人工智能应用于青光眼临床筛查及卫生效益分析

目的:探讨应用人工智能系统对青光眼患者的检出率、筛查的时间成本和经济成本,总结分析其应用于青光眼筛查的优越性与可行性。方法:回顾性研究。收集2019-2020年使用腾讯觅影眼底照片辅助诊断系统进行青光眼筛查的53700例受检者,2012-2018年使用北京同仁医院眼科研究所远程眼科会诊中心的493221例患者,邯郸眼病研究中接受基础眼病筛查的6716名受检者资料。评价人工智能筛查系统对青光眼的检出率,并采用Pearson x~2检验,比较人工智能筛查系统与远程阅片平台、基础眼病筛查对于青光眼检出率的差异,并对三种筛查方式的时间成本和经济成本进行比较分析。结果:临床应用表明,其成本效益的可靠数据及主要指标:检出率、x~2值、时间成本、经济成本等效益显著。人工智能筛查系统对青光眼的检出率为6.56%,远程眼科会诊平台的检出率为2.78%,邯郸眼病研究的检出率为1.70%,人工智能筛查系统与另外两种模式对青光眼诊断检出率的差异有统计学意义(P0.05)。而且使用人工智能筛查系统的患者其医疗时间成本和经济成本花费较低。结论:可行性分析表明,相较于远程眼科会诊平台和基础眼病筛查,人工智能筛查系统对青光眼的检出率较高,同时患者的时间成本和经济成本都得到了大幅度降低,这为青光眼筛查提供了一种有效而快捷的方式,值得临床推广。     

基于物联网技术的医疗设备管理

医疗设备管理是医院内部管理的重点之一,影响着整个医院的综合管理水平。传统的医疗设备管理方法在越来越多的设备和越来越大的资产金额面前容易造成管理工作量大、设备利用率低下、资产盘点困难甚至设备流失等问题。对医疗设备管理现状进行了探讨,在考虑成本的前提下设计了一个新型的基于物联网技术的设备管理系统。此系统根据设备的价值高低分为高值设备管理系统、中高值设备管理系统和低值设备管理系统3个子系统和一个控制中心。3个子系统拥有同一个控制中心,统一对设备的出入库、维修、调配等进行管理。系统正在深圳市人民医院进行实施部署,将有效提升医院设备管理效率。     

基于医疗成本项目标准化核算的成本控制研究

首先对医疗成本项目进行分类标准化处理，统一和规范医疗作业成本项目；在此基础上借助作业成本法，通过对医疗项目的价值分析与优化，达到节约卫生资源，控制医疗成本的目的；最后，通过实例和数学模型证明医疗成本项目标准化核算下的医疗成本控制的有效性。     

医院医疗设备管理存在的问题及对策初探

现代医院的生存与发展离不开优秀的医务工作者,更需要高精尖的医疗设备进行辅助。医院医疗设备主要包括诊断设备、 治疗设备及辅助设备。先进的医疗设备不仅为医疗水平的提高提供了有力保证,同时也是医院实力的体现。近年来医疗机构改革 不断深入,大部分医院均加大了在先进医疗设备上的投资,但在医院的现代化建设中,医疗设备管理存在诸多问题,包括设备管 理人员稀缺、配置不均衡、重用轻管、制度监管不严等,这些问题如不能及时解决,可能会导致设备仪器诊疗结果不准确,进一步 影响患者的病情恢复,损害医院的经济效益及社会效益。2011 年我国卫生部公布的《医疗卫生机构医学装备管理办法》中,规定医 疗卫生机构的医学装备管理实行机构领导、医学装备管理部门和使用部门三级管理制度,为医院医疗设备管理进行了规范。本文 对医院医疗设备管理常见的问题进行分析总结,并提出一系列改善措施,以期为医院医疗设备实现科学化管理,及长期、安全、有 效使用提供参考,提升医院服务质量,增加医院经济效益及社会效益。     

