Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Incorporating Exercise Efficiency to Evaluate the Accessibility and Capacity of Medical Resources in Tibet, China

Accessibility and capacity of medical resources are key for the health care and emergency response, while the efficiency of the medical resources is very much limited by hypoxia in Tibet, China.Through introducing exercise efficiency, this study explores the accessibility of township residence to county-ship medical resources in Tibet using weighted mean travel time(WMT), and evaluates the medical capacity accordingly.The results show that: 1) the average travel time of township residence to county-level hospital is around2 h by motor vehicle in Tibet.More than half of the population can not reach the county-ship hospital within 1 h, 33.24% of the population can not reach within 2 h, and 3.75% of the population can not reach within 6 h.2) When considering the catchment of the medical resources and the population size, the WMT of the county-ship medical resources ranges from 0.25 h to 10.92 h.3) After adjusted by travel time and exercise efficiency, the county-ship medical capacity became more unequal, with 38 out of 74 counties could not meet the national guideline of 1.8 medical beds per 1000.4) In total, there are 17 counties with good WMT and sufficient medical resources,while 13 counties having very high WMT and low capacity of medical resources in Tibet.In the end, suggestions on medical resources relocation and to improve the capacity are provided.This study provides a method to incorporate exercise efficiency to access the accessibility and evaluate medical capacity that can be applied in high altitude ranges.

Association between medical resources and the proportion of oldest-old in the Chinese population

The potential association between medical resources and the proportion of oldest-old(90 years of age and above)in the Chinese population was examined,and we found that the higher proportion of oldest-old was associated with the higher number of beds in hospitals and health centers.

Resources for Medical Editors in World Association of Medical Editors

Introduction Established in 1995, WAME （pronounced ＂whammy＂） is a nonprofit voluntary association of editors of peer-reviewed medical journals from countries around the world who seek to foster international cooperation among and education of medical journal editors.

Spatial Distribution Characteristics of Medical Resources for Epidemic Prevention in the Main Urban Area of Handan City Based on GIS

The spatial distribution of medical resources for epidemic prevention (including a total of 79 facilities in designated hospitals,fever clinics,and primary medical institutions) in the main urban area of Handan City was studied by using three algorithms (average nearest neighbor algorithm,kernel density estimation method and standard deviation ellipse method).The results show that the medical resources for epidemic prevention in the main urban area of Handan City are all in a state of agglomeration,but due to the different functions of different types of medical resources,their distribution range and distribution direction also show different characteristics.Therefore,the spatial balance of comprehensive medical resources in the main urban area of Handan City needs to be further improved.

Dynamics and data fitting of a time-delayed SIRS hepatitis B model with psychological inhibition factor and limited medical resources

Hepatitis B is an infectious disease worthy of attention.Considering the incubation period,psychological inhibition factor,vaccine,limited medical resources and horizontal transmission,an SIRS model is proposed to describe hepatitis B transmission dynamics.In order to describe the behavior changes caused by people's psychological changes,the non-monotonic incidence rate is adopted in the model.We use the saturated treatment rate to describe the limited medical resources.Mathematical analysis shows the existence conditions of the equilibria,forward or backward bifurcation,Hopf bifurcation and the Bogdanov-Takens bifurcation.During the observation of the case data of hepatitis B in China,it is found that there are mainly three features,periodic outbreaks,aperiodic outbreaks,and periodic outbreaks turns to aperiodic outbreaks.According to the above features,we select three different representative regions,Jiangxi,Zhejiang province and Beijing,and then use our model to fit the actual monthly hepatitis B case data.The basic reproduction numbers that we estimated are 1.7712,1.4805 and 1.4132,respectively.The results of data fitting are consistent with those of theoretical analysis.According to the sensitivity analysis of Ro,we conclude that reducing contact,increasing treatment rate,strengthening vaccination and revaccinating can effectively prevent and control the prevalence of hepatitis B.

