An automated management system for the community health service in China

Objective:To explore a useful tool for health administrative departments to manage the com-munity health service(CHS).Methods:On the basis of existing health laws and regulations in China,we describe the design of an automated management system for the CHS with a supervision system and an evaluation system using computer technology and corresponding design software.Results:Four changes to the management of the CHS were made:repetitive work became automated,complicated work became simplified,nonregular services decreased,and obscure in-structions became clear and specific.Conclusion:The automated management system will promote the development of CHS man-agement.

Research progress on the health status and community management service needs of mobile elderly people

The health status of the floating elderly population and the need of community management services are complex and important problems.Owing to the change of living environment and the insecure medical care,the mobile elderly people have more health and psy-chological problems compared to the rest of the elderly population.Therefore,the community should take a variety of measures to meet their needs and help them to better adapt to the new living environment,and maintain their physical and mental health.This paper aims to summarize recent studies on the physical and emotional health problems of mobile elderly people and related community management service needs.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

The Management of Mental Health, and Service Networks in Italy

Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and still have,the same relationship with madness.It is only with the affirmation of the Modern State,and of Capitalism,that the idea of“normality”indispensable to be able to conceive diversity as something dangerously distant and different from the norm takes over.In our post-modern society,people with mental illness in Italy can resort to specialists and social-health services.But the heterogeneous answers given after the approval of law 180 appear to be increasingly diversified.In this research,much attention will be paid to how the social and health services,located in different areas of Italy(Messina,Rome,Trento)face the current growing risk of social,housing and economic isolation of these fragile subjects.The aim of the research is to explore the possibility of a new relationship between the social-health service and the local community.On the one hand,research investigates what the contribution of the services could be.On the other what the spaces of protagonism and participation of the community could be in inclusion process account.In order to better understand the differences between these two dimensions,a qualitative research approach was chosen through the conduct of in-depth interviews.In this way it was possible to investigate:(1)the partial representations characteristic of the single individual,family members,operators and stackholders in general;(2)the services around the topic dealt with is articulated.From the first results of the research it emerges that the territory can no longer be considered as an abstract entity,but becomes the social space within which the construction of a new community welfare can and must take place.

General medical practice in China:evaluation of urban community health care service functions based on a rough set reduction theory

Objective:This study aims to achieve an empirical evaluation on the functional performances of urban community health care services in fi ve administrative districts of Nanchang city in China.Methods:In order to increase effectiveness,data collected from fi ve administrative districts of Nanchang city were processed to exclude redundant information.Rough set reduction theory was brought in to evaluate the performances of community health care services in these districts through calculating key indices’weighed importance.Results:Comprehensive evaluation showed the score rankings from high to low as Qing-yunpu district,Xihu district,Qingshanhu district,Donghu district,and Wanli district.Conclusion:The objective performance evaluation had actually reflected the general situation(including social-economic status)of community health care services in these administrative districts of Nanchang.Attention and practical works of community health service management were needed to build a more harmonious and uniform community health care service system for residents in these districts of Nanchang.

“政府办管”“院办院管”和“市场办管”三种社区卫生服务模式比较分析

"政府办管""院办院管"和"市场办管"模式是当前我国社区卫生服务的三种主要模式。本文通过文献研究、政策分析等方法对三种模式进行界定,并从卫生经济学、公共管理学、社会保障学等视角进行分析比较,最后提出政策建议:根据各自的社会经济发展水平选择社区卫生服务发展模式;发展社会组织,共同参与社区卫生服务的治理;继续推进社区卫生服务管理体制和运行机制改革。

社区卫生服务机构健康管理师岗位设置分析与策略研究

目的了解现阶段在我国社区卫生服务机构设置健康管理师岗位的意义与现实障碍,以此为基础,提出在我国社区卫生服务机构设置健康管理师岗位的可操作策略措施。方法借鉴SWOT分析的思路,分析现阶段我国社区卫生服务机构设置健康管理师岗位的内部优势与劣势、外部机会和威胁。结果社区卫生服务机构健康管理师岗位的设置符合医改"保基本、强基层、建机制"的方针,能够在一定程度上促进有限的社区卫生资源更加合理地使用,促进社区服务模式转变并提高服务供给能力;目前人才培养、机构编制与岗位、经费补偿等宏观管理政策的缺失影响了该职业在社区卫生服务机构的发展;上海闵行区对社区卫生服务人员进行健康管理师在岗培训与资格考试及家庭医生服务模式的实践提供了可供借鉴的经验。结论健康管理师职业在社区卫生服务机构有广阔的发展空间,现阶段需要在岗位设置、补偿机制、人才培养、职称晋升方面取得突破。

社区卫生服务管理制度缺陷与完善——社区卫生服务管理制度现况调查与分析

目的:建立一套科学、完整、规范的社区卫生服务管理制度。方法:文献研究、调查研究、专题讨论。结果:各市均制定了一些制度,但不健全,也不规范。91.6％的人认为制定管理制度是必要的,37.9％的人认为现行管理制度存在较多问题,60.0％的人认为应尽快完善管理制度。建议:要充分认识管理制度制定的必要性和科学性,要确立管理制度制定的依据和原则,要制定、颁布实施统一的《社区卫生服务管理制度》。

