我国公立医院补偿强度的多视角研究

通过对公立医院补偿强度进行多视角研究发现,即使在“政府对公立医院投入不足”的局面下,公立医院依然可能出现“营养过剩”的问题。应制定适度并可执行的财政补偿政策,制定合理、有效的税收返还和转移支付制度,放宽社会资本办医融资政策,适当转移土地补偿政策,注重医院软实力建设和加快推进人事制度改革等。     

我国公立医院多元监督模式的构建

为保证公立医院服务质量,推动公立医院改革,最终达到促进社会和谐的目标,必须完善和重建我国公立医院监督模式。基于社会学和管理学的双重角度,基于新一轮医药卫生体制改革的要求,针对我国公立医院监督的突出问题,提出构建公立医院多元监督的模式。     

上海市不同治理模式公立医院的运营状况分析

通过调查和现有资料收集,分析了目前上海市公立医院3种治理模式的运营状况,指出了对公立医院不同治理模式运营状况评价的必要性,揭示了公立医院不同治理模式下的医院运营状况,提出了公立医院治理结构改革应关注于治理要素有用的原则。

     

我国公立医院法人治理结构下的管理者激励机制探讨

建立管理者有效激励机制,化解公立医院法人治理结构下的委托代理问题是公立医院体制改革的重要保障。该激励机制通过弥合管理者与所有者的价值及行为取向差异,促使管理者自觉自愿地履行并实现公共利益。但由于机制建立过程中存在效益目标不明晰、绩效水平难于考量等难题。为此,需以公共利益为导向设置董事机构,加强效益评价指标体系和外部监管制度建设,同时创新激励手段,从而提高公立医院法人治理结构下的整体绩效。     

公立医院非在编人员工作满意度调查与分析

?????? 目的　通过分析公立医院非在编人员工作满意度影响因素,提出改进建议,以更好地为患者提供优质服务。　方法　满意度问卷调查表采用李克特量表,使用STATA10.0软件进行统计数据分析。　结果　非在编人员工作总体满意度平均得分为（3.66+0.78）分,评价一般。影响满意度的因素有：个人职业期望、科室管理、工作氛围、奖金待遇、学习培训等。　结论　医院应关注非在编员工满意度管理工作,关注不同群体的差异和不同影响因素,有效提高满意度,增强医院的可持续发展力。     

我国公立医院管办分开的路径及思考 ——基于17个试点城市的经验

随着《关于公立医院改革试点的指导意见》的出台,探索管办分开的实现形式成为公立医院管理体制改革的主要任务。笔者总结了新医改方案中颁布的关于管办分开的政策和思路,并试图归纳比较17个新医改试点城市实施公立医院管办分开改革方案的异同,进行分析与探讨并得出相关启示,旨在为我国更好地推进公立医院改革提供借鉴。     

公立医院法人治理下医师绩效考核标准体系创新研究

法人治理结构下,公立医院医师绩效考核尤为重要。但目前的医师绩效考核机制中存在公益性缺乏、重过程轻结果、搭便车和激励惰性以及重热门轻冷门等问题。为此,本文在实证调研和文献分析的基础上,借助德尔菲法和层次分析法,基于公益性、公平性、全面性、客观性和可操作性四个原则,选取人才素质类、价值贡献类和工作效果类三个方面指标,构建出新型公立医院医师绩效考核标准体系。

     

平衡计分卡在公立医院绩效管理中的应用与实践

通过分析医院面临的内外环境,把平衡计分卡运用到医院绩效管理中,建立了财务收益、客户、医疗服务、学习与成长多角度的绩效评价体系,经过不断完善和改进,取得了患者满意、职工积极性提高、医院可持续发展的良好效果。     

卓越绩效管理模式在医院绩效考核中的应用

绩效考核是医院经济管理的重要组成部分,如何通过绩效考核,实现医院发展战略目标,是每个医院管理者正在思考的重要问题。将卓越绩效管理模式融入医院绩效考核,分析其在实际运用过程中的必要性和有效性,并提出相应建议。     

国外医院院长职业化发展模式及对我国的启示

利用文献研究法,回顾国外医院院长职业化的发展历程,分析其发展现状,并与我国医院院长管理现状进行对比分析,从中总结对我国公立医院院长职业化改革的启示。     

Solution-mediated syntheses and characterizations of two new zincophosphites [C6H14N2]0.5[Zn(H2PO3)2] and [C4H12N2]0.5[(CH3)2NH2][Zn2(HPO3)3]

