性医院成本快速上升是造成亏损的主要原因,医院仍然处于“粗放”式经营阶段。     

疾病诊断相关组在医院绩效评价中的应用探讨

目前,尽管国内外关于医院绩效评价的研究较多,但普遍存在评价结果缺乏可比性的不足。其主要原因是不同医院收治的疾病类型不同、治疗难度和风险差别较大。基于DRGs的医院绩效评价方式为研究打开了思路。本文在明确当前公立医院绩效评价内容的基础上,指出了基于DRGs开展医院绩效评价的两个条件,即统一优质的数据和完善的信息系统,阐述了评价的三个维度,即医疗服务产出、效率和质量,并就上述三个维度内的相关评价指标的计算方法进行了说明。本文最后给出了基于DRGs开展医院绩效评价的五点现实意义:一是有助于优化医院内部成本结构;二是有助于规范科室临床路径工作;三是创新科室或医生的绩效考核方式;四是形成政府与医院间的长效监管机制;五是有助于探索DRGs付费模式在全国的推广。     

2005—2009年我国中医医院资源情况分析

医院资源主要包括人员、床位、医疗设备、固定资产等。通过对2005—2009年我国中医医院机构数、床位、人员、固定资产等资源情况进行分析,并与综合医院进行比较,找出存在的问题,以期为“十二五”中医医院的发展提供参考。数据均来源于2005—2009年卫生部《中国卫生统计年鉴》和国家中医药管理局《全国中医药统计摘编》。     

Stochastic models of some endemic infections

Stochastic models are established and studied for several endemic infections with demography. Approximations of quasi-stationary distributions and of times to extinction are derived for stochastic versions of SI, SIS, SIR, and SIRS models. The approximations are valid for sufficiently large population sizes. Conditions for validity of the approximations are given for each of the models. These are also conditions for validity of the corresponding deterministic model. It is noted that some deterministic models are unacceptable approximations of the stochastic models for a large range of realistic parameter values.     

Variances and Asymptotic Distributions of Direct Standardized Rates

Formulas for the variance of direct standardized rates are given for three different sampling models. The three models are product multinomial models when population totals are fixed by design, or strata totals are fixed by design, or cell (each population—each stratum) totals are fixed by design. Asymptotic distributions are derived for each model. A discussion on the relevance and use of standardized rates and the need for distribution theory is also provided.     

Linear regression analysis of censored medical costs

This paper deals with the problem of linear regression for medical cost data when some study subjects are not followed for the full duration of interest so that their total costs are unknown. Standard survival analysis techniques are ill-suited to this type of censoring. The familiar normal equations for the least-squares estimation are modified in several ways to properly account for the incompleteness of the data. The resulting estimators are shown to be consistent and asymptotically normal with easily estimated variance-covariance matrices. The proposed methodology can be used when the cost database contains only the total costs for those with complete follow-up. More efficient estimators are available when the cost data are recorded in multiple time intervals. A study on the medical cost for ovarian cancer is presented.     

New Staphylinidae (Coleoptera) records with new collection data from New Brunswick, and an addition to the fauna of Quebec, Canada: Aleocharinae

Thirty-eight species of Aleocharinae are newly reported from New Brunswick, bringing the total number of species known from the province to 216. Thirty-one of these species are newly recorded for the Maritime provinces, and four of them, Phloeopora oregona Casey, Gyrophaena michigana Seevers, Gyrophaena wisconsinica Seevers, and Tomoglossa decora (Casey), are newly recorded for Canada. Tomoglossa constitutes a new generic record for Canada. Collection and habitat data for all these species are presented and discussed. Color habitus, median lobe of the aedeagus, and male tergite and sternite 8 images are presented for the first time for Phloeopora oregona, and references to illustrations are provided for all other species included in this paper. A color habitus image is presented for Tomoglossa decora.     