基于SWOT分析的三级医院支援社区卫生服务“院办院管”模式研究

"院办院管"模式是三级医院支援社区卫生服务工作的一种模式。本研究运用SWOT分析法对此模式的优势和劣势、机遇和风险进行系统的分析,并提出建议,从而充分利用内部优势和外部机遇,避免内部劣势和外部风险,达到完善此模式的目的 。

深圳市社区健康服务运行机制改革试点成效比较分析

目的比较分析深圳市社区健康服务运行机制改革试点措施的最新进展及实施效果。方法对深圳市未实施社区健康服务中心改革试点的TR1区、TR2区以及改革试点地区RE3区共计65家社区健康服务中心进行问卷调查。结果社区健康服务中心改革试点地区本科及以上学历人员(P=0.003)、中级职称及以上人员(P=0.000)比例均高于非试点地区,学历及职称构成比差异有统计学意义;2008—2009年改革试点地区双向转诊人次增长率高于非改革试点地区。结论社区健康服务中心运行机制改革试点进一步促进了社区健康服务中心与举办医院之间在人员、技术和管理等方面的协作发展。

深圳市院办院管模式运行现状及改革试点措施研究

目的全面了解深圳市院办院管模式的运行现状,分析社区健康服务中心改革试点措施的实施效果。方法对3个区共计65家社区健康服务中心进行问卷调查,同时深入访谈相关知情人。结果深圳市社区健康服务中心诊疗服务量占全市诊疗量的比重由2004年的20.0%上升至2010年的31.3%,门诊次均诊疗费用则由2005年的59.1元下降至2010年的45.6元。调研地区2009年门诊次均费用水平均低于全国平均水平,差异具有统计学意义(P=0.000)。结论深圳市社区健康服务中心网络已基本实现社区全覆盖和人口全覆盖,社区健康服务中心的改革试点进一步完善了院办院管模式的运行机制和管理架构。

院办院管社区卫生服务中心面临的问题及对策建议

分析了三级医院举办的社区卫生服务中心面临机构管理、人员调配、服务理念、公卫服务、以医养卫及双向转诊等现实问题,从地方政府、举办医院及社区卫生服务机构三个角度提出相关建议,为"院办院管"模式下的社区卫生服务机构运营及可持续发展提供参考。

新医改形势下深圳市院办院管模式对社康中心发展影响及对策研究--以坪山新区21家社康中心为例

目的:全面了解新医改形势下深圳市院办院管模式对社康中心发展影响,为进一步推进社区卫生服务体系建设提出发展建议。方法:定量数据采用SPSS17.0统计软件进行描述性统计分析,定性数据采用Nvivo10软件,运用框架法分析。结果:院办院管模式下:1社康中心医务人员的总体数量不够,人员编制紧缺,结构仍不合理;长期处于亏本运营的状态,经费投入不足;业务用房租金负担沉重,基本设备陈旧老化,基础设备配置不足;2社康诊疗量逐年增长,双向转诊以上转为主;部分公共卫生服务未能全面开展。结论:院办院管模式存在不足,建议建立社管中心,突破现有管理体制;加强医疗资源配置,提高社康中心服务水平;规范双向转诊制度,落实社区基本公共卫生服务。

上海市松江区新型社区卫生服务一体化建设的实践与思考

2000年松江区开始探索镇、村卫生机构一体化管理实施办法。2005年松江区以卫生综合改革为契机,为社区卫生服务的运行机制、区域卫生资源整合联动和医药分开等举措的一体化建设奠定了基础,初步形成了具有上海市郊区特点的新型社区卫生服务体制一体化、管理一体化和服务一体化。介绍松江区开展新型社区卫生服务一体化建设的具体做法和思考,为国内类似地区探索社区卫生服务一体化建设提供借鉴。

卫生事业管理专业应用型人才培养机制的构建

作为卫生体制改革的主体，卫生管理人员的知识、能力和素质，直接影响着我国卫生事业的发展。为了适应高等教育发展。以及新一轮医疗卫生体制改革的要求，高校应当培养卫生事业管理专业的应用型人才。卫生事业管理专业的人才培养应当实现通识教育基础上的专才教育，构建理论、实践、素质提升三大教学体系，根据学年划分四大阶段目标，同时建立长效的社会合作机制，培养适应社会需要的卫生事业管理人才。

社康中心绩效核算方法的应用和效果评价

目的探索院办院管模式下的社区卫生服务中心绩效核算方法及实施效果。方法采用数量指标、质量系数、满意度系数3个方面相结合核算社区卫生服务中心的绩效,把不直接产生经济效益的公共卫生服务项目纳入核算指标中,并对实施前后的效果进行比较。结果建立了社区卫生服务中心绩效工资核算公式,实施后基本诊疗量、公共卫生服务量、年度评估分值分别提高了35.13%、34.32%、7.15%,居民满意度和职工满意度均明显提高,与实施前比较差异有统计学意义(P<0.01)。结论以"数量-质量-满意度"三方相结合核算社区卫生服务中心绩效的做法,能提升社区卫生服务中心的整体服务水平和满意度。