基于门诊多类型就诊卡模式的数字化医院建设探讨

提出并实现了基于“三卡通”(医保卡、就诊卡、银行借记卡)支付的医院门诊就医新模式,从而进一步改善门诊就医环境,便捷就医流程,缓解群众“就医难”的问题,提升医院的财务管理水平和医疗服务质量,推进数字化医院建设。     

上海市公立医院门诊医疗服务质量的观察性调查

对上海市公立医院门诊医疗服务质量进行了观察性调查。结果显示,观察员对上海市公立医院门诊医疗服务质量的总体评价较高,但部分项目较病人评价低。研究表明,经培训的观察员更容易发现公立医院门诊服务质量存在的关键问题,且观察性调查有助于消除病人个体特征和期望对门诊服务质量评价的影响。     

上海市公立医院病人满意度状况和影响因素研究

通过病人满意度问卷调查,对上海市公立医院的门诊病人满意度和住院病人满意度进行了分析。调查结果显示,上海市公立医院病人满意度总体较高,且比上一年度有所提升,但三级专科医院的医疗服务质量相对较低。建议改进医院门诊服务流程、注重诊疗过程中的隐私保护,建立公立医院分级诊疗制度,进一步改善医疗服务质量。

     

我国医养结合服务发展现状分析与政策建议

随着我国老龄化进程加快,医养结合在卫生政策与管理实践上已经成为普遍共识。现有研究主要从养老服务角度分析医养结合的概念、内涵以及实现路径,或从医学护理、医疗照护等方面探讨技术问题。医养结合模式,既不单纯是一种养老模式,也不单纯是一种医疗模式,而是医疗和养老融合的新模式,将改变传统的养老和医疗服务提供理念和方式,是解决我国老年人养老、医疗的创新之举,是建设健康中国的重要组成内容。本文从政策分析的角度出发,通过对医养结合概念的阐述、深入分析我国目前医养结合模式和存在的问题,提出政策建议。

     

基于管理改进视角的医院患者满意度测评研究

患者满意度测评对于提升医疗服务质量、减少医患纠纷、构建和谐医患关系具有重要意义,因此,患者满意度测评在医院管理当中得到了广泛的应用。满意度测评具有宏观与微观两个不同的层面,从医院管理的角度来讲,微观层面的患者满意度测评具有重要意义。文章基于医院管理改进的视角,从测评体系的构建、测评方法的选择、测评结果的应用等方面对患者满意度测评进行了探讨,研究结果有助于医疗机构患者满意度测评的开展与实施。

     

肿瘤专科医院志愿者服务的实践与探索

????? 为改善医疗环境和提高医疗服务质量,满足患者多层次的医院服务需求,建立医院志愿者服务体系,开展志愿服务已成为医务社会工作的一条创新之路。志愿者作为促进现代医学技术与社会人文精神紧密结合的良好媒介与助推器,切实将“全心全意为患者服务”的宗旨落实到实处,为医院发展提供有力支持。

     

三级综合性医院平均住院日影响因素分析

平均住院日是衡量医院医疗技术水平、医疗服务质量的综合性指标,平均住院日的长短反应医院的医疗工作效率及医院综合管理水平。运用病历分析及问卷调查相结合的方法,初步筛选出影响平均住院日的因素,然后通过因子分析法对初步筛选出的因素进进行降维、数据浓缩等处理,最终将影响平均住院日的因素按照重要程度进行排序。旨在更好的有针对性的管理这些因素,从而科学地缩短平均住院日,最终保证医疗质量水平的提高。     

基于患者体验的医疗服务质量关键指标体系构建

??????? 目的 初步构建基于“患者体验”的医疗服务质量关键指标体系。方法 通过检索国内外相关文献,构建指标体系框架和专家咨询表并进行2轮专家咨询,确定了基于“患者体验”的医疗服务质量关键指标体系。结果 构建基于“患者体验”的医疗服务质量关键指标体系,一级指标有有形性、可靠性、反应性、保证性、关怀性和连续性6个,二级指标28个,三级指标83个。结论 基于患者体验的医疗服务质量关键指标体系具有很强的实用性,为患者体验量表开发奠定基础。研究结果对于改进我国医疗服务质量评价手段和策略具有重要意义。     

试论政府职能转变与公立医院管理体制改革

当前,如何加快推进政府行政管理体制改革,实现政府职能重构,已成为我国经济社会整体转型的现实要求。公立医院改革是我国医疗卫生体制改革的核心乃至关键环节,只有把公立医院改革提升到体制改革的层面,实现政府医疗卫生服务管理职能的重构与转变,才能推动公立医院管理体制和治理结构改革,也才能构建与市场经济体制和社会需求相适应的基本医疗卫生制度,从而实现全社会医疗福利最大化的医改最终目标。     

