基于卫生经济学的公立医院国有资产管理策略探讨

随着医院财务制度的完善和医院精细化管理的推进,公立医院国有资产管理将更加注重科学有效的方法学。研究主要针对设备使用率低、库存物资闲置、无形资产保护不足等3个医院面临的主要资产管理问题,探讨需求分析、市场战略分析、成本效益分析、成本核算、预算控制等卫生经济学方法在公立医院资产管理中的应用与实践,以此探索公立医院资产管理的科学方法,提高资产管理效率。     

全成本精细化管理在医院经济管理中的运用探讨

随着医药卫生体制改革不断深入,公立医院原有的经济管理模式已不能适应形势发展的需要,全成本精细化管理将成为医院经济管理的必要手段。通过分析全成本精细化管理的概念,并以哈尔滨医科大学第四临床医学院为例探讨全成本精细化管理在医院经济管理中的运用以及应注意的相关问题,为医院提高经济管理水平提供新的思路。     

单病种临床路径的成本核算管理研究进展

医院成本核算是医院经济管理的重要内容,医院加强成本核算,走“优质、高效、低耗”的发展之路,将是建设节约型社会的必然要求,也是医疗服务进入市场参与竞争的必然结果。以单病种临床路径为基础进行成本核算研究是医院成本核算管理的新模式。综述了以单病种临床路径为基础的成本核算管理的国内外相关研究成果,并对研究现状进行了总结和分析。     

NHS筹资模式下医院成本管理策略及借鉴 ——以剑桥大学医院联合体为例

文章从“购买方”职责的完善、资金分配的途径以及基于结构的支付模式三个方面介绍了英国国家医疗服务体系的筹资模式;以剑桥大学医院联合体为例分析了此体系下医院成本管理的重点与策略;从成本核算体系、方法及管理策略三个方面探讨该体系下的医院成本管理。     

精细化管理形式在高校后勤管理中的应用

目前,我国不断深入的教育改革前提下,高校后勤管理的形式已经从粗放型转换为精细化,其工作将面对新的高度。实行好高校后勤精细化的管理不但能够使管理的成本降低,还能够更加有效的利用资源并且让团队及个人的执行力得以提高。所以贯彻运用精细化管理的理念在高校后勤管理中尤为重要。不断提高后勤服务质量,更好的为广大师生的生活、教育和学习提供良好环境,是高校后勤管理工作者的毋庸置疑的义务。     

以药补医历史、现状及后以药补医时代的政府责任

实行医药分开、破除以药补医无疑是公立医院改革的关键领域,不仅有着复杂的历史背景,而且涉及多个利益相关者。在此项改革推进过程中,政府有关部门出台相关政策,探索出了改革支付方式、降低或取消药品加成、实行收支两条线管理、设立独立于医院外的药品管理中心等4种医药分开的实现形式。后以药补医时代,政府责任主要在：通过约束公立医院的逐利性缓解“看病贵”;促使医疗技术服务价格回归价值以改善“看病难”;通过合理财政投入、有力政策保障,主导公立医院落实公益性。     

基于供应链的公立医院体外诊断试剂管理

公立医院体外诊断试剂管理因试剂种类复杂,横跨药品和医疗器械两个行业,监管有一定难度,导致试剂的“进、销、存”缺乏整体性管理,严重影响医院的医疗安全和运行效率。江苏省人民医院采用信息化手段,运用供应链管理的理念来研发体外诊断试剂管理项目,实现医院体外诊断试剂的精细化的管理,有效地提高医疗安全。     

以岗位等级考核为主体的绩效分配模式探讨

科学、合理的内部分配是调动医护人员工作积极性的杠杆之一。岗级考核分配方案的实施是我院内部分配制度改革的重要内容，随着卫生事业改革的不断深入及医院的可持续发展，需要继续完善内部分配制度，实行注入要素内涵的岗位工资及以“成本核算”为基础的效益奖励的绩效分配模式，真正建立起医院内部的长效激励机制。     

现场监督精细化管理

精细化管理是一种管理理念和管理技术,是通过规则的系统化和细化,运用程序化、标准化和数据化的手段,使组织管理各单元精确、高效、协同和持续运行。所谓精细化管理就是落实管理责任,将管理责任具体化、明确化,它要求每一个管理者都要做到位、尽到职。也就把工作做到位,工作要日清日结,每天都要对当天的情况进行盘点:发现问题及时纠正,及时处理等等。而精细化管理对现场作业监督来说是一种意识、一种认真的态度、一种精益求精的管理。     

科室全成本核算下公立医院责任成本体系研究

在当前科室全成本核算的基础上,建立责任成本体系,能够克服成本管理工作成本责任不明确的现象,对各科室的成本控制起到引导和激励作用,是全成本核算下进行成本控制的有效途径。责任成本体系的构建与实施包括：建立责任成本中心,分解成本责任,明确责任成本目标,组织责任成本核算,实施责任目标成本控制,并根据责任成本落实情况进行考评。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.