ABSTRACT
The Balanced Score card ( BSC) is a new set of performance measurement and strategic management tools. Based on the basic theory of BSC, and on the basis of establishing the basic framework for performance evaluation of four dimensions, namely satisfaction, financial, internal operation, and growth and development, this paper systematically designs specific evaluation indexes from the 4 dimensions in order to construct the performance evaluation index system for catastrophic disease insurance. The objective of this study is to provide a more scientific and reasonable reference for the operational performance evaluation of catastrophic disease insurance offered to urban and rural residents.
ABSTRACT
OBJECTIVE:To observe the effects of dexmedetomidine on hemodynamics of patients underwent cardiac valve re-placement in the anesthesia induction. METHODS:92 patients underwent cardiac valve replacement were randomly divided into ob-servation group and control group,with 46 patients in each group. Both groups received routine anesthesia induction regimen of midazolam 1-2 mg/kg+ fentanyl 0.05 mg/kg+ propofol 1-2 mg/kg+ cis-atracurium 0.15 mg/kg. Observation group was additionally given dexmedetomidine 0.5 μg/kg,within 10 min with pumps,and then maintained with 0.4 μg/(kg·h)till the end of operation;control group was additionally given constant volume of normal saline with pumps. SBP,DBP,MAP,HR,cardiac output(CO), cardiac index(CI),stroke volume(SV),stroke volume variation(SVV)before anesthesia induction(T0),5 min after medication (T1),2 min after anesthesia induction (T2),1 min after intubation (T3),3 min after intubation (T4) and 5 min after intubation (T5)were recorded in 2 groups as well as OAA/S at T0 and 5 min after pumping dexmedetomidine(T1). ADR of 2 groups during anesthesia was also recorded. RESULTS:There was no significantly difference in SVV of 2 groups at T0-T5 (P>0.05);SBP, DBP,MAP,HR,CO,CI and SV of observation group at T0-T5 were all better than those of control group,with statistical signifi-cance(P0.05),and OAA/S of observa-tion group at T1 was decreased significantly and lower than control group,with statistical significance(P0.05). CON-CLUSIONS:Dexmedetomidine can reduce the influence of anesthesia on the hemodynamics of patients underwent cardiac valve re-placement with good safety.
ABSTRACT
Objective: To analyze the influences of implementing essential medicine system on primary medical institutions and give suggestions. Methods: Using system dynamics method to construct the compensation mechanism model for primary medical institutions. Compare the growth in revenue and expenditure of primary medical institutions before and after essential medicine system implementation. Results: After the implement of essential medicine system, the growth in total expenditure and total income of primary medical institutions is steadier; when the annual growth rate of government financial subsidies invested more than 13%, the growth in total receipts will keep balance. Conclusion: It’s better to guarantee the government financial subsidies invested in time, raise medical service price properly and establish comprehensive compensation mechanism for implementing compensation mechanism of primary medical institutions.