Public satisfaction with the quality of First Health Facility Services in Indonesia: Does sociodemographic matter?

Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.

Challenges of a negative work load and implications on morale,productivity and quality of service delivered in NHS laboratories in England

The National Health Service(NHS)is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom.There are several challenges militating against the effective laboratory service delivery in the NHS in England.Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients.They provide the"engine room"of modern medicine with 70%of diagnosis based on the laboratory results generated by them.This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England.Laboratory service delivery in the NHS in England faces numerous daunting challenges;staffing levels in the last few years have become dangerously low,less remunerated,relatively less experienced and predominantly band 5's,multidisciplinary rather than specialty based,associated with working more unsocial hours without adequate recovery time,de-banding of staff,high staff turnaround,profit and cost driven rather than quality.These factors has resulted in burn out,low morale,high sickness absences,increased error rate,poor team spirit,diminished productivity and suboptimal laboratory service delivery.There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix,ensuring adequate remuneralion of laboratory staff,implementing evidenced-based specialty oriented service,determining the root cause/s for the high staff turnover and implementing corrective action,identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

Immigrants’ Satisfaction from the National Health System in Greece: In the Quest of the Contributing Factors

Immigrants deserve special attention as they constitute a very sensitive social group, facing an increasing risk of social exclusion. The access of immigrants to health services is one of the most important factors, which contributes to their integration into the society of induction. The purpose of this study is to track and assess the immigrants’ satisfaction from the health services provided by the Greek National Health System (NHS). The satisfaction level assessment is examined in conjunction with demographic and socio-economic characteristics of the study participants, as well as with the characteristics that are related to their personal experience with the National Health System in Greece. The research was conducted from March 2012 to May 2013. The sample of the research comprises of 126 “first-generation” immigrants on legal permit of residence in Greece, who lived in the prefecture of Attica. It is panel study based on “snowball sampling” and the statistical analysis was conducted with the use of the Stata (ver. 11), while the statistical analysis used probit estimation techniques. The demographic and social variables—particularly the variables of gender, “understanding the Greek language”, “education”, “participation in the community of origin” and “insurance”—the variables of “health” and specifically “long-term diseases” and the variable of “trust” are found to be highly related with immigrants’ satisfaction degree from the Greek health system. Our research concludes that health is a fundamental, human right and immigrants’ access to health services is essential not only for their instant and effective treatment of their health problems and the improvement of their lives but also for ensuring the public health in Greece. In order to properly incorporate immigrants in Greece in particular, the health policy decision-makers have to pay attention to the contributing factors.

英国NHS体系对我国卫生服务的启示

本文介绍英国NHS体系的特点,包括公平优先、兼顾效率,合理的分级保健体制,健全的医药体制及电子化健康服务,对我国卫生服务启示:动员社会资金投入卫生服务,推行家庭医师制度,推进药物制度建设,加强卫生信息化建设。

英国NHS改革对我国的启示

回望近30年的改革历程,以内部市场导向的NHS改革在提升医疗服务效率、增强医疗机构回应性以及控制医疗费用增长等方面取得了较好的成效。本文旨在考察和分析英国NHS改革的现实动因与路径选择,以期获得对英国NHS改革的理性认识及其对我国医疗卫生体制改革的有益启示。

英国国民医疗保健体制(NHS)探析

英国国民医疗保健体制优点与缺陷并存,较好地实现了公平,但卫生机构的效率始终不尽人意。值得我们借鉴的是:重视预防,胜于治疗;改革支付方式,逐步取消"以药养医"现象;培养技术精湛的社区医疗队伍,发展社区卫生服务至关重要;建立独立机构监管公立医院,促进服务质量的提高;利用信息化的有效手段,提供方便的卫生服务;扩大筹资渠道,打破政府垄断。

英国国民卫生服务制度(NHS)的结构性改革与治理模式

基于英国NHS在管理体制与机制上所实施的结构性改革措施,从完善法律、建立问责机制、完善财务管理和经营模式4个维度,系统阐述了NHS的结构性改革与治理模式的特点;作为一种"公共利益公司",NHS所属公立医院基于公私伙伴关系的原则,在坚持公益性的前提下,引入企业经营行为组建了信托基金医疗联合体,并根据NHS的核心原则,免费医疗、需求导向、可负担性等,基于购买合同向辖区患者或居民提供医疗保健服务。随着相关改革措施的逐步实施,NHS信托基金医疗联合体的法人地位和自主决策权得到明显提升,能真正做到对自身的发展负责;同时,随着对提供者行为的规范,以及医疗服务市场竞争与规制机制的完善,也极大的促进了医疗机构之间的有序竞争和医疗服务供给的多元化发展。