基于7所三甲医院数据的血液透析成本测算与分析

目的 通过对7所三级甲等医院血液透析医疗成本的测算和成本构成分析,找出成本构成的主要因素。方法 回顾性调查,分别采用传统成本法和作业成本法对血液透析的直接医疗成本和间接医疗成本进行测算。结果 成本构成中直接医疗成本占总医疗成本的比重最大,为36.68%,其中6所医院的血液透析收费标准低于成本,是血液透析成本的89.35%（均值）。结论 透析液和一次性材料应成为成本控制的重点,调整血液透析收费标准和调整支付方式已经成为可能。     

许昌市新生儿接种乙型肝炎疫苗的成本效益分析

目的分析1992—2015年许昌市新生儿乙型病毒性肝炎(乙肝)疫苗接种成本效益,为乙肝的预防和控制策略提供经济学依据。方法运用成本效益分析方法,对许昌市新生儿乙肝疫苗接种总成本、成本效果、成本效益和成本效用进行测算及分析。结果许昌市对新生儿乙肝疫苗免疫接种投入成本2 263.84万元,获得总经济效益138.29亿元,净效益138.06亿元,效益成本比为601.26∶1。共减少乙肝病毒表面抗原阳性携带者114 320例,慢性乙肝11 432例,肝硬化1 143例,肝癌114例,成本效果比为196.84∶1。共挽回65 992.97个失能调整寿命年(DALY),成本效用比为345.06∶1。结论许昌市实施新生儿乙肝疫苗预防接种的经济效益和社会效益非常显著。     

智慧化医疗设备管理系统的研究与应用

??????? 目的 科学管理各种医疗设备,充分发挥其作用,避免造成资源浪费。方法 针对医疗设备的管理现状,提出了基于实时定位系统的智慧化医疗设备管理系统的研究与应用。结果 基于实时定位系统的智慧化医疗设备管理系统将基于无线个域网、无线射频识别的无线传感网络技术、实时定位系统技术与临床信息系统进行有效集成,实时动态感知设备运行状态、位置,有力提升了医疗设备的智慧化管理程度,改善了医疗工作流程与效率,提升了设备使用价值,为单机成本核算等精细化管理提供了技术基础。结论 基于实时定位系统的智慧化医疗设备管理系统的应用能够给医院的医疗设备管理带来管理效益、经济效益和社会效益。     

关于苏北地区某三甲医院进口与国产医疗设备和耗材使用情况及反馈的研究．

目的：初步了解了进口与国产医疗设备与耗材的发展状况和使用反馈情况,并对国内医疗设备与耗材行业的发展提供合理化建议。方法：通过对苏北地区某三级甲等医院设备科工作人员、医生、护士长、患者及患者家属进行调研或访谈,并以调研和访谈的统计结果为依据得出结论并提出建议。结果：技术成熟的中小型医疗设备或耗材,从质量、价格等因素综合考虑,国内产品优于进口产品,一定程度上得到了医务人员和消费者的认可。在高端大中型医疗设备与耗材方面,进口产品具有较大的技术优势。结论：国内医疗设备生产企业应当积极开展研发工作,提高产品的技术含量与质量,巩固自身在中小型医疗设备与耗材方面的优势,并努力在高端大中型医疗设备与耗材方面取得突破。     

浅谈医疗设备维修管理模式与实践

随着医疗事业单位的不断发展和完善,大部分医院都具有较为完善的医疗设备,可协助医生完成诊断及治疗工作。为降低医疗设备的维修成本,方便就诊,提高医疗质量,本文主要探讨医疗设备维修管理模式与实践。     

关于苏北地区某三甲医院进口与国产医疗设备和耗材使用情况

目的:初步了解了进口与国产医疗设备与耗材的发展状况和使用反馈情况,并对国内医疗设备与耗材行业的发展提供合理化建议。方法:通过对苏北地区某三级甲等医院设备科工作人员、医生、护士长、患者及患者家属进行调研或访谈,并以调研和访谈的统计结果为依据得出结论并提出建议。结果:技术成熟的中小型医疗设备或耗材,从质量、价格等因素综合考虑,国内产品优于进口产品,一定程度上得到了医务人员和消费者的认可。在高端大中型医疗设备与耗材方面,进口产品具有较大的技术优势。结论:国内医疗设备生产企业应当积极开展研发工作,提高产品的技术含量与质量,巩固自身在中小型医疗设备与耗材方面的优势,并努力在高端大中型医疗设备与耗材方面取得突破。     

