ABSTRACT
The scientific and standardized articles recognized and followed by all members of the hospital are significant tools to ensure that the hospital adheres to the development direction of public welfare, to guide the operation and development of the hospital, to guarantee the autonomy of hospital management, and to promote the legalization of hospital management system and operation mechanism. Public hospitals are the main body of their articles′ formulation, and other stakeholders such as the organization running hospitals, industry association, health administrative departments can also play an active role in the process of public hospital articles′ formulation. The articles of public hospitals should cover the basic situation of hospitals, internal organizational structure, decision-making system, management system, external governance structure and relationship, etc. In the formulation of the public hospital′s articles, we should not only comply with requirements from policy documents, but also reflect the characteristics of the hospital. We should not only standardize the hospital′s governance and management, but also coordinate the existing institutional arrangements of the hospital. And we should not only formulate the articles, but also actively promote their implementation.
ABSTRACT
Informationization as conducted by the Hospital Authority (HA) of Hong Kong features the following aspects.Collective deployment of IT professionals from its medical institutions is designed for development of a unified,coordinated and clinical centered information system among its medical institutions.In addition,HA has built a control center for centralized information system operation & maintenance,which enjoys sufficient funding support for health informationization.In the course of information sharing,HA pays close attention to patients' privacy protection.Shanghai Hospital Development Center can take HA's experience on municipal hospitals health informationization,for the purposes of building a unified,coordinated and clinical centered information system and furthering Shanghai municipal hospital's health informationization.
ABSTRACT
The experiences of building modern hospital management systems of public hospitals in Beijing,Shanghai and Guangdong were picked up.The study of such experiences of these three places identified three common features as follows.Firstly,performance evaluation served as a breakthrough for incentives and constraints of (leaders of)the public hospitals;secondly,reform of human resources and salary system served as a means to innovate the internal mechanism of public hospitals;thirdly,real-time health data platform served as a pillar to improve and optimize management decision making.
ABSTRACT
Objective To explore methods for performance appraisal of directors of municipal hospitals in Shanghai.Methods To assess the management performance of directors of 24 tertiary hospitals each year,measured by five dimensions of social satisfaction,management efficiency,capital operation,development sustainability and staff satisfaction,and 23 indexes.Results Implementation of the performance appraisal has witnessed constant improvement of patient satisfaction and quality of medical care,as well as rational control of medical expenses and cost.In 2014 for example,the cost of emergency/outpatients per visit at such hospitals were 312 yuan and 1 5 600 yuan per hospitalization respectively,with 7.6 days of stay in average.Also improved were service efficiency,clinical research output and hospital business performance in general.Conclusion Performance appraisal of directors of public hospitals proves an important means for guiding the hospitals to adhere to public welfare, consistent with the government medical institution operation target, and to strengthen internal management of such hospitals.
ABSTRACT
To sum up the reform of internal performance appraisal system and income allocation system of Shanghai municipal hospitals.The internal performance appraisal index system,evaluation methods and corresponding income allocation system,featuring two breaks,one change and eight elements.The reforms highlight public welfare nature of public hospitals,which is expected to create profound impacts on hospital operation and medical staff behavior.
ABSTRACT
This study summarized the experiences of disease-specific performance appraisal at tertiary hospitals in Shanghai,which was launched since year 2013 by Shanghai Hospital Development Center (SHDC). 38 tertiary hospitals in Shanghai were included in the study. A disease-specific performance appraisal system centering on quality and performance, by means of case-mix model, classified surgery management and typical disease screening, and leveraging disease and surgery difficulties analysis, and inter-hospital performance appraisal of typical diseases. This reform has established appraisal criteria of disease difficulty management,coding criteria and data norms,guiding such hospitals to consolidate their functional positioning of focusing on difficult,urgent and complicated cases in the medical service delivery system.All these efforts have paved the way for the reforms to build a hierarchical medical service system, pricing per disease, payment per disease, and consolidate performance appraisal of medical workers.
ABSTRACT
Focusing on the efforts on governance and administration separation made in Shanghai,Beijing,Wuxi and Zhenjiang,the paper discussed how to evaluate and how to practice such a reform at public hospitals.Authors tried to define and classify the reform and summarize the functions and roles of the hospitals,offering insights for further reforms.
ABSTRACT
Following an analysis of the problems and challenges of public hospitals in Shanghai,the paper presented the approach of Shanghai Shenkang Hospital