Changes and Adjustments:The Rule of Law Response to Medical Institution Data Compliance

Medical institution data compliance is an exogenous product of the digital society,serving as a crucial means to maintain and balance the relationship between data protection and data sharing,as well as individual interests and public interests.The implementation of the Healthy China Initiative greatly benefits from its practical significance.In practice,data from medical institutions takes varied forms,including personally identifiable data collected before diagnosis and treatment,clinical medical data generated during diagnosis and treatment,medical data collected in public health management,and potential medical data generated in daily life.In the new journey of comprehensively promoting the Chinese path to modernization,it is necessary to clarify the shift from an individual-oriented to a societal-oriented value system,highlighting the reinforcing role of the trust concept.Guided by the principle of minimizing data utilization,the focus is on the new developments and changes in medical institution data in the postpandemic era.This involves a series of measures such as fulfilling the obligation of notification and consent,specifying the scope of data collection and usage,strengthening the standardized use of relevant technical measures,and establishing a sound legal responsibility system for data compliance.Through these measures,a flexible and efficient medical institution data compliance system can be constructed.

Application and Practice of Traditional Chinese Medicine Characteristic Technology Inheritance in Research and Development of Traditional Chinese Medicine Preparations in Medical Institutions

Medical institution preparations play an important role in the development of hospitals,being one of the main forms of traditional Chinese medicine clinical characteristic medication,as well as an important carrier for the inheritance and innovation of traditional Chinese medicine.In recent years,the research and development of traditional Chinese medicine preparations has become a hot spot in the research and development of preparations by medical institutions.Traditional Chinese medicine preparations prepared by traditional processes and their entrusted preparation matters have changed from the current licensing management to filing management.The registration model of traditional Chinese medicine preparations has undergone significant changes,emphasizing more on real data and evaluation results from the objective world,respecting traditional medication experience,and emphasizing the inheritance and innovative development of traditional technological experience.In the process of following teachers in the inheritance project of traditional Chinese medicine,we combined the inheritance of traditional Chinese medicine characteristic technology with the research and development practice of traditional Chinese medicine preparations in medical institutions,and focused on the analysis and discussion of technical problems such as prescription screening,dosage form selection,process route design and clinical observation of traditional Chinese medicine preparations,hoping to provide reference for scholars in the same field of traditional Chinese medicine.

Research on the Problems and Countermeasures of the Landing of Negotiated Drugs

Objective To provide reference for better landing of the negotiated drugs in the future.Methods Relevant data on the negotiated drugs in designated medical institutions and retail pharmacies from the website of the Medical Security Bureau was obtained,and then the allocation and problems of negotiated drugs were summarized and analyzed.Results and Conclusion The main problem for the landing of negotiated drugs is the difficulty of using them in medical institutions.First,there is a small number of designated medical institutions that can use some negotiated drugs.Second,the negotiated drugs vary greatly in the designated medical institutions.Lastly,some designated retail pharmacies do not supply the negotiated drugs.The difficulties in using the negotiated drugs can include subjective reasons and objective reasons.Retail pharmacies are not the official places where patients can use the negotiated drugs.Besides,if medical institutions do not supply and use negotiated drugs,it will pose a great risk to drug safety.Negotiated drugs should be used in designated medical institutions ultimately,which is conducive to safeguarding the rational drug use for patients.

Investigation and Analysis of Rural Medical Waste Management

Objective: The aim is to understand the status of rural medical waste management and problems and to make recommendations. Methods: The questionnaire survey, interviews and comparative analysis are used. Results: Compared with urban medical waste management, rural medical waste management is weaker in classification, unified recycle, disposals, protect measures of related personnel, regulations and policies of awareness. Conclusion: It is recommended to improve policies and regulations of rural medical waste management, strengthen rural infrastructures and facilities, improve supervision and innovates means of supervision.

Tianjin Medical University Cancer Institute and Hospital

Tianjin Medical University Cancer Institute and Hospital (TMUCIH) is the birthplace of Oncology in China. It has a history of more than a hundred years and has become one of the most famous modernized cancer hospitals worldwide. It is also one of the largest bases for cancer prevention, treatment, training and research in China.

Research on Aging Design of Living Space in Medical and Nursing Institutions

Aging design principle of living space in medical and nursing institutions is taken as the basis.Coming the principles of ergonomics,rehabilitation medicine and gerontology,possibility of using living space in the medical and nursing institutions dominant by the mediating elderly and supplemented by the self-care elderly is explored,and different scales of living space are deduced.Moreover,the rationality of the room layout is compared and analyzed under the relevant scale,and layout of aging room in medical and nursing institutions is summarized.The research aims to provide the reference for deeply studying future design of living space in medical and nursing institutions.