Two new zincophosphites [C₆H₁₄N₂]_0.5[Zn(H₂PO₃)₂] 1 and [C₄H₁₂N₂]_0.5[(CH₃)₂NH₂][Zn₂(HPO₃)₃] 2 have been solvothermally synthesized in mixed solvents of N,N-dimethylformamide (DMF) and 1,4-dioxane (DOA), respectively. Single-crystal X-ray diffraction analysis reveals that compound 1 exhibits a neutral inorganic chain formed by ZnO₄ and HPO₂(OH) units. Interestingly, the left- and right-handed hydrogen-bonded helical chains are alternately formed via the hydrogen-bonds between two adjacent chains. Compound 2 exhibits a layer structure with 4- and 12-MRs formed by ZnO₄ and HPO₃ units, in which two kinds of organic amine molecules both act as countercations to compensate the overall negative electrostatic charge of the anionic network.     

p-Quinquephenyl diamine, C6H5-p-C6H4-p-C6H2(2,3-NH2)-p-C6H4-C6H5, and its corresponding diimine-Ru(II) complex: Crystal structure and electrochemical and optical properties

The molecular structure of an o-phenylenediamine unit-containing oligophenylene (1), Ph-Ph′-Ph′(2,3-NH₂)-Ph′-Ph (Ph = phenyl; Ph′ = p-phenylene; Ph′(2,3-NH₂) = 2,3-diamino-p-phenylene), was determined by X-ray crystallography. 1 has a twisted structure, and forms an intermolecular C-H?π interaction network. The -NH₂ group of 1 was air-oxidized to an imine, NH, group in the presence of [RuCl₂(bpy)₂] (bpy = 2,2′-bipyridyl) and gave a ruthenium(II)-benzoquinone diimine complex [Ru(2)(bpy)₂](PF₆)₂ (2: Ph-Ph′-Ph′(2,3-imine)-Ph′-Ph). The molecular structure of [Ru(2)(bpy)₂](PF₆)₂ was confirmed by X-ray crystallography. [Ru(2)(bpy)₂](PF₆)₂ underwent two-step electrochemical reduction with E^1/2 = −0.889 V and −1.531 V versus Fc⁺/Fc. The E^1/2’s were located at higher potentials by 91 mV and 117 mV, respectively, than those of reported [Ru(bqdi)(bpy)₂](PF₆)₂ (bqdi = benzoquinone diimine). Electrochemical oxidation of [Ru(2)(bpy)₂](PF₆)₂ occurred at a lower potential by 180 mV than that of [Ru(bqdi)(bpy)₂](PF₆)₂. Occurrence of the easier reduction and oxidation of [Ru(2)(bpy)₂](PF₆)₂ than those of [Ru(bqdi)(bpy)₂](PF₆)₂ is ascribed to the presence of a large π-conjugation system in 2.     

New preparations and molecular structures of cis-MCl2(Ph2PCH2PPh2)2, M = Ru,Os and trans-RuCl2(Ph2PCH2PPh2)2

The title compounds were made by reacting bis(diphenylphosphino)methane (dppm) with reduced solutions of OsCl₆^4? and Ru₂OCl₁₀^4?. The crystal and molecular structures of these compounds have been determined form three-dimensional X-ray study. The cis-isomers crystallize with one CHCl₃ per molecule of the complex. All three compounds crystallize in the monoclinic space group P2₁/n with unit cell dimensions as follows: Cis-OsCl₂(dppm)₂·CHCl₃: a = 13.415(4) Å, b = 22.859(4) Å, c = 16.693(3) Å, β = 105.77(3)°, V = 4926(3) ų, Z = 4. cis-RuCl₂(dppm)₂·CHCl₃: a = 13.442(3) Å, b = 22.833(7) Å, c = 16.750(4) Å, β = 105.53(2)°, V = 4953(3) ų, Z = 4. trans-RuCl₂(dppm)₂: a = 11.368(7) Å, b = 10.656(6) Å, c = 18.832(12) Å; β = 103.90(6)°, V = 2213(7) ų; Z = 2. The structures were refined to R = 0.044 (R_w = 0.055) for cis-OsCl₂(dppm)₂·CHCl₃; R = 0.065 (R_w = 0.079) for cis-RuCl₂(dppm)₂·CHCl₃ and R = 0.028 (R_w = 0.038) for trans-RuCl₂(dppm)₂. The complexes are six coordinate with stable four-membered chelate rings. The PMP angle in the chelate rings is ca. 71° in each case.     