Smart Dynamic Resource Allocation Model for Patient-Driven Mobile Medical Information System Using C4.5 Algorithm

A mobile medical information system (MMIS) is an integrated application (app) of traditional hospital information systems (HIS) which comprise a picture archiving and communications system (PACS), laboratory information system (LIS), pharmaceutical management information system (PMIS), radiology information system (RIS), and nursing information system (NIS). A dynamic resource allocation table is critical for optimizing the performance to the mobile system, including the doctors, nurses, or other relevant health workers. We have designed a smart dynamic resource allocation model by using the C4.5 algorithm and cumulative distribution for optimizing the weight of resource allocated for the five major attributes in a cooperation communications system. Weka is used in this study. The class of concept is the performance of the app, optimal or suboptimal. Three generations of optimization of the weight in accordance with the optimizing rate are shown.

The Development Opportunities and Dilemmas of Telemedicine - Base on the Perspective of Medical Resource Distribution

Objective To discuss issues related to telemedicine in the context of the“Internet plus”and the prevention of novel coronavirus in early 2020,so as to provide some reference for the rapid development of Internet plus telemedicine.Methods Literature analysis method was used to summarize the current status of telemedicine at home and abroad.Descriptive statistical analysis and comparative analysis were also conducted to analyze the data of population and health in the“China Health Statistical Yearbook”and“China Statistical Yearbook”from 2009 to 2018.Results and Conclusion The distribution of medical demand and medical resources is uneven in 31 provinces,municipalities and autonomous regions,such problems are more serious between urban and rural areas in different regions.The population’s demand for medical care and the allocation of medical resources have the characteristics of positive correlation,large urban-rural differences and regional imbalance.Confronted with the situation that the uneven distribution of medical resources provides potential development opportunities for telemedicine and the difficulties in the further development of telemedicine,the government should formulate policies to improve the publicity of telemedicine,setting up a full coverage of telemedicine service system.Besides,hospitals should ensure the information security monitoring.

A Study on Service-Oriented Smart Medical Systems Combined with Key Algorithms in the IoT Environment

A smart medical service system architecture is proposed in this paper to increase medical resource utilization and improve the efficiency of the medical diagnosis process for complex business scenarios in the Medical Internet of Things(MIoT)environment.The resource representation model theory,multi-terminal aggregation algorithm,and the resource discovery algorithm based on latent factor model are also studied.A smart medical service system within the IoT environment is then developed,based on the open source project.Experimental results using real-world datasets illustrate that the proposed smart medical service system architecture can promote the intelligent and efficient management of medical resources to an extent,and assists in the develop towards digitization,intelligence,and precision in the field of medicine.

Medical students’ willingness to work in post-conflict areas: A qualitative study in Sri Lanka

Background: The north-east (NE) region of Sri Lanka observed a critical health workers’ shortage after the long-lasting armed conflict. This study aimed to explore medical students’ attitudes towards working in the NE and to identify factors determining such attitudes. Methods: A semi-structured, self-administered questionnaire survey was conducted in two medical schools, one in the NE and the other near the capital, in October 2004. Data were qualitatively analysed using the framework approach. Results: Three main themes were identified: 1) Professional motives and career plans;2) Students’ perceptions of the healthcare situation in the NE;and 3) Students’ choice of the NE as a future practice location. It was found that familiarity with the difficulties faced by the NE people was a major motivation for medical students to work in the NE in the future. For NE students, familiarity was linked to their sense of belonging. For non-NE students, their personal experience of the NE familiarized them with the difficult situation there, which positively influenced their willingness to work there. Demotivations to work in the NE were poor working and living conditions, fewer opportunities for postgraduate education, language differences, insecurity, and fear of an unpleasant social response from the NE communities. Conclusions: NE local medical students had a sense of belonging to the NE and compassion for the Tamil people as members of the ethnic group. They were willing to work in the NE if their concerns about difficult working and living conditions and postgraduate education could be solved. Non-NE students who were familiar with the NE situation through their personal experience also showed a willingness to work there;thus, early exposure programmes in medical education might help to increase the health workforce in the NE. It is also expected that non-NE physicians working for the NE people would facilitate reconciliation and the rebuilding of trust between two ethnic groups.

