ABSTRACT
It systematically analyzed the basic framework and key elements of health sector governance,such as,accountability,transparency,participation,integrity and capacity of policy,based on the method of systematic literature review and related theory and practice of governance.It systematically expounded the concepts of each element,the associated policy and managed tools,as well as the authority-responsibility relationship of pluralistic subjects in the governance framework.These five key elements were mutually reinforcing,not only to build the basic framework of the health sector governance,also to determine its policy decision-making pattern,which aimed to identify actual or potential governance problems.Through forming an inclusive and mutually reinforcing governance framework,the coordination among the conflicting or different stakeholders was encouraged by the mode and mechanism which embodied their governing bodies' values.The cooperation and sustainable development way formed to improve the supply of the medical and health services,and the use efficiency of resources.
ABSTRACT
Based on the formation and development of health governance concept in international community, some representative countries from the two aspects, namely the cooperative governance of both the government and the society as well as the inter-organizational vertical and horizontal governance made the relevant experience of health governance practice. On this basis of the shared values and policy objectives consensus, the health governance con-cept was transformed into common practice with the participation of both the government and the society. It not only reflects the multiple objective value orientation of equality, diversity, trust, cooperation and participation, but also promotes the transformational development of the international community health management system and health serv-ice pattern, which could provide a valuable experience for the construction of health governance model in China.
ABSTRACT
Objective To investigate the bacterial distribution and resistance of clinical isolates ,so as to provide basis for the clinical medication .Methods The drug susceptibility testing was performed by Kirby‐Bauer method or automated system .The re‐sults were analyzed by WHONET 5 .6 referring to the breakpoints of CLSI 2013 .Results Of 1 240 clinical iso1ates ,the gram‐posi‐tive cocci and gram‐negative bacteria accounted for 32 .7% and 67 .3% respectively .The top five of isolated strains were Escherichia coli ,Klebsiella spp ,coagulase negative staphylococci ,Staphylococcus aureus ,Streptococcus pneumonia;the first five of isolated spec‐imens constitute followed by sputum ,urine ,blood ,secretions and stool .The average prevalence of methicillin‐resistant strains in S . aureus (MRSA) and coagulase‐negative Staphylococcus (MRCNS)was 17 .1% and 74 .7% ,respectively ;no vancomycin ,teicoplanin or linezolid‐resistant strains were found;no vancomycin‐resistant strains were found in Enterococcus spp;Enterobacteriaceae was still highly susceptible to imipenem and meropenem (> 85% );extended spectrum beta‐lactamases(ESBLs) producing strains ac‐counted for 56 .7% of Escherichia coli ,and accounted for 18 .6% of Klebsiella pneumonia;the drug resistance rates of Pseudomonas aeruginosa to imipenem was 11 .9% .The drug resistance rates of Acinetobacter spp to imipenem was 19 .0% .Conclusion The main infection site of patients in this hospital is respiratory tract and attention should be paid to docimastic sample .The top five clinical i‐solates and drug resistance are roughly the same with the results of Chongqing drug resistance monitoring net .
ABSTRACT
Objective: To analyze the efficiency characteristics and trend of tertiary general public hospitals from both static and dynamic perspectives. Methods: After collecting data of personnel, equipment, assets, health services and other inputs-output indicators from 50 tertiary public hospitals from 2006 to 2012 , this paper uses C2 R-DEA and BC2-DEA models, as well as Malmquist Index model to build suitable analysis model. Results:About 10%~12% of the sample hospitals are in a relatively effective operational state, and the mean values of allocation effi-ciency and scale efficiency are 0. 956 and 0. 943, respectively, which are close to the efficient frontier. The mean values of pure technical efficiency, technical efficiency, cost efficiency and overall efficiency are 0. 796, 0. 784, 0. 714 and 0. 714, respectively, which are relatively poor compared with the efficiency frontier. Moreover, the number of hospitals that are in the state of diminishing returns to scale increased from 7 . 69% to 26 . 31%, while the number of hospitals that are in the state of increasing returns to scale decreased from 80. 77% to 58. 34%. The changes in techno-logical progress, Malmquist productivity index, technical efficiency index, pure technical efficiency index and scale effi-ciency index remained a relatively stable consistency, and showed continuous improvement and steady development trend. Conclusion:Tertiary general public hospitals are facing the transformation of driving force for development and incentive mechanisms. This needs not only to change the management concept and development mode of the hospitals, but also to build evaluation standards of optimum efficiency that are relevant to the structure, process and outcome, in order to pro-mote the transformation of hospital governance and development model that includes the functions of government.
ABSTRACT
Under the health integration strategies of public policy to health in all policies of all sectors and so-cial areas, government departments and social organizations form a broad consensus on the basis of the goals of gov-ernance, led by government health system operations, through the strengthening of coordination and cooperation a-mong government departments and social organizations as well as overall planning of the service functions of the health system, and the establishment of community participation in the performance accountability mechanism, in order to enhance the level of health sector governance and improve community health outcomes.
ABSTRACT
Objective: Based on the input-output efficiency evaluation index system of community health service system, analyze the operating efficiency of community health service system in Hunan. Methods:Use the ultra efficiency DEA model to analyze public health service projects and health statistics report data. Results: Community health service resources in Hunan are not fully utilized and the operating efficiency is also unbalanced;decreasing returns to scale occurs in 1/3 cities, which is shown concretely as following: technical efficiency is lower than the scale efficiency and personnel agency input redundancy coexists with service output volume deficiency. Conclusion: Improving the basic quality of community health technical personnel’s and guiding the rational development of community institution scale are the issues need to concern in the process of further perfecting the community health service.
ABSTRACT
Literature review, field survey and data analysis were called into play in this paper for systematic analysis of the basic models and performance of government health spending in China. The paper covered features and problems in China's health spendings and analyzed the growth rate and performance appraisal of such spendings. Recommendations for improved government health spendings include such six aspects as forming a consensus for building a new concept on government spendings, building a stable and sustainable health input mechanism for public finance, expanding government health financing capacity for assured health spendings, building a mechanism of balanced interests in health reform, intensifying health governance and government accountability mechanism, as well as reinforcing the supervision and assessment of government health spending.
ABSTRACT
A review of the yearbook World Health Statistics 2009 revealed the basic features of health spending of member states of the World Health Organization. A review of the policies and experiences of government health spending of the international community points the following findings:this health spending is characteristic of social values deciding government health spending, legislature determines the stable mechanism and priority of government health spending local government shoulders main duties of government health spending, policy objectives of government health spending may be dynamic with stronger function of guidance, greater health financing sources of the government can empower government health spending, a government accountability mechanism should be built for better governance of the health system and for a better social medical assurance system.