Synthesis of tantalum and niobium complexes that contain the diamidoamine ligand, [(3,4,5-F3C6H2NCH2CH2)2NMe], and the triamidoamine ligand, [(3,5-Cl2C6H3NCH2CH2)3N]

Several niobium and tantalum compounds were prepared that contain either the diamidoamine ligand, [(3,4,5-F₃C₆H₂NCH₂CH₂)₂NMe]²⁻ ([F₃N₂NMe]²⁻), or the triamidoamine ligand, [(3,5-Cl₂C₆H₃NCH₂CH₂)₃N]³⁻ ([Cl₂N₂NMe]³⁻). The former include [F₃N₂NMe]TaCl₃, [F₃N₂NMe]NbCl₃, [F₃N₂NMe]TaMe₃, [F₃N₂NMe]NbMe₃, [(F₃N₂NMe)TaMe₂][MeB(C₆F₅)₃], [F₃N₂NMe]Ta(CHSiMe₃)(CH₂SiMe₃), [F₃N₂NMe]Ta(CH₂-t-Bu)Cl₂, [F₃N₂NMe]Ta(CH-t-Bu)(CH₃), and [F₃N₂NMe]Ta(η²-C₂H₄)(CH₂CH₃). The latter include [Cl₂N₂NMe]TaCl₂, [Cl₂N₂NMe]TaMe₂, [Cl₂N₂NMe]Ta(η²-C₂H₄), and [Cl₂N₂NMe]Ta(η²-C₂H₂).X-ray diffraction studies were carried out on [F₃N₂NMe]Ta(CHSiMe₃)(CH₂SiMe₃), [F₃N₂NMe]Ta(η²-C₂H₄)(CH₂CH₃), and [Cl₂N₂NMe]TaMe_2..     

Selective synthesis of triangular cluster oxido-sulfidocomplexes of Mo and W: High yield preparations of [Mo3O2S2(H2O)9], [W3O2S2(H2O)9], [W2MoO2S2(H2O)9] and their derivatization

Reaction of [Mo₂O₂(μ-S)₂(H₂O)₆]²⁺ with Mo(CO)₆ or metallic Mo under hydrothermal conditions (140 °C, 4 M HCl) gives oxido-sulfido cluster aqua complex [Mo₃(μ₃-S)(μ-O)₂(μ-S)(H₂O)₉]⁴⁺ (1). Similarly, [W₃(μ₃-S)(μ-O)₂(μ-S)(H₂O)₉]⁴⁺ (2) is obtained from [W₂O₂(μ-S)₂(H₂O)₆]²⁺ and W(CO)₆. While reaction of [Mo₂O₂(μ-S)₂(H₂O)₆]²⁺ with W(CO)₆ mainly proceeds as simple reduction to give 1, [W₂O₂(μ-S)₂(H₂O)₆]²⁺ with Mo(CO)₆ produces new mixed-metal cluster [W₂Mo(μ₃-S)(μ-O)₂(μ-S)(H₂O)₉]⁴⁺ (3) as main product. From solutions of 1 in HCl supramolecular adduct with cucurbit[6]uril (CB[6]) {[Mo₃O₂S₂(H₂O)₆Cl₃]₂CB[6]}Cl₂⋅18H₂O (4) was isolated and structurally characterized. The aqua complexes were converted into acetylacetonates [M₃O₂S₂(acac)₃(py)₃]PF₆ (M₃ = Mo₃, W₃, W₂Mo; 5a-c), which were characterized by X-ray single crystal analysis, electrospray ionization mass spectrometry and ¹H NMR spectroscopy. Crystal structure of (H₅O₂)(Me₄N)₄[W₃(μ₃-S)(μ₂-S)(μ₂-O)₂(NCS)₉] (6), obtained from 2, is also reported.     

Synthesis and crystal structure of the MgCl2(CH3COOC2H5)2· (CH3COOC2H5) adduct

The reaction of α-MgCl₂ with boiling ethyl acetate affords MgCI₂(CH₃COOC₂H₅)₂· (CH₃COOC₂H₅), which is obtained as crystals suitable for X-ray analysis only from the mother liquor. M=315.5, orthorhombic, space group P2₁22₁ (No. 18), a=25.077(3), b=8.616(1), c=7.345(1) Å, V=1587.0(3) ų, Z=4, D_x=1.32 g cm⁻³,λ A(Mo Kα)=0.71069 Å, μ=4.17 cm⁻¹, F(000)=664, T=298 K, observed reflections: 1667, R=0.059 and R_w=0.069. The structure is composed of polymeric chains of MgCl₂(CH₃COOC₂H₅₎₂ and the ethyl acetate molecules occupy a mutually trans position.     