Research of the Exploitation of Human Resources in Blind Prevention and Primary Eye Care

Purpose:This research studied how to establish a relatively advanced blindness prevention and eye care cause in economically underdeveloped countryside.Methods:Ophthalmic vocational schools and professional lectures were held to train“practical type”primary eye care workers for the coumtryside.Further study in high-level(above provincial)hospitals was taken to train blindness preention &eye care backbones and leaders.Results:In 1986,the ratio of the number of the eye care workers of all levels to the number of the whole population in the prefecture was1:26000.In1992,it roseto1:17000.Aneye care network of 222stations had been established in tb countryside.Ten in the 13county hospitals had a seperated ophthalmology ed- partment,in which 3were awarded“National advanced blindness prevention County”.Twenty one hospitals were appointed as the Unit of Surgical Vision-Rehabilitation of Cataract.Blindness prevention and eye care convered1000000population(eye care avaliable within 5kilometers),23.5%of the whol popula-tion.Conclusions:In a demographically large but economically underdexeloped country-side area,the key to wide-range blindness prevention and eye oare is to exploti human resources effectively.We should train“Practical type”primary eye care workers,and have a number of edpartment leaders who are authoritive,influential in this field and ready to sacrifice to this cause.

Telemedicine System Based on Medical Consultation Assistance Integration

With the aging of the global population, how to provide effective telemedicine for the aging population has become a very important issue, especially for the elderly with limited mobility. If there is a complete telemedicine system, it will not only greatly improve medical efficiency. It can reduce the chance of contact between people and avoid the medical risks caused by severe special infectious pneumonia. This paper focuses on the development of a high-efficiency telemedicine system platform that conforms to international standard data exchange formats. This system platform can not only solve the problem of shortage of medical staff but also allow patients to be free from medical outpatient time constraints. Achieve the effect of telemedicine at any time, and digitize the medical process rules to establish a complete online telemedicine system platform.

省级医院优质医疗资源下沉实践与思考

全面深化医疗供给侧结构性改革,作为全周期医疗健康服务体系的重要一环,省级公立医院积极推进多形式医联体建设,促进优质医疗资源均衡布局和扩容下沉,构建分级诊疗服务格局。笔者以河南省人民医院“医院-政府”托管县级公立医院实践为案例,探析其经验做法,从体制机制、技术支撑、人才能力方面剖析存在的问题,并提出针对性建议。

2021年河南省中医儿科医疗资源配置的公平性及效率分析

目的:分析2021年河南省中医儿科医疗资源配置公平性及效率。方法:采用洛伦兹曲线、基尼系数与数据包络分析(DEA)法对河南省2021年中医儿科医疗资源按人口及地域面积的分布进行公平性和效率研究。结果:2021年河南省千儿童中医儿科床位数为0.214张,千平方米中医儿科床位数为0.028张。中医儿科床位数、中医儿科执业(助理)医师数、中医儿科护士数按人口分布的基尼系数分别为0.27、0.25、0.25,处于公平状态;按地域面积分布的基尼系数分别为0.41、0.41、0.40,处于不公平状态。全省有5个(27.8%)地级行政区DEA综合效率为1.000。结论:河南省各地级行政区中医儿科医疗资源配置差异明显,资源投入过剩与产出不足同时存在,资源配置效率有待提高。

长三角地区医疗卫生资源供给的时空演化特征及其影响因素

在健康中国与长三角区域一体化发展国家战略的目标驱使下,医疗卫生资源供给能力日渐成为区域公共设施均等化发展的重要指标,新型冠状病毒肺炎疫情等突发公共卫生事件对地区医疗卫生资源供给能力提出了更高的要求。为辨明长三角地区医疗卫生资源供给的发展特征与影响因素,构建了以时间演变、空间分异与因子探究为主的分析结构,采用泰尔指数、空间自相关、多尺度地理加权回归等方法,研究了2001—2019年长三角地区41个城市医疗卫生资源供给的区域差异与影响因素。结果表明,研究期内长三角地区医疗卫生资源增长迅速,区域均衡性提高;总体格局与长三角“Z”字形空间结构相吻合;医疗卫生资源供给的影响因素涵盖社会、经济与政治3个维度,且作用强度存在空间异质性。在此基础上,提出了促进长三角地区医疗服务一体化发展的对策及建议。