健康信息服务驱动公共图书馆未来发展——基于《英国NHS图书馆质量评估标准》的分析与启示

《英国NHS图书馆质量评估标准》是英国官方的健康图书馆信息服务质量评估标准,规定了包括政策、经费、员工、服务设施、图书馆信息服务等在内的48个健康信息服务质量标准,将图书馆健康信息服务纳入到国家发展规划日程。以《英国NHS图书馆质量评估标准》为切入点,深入解读其服务政策、员工资质、服务空间、资金来源、服务内容等五项涉及公众健康信息服务的重要质量标准,以期找到英国图书馆健康信息服务的成功所在。从紧密围绕国家政策指示、创设高体验值服务环境、争取社会力量支持、开展多元化服务推广、倡导健康知识服务等方面为我国公共图书馆健康信息服务的发展提供参考,以期推动我国图书馆健康信息服务的理论研究与实践创新。

英国全民医疗服务(NHS)的组织管理体制探析——兼论对中国的启示

国家对医疗服务体系的深刻调控和医疗服务机构的高度公共化,是英国NHS体系建制之初的核心特征。近年来,NHS历经内部市场化、政府向地方和社会放权、医疗服务购买和提供机制的调整、公立医院自主性的增强和私人医院的参与等变革。但公平普惠的理念始终没有动摇,税收仍是首要筹资来源,完备的全科医疗服务及守门人制度仍是NHS之基石。NHS发展的经验和教训可为中国提供借鉴。

英国国家卫生服务体系(NHS)绩效评估及其实践评价

介绍了英国国家卫生服务体系(NHS)绩效评估的实施背景及绩效评估框架(PAF)和绩效示标体系,并对其在实践中的实施效果和局限进行了评价,以期对中国医疗机构绩效评估提供经验借鉴。

The impact of a computerized care records service (CRS) on doctors’ work patterns in urological outpatient clinics

Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.

Effectiveness of the Service Mapping Method in Re-designing the Bariatric Surgery Clinical Pathway of a Public Hospital

Background： Nowadays obesity is the world＇s common disease. Bariatric surgery is the only therapy that providessignificant cost savings within Public Health Service, but the lack of diagnostic paths universally accepted causes enormous waste ofresources and disruptions. Service Mapping is the ideal methodology to describe work＇s organization and to plan a new service model.Methods： The Service Mapping has been used to represent the actual state of the bariatric surgery service and starting from the criticalaspects found, we have developed a desirable state of the service. Results： Experience-based design has given centrality to thebeneficiary, making the bariatric service sensitive to patient＇s needs and expectations. The micro-organization of work has improvedprofessionals＇ integration, avoiding the creation of new operational entities or additional costs. The service has been simplified both forclinicians and hospital managers. The strategic repositioning of the dietician and general practitioner＇s recognition within the bariatricpath allowed us to achieve better clinical outcomes. Conclusions： Service Mapping has highlighted clinicians＇ difficulties in providingthe service, emphasizing the importance of the beneficiary. The iconic representation is a powerful explicit framework, fundamental formanagement purposes, to understand the role of every subject involved in the service, to rationalize work＇s organization, and integratehealthcare activities.

Interpretations of Key Points of National Nursing Developmental Project from 2016 to 2020

National Nursing Developmental Project from 2016 to 2020 w as printed and published by General Office of National Health and Family Planning Commission to further accelerate the development of medical nursing so as to meet the healthy requirements of the masses.This paper aimed to interpret the key points of the project from the aspects of excellent achievements in medical nursing development during the 12thFive-Year Plan,opportunities and challenges in nursing development during the 13thFive-Year Plan,guiding thought and primary principles,as w ell as the developmental targets,the primary assignments,the key projects and the supporting measures in the 13thFive-Year Plan,so as to provide the latest important information for nurses and patients w ith special requirements,and to improve nurses’professional nursing quality and capacity in medical nursing profession.