Medical Malpractice:A Comparative Perspective Between China and the United States

At the beginning of the 1970s,the United States turned onto the winding road of medical malpractice compensation.With the goal of properly dealing with this issue,the United States embarked on a process of continuous reform.In recent years,the number of disputes over medical malpractice liabilities in China has increased considerably.However,dealing with these disputes in accordance with the provisions of the current law is not going smoothly,and maybe we can learn from the experiences of the United States.The relevant measures for the solutions to medical malpractice in the United States and China will be analyzed from a comparative perspective.These include enactments of medical malpractice,the classification of medical malpractice,the doctrine of liability fixation,the burden of proof,the criterion of judging negligence,the liability subject,the authentication system,expert witnesses,standards of compensation,and suggested reforms in the system of the medical malpractice liability,including stipulating the medical malpractice liability of administration in the Civil Code,optimizing the criteria of recognizing negligence,applying organizational fault liability,establishing pilot projects of no-fault medical liability,developing an open mechanism for medical malpractice disclosures and improving the capacity to deal with medical chaos.

Medical Information Breaches Occurrence with Respect to Social Media Usage, in Selected Medical Institutions in Uganda

The purpose of this manuscript is to present research findings based on the reported cases of medical information breaches due to Social Media (SM) usage, in selected medical institutions in Uganda. The study employed online survey techniques. Altogether, 710 questionnaires (Google forms) were developed, and operationalized. The main respondents included 566 medical students, and 143 medical staff from Mbarara University of Science and Technology (MUST), and Kampala International University (KIU), accordingly. Using SPSS, the main statistical analysis tools employed include frequency distribution summary, and Chi-square (x2) test. According to the frequency distribution summary, 27% to 42% of the respondents within categorical divides acknowledged occurrence of medical information breaches due to SM usage. Notably, higher levels of the breaches were reported among male students (64%), age-group 18 to 35 years (68%), and WhatsApp users (63%). On the other hand, Chi-square results showed significant levels (p p > 0.05) between medical institutions and medical information breaches. Overall, the vulnerable areas of the breaches identified would serve as important reference points in the process of rationalizing SM usage in medical institutions. Nevertheless, further studies could focus on identification of the key SM usage factors associated with medical information breaches in medical institutions in Uganda.

Investigation of Cognition Status of Menopausal Hormone Therapy in Medical Institutions Staff

Objective:To investigate the cognition,application and commendation of menopausal hormone therapy(MHT)among medical institution staff with different professional background.Methods:Female staff aged 40-60 years in 4 tertiary hospitals were randomly selected.The participants'characteristics and the information of cognition,application and recommendation of MHT were collected by questionnaire.Results:A total of 341 people participated in this study,the cognition rate of MHT was 37%and the recommendation rate was 44%.For people with indications of MHT,the utilization rate is 15%,and 84.6%of them have used MHT for less than 3 years.84.6%of those who did not use MHT considered menopause is not a disease and there was no need to use medication.Compared with nurses,doctors know more about MHT(P<0.01),and MHT recommendation rate of doctors was higher than that of nurses(P<0.01).The cognition of MHT were analyzed in menopause group,irregular menstruation group and regular menstruation group,there was no difference was found among these three groups(P>0.05).Conclusion:Strengthening the training of MHT related knowledge in medical institutions,will be helpful to improve the cognition and utilization rate of medical institutions and promote the whole society to study and use MHT.

强基层:深圳南山区域医疗联合体的策略和效果

目的分析区域医疗联合体(以下简称“医联体”)政策指引下深圳南山区域医联体发展的探索,为其他地区医药卫生体制改革提供参考。方法通过知情人访谈、现场调研、二次资料分析、头脑风暴等方法剖析深圳南山区域医联体强基层的策略背景、实施内容和实施效果。结果统一管理所有基层医疗卫生机构,实行标准化建设,有助于更好地发展基层医疗卫生机构;实施区域学科联盟,以契约方式加强医院和基层医疗卫生机构的人员联系,具有可行性。结论强基层是医药卫生体制改革的重点,深圳南山区域医联体强基层的策略具有参考借鉴价值。

Quality Medical Services at Doorway——Beijing's community-based medical institutions

For years suffering from hypertension, Mrs. Zhang, now in her 60s, is a frequent visitor to Beijing Dewai Community Hospital in her neighborhood.＂I feel too painstaking to go to a ＇big hospital,＇＂ she says. ＂Buses are always overcrowded and slow, not suitable for people like me. Besides, community-based medical institutions charge less for treatment of the same diseases.＂

