Analysis of Professional Quality Cultivation Strategies for Infant and Child Care Service Talents from the Perspective of Collaboration of Medical Care,Parenting,and Education,and Integration of Industry and Education

The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.

Implementation Strategy of“Eight in One”of Integrated Medical and Care Service System in China:A Case Study of Anshan City of Liaoning

With the gradual intensification of aging in China,the issue of elderly care has become the primary issue that needs to be urgently solved in society.The construction of a reasonable and scientific integrated medical and care service system can not only efficiently allocate medical resources and services,but also better meet the needs of the elderly.Due to the involvement of multiple disciplines such as architecture,sociology,psychology,and behavioral science in the construction of the system,as well as the restriction of various objective factors such as medical capacity,spatial scale,and operating costs,the government and elderly care institutions have always been unable to find the best solution for how to scientifically and reasonably construct an integrated medical and care service system.This paper is based on Anshan City,Liaoning Province,which has prominent aging issues and distinct characteristics of the elderly population.Through extensive field research in elderly care institutions,and face-to-face communication with personnel from relevant government departments such as the Municipal Commission on Aging,the Civil Affairs Bureau,the Health Commission,the Medical Insurance Bureau,and the Human Resources and Social Security Bureau,it truly understands the problems that arise in the construction of the urban integrated medical and care service system.From three aspects:urban situation,institutional situation and the needs of the elderly,it is proposed to establish a clear departmental linkage mechanism with clear rights and responsibilities,a policy guarantee mechanism tailored to local conditions,a multi-measure operation mechanism,a technology first intelligent response mechanism,a warm and efficient service mechanism for the people,an overall layout mechanism,an evaluation and supervision mechanism for full process control,and a talent supply mechanism of external introduction and internal training.It aims to provide reference for the construction of an integrated medical and care service system in similar cities.

Overview of the Shenzhen Emergency Medical Service Call Pattern

BACKGROUND:In Shenzhen,the Emergency Medical Service(EMS) system has been in service since 1997.This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS.METHODS:In this retrospective quantitative descriptive study,the data from the Shenzhen 120 EMS registry in 2011 were analyzed.RESULTS:Shenzhen 120 EMS center is a communication command center.When the number of 120 are dialed,it is forwarded to the closest appropriate hospital for ambulance dispatch.In2011,the Shenzhen 120 EMS center received 153 160 ambulance calls,with an average of 420 calls per day.Calling emergency services was mainly due to traffic accidents.Trauma and other acute diseases constituted a majority of ambulance transports.The adult patients aged 15-60 years are the principal users of EMS.There are no recognized 'paramedic' doctors and nurses.The pre-hospital emergency service is under the operation of emergency departments of hospitals.Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in posttrauma management.Moreover,specialized pre-hospital training,financial support,and public health education on proper use of EMS should be emphasized.CONCLUSION:The Shenzhen 120 EMS center has its own epidemiology characteristics.Traumatic injury and traffic accident are the main reasons for calling ambulance service.In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.

A Scale of Parental Anxiety about Pediatric Emergency Medical Care Services of Japan: Development, Reliability, Validity, Generalizability and Usefulness

Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.

Physicians’Perception of Palliative Care Consultation Service in a Major General Hospital in China

Objectives The in-hosptial palliative care consultation(PCC)is emerging as a routine service in some medical center in China.The current study evaluated how physicians in primary care team and consultation team perceive the PCC service for the purpose of investigating the effectiveness of this consultation model in a general hospital.Methods In-hosptial palliative care consultations have been carried out at Peking Union Medical College Hosptial by a dedicated consultation team,and37consultations were completed in2016.A questionnaire was designed for physicians in terms of its benefits to patients,their family as well as the primary care team.Physicians who applied for consultation in2016formally(requested from the department other than the Geriatrics)and informally(by rotating residents and unemployed visiting doctors in geriatric department)were invited to participate in the survey by scanning a two dimentional code on social networking platform.Results There were103physicians participated in the survey,including primary care physicians from the department of Internal Medicine(n=8),Gynaecology(n=16)and Surgery(n=13),rotating residents(n=30),visiting doctors(n=16)in Geriatric department,and PCC team members(n=20).94.0%of the non-PCC physicians agreed that PCC relieved the suffering of patients;89.2%thought PCC improved the quality of patients'life;there were91.6%,95.2%,90.4%physicians who felt it relieved the anxiety of patients,of family members and of care providers,respectively.There were96.4%physicians who felt it could ease the tension in physician-patient relationship;97.6%felt it lower the risk for medical negligence,and96.4%of doctors who applied for PPC felt satisfied with PCC service in terms of process and achieving objectives of consultation.More primary-team physician agree"PCC service helps the physicians better understand palliative care"than PCC members(97.6%vs.80%,P<0.05),while both were interested in learning more on palliative medicine(100%vs.96.4%,P>0.05).