我国基层中医药服务现状及发展路径探讨

背景我国对基层中医药卫生服务的关注度持续提升,但是目前基层中医药卫生服务体系仍存在问题,制约了我国中医药事业的发展。目的分析我国基层中医药卫生服务体系现状,探索持续提升基层中医药服务能力的策略。方法于2022年12月,检索《中国卫生健康统计年鉴》《全国中医药统计编摘》及国家疾病预防控制局和国家心血管病中心官方网站获取数据,从卫生投入、服务产出、健康需要3个层面构建指标体系,结合秩和比法和WHO卫生系统绩效模块框架对基层中医药服务现状进行综合评价。结果卫生投入方面:2017—2021年,除乡镇卫生院外,其他能够提供中医药服务的基层医疗卫生机构数量均有所增加;社区卫生服务中心(站)、乡镇卫生院、门诊部中医类临床科室床位数呈现上升趋势,但门诊部中医类临床科室床位数占门诊部总床位数的比例有所下降;社区卫生服务中心(站)、乡镇卫生院、诊所中医类执业(助理)医师占比明显上升,而村卫生室的中医类执业(助理)医师占比保持稳定,门诊部的中医类执业(助理)医师占比逐年递减;近5年,基层医疗卫生机构财政投入的绝对数值稳步提高,而中医机构财政拨款波动减少。服务产出方面:尽管各类机构中医诊疗人次占机构总诊疗人次的比例按照一定增幅稳步增长(除中医类门诊部外),但仅村卫生室的中医诊疗量占比始终保持在30.0%以上;除乡镇卫生院外,其他基层医疗卫生机构的中医类执业(助理)医师人均担负年诊疗人次总体上呈下降趋势。根据综合评价结果,2017、2018、2021年处于资源分配适宜状态,而2019、2020年处于资源分配不均衡状态。结论目前,我国基层中医药卫生服务体系建设得到有效落实,但在有序推进的过程中也存在一些不足。基层中医药资源不足、服务与利用不均衡、中医药优势未充分发挥、人才培养机制不健全、财政投入少等问题制约中医药事业的发展。为推动基层医疗卫生机构持续提高中医药卫生服务能力,需要夯实政府职能,进一步弘扬中医药文化,建立激励机制以优化人才培养模式,加强中医药服务与医保政策紧密结合,建设以“信息一体化”为支撑的中医医联体。

AI赋能哲学社会科学研究、传播及评价

人工智能正在改变整个人类社会,丰富人们的文化生活,促进科技创新与发展,是各行各业“新质化”的促进剂。人工智能可为哲学社会科学提供高效的研究工具和研究场景,将深刻影响哲学社会科学研究、传播及评价的方方面面。加速人工智能在哲学社会科学研究、传播及评价领域的深入应用,提升哲学社会科学研究效率,促进哲学社会科学的创新与发展,构建自主知识体系,是当下哲学社会科学工作者的重要使命。为推进AI赋能哲学社会科学(AI4SS),2024年9月28日,由西华大学、四川省社会科学学术期刊协会主办,西华大学学术期刊部、四川省社会科学重点研究基地四川学术成果分析与应用研究中心承办的“AI赋能社科研究与评价天府论坛”在西华大学举行。来自南京大学、中国人民大学、四川大学等高校与科研机构的20位专家学者,从不同学科、研究领域出发,就人工智能赋能哲学社会科学研究、传播及评价进行了深入交流。文章为20位专家学者在论坛上所作报告的主要观点。这些报告议题包括AI赋能人文社科研究方法的变革,法学、教育学、经济学、图书情报学、新闻传播等社会学科视域下的人工智能,AI辅助社会科学研究的学术伦理,人工智能在医疗健康、大宗商品价格风险监测、大学生高阶思维能力培养等方面的应用,AI赋能学术期刊出版与传播,AI赋能哲学社会科学评价新模式、新平台、新场景,等等。这些议题共同描绘了一个由AI技术驱动的多学科融合与创新的新时代。

运动转诊服务纳入医疗卫生优先事项的卫生经济学分析

当前,运动转诊服务获得了世界卫生组织推荐,正成为全球公共卫生优先事项。中国体医融合服务尚未获得政策优先级,可能受制于卫生经济学证据不足。文章系统梳理了身体活动不足的全球疾病负担研究,得知:(1)患病率。2010—2018年中国身体活动不足患病率上升7.93%;(2)健康负担。1990—2019年中国可归因于身体活动不足的死亡人数增长3.24倍、残疾调整寿命年增长2.64倍、健康寿命损失年增长2.89倍、寿命损失年增长2.58倍,过去近30年健康负担持续增长;(3)经济负担。2020—2030年,身体活动不足将引起4 517.01万例12种常见非传染性疾病,导致医疗卫生和医疗保健总成本达到36 694.53亿元;(4)宏观经济收益。2020—2050年解决身体活动不足将为中国带来的累积经济收益41 473.48~150 124.07亿元。这些数据为中国运动转诊服务纳入医疗卫生优先事项提供卫生经济学证据,但提升政策优先级还需:(1)进行独立的中国身体活动不足的疾病负担测算,为医疗卫生政策提供可靠证据;(2)将运动转诊作为中国非传染性疾病治理的优先政策;(3)建立运动转诊机制,并将运动转诊服务纳入医疗卫生服务目录。