极致化医疗服务的理论研究与实践探索

初步探讨了极致化医疗服务满足现实需求、引领行业发展的理论和实践价值,提出了其“坚持以人为本、突出全面质量、追求无限标准”3个方面的理论内涵,并从文化熏陶、教育引导、制度规范和监督约束4个方面探讨了其实现路径。     

Characteristics of the membranes of the pellicle of the ciliatePseudomicrothorax dubius

Summary The membranes of the pellicle of the ciliatePseudomicrothorax dubius are investigated using thin section electron microscopy and freeze-fracture replicas. The plasma membrane is covered by a surface coat and is connected to the outer alveolar membrane by short, sometimes branched, bridges. The inner alveolar membrane is coated on both sides. The epiplasm lies in intimate contact with the cytoplasmic surface of this membrane, and there is a corresponding deposit on the other surface. This deposit is regularly striated.The epiplasmic layer and the alveoli are interrupted at sites of cytotic activity,e.g., the attachment sites of trichocysts, the cytoproct, and the parasomal sacs. The striated deposit ends where the epiplasm ends, indicating a direct relationship between these two epimembranous layers.There is a deposit along the sides of the first part of the tip of the trichocysts, and in this region the trichocyst membrane is free of intramembranous particles.The membrane of the parasomal sacs has a coat on both surfaces. That on the extraplasmic surface is similar to the surface coat of the plasma membrane. The origin of the cytoplasmic coat is unknown. The cytotic activity of these sacs is indicated by their highly irregular profiles.     

The early development of the tail and the transformation of the shape of the nucleus of the spermatid of the domestic fowl,Gallus gallus

Summary The differentiation of the spermatid, especially in reference to the formation of the flagellum, and transformation of the shape of the nucleus was investigated in the domestic fowl.In the early stage of the spermatid, a prominent Golgi apparatus appears around the centrioles. The Golgi vesicles then surround the axial-filament complex which develops from the distal centriole. These vesicles fuse to form continuous membrane at the earliest stage of flagellar formation, and in the succeeding stage Golgi lamellae are attached to the plasma membrane of the developing flagellum. From these observations, it is assumed that Golgi apparatus may be a source of the membrane system of the flagellum.The microtubules distributed around the nucleus form the circular manchette. The anterior region of the nucleus with the manchette is cylindrical in shape and the posterior region without it remains irregular in shape. When the circular manchette has been completed, the whole nucleus acquires a slender cylindrical shape. The circular manchette then changes into the longitudinal manchette. The nuclei of spermatids without a longitudinal manchette are abnormal in shape. In view of these observations it is assumed that the nuclear shaping of the spermatid may be accomplished by circular manchette and the maintenance of shape of the elongated nucleus by longitudinal manchette.The authors wish to thank Mr. Takayuki Mori for his helpful suggestions and technical advices     

Characterization of the composition of the aqueous humor and the vitreous body of the eye of the frog Rana temporaria L

This study aimed to analyze the aqueous humor (AH) and the vitreous body (VB) of the eye of the adult frog Rana temporaria L. as a representative species of amphibians, which lead a semi-terrestrial life. The presence of collagen, albumin, uric acid and electron donors was shown in both media; however, there are slight differences in their concentrations. To determine collagen, a spectral-fluorescent probe, cyanine dye, was used. The presence of collagen in AH of the frog was found at the first time. The total content of electron donors (ascorbic and uric acids, tryptophan, and tyrosine) in VB and HA was roughly estimated at ~ 1.5 × 10^− 4 mol/L. Both VB and AH absorb light in similar UV regions. The total protein and albumin contents in AH were found to be somewhat higher than those in VB. The uric acid content was at an equally low level in both intraocular media. It is supposed that the similarity of VB and AH compositions shown in this work is due to some exchange between VB and AH contents in the course of accommodation. The role of intraocular fluids in physiological functions of the eye and in protecting the retina against UV light is discussed.     

Observations on the permeability of the choriocapillaris of the eye

Summary The choriocapillaris is a fenestrated capillary bed located posterior to the retinal pigment epithelium. It serves as the main source of supply to the photoreceptors, retinal pigment epithelium, and other cells of the outer retina. The permeability of these capillaries to intravenously injected ferritin (MW — approx. 480,000; mol. diam. 11 nm) was examined in the mouse, rabbit, and guinea pig, each of which is characterized by a different type of retinal vascularization. In all three species, the bulk of the ferritin remained in the capillary lumina, where it appeared to be blocked at the level of the diaphragmed fenestrae. Some ferritin was present in endothelial cell vacuoles. The results confirm previous work on the rat choriocapillaris and indicate that the barrier function of the choriocapillary endothelium is present even among species in which the retinal circulation differs significantly.Supported by NIH grant EY03418