Crystal structures of MoCl2(O)(O2)(OPMePh2)2 and mixtures of MoCl2(O2)(OPPh3)2 and MoCl2(O)(O2)(OPPh3)2: allylic alcohol isomerization studies using MoCl2(O)(O2)(OPMePh2)2

Adding one equivalent of H₂O₂ to compounds of stoichiometry MoCl₂(O)₂(OPR₃)₂, OPR₃ = OPMePh₂ or OPPh₃, leads to the formation of oxo-peroxo compounds MoCl₂(O)(O₂)(OPR₃)₂. The compound MoCl₂(O)(O₂)(OPMePh₂)₂ crystallized with an unequal disorder, 63%:37%, between the oxo and peroxo ligands, as verified by single-crystal X-ray diffractometry, and can be isolated in reasonable yields. MoCl₂(O)(O₂)(OPPh₃)₂, was not isolated in pure form, co-crystallized with MoCl₂(O)₂(OPPh₃)₂ in two ratios, 18%:82% and 12%:88%, respectively, and did not contain any disorder in the arrangement of the oxo and peroxo groups. These complexes accomplish the isomerization of various allylic alcohols. A mechanism of this reaction has been constructed based on ¹⁸O isotopic studies and involves exchange between the alcohol and metal bonded O atoms.     

Hydrothermal synthesis and structure of an open framework Co0.7Zn1.3(PO4)2(NH3-CH2CH2NH3) and Co6.2(OH)4(PO4)4Zn1.80, a new adamite type phase

The hydrothermal reaction of cobalt(II)oxalate di-hydrate, zinc oxide, and triethyl-orthophosphate, using 1,2-diaminoethane as structure directing template in water, produced two major crystal phases in almost equal amount: the purple crystals of [NH₃-CH₂CH₂NH₃][Co_0.7Zn_1.3(PO₄)₂] (1) and the red burgundy crystals of Co_6.2(OH)₄(PO₄)₄Zn_1.80 (2), a new adamite type phase. The structure of [NH₃-CH₂CH₂NH₃] [Co_0.7Zn_1.3(PO₄)₂] (1) exhibits a 3D open framework built from PO₄ and (Co/Zn)O₄ tetrahedra, and (Co/Zn)O₅ trigonal bipyramids, forming two major channels, an 8-membered ring channel and a 16-membered ring channel, that host the ethanediammonium ions. The Co_6.2(OH)₄(PO₄)₄Zn_1.80 (2) is isomorphous with adamite-type M₂(OH)XO₄ structure, with a condensed vertex and edge sharing network of (Co/Zn)O₅, and distorted CoO₆, and PO₄ subunits. The cobalt preference for higher coordination numbers is displayed in this structure, where the octahedral sites are wholly occupied by cobalt. Thermal analysis confirmed that these compounds display high thermal stability.     

Metal-organophosphonates: hydrothermal synthesis and structures of [Cu(O3PC10H6CO2H)] and [Cu(bpy)(HO3PC10H6CO2)] (H2O3PC10H6CO2H = 2,6-carboxynaphthalene phosphonic acid)

Hydrothermal methods were used to prepare [Cu(O₃PC₁₀H₆CO₂H)] (1) and [Cu(bpy)(HO₃PC₁₀H₆CO₂)]·2H₂O (2·2H₂O), where H₂O₃PC₁₀H₆CO₂H is 2,6-carboxynaphthalene phosphonic acid (H₃cnp). The two-dimensional structure of 1 consists of layers of edge-sharing {CuO₆} octahedra, producing an AlCl₃- type structure of fused hexagonal rings of copper octahedra, enclosing voids of hexagonal profile. The layer composition is CuO₃ or CuO₆/₂ as each oxygen bridges two copper sites. The Hcnp ligands project from either face of the copper “oxide” layer. Adjacent layers interact through hydrogen bonding interactions between the pendant -CO₂H groups of the ligand. Coordination of the bipyridine ligand in [Cu(HO₃PC₁₀H₆CO₂)] (2) obstructs expansion in two-dimensions, and the material exhibits a chain structure. The chain is constructed of binuclear units of edge-sharing ‘4+1’ {CuO₃N₂} square pyramids linked through the dipodal {HO₃PC₁₀H₆CO₂}²⁻ ligands.