新医改后我国乡镇卫生院医疗服务量变化趋势及其影响因素:基于29个省际面板数据的实证分析

目的了解我国乡镇卫生院医疗服务量情况,明确不同因素对乡镇卫生院医疗服务量的影响及其程度,为进一步发挥乡镇卫生院功能提供依据。方法数据来自2010—2019年《中国农村统计年鉴》《中国人口和就业统计年鉴》《中国卫生健康统计年鉴》《中国交通年鉴》,对新一轮医药卫生体制改革后我国29个省(自治区、直辖市)乡镇卫生院医疗服务量情况进行描述性分析。利用面板数据分析乡镇卫生院医疗服务量的影响因素,包括乡镇卫生院医疗卫生资源配置,以及农村地区经济、老龄化、教育、社会发展水平。结果2009—2018年我国乡镇卫生院医疗服务量整体呈上升趋势。卫生资源配置是影响乡镇卫生院医疗服务量的重要因素;农村道路密度对医疗服务量有显著正向影响,即农村道路密度越高,医疗服务量越多;农村地区老龄化水平、居民教育水平对出院人数具有负向影响。结论我国仍需重视乡镇卫生院卫生资源配置,关注卫生资源配置数量、质量与效率;提高乡镇卫生院服务能力,拓展服务内涵,持续推进强基层建设。

三级医疗机构医院卫生技术评估实施现况

目的分析三级医疗机构医院卫生技术(hospital-based health technology assessment,HB-HTA)评估开展现状,为完善医疗机构HB-HTA的应用提供参考和依据。方法运用便利抽样方法,对国家卫生健康委员会医疗管理服务指导中心HB-HTA工作试点医院和已开展HB-HTA的其他医院进行问卷调查和关键知情人访谈。结果共调查19家三级医疗机构,开展HB-HTA有利于促进医疗机构科学管理决策、保障医疗质量和安全、节约医院预算、提高HB-HTA认知水平。但目前HB-HTA还存在缺乏长期持续开展的激励机制、缺乏HB-HTA相关专业人才和部门、HB-HTA流程过于繁杂、卫生技术评估时效性较差、决策支持效率较低、研究结果推广率低等问题。结论建议加强政策、资金支持,注重加强医院内部卫生技术评估人才的引进和能力培训,积极鼓励和引导医院内部建立具体HB-HTA小组或者部门,探索开发HB-HTA支持决策流程的智能化工具或软件,通过多种方式促进评估成果和评估报告的传播共享,不断完善HB-HTA的开展。

上海市医疗卫生机构职工休息室建设需求与对策建议

目的调查分析上海市医疗卫生机构职工休息室建设需求和管理现状,为改善医务职工的工作环境和工作条件提供方法和经验。方法对各级医院和医疗急救中心的医务职工进行线上电子问卷调查,内容包括休息室现状及对休息室需求等,共回收有效问卷1434份。对9家医疗卫生机构开展现场调查,并与休息室建设负责人、管理负责人等15名相关人员进行访谈。结果所调查的医务职工中,13.7%没有时间休息,16.9%在休息室中休息,医疗机构现有职工休息室建设存在设置不均衡、总体数量少、使用率有待进一步提高等问题。医务人员对休息室的需求主要集中于面积、布局、室内环境、功能等方面,其中不同工作特性医务人员的休息需求有所不同。医务职工休息室建设与推行难点主要为用房紧张、法规标准不明确、管理困难、医务职工休息需求不被重视。结论在医务职工休息室规划建设上,建议加大政策支持力度,建立规范化管理制度,并通过加强组织领导、多方协同合作,确保休息室建设改善工作能有效落实。在具体建设方面,应满足医务职工多元需求,可因地制宜规划设计、合理划分功能分区。此外,还应重视宣传总结,营造“健康工作,科学休息”的积极氛围。

河南省远程医疗业务系统建设及应用

目的了解河南省远程医疗业务系统建设与应用效果,为河南省远程医疗发展提供建议。方法2019年10月—2020年12月,采用自行设计的调查问卷对河南省二级、三级医疗机构的业务系统建设及业务开展情况进行调研,并采用描述性分析方法对不同等级医疗机构远程医疗建设情况进行分析。结果河南省三级医院远程会诊系统、远程教育系统建设占比达100.0%,其中远程教育系统2019年占比较2018年上升30.0个百分点,二级医院除远程会诊系统之外,其余远程医疗业务系统建设占比下降。远程教育服务人次最多,服务1000人次以上的三级医院占50.0%,二级医院占5.0%。三级医院普通会诊响应时长在12 h以内的占比提升16.5个百分点,紧急会诊响应时长在2 h以内的占比提升26.6个百分点。结论远程医疗在三级医院发展速度较快,在二级医院普及速度放缓,并存在基础建设工作推进困难以及平台、数据标准不统一的问题。应引导大型医院、企业点对点帮扶基层医疗卫生机构,在各级医院推广远程教育,提高医护工作者远程服务意识,并加强医疗系统标准化建设工作,促进数据互联互通,提高远程医疗业务便捷度。

