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目的 分析上海市浦东新区区属综合性医院心力衰竭住院诊疗的过程质量。 方法 根据国家卫生和计划生育委员会对心力衰竭质量控制的要求,对浦东新区7所区属公立综合性医院随机抽取的145份病案进行评价。 结果 病人入院24小时内进行左心室功能首次评价的比例为77.44%,且住院期间都得到较好的健康教育;但部分心衰住院患者未能得到适宜的药物治疗,或使用后未记录。结论 医院加强对员工培训,强化对关键过程环节 (如心力衰竭住院患者的心功能评价、药物治疗与病案记录) 的监控与良好医疗行为的激励,以提高医疗质量水平。 相似文献
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综合医院单病种过程质量及其影响因素分析 总被引:1,自引:0,他引:1
目的 分析上海市浦东新区区属公立综合医院6个单病种的医疗规范性、治疗有效性、住院天数与医疗费用以及有关影响因素。 方法 按照国家卫生计生委单病种控制和临床路径要求,对浦东新区7所区属公立综合医院的肺炎、急性心梗死、心力衰竭、2型糖尿病、急性单纯性阑尾炎、计划性剖宫产等6个病种进行病案评价。 结果 (1)6个单病种的医疗规范率总体为40.94%,治疗有效率(治愈或好转率)总体为96.84%。(2)平均住院日为2型糖尿病最长,急性阑尾炎最短;医疗费用最高为急性心梗,最低为急性阑尾炎;此外,遵循单病种质量控制或临床路径要求可降低部分疾病的住院天数及住院费用。 结论 浦东新区卫生行政部门和医院应进一步加强病种质量控制管理,提高医疗质量。 相似文献
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实施临床路径的意义及其应用现状 总被引:9,自引:0,他引:9
由于医疗费用急剧上升,使得世界范围内各个国家的社会保障部门都在采取不同措施,以期控制医疗费用的过度增长.临床路径是一种新型的医疗服务模式,它是各相关部门或科室的医务人员共同针对某一病种的检测、治疗、康复和护理等制定的医疗护理服务程序,它与传统医疗护理模式相比,在提高医疗护理质量的同时,使患者本人能参与其中增加了患者知情权,而且提高了整个医疗过程的团队协作精神,并改善医疗、护理的持续活动.临床路径是提高医疗护理质量、改善医疗品质的方法之一,是控制医疗成本和提高服务质量的成功手段,临床路径的应用将成为一种发展趋势.本文就临床路径的概念、起源、在国内外的应用现状及实施步骤等进行描述,阐明应用临床路径的意义,并对其在医疗护理中的应用前景进行综述. 相似文献
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目的:探讨6周康复运动治疗老年慢性心力衰竭(心衰)患者的有效性和安全性。方法:44例老年慢性心力衰竭(心功能NYHAⅡ-Ⅲ)患者随机分为两组,康复组在实施临床医疗措施并同时进行6周康复运动;对照组仅实施临床医疗措施。比较治疗前后及不同两组治疗后的六分钟步行实验距离,完成运动平板所需要的时间和代谢当量,明尼苏达心力衰竭生活质量调查表积分,血浆脑钠肽含量以及左室射血分数。结果:经过6周康复运动治疗后康复组心功能分级、六分钟步行实验距离、运动平板时间和运动平板的最大代谢当量(METS)较对照组改善更明显(P<0.05)。结论:6周康复运动治疗显著提高老年慢性心力衰竭患者的运动耐量和生活质量。6周康复运动治疗老年慢性心力衰竭(心衰)患者是有效的和安全的。 相似文献
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Much attention has been directed toward the measurement of health outcomes and the quality of medical care. Some policymakers tout outcomes measurement as a promising tool for improving health care, while others question whether current quality of care assessment is valid and of practical importance. Although significant advances have been made in the ability to measure quality of care with validity, several major methodological challenges remain. We analyze the quality of quality of medical care measures, using a conceptual framework that outlines the purpose of the measures; paradigms of the quality of care, including Donabedian's structure-process-outcome model and continuous quality improvement; and other key elements, such as scope, time, unit of analysis, and perspectives. Patient preferences and organizational contexts have been underemphasized, and should be incorporated into the framework for conceptualizing quality of care. Quality of care has relativistic and dynamic aspects. Different perspectives lead to different views of what high quality care is, and quality of care is a changing concept since medical science and treatment are constantly evolving. The most appropriate quality measures depend upon whose perspective one takes and the purpose of the measures; if the measures are chosen wisely, the current state of quality of medical care measurement is adequate for both accountability and quality improvement. 相似文献
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John E. Affeldt 《The Western journal of medicine》1980,132(2):166-170