Determining the filtration efficiency of half-face medical protection mask (N99) against viral aerosol

Hospital-based outbreaks of severe acute respiratory syndrome (SARS) have once again highlighted the vulnerability of healthcare workers (HCWs). Use of personal respiratory protective equipment was the main method used by HCWs to avoid nosocomial transmission. This paper describes the technology used to evaluate the filtration efficiency of the half-face medical protection mask (N99), manufactured by Firmshield Biotechnology, against viral aerosol. Viral aerosol was generated and then sampled simultaneously with and without the test mask. This enables a percentage efficiency value to be calculated against test phage f2 aerosols (surrogates of viral pathogen aerosols). At the same time the mask filtration efficiency against NaCl particle aerosol was determined by use of TSI8130 equipment and face-fit factor was tested by use of TSI8020 equipment. The half-face medical protection mask (N99) evaluated by use of the viral aerosol had a filtration efficiency >99%. The mask filtration efficiency against NaCl particle aerosol was 99.634 ± 0.024% and it had a good face-fit factor. This half-face medical protection mask (N99) can protect the wearer from viral aerosol disease transmission. The test method can be used to assess filtration efficacy against viral aerosol of masks used for respiratory protection.     

医院医疗器械维修中存在的问题及维修管理对策研究

近几年来,随着科学技术的发展和医院规模的扩大,社会对医疗技术要求不断提高,因此,高端医疗器械和新型医疗设备需求加大,医疗器械管理与维修也需跟进。医疗器械的正常使用在医疗工作中有着举足轻重的作用,可提高医疗人员的工作效率,提升临床诊治的水平,但其在改善医疗条件的同时也存在一系列的问题,若无法保质和及时维修医疗器械,对正常医疗设备的使用具有严重影响,延误患者的就诊与治疗。目前医院医疗器械维修中存在的维修人员整体素质偏低、管理机制不健全、维修技术落后、医疗器械维修人员不足、缺乏积极性及再学习的机会、医疗器械缺乏定期保养和管理等实际问题,导致医疗器械维修效率低,本文就以上问题展开讨论,旨在为医院维修管理的制定提供参考。     

导入JCI标准提升医疗影像设备管理系统

引进JCI认证标准（Joint Commission Intemational国际医疗卫生机构认证联合委员会）,使医疗影像设备管理从结构导向到结果导向转变。当今传统的管理评审标准：结构、过程、结果这一程序来讲,最关注的是结构,如设备的故障率、检查病人次数、单机收入等,但JCI的理念认为应该关心的是结果,是安全、质量、整体绩效,这是一个从结构为中心的导向转为以结果为中心、以病人为中心的导向。对任何可能产生的风险都要提前考虑预警,更具前瞻性。学习这一国际先进医院管理体系,改进医疗影像设备管理系统,抓好医疗影像设备的管理,提升医院医疗服务质量。让医疗影像设备在医疗工作中充分发挥作用,提高社会效益和经济效益。     

Epidemiology and prophylaxis of the hospital contamination of medical personnel with viruses of hepatitis B and C

Medical personnel is one of the main risk groups with respect to hospital infections for which hepatitis B and C are professional pathology. The degree of the risk of contamination of the personnel greatly depends on the character, urgency and duration of professional activity, accuracy in following the rules of personal safety while working with infected material, the proportion of patients contaminated with viruses of hepatitis B and C in specialized departments, the epidemiological danger of therapeutic and diagnostic methods, the possibility of reliable disinfection and sterilization of the equipment. In the system of measures aimed at preventing the infection of the medical personnel a special role belongs to the specific immunoprophylaxis of hepatitis B. Prolonged experience in the immunization of the medical personnel of a big hospital demonstrates a high immunological and epidemiological efficiency of the use of vaccine against hepatitis B, produced by the Research and Manufacturing Complex "Combiotech", Russia.     