Mobile EMR Use for Epidemiological Surveillance on a Medical Service Trip in Honduras: A Pilot Study

Rationale: Medical treatment on short-term primary care medical service trips (MSTs) is generally symptom-based and supplemented by point-of-care testing. This pilot study contributes to the effective planning for such austere settings based on predicted symptomology. Objective: We aimed to prospectively document the epidemiology of patients seen during two low-resource clinics on a MST in Honduras and apply predefined case definitions adapted from guidelines used by international healthcare organizations (e.g. World Health Organization). Methods: An observational design was used to track the epidemiology during two clinics on an MST in Limon, Honduras in March 2015. The QuickChart mobile electronic medical record (EMR) application was piloted to document diagnoses according to predefined case definitions. Results: The most commonly diagnosed syndromes were upper respiratory complaints (20.19%), nonspecific abdominal complaints (20.19%), general pain (15.38%), hypertension (9.62%), pruritus (6.73%), and asthma/ COPD (4.81%). The case definitions accounted for 94% of all complaints and diagnoses on the brigade. Discussion: The distribution of common patient diagnoses on this MST was similar to that which had been reported elsewhere. The use of broader symptom-based case definitions for epidemiologic surveillance could also facilitate the syndromic management of patients seen on MSTs, and improve the consistency of treatment offered. Conclusion: Case definitions for common syndromes on primary care MSTs may be a feasible method of standardizing patient management. Preliminary use of the QuickChart EMR was acceptable for documentation of epidemiology in the field. Further study is necessary to investigate the reliability of syndromic diagnostic criteria between different clinicians and in a variety of MST settings.

On Rural Medical Care and Health Undertaking Development during New Medical Reform

Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

北京市老年人医养结合的难点与对策:机构的视角

中国老年群体在全国人口中的比例越来越大,如何通过医养结合真正做到老有所养、病有所医,是当前亟须解决的重要难题。以北京市为例,分析了北京市医养结合的发展形势,通过对北京三种主要的医养结合模式进行实地调研,从组织机构的视角总结不同模式面临的困难和挑战,建议进一步统筹协调京津冀医养结合政策,加快长期照护险落地,加强养老人才队伍的专业化建设,强化对养老机构的标准化建设和监管,大力发展科技养老、智慧养老。

北京市综合医改前后社区卫生服务机构治疗费用的受益人群分析

背景厘清社区卫生服务机构主要服务的人群特点,对下一步社区卫生服务机构的精准改革具有十分重要的意义。目的通过分析综合改革前后北京市社区卫生服务机构治疗费用的受益人群特征,为下一步改革政策制定和调整提供精准的数据支持。方法本研究基础数据来源于2016—2019年北京市卫生总费用核算基础数据库,其他数据来源于2016—2019年《北京市卫生健康统计年鉴》《北京市卫生财务统计年报》《北京市卫生费用核算报告》等。采用多阶段分层整群抽样的方案选取社区卫生服务机构,从HIS系统纳入全年的门诊数据、住院患者的数据。采用卫生费用核算体系2011(SHA2011)核算、分析社区卫生服务机构治疗费用的受益人群状况。结果2016—2019年北京市社区卫生服务机构治疗费用从121.81亿元增长至222.45亿元,年均增长19.07%。40岁以上中老年患者治疗费用历年占比均在92%以上,60~岁、80~岁两个年龄组患者治疗费用增长较快,年均增速分别为24.08%、25.84%;治疗费用中内分泌、营养和代谢疾病,症状、体征和检验异常、循环系统疾病占比最高,内分泌、营养和代谢疾病,神经系统疾病,症状、体征和检验异常疾病治疗费用增长较快,年均增速分别为40.11%、48.40%和32.43%。结论综合改革后分级诊疗成效初显,社区医疗服务资源主要由中老年患者、内分泌、循环系统等慢性非传染性疾病患者所消耗,改革引导更多中老年和慢性病患者流向社区,社区卫生服务机构应该从服务能力、人才队伍、慢性病管理、医联体建设等多方面着手,提升其服务能力,巩固和维持改革的效果。