The Joint Commission on Accreditation of Hospitals (JCAH) has continuously emphasized improvement in the quality of care provided in hospitals as the central purpose of the accreditation process. In striving to assure such improvement, the JCAH has stressed the need for, and the responsibility of, the medical and other professional staffs to provide continuing review and evaluation of patient care. In recent years, quality assessment activities have evolved, proliferated and matured to the extent that they require a purposeful integration if they are to effect sustained improvement in patient care and clinical performance. To assist hospitals in the coordination or integration of quality assessment activities, the Board of Commissioners of the JCAH has approved an important new quality assurance standard.Significant requirements of the new standard are a comprehensive quality assurance program, a written plan, a problem-focused approach to the review and evaluation of patient care and clinical performance, an annual reassessment of the program, and an improvement in patient care or clinical performance. The new standard reflects the JCAH belief that an integrated, problem-focused approach to quality assurance will significantly improve the quality of care provided throughout a hospital. Such an approach recognizes the interdependence of hospital departments and services in the provision of patient care, and, therefore, requires a purposeful integration or coordination of quality assessment data and activities. Consequently, quality assessment data may be utilized effectively and efficiently, and many potentially useless or duplicative quality assessment activities can be eliminated. The new standard affords hospitals considerable flexibility in the manner in which they implement and administer the program and encourages innovation. 相似文献
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Haeck ML Hoogslag GE Rodrigo SF Atsma DE Klautz RJ van der Wall EE Schalij MJ Verwey HF 《Netherlands heart journal》2012,20(4):167-175
Chronic heart failure is a major healthcare problem associated with high morbidity and mortality. Despite significant progress in treatment strategies, the prognosis of heart failure patients remains poor. The golden standard treatment for heart failure is heart transplantation after failure of medical therapy, surgery and/or cardiac resynchronisation therapy. In order to improve patients' outcome and quality of life, new emerging treatment modalities are currently being investigated, including mechanical cardiac support devices, of which the left ventricular assist device is the most promising treatment option. Structured care for heart failure patients according to the most recent international heart failure guidelines may further contribute to optimal decision-making. This article will review the conventional and novel treatment modalities of heart failure. 相似文献
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通过理论分析和文献综述,介绍此付费制度与医疗服务质量关系的研究现状,探讨了一些国家通过引入医疗机构提供能力、医疗服务质量评价标准及全面质量管理观念等措施,对制度进行改良的实践效果,对我国医疗付费制度的改革和优化具有重要的启示意义。 相似文献
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随着我国法治社会的发展及医疗体制的改革,医疗风险成为军队医院管理面临的难题和挑战。目前,我国现有的医疗法规不够完善,医务人员与患者的医疗风险防范意识不足,社会舆论导向性偏移等问题制约着我国医疗系统的发展。作为医疗卫生系事业的重要力量,军队医院要加强医疗风险管理,制定风险评估方法,完善风险管理体系以及加强风险教育,进一步提高医疗服务质量,从而有利维护军队医院在群众心中的信誉和形象。 相似文献
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临床医学教育作为高等医学教育的重要组成部分,对医学人才的培养、医疗水平的提高起到了至关重要的作用。通过梳理我国高等医学体制改革,对比我国和欧美发达国家高等医学教育管理体制差异,提出改革我国高等医学院校与附属医院关系的政策建议,以求更好地保障和提高临床医学教育质量。 相似文献