2021-2023年云南省重点人群对国家基本公共卫生服务知晓率和满意度的调查研究

[目的]了解2021-2023年云南省65岁及以上老年人、高血压和糖尿病三类重点人群对国家基本公共卫生服务项目的知晓率和满意度,为进一步提高服务质量,提升居民的获得感以及更好地开展个体化健康教育工作提供参考。[方法]采取随机抽样的方法,选取云南省16个州(市)重点人群进行现场问卷调查,采用描述性分析、Kruskal-Wallis非参数检验对调查数据进行分析。[结果]2021-2023年,云南省重点人群对国家基本公共卫生服务项目的总体知晓率为72.69%,其中居民健康档案管理知晓率最高(95.38%)。重点人群对基本公共卫生服务总体满意度为74.04%,其中医患关系满意度最高(87.50%)。重点人群首诊选择村卫生室的占61.25%,乡镇卫生院占50.87%。[结论]云南省重点人群对国家基本公共卫生服务项目的知晓率和满意度相对较低,知晓率呈逐年上升趋势。建议加强针对老年人和慢性病等重点人群的教育和健康促进工作,提高基层医务人员的专业能力和服务水平,从而有效提高居民的获得感。

国家公园生态系统健康测度模型构建及黄山实证研究

国家公园是中国生态文明建设的重要制度实践,其生态系统健康的科学评估是国家公园分区管理、空间管制、生态保护的基础。国家公园生态系统具有特殊性和复合性,区别于城市、流域、湿地等生态系统,亟需建立一套适合国家公园生态系统的生态系统健康测度模型。基于国家公园生态系统的特殊性和生态系统健康概念的多维性,探讨了现有模型存在的问题和不足,从生态系统与人类活动交互的视角,建立了“VSR”(生态活力Vigor、服务能力Service、抗干扰力Resilience)国家公园生态系统健康测度模型。此外,将“VSR”模型应用到黄山国家公园生态系统健康的测度中,可视化了黄山国家公园生态系统健康的时空过程和格局,通过随机森林回归模型和增强回归树模型验证了“VSR”模型的有效性和稳定性。“VSR”国家公园生态系统健康测度模型有效量化了国家公园生态系统健康的时空差异性和时空动态性,为国家公园空间管制、生态保护等目标实施提供了科学支撑。

海南省居民对国家基本公共卫生服务项目知晓率与满意度网络调查分析

[目的]了解海南省居民对国家基本公共卫生服务项目的知晓率和满意度情况。[方法]采用方便抽样方法,对海南省31507名居民进行网络问卷调查,运用卡方检验、二分类Logistic回归和Spearman相关分析进行统计分析。[结果]海南居民对基本公共卫生服务项目的总体知晓率为85.8%,知晓率的主要影响因素为性别、民族、居住地区、年龄、文化程度、职业、人群类型和家庭平均月收入。居民总体满意度为93.8%,满意度的主要影响因素为年龄、文化程度、居住地区和职业。知晓率与满意度之间呈正相关(r s=0.330,P<0.001)。[结论]海南省居民对国家基本公共卫生服务项目知晓率和满意度较高,应进一步加大宣传力度,提高服务质量,进而提高居民的获得感。

新时代全民健身志愿服务的实践探索与制度创新

全民健身志愿服务承载着“全民健身”与“志愿服务”的双重属性,支撑健身运动普及与志愿精神传承,助力全民健身活动创新与体育制度治理,增强全民族健康水平与体育文化交流。研究发现,目前我国全民健身志愿服务正发挥着日益精进的作用,不论从志愿服务开展的内容、形式、组织还是志愿者参与度来看都取得了长足的发展,但是也面临着法律保障有待加强、激励政策亟待完善、政府机构间协同乏力、志愿者培养与管理制度尚待改进等问题,难以满足新时代人民群众日益增长的健身志愿服务需要。因此,提出健全法律保障、建立科学的激励手段、完善政府部门协同合作、建立长效化培养与管理机制等建议,以此创新我国新时代全民健身志愿服务发展思路。