上海市试点推进医疗机构疾控监督员制度创新探索与实践

上海市推进医疗机构疾控监督员制度试点工作,以系统集成理念探索试点制度创新,推动打造预防、治疗、管理一体化的医疗服务模式。选取浦东、长宁、嘉定作为试点区,开展多元路径实践,推出多项创新举措,探索疾控监督员驻点模式,形成了行之有效的经验做法,提高重大传染病疫情早发现、早报告、早处置能力,建立了可借鉴、可复制的工作样板。同时,也指出了当前面临能力建设、激励机制等问题和挑战,提出了未来高质量推进疾控监督员制度建设的工作举措。

国家组织药品集中采购和使用试点对临床用药管理与使用的影响

目的调查国家组织药品集中采购和使用试点(以下简称“‘4+7’试点”)的影响,提出政策建议,为进一步推行国家组织药品集中采购提供参考。方法用焦点组访谈法,对北京、上海、广州、西安和沈阳5个试点城市的64位医疗保险管理者、卫生行政管理者、医院管理者和医师代表进行访谈。用问卷调查法,就政策影响对5个试点城市的509位医师和498位患者进行分层抽样调查。结果医师对“4+7”试点的认可程度高,认为药品的临床效果达标,不良反应处于常态水平。患者给予中标药品正向反馈,对中标药品的接受度较高,试点降低了患者的医疗费用,患者满意度较高。试点也存在医院为达成政策实施目标而限制医师的处方权、医师工作量加大但激励不足等问题。结论药品集中采购的积极影响明显,但要实现控制药品总费用、保障药品供应和“三医联动”的目标,还应平行推进相关配套改革措施,如加快医疗保险支付改革,依托药品临床综合评价以真实世界数据推动药品的遴选和合理使用,调整医药费用结构,促进公立医院绩效及薪酬制度改革,推进行业监管和医疗卫生服务精细化管理等。

安徽省公立医疗机构医用耗材两票制实施若干问题及对策建议

目的分析安徽省公立医疗机构医用耗材两票制执行中存在的若干问题,提出对策建议,为省级层面推行两票制提供借鉴。方法通过回顾性横断面研究和问卷调查相结合的方法,分析医疗机构两票制执行情况和存在的问题。结果省、市级医疗机构政策执行较好,县(区)级医疗机构执行率偏低;医疗机构普遍反映部分产品断供、两票制相关材料核验工作繁杂;经营企业集中度、配送效率、技术服务水平有待提高;议价空间明显提高,尤其配合其他政策,耗材费用明显降低。结论在省级层面推行两票制应点面兼顾,将资质材料审核前置;搭建信息平台,推行电子发票和经营企业评价体系;加快生产企业和经营企业职能转变;推进多项政策联动,使患者享受流通改革红利。

上海23家民营医疗美容机构及其从业人员现况调查

目的 了解民营医疗美容机构医疗美容项目及医护人员配置和能力情况。方法 通过分层抽样抽取上海市5个区23家民营医疗美容机构,采用现场调查、个人访谈及调查表进行调查分析。结果 调查的医疗美容机构以医疗门诊部为主(73.91%),60%以上经营时间在10年以内,60%以上设立在写字楼内或沿街商铺。项目以轻医疗美容为主,皮肤美容项目最多,占95.65%,其次是美容外科,占91.30%。美容间、手术室及苏醒室的平均周转速度分别为每间201.72人次/月、42.41人次/月及167.19人次/月。平均每家机构有专业医护人员40.08人、行政辅助人员21.52人。感染控制(以下简称“感控”)人员的均数为2.17人/家,专职比例为36.00%。感控继续教育中无菌操作、手卫生、安全注射等项目的培训参与率为95.45%、90.91%、68.18%。结论 民营医疗美容机构项目主要以轻医疗美容为主,感控能力建设不足,在硬件设置、人员配备和培训上仍需加强。

2020—2025年广东省医疗机构床位需求预测

目的预测2020—2025年广东省医疗机构的床位需求总量。方法基于卫生服务需求法与Holt双参数指数平滑模型,结合年龄别人口数据预测床位需求。结果2025年,广东省住院人数为2425.11万人,床位需求数为70.04万张,每千常住人口床位需求数为5.63张、每千常住人口拥有床位数5.55张,供需比例为98.58%。预测模型的平均百分误差为1.63%(标准差=±1.90%,均方根误差=20.63)。结论结合人口的年龄结构进行预测结果更稳定、误差更小。2020年,广东省的床位配置量基本能满足床位需求,供需较为平衡。但2024年床位需求将超过床位配置总量。未来,广东省应加大床位资源的投入力度,提高基层卫生机构的床位利用率,全面落实分级诊疗制度。