Analysis on grade evaluation system of physician competency in Shenzhen pilot project / 中国卫生政策研究

In order to reform the medical talent evaluation system, establish evaluation systems of physician competency, and implement physician resources management systems according to work position, and the compensa-tion system which reflects the value of medical services, The basic principles and standards of different physician tiers and grades are created in Shenzhen based on literature review, expert consultation and the methods from the American Centers for Medicare and Medicaid Services ( CMS) . Some results have achieved, including medical competency as-sessment of a certain number of physicians in the pilot project ( the coincidence rate of special hospitals is higher than general hospitals, respectively 78. 9% and 44. 8% ), comprehensive personnel systems reforms in public hospi-tals, and the trial selection of medical talents. The paper also provides some implications:The cognition of all sectors of society and physician themselves should be improved, Transitional policies for position recruitment and performance pay needs further improvement. Meanwhile, the grade evaluation system of non-physicians must also be given greater attention.

Reform attempts in Shenzhen to build a contemporary management system of public hospitals / 中华医院管理杂志

Since its founding,the Management Center of Shenzhen Public Hospitals,on the basis of summarizing and inheriting reform outcomes in the past,has been working on to streamline the relationship between the government,public hospitals and the society in line with the general reform requirements of the stateupholding public welfare nature,motivating and ensuring sustainability.The center carries out a general reform covering the hospital management system,operating mechanism,supervision mode,and service mode.This way the center has built a set of contemporary hospital management system fitting Shenzhen' s conditions,encouraging hospital operations to better embody the interests of the government,medical workers and the society,and to better cover quality,equity and efficiency,thus effectively improving the management performance and services of the hospitals in question.

Retrospect and prospect of the ongoing health reform in Shenzhen / 中华医院管理杂志

This articles introduced the development of the four systems and eight mechanisms in Shenzhen's health reform,and described the implementing measures of the public hospitals reform and major mechanisms reform.It also reviewed the major achievements and challenges met in the health reform and made an outlook of the future steps in the reform.

Outcomes and insights on separation of drug prescribing and dispensing policy in Shenzhen / 中华医院管理杂志

Shenzhen implemented the health reform on the separation of drug prescribing and dispensing.This policy abolished the drug price addition system,which interrupted the interest chain between hospitals and pharmaceutical enterprises,and curbed the over-medication and use of expensive drugs.Such a reform has lowered the average cost of diagnose and treatment,the out-of-pocket payment by those covered by social insurance,outpatient infusion and the utilization of antibiotics.To further strengthen these outcomes and maintain the momentum of this policy,Shenzhen will further improve the compensation system for public hospitals,encourage the medical staffs' work enthusiasm and implement the reform measures actively.

Pathogens Distribution and Antibacterial Resistance in Lower Respiratory Tract Infection from Department of Respiratory Medicine / 中华医院感染学杂志

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in department of respiratory medicine,then instruct clinical application of antibiotics reasonably.METHODS By the retrospective methods,we analyzed the pathogens isolated from the sputa of the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine from Jul 2007 to Jun 2009 and their drug resistance.RESULTS A total of 1508 strains of pathogens were isolated,Gram-negative bacilli were 47.3%,The most common pathogens of them were Pseudomonas aeruginosa(15.6%).The rate of the ESBLs-producing strains of Escherichia coli and Klebsiella pneumoniae were 41.0% and 35.8%,respectively.Fungi were 44.1%.And all the fungi were sentive to amphotericin B,fluconazole and ketoconazole.Gram-postive cocci accounted for 8.6%.The most common pathogen of Gram-postive cocci was Staphylococcus.Meticillin resistant strains of Staphylococcus aureus accounted for 62.4%.CONCLUSIONS The drug-resistance of pathogenic bacteria due to nosocomial infection and community-acquired infection in respiratory medical ward is increasing year-by-year.It is necessary to continuously monitor drug-resistance and rationally use antibiotics.

Distribution and Antibacterial Resistance of Nosocomial Infection Pathogens in Hospital / 中华医院感染学杂志

OBJECTIVE To investigate the tendency of bacterial distribution and resistance of hospitial infections,and to provide the reference for the clinical treatment and infection control in hospital.METHODS Bacteria isolated from patients in our hospital from Jan 2004 to Dec 2005 were identified by ATB expression,and bacterial susceptibility tests were performed on strains using Kirby-Bauer method.RESULTS A total of 3066 pathogens strains were isolated,among them 927 strains were Gram-positive cocci(30.2%).The most common pathogens of them were Staphylococcus.Meticillin resistant strains of Staphylococcus aureus and coagulase negative Staphylococcus(CNS) accounted for 69.0% and 77.6%,respectively.In our data,no vancomycin resistant S.aureus were isolated.There were 2134 strains of Gram-negative bacilli(69.6%),the most common pathogens of them were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae.The ESBLs producing strains of E.coli and K.pneumoniae accounted for 30.1% and 40.1%,respectively.The highest susceptible to Gram-negative bacilli was carbapenem,then were cefoperazone/sulbactam,piperacillin /tazobactam and cefepime.Mainly pathogenic bacteria were multi-resistant to some antibiotics.CONCLUSIONS Drug resistance of the nosocomial infection bacteria is a serious problem.It's important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics and effective controlling nosocomial infections.