基于政策工具的河南省医养结合政策文本分析

目的:选取2016~2023年河南省医养结合政策文本为研究对象,研究分析政策文本内容的特征及不足,提出合理化建议,为完善河南省医养结合政策体系提供参考。方法:以政策工具为视角,结合参与主体维度构建二维分析框架,采用内容分析法对27个政策文本进行分析,得到有效编码172条。结果:政策工具结构不平衡,供给型政策工具占29%,需求型政策工具占8%,环境型政策工具占63%;参与主体分布不均衡,政府参与占61%,养老机构参与占8%,医疗卫生机构参与占16%,社会组织参与占12%,健康产业参与占3%。结论:河南省医养结合政策内容丰富、层次鲜明、目标清晰,但政策工具结构不平衡、参与主体分布不均衡,要优化政策工具间结构、协调各参与主体在政策工具中分布、加强各参与主体在各个政策工具中的交互协作,促进河南省医养结合政策发展。

医养服务机构质量评价指标体系的构建与初步应用

目的以“结构-过程-结果”理论为框架,构建医养服务机构质量评价指标体系并初步应用。方法基于文献研究、小组讨论、德尔菲法及层次分析法,确定评价指标体系和各指标权重。应用该指标体系在长沙市3家医养服务机构进行现场评价。结果共进行2轮函询,专家权威系数分别为0.915和0.927,协调系数分别为0.211和0.164,最终确定一级指标3个,二级指标13个,三级指标53个。评价指标体系的Cronbach'sα系数为0.786,平均内容效度指数为0.862。在3家医养服务机构进行的预调查效果较好。结论医养服务机构质量评价指标体系信度、效度较好。构建的指标科学、合理、实用性强,能有效评价医养服务机构质量并发现问题。

基于SERVQUAL模型的基层医疗卫生服务质量评价研究

目的:在县域医共体的建设背景下,评价社区卫生服务中心服务质量及影响因素,提出基层医疗卫生服务质量改善对策。方法:运用SERVQUAL模型,从社区卫生服务中心服务质量的有形性、可靠性、响应性、信任性、移情性方面,形成问卷条目;通过多因素二分类logistic回归探索筛查服务质量差距的影响因素;借助IPA象限图呈现居民对社区卫生服务中心的SERVQUAL模型各维度服务质量重要性的分布情况。结果:问卷各项条目的服务质量差距均为负值,服务保证性和移情性维度的服务质量差距得分最高,分别为-0.47±0.59分和-0.47±0.65分;服务有形性维度的服务质量差距得分最低,为-0.40±0.55分。年龄、收入情况和慢病年限是服务质量差距的影响因素。结论:当前基层医疗卫生服务质量与居民的期望之间存在一定差距,基层医疗卫生服务机构应重视对低年龄、高收入和慢病病程较长的居民的服务需求。

党建引领视角下医疗卫生人才培养的实践研究

加强党建工作建设,充分发挥党组织领导核心的作用,为医疗卫生教育机构深化医疗人才培养提供坚强保障。在党建引领背景下对医疗卫生人才培养进行探索和研究,构建全员、全方位、全过程育人体系,聚焦党建引领,建强育人队伍,凸显全员育人合力,培养兼具扎实专业理论和综合素质能力的复合型人才成为重要的育人目标。推动党建引领实践育人工作,即有利于强化党对医疗卫生教育机构的领导,还有利于创新党建引领、医疗卫生教育机构主导和社会力量参与的实践育人模式。文章从党建引领,在医疗人才培养的实践探索、实践策略等方面,探索党建引领实践育人策略,以为相关工作提供一定的借鉴和参考依据。