基于全面质量管理理论的临床专科能力建设实践

临床专科能力建设是优质医疗资源扩容的基础。以全面质量管理理论的六要素为框架,从人才队伍建设(人)、设备耗材管理(机和料)、制度流程管理(法)、医院文化建设(环)、质量控制和系统评价(测)等6个方面阐述了临床专科能力建设的主要做法。实践后,临床专科能力持续提升,并提高了优质医疗服务可及性。还需进一步整合各类资源,注重分院区专科能力建设,促进专科同质化发展。

新形势下医学检验专业实习生带教的思考

新形势下,医学检验科的发展逐渐自动化、信息化、智能化,这就使得医学检验科的实习带教工作应该俱进创新。目前,医学检验科的带教工作仍存在一些问题,表现为具有资质的带教人员相对不足、带教工作压力大;带教工作仍存在重医学实践,轻理论指导的现象;师生之间、检验与临床之间的沟通交流缺乏,实习效果不佳。同时,新形势下实习生存在未来规划压力较大、实习心态松懈、实践能力不足以及生物安全意识薄弱等问题。文章针对这些问题,总结并提出医学检验科应建立带教人员考核制度,加强具有带教资质人员的学习。带教人员可以充分结合多元教育资源,如使用小规模限制性在线课程(small private online course,SPOC)混合型教学模式,提升教学质量。同时,在带教时应结合不同专业组的特色,依据岗位特点制定培训计划,加强培养实习生的生物安全意识,为更好地培养医学检验优秀人才打下基础。

传染病流行事件下医疗资源需求模型构建与仿真试验

目的构建重大传染病流行事件下包含普通病床、重症监护病房(ICU)病床、呼吸机、医护人力四类医疗资源的需求模型,同时对不同医疗资源紧缺时传染病救治情况进行模拟分析。方法以传染病动力学模型(SEIR)为基础,考虑感染者传染性、人群易感性和康复者免疫性,同时结合新型冠状病毒感染(COVID-19)无症状感染者和不同临床分型特点扩展构建“COVID-19传染-住院模型”,收集设定疾病传播、临床病程和医疗资源紧缺情景各项参数,依托Anylogic平台初步形成传染病流行事件下城市医疗资源配置供给分析模型,分析不同场景传染病事件下医疗资源供给需求情况。结果无干预情景下,COVID-19床位资源需求峰值时间为第107天,峰值为160.92张/千人;呼吸机资源需求峰值时间为第122天,峰值为5.61台/千人;ICU床位需求峰值时间为第117天,峰值为12.78张/千人;医护人力资源需求峰值时间为第109天,峰值为151.12人/千人。仿真试验结果提示不同医疗资源对医疗救治结局的影响存在一定的差异。结论本研究构建了传染病流行事件下城市医疗资源配置供给的分析工具,多个仿真试验结果提示,床位资源和医护人力资源对于医疗救治结局有着更为重要的作用。

基于互联网医院平台的区域医联体建设研究

甘肃省自2015年起探索医联体建设,但效果甚微,未能从根本上改变医疗资源分配不均的现状。互联网医院的发展为城乡医疗资源整合提供了全新技术路径。甘肃省某医联体牵头医院利用信息化手段,以互联网医院平台为基础,构建了覆盖医联体各级医院的“互联网+”运营体系,较好地实现了医疗资源的整合,在促进医联体高效可持续发展的同时,极大程度上满足了基层患者的诊疗需求。

健康中国背景下的“看病贵”与政府支出——基于资源配置结构性失衡视角的分析

“看病贵”意味着医疗卫生资源转化为医疗卫生服务的成本高,有限资源下医疗卫生服务供给的数量和质量难以满足公众健康需求,从而直接影响健康中国建设。同时,人口快速老龄化带来的医疗卫生需求爆发式增长,将形成医疗卫生体系的额外压力,加剧供求矛盾。基于医疗卫生资源配置结构性失衡视角研究“看病贵”与政府支出之间的关系发现:政府增加卫生支出会通过加剧人力资源配置的结构性失衡而加剧“看病贵”问题;只有将增加政府卫生支出与深化医疗卫生体制改革相结合,才能真正缓解全社会“看病贵”问题。因此,应深化公立医院改革,优化政府对医疗卫生资源的配置方式,加强基层医疗卫生体系建设,重塑医疗卫生服务治理模式,构建专业化治理模式,系统性重构中国医疗卫生领域人才建设。