Wood, bark and stem anatomy of New World species of Gnetum

Quantitative and qualitative data are presented for 11 collections of six species. The wide range of character states for the species is presented in the form of a key to emphasize their potential systematic correlations. Distinctive among these are phcllem characteristics. Fibre-tracheids are newly reported for lianoid Gnetum species. Cells previously thought to be like companion cells in secondary phloem are shown to be uniseriate rays, counterparts to uniseriate xylem rays. Laticifers are abundant in most of the species, and are newly described for secondary tissues of Gnetum. Presence of tyloses in laticifers of two species is apparently a new report for vascular plants. Tori are present in two New World Gnetum species, adding to the report in African species. Perforation plates are simple except near or in primary xylem, where they are simple or foraminate. Torus presence and foraminate perforation plate presence are features more reminiscent of Ephedra and other gymnosperms than of angiosperms. The bark of Gnetum is also very similar to that of Ephedra.     

Estimatingdendroctonus frontalis (Coleoptera: Scolytidae) daily infestation dynamics

Summary Mathematical procedures are given to estimate infestation totals and daily life stage arrivals, departures, and mortality ofDendroctonus frontalis Zimmermann for an infested tree in the field. These estimates are based on minimal sample data and are designed to utilize all available information. Daily arrival estimates for larvae, pupae, and callow adults are obtained by indirect analysis without direct observation of these stages. The procedures are applied to 147 infested trees, and the results are transformed to a common time basis to obtain daily expectations by life stage for an “average” tree. These expectations suggest optimal times for field sampling or relative times of sampling when optimal times are missed. Expected daily arrival distributions by life stage for a single egg and a single attacking adult are given. Procedures are given for utilizing collateral information to obtain an infestation total and daily arrival estimates for a boundary life stage. The results of this study are applicable to anyD. frontalis field study, and the procedures given are applicable to any bark inhabiting insect having similar habits.     

Method agreement analysis: A review of correct methodology

The correct approach to analyzing method agreement is discussed. Whether we are considering agreement between two measurements on the same samples (repeatability) or two individuals using identical methodology on identical samples (reproducibility) or comparing two methods, appropriate procedures are described, and worked examples are shown. The correct approaches for both categorical and numerical variables are explained. More complex analyses involving a comparison of more than two pairs of data are mentioned and guidance for these analyses given. Simple formulae for calculating the approximate sample size needed for agreement analysis are also given. Examples of good practice from the reproduction literature are cited, and common errors of methodology are indicated.     

Comparative biogeography of mammals on islands

Insular faunas of terrestrial mammals and bats are examined on a worldwide basis to test the adequacy of equilibrium and historical legacy models as explanations for species-area relationships. Species numbers of bats on islands conform to predictions from equilibrium theory, whereby recurrent immigrations and extinctions influence species richness. By contrast, species numbers of terrestrial mammals on islands result from a historical legacy of very low immigration rates on oceanic islands (the faunas are colonization-limited) and by the fragmentation of once contiguous continental faunas to form relictual populations, which subsequently undergo extinctions, on landbridge islands (the faunas are extinction-limited). This explanation is supported by several lines of evidence: (1) z values (slopes of species-area curves) are lower for non-volant mammals on oceanic islands than for those on landbridge islands, but are the opposite for bats; (2) z values for non-volant mammals are lower than those for bats on oceanic islands, but are higher than those for bats on landbridge islands; and (3) landbridge island faunas are attenuated mainland faunas, whereas those on oceanic islands are ecologically incomplete. No support is found for alternative hypotheses to explain low species-area slopes for terrestrial mammals on oceanic islands.     

Continuous fermentation systems for alcohol production

Many batch fermentation processes are operated throughout the world for the production of alcohol (ethanol) from sugar-based feedstocks but very few truly continuous processes are in operation. This review compares the two modes of operation and some advantages of the continuous processes are examined. Possible markets for continuous processes are identified and some possible explanations for the, as yet, lack of wide acceptance of continuous processes are offered. Seven different commercially available processes are reviewed.