人口老龄化背景下农村医养结合服务的现状与对策——以唐山市乐亭县为例

以唐山市乐亭县农村医养结合服务模式和现状为例,针对目前农村地区医养结合服务存在的供需失衡、“医”与“养”资源融合不足、设施落后、缺乏专业服务人员等问题,提出完善政策体系和保障制度,强化医养衔接,开展多层次医养结合服务,加强人才队伍建设,构建医养结合信息化系统的对策建议,从而推动农村医养结合的发展。

“互联网+居家护理”在志愿护理服务中的应用效果

目的探讨"互联网+居家护理"在志愿护理服务中的应用效果。方法选取2020年12月至2021年12月"党群服务365平台"82例需要服务人群作为研究对象,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组实施常规医疗服务,观察组实施"互联网+居家护理"服务,两组均持续护理12个月。比较两组的医院看病次数、医疗花费情况、日常生活能力、精神状态、照护者照护技能水平以及生活满意度。结果观察组医院看病次数、医疗花费情况均少于对照组,差异有统计学意义(P<0.05);观察组护理后日常生活活动能力量表(ADL)评分低于对照组,简易精神状态检查量表(MMSE)评分、照护技能水平评分均高于对照组,差异有统计学意义(P<0.05);观察组护理后生活满意度调查表(LSR)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论通过互联网平台,护理志愿者对服务人群进行居家护理,能够改善服务人群的精神状态,促使其保持身心健康,提高生活自理能力,还能提高照护者的护理技能,一定程度上减少看病次数和医疗花费,从而提升服务人员满意度。

信息化医养结合式院外干预在淋巴瘤患者全程管理中的应用

目的:探讨信息化医养结合式院外干预在淋巴瘤患者全程管理中的应用效果。方法:选取2022年1月1日~6月30日收治的273例淋巴瘤患者作为对照组,采用常规院外干预;选取2022年7月1日~12月31日收治的250例淋巴瘤患者作为研究组,实施信息化医养结合式院外干预。比较两组干预前后癌因性疲乏情况[采用癌因性疲乏量表(CFS)]、心理状况[采用简明心境问卷(POMS)]、应对方式[采用医学应对方式问卷(MCMQ)]、健康行为[采用健康行为量表(HPLP-Ⅱ)]。结果:干预后,两组CFS各维度评分均低于干预前(P<0.05),且研究组低于对照组(P<0.01);干预后,两组POMS中精力-活力维度评分高于干预前(P<0.05),其他维度评分均低于干预前(P<0.05),且研究组优于对照组(P<0.01);干预后,两组MCMQ中屈服、回避维度评分均低于干预前(P<0.05),面对维度评分高于干预前(P<0.05),且研究组优于对照组(P<0.01);干预后,两组HPLP-Ⅱ各维度评分均高于干预前(P<0.05),且研究组高于对照组(P<0.01)。结论:将信息化医养结合式院外干预应用于淋巴瘤患者全程管理中,能有效改善其癌因性疲乏情况及负性情绪,促使其以积极的应对方式对待疾病,提高其健康行为。

人口老龄化背景下辽宁省实施智慧医养服务有效路径分析

随着全球人口老龄化程度的加深,我国迎来了“银发时代”,养老问题在面临严峻挑战的同时也衍生出了新的机遇.目前,辽宁省已经进入深度老龄化社会,随着人们养老需求的增加及电子信息技术的飞速发展,智慧医养成为老龄化时代的必然产物.通过对国家统计局、中国互联网络信息中心、智慧医养等相关平台发布的数据进行统计、对比分析,发现辽宁省实施智慧医养服务面临着在老年群体中推广度较低、覆盖面不全、基础有待提升、网络信息平台存在安全隐患等困境,最终从4个方面提出针对辽宁省实施智慧医养服务的有效实施路径,希望能够以此促进辽宁省智慧医养服务高质量发展,对辽宁经济的发展及健康中国战略的实施起到一定的推动作用.