Product liability aspects of bioengineering

The introduction of the Consumer Protection Act 1987 brought the problems of product liability directly into hospital bioengineering and medical physics departments. This law makes great demands upon manufacturers, but also on suppliers and maintainers of medical equipment. Departments which manage medical equipment carry a responsibility for ensuring the requirements of product liability are known by all those whose actions may affect the potential of a piece of equipment to injure or damage a patient. This paper addresses these problems from a bioengineering, rather than a legal, viewpoint. The problems of design, manufacture, modification, maintenance and use are discussed and examples of potential problems are identified. The paper concludes that as long as good standards of quality control and professionalism are applied in bioengineering and medical physics departments then there is little to be feared from this piece of legislation.     

Integrated software system for improving medical equipment management

The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot evaluation trial.     

基于专利分析的医学科技重点技术前沿领域的识别研究

目的:采用定量分析与定性分析相结合的方法识别医学科技重点技术前沿领域。方法:在Thomson Innovation数据库中检索2006-2012年制药技术、生物医药技术和医疗器械三个领域申请的专利数量,采用专利计量分析、统计学趋势分析等定量分析方法结合专家专业知识的定性分析方法对检索、采集的专利进行分析并识别前沿领域。前沿领域的选择原则是专利申请数量标化平均值较高(制药技术、生物医药技术和医疗器械领域标化平均值分别选择大于10%、15%和20%的子领域),或者有显著性增长趋势(P0.05且b0)。结果:本研究共识别医学科技重点技术前沿领域12个,其中制药技术前沿领域4个,分别是:天然产物,普通药,杂环化合物和其他有机物;生物医药技术前沿领域4个,分别是:疾病诊断和检测,基因治疗和核苷类药物,蛋白多肽类药物和生物合成技术;医疗器械前沿领域4个,分别是:电子医疗设备,诊断及手术设备,消毒、注射及电疗设备和医疗救助及口服设备。结论:通过定量与定性分析方法相结合共识别医学科技重点技术前沿领域12个,对专利进行多角度分析可以全面把握前沿领域的技术发展方向和特点,为我国医学科技政策的制定提供基于数据和事实的信息支撑。     

Characterizing IT asset disposition flows for the circular economy: A case study on export for reuse from Ireland

Understanding flows of resource-rich electrical and electronic equipment throughout its life cycle is increasingly important in the development of global circular economies, reflected by heavy legislative focuses on waste prevention and resource use efficiency. This research facilitates broader material flow analysis by characterizing flows of professional IT equipment within the Republic of Ireland, emphasizing the flow of legal exports for the purposes of refurbishment and reuse. The analysis of transboundary movement of non-waste used equipment contributes to a less often measured, but influential, facet of material flows. Eight key exporters of used equipment, comprising original equipment manufacturers, information technology asset disposition companies, and waste treatment facilities, were interviewed to characterize the sector, map the flow of materials, and identify gaps in existing reporting. Interviewed organizations declared exports of used equipment by category using a voluntary declaration form. Two key flows were identified representing currently unreported and unmeasured flows of non-waste professional equipment. A total of 441,261 units of equipment were declared to be exported for reuse from the Republic of Ireland through these previously unmeasured flows in 2019. Product keys developed by United Nations University were used to estimate the weight of total units exported as approximately 576 metric tons, amounting to an additional approximately 9% of the weight of IT equipment collected in the Republic of Ireland in 2018, or 0.1 kg per inhabitant. These quantifications of IT equipment exported for reuse will be a key component of future material flow analyses in the development of a circular economy.     

KeeT Stephen, Gehl Julie and LeeW Edward: Clinical aspects of electroporation

Human factors is the study of the relationship between people and devices or systems. The goal of considering human factors in the design of medical devices is to create devices that take into consideration the way people use technology and process information to create a man-machine interface that leads to the best possible performance. This text describes the significant aspects of human factors issues related to medical device design. It is well written and is useful for medical device designers and for others who use or evaluate medical equipment.     

临床科室医疗设备监督管理体系的建立与实施

????? 目的 设计一套医院医疗设备监督管理体系,实现对医院临床科室医疗设备的标准化、规范化、统一化管理。方法 结合企业最新、最实用的管理方法,提出医院医学工程科有效开展临床科室医疗设备管理的新方法。结果 制订并实施医院临床科室医疗设备监督管理体系。结论 体系的引入,可以有效改善医疗设备的质量管理,确保医疗器械使用的安全性、可靠性、合法性,使医患双方的合法利益都得到保护,从而提高医院医学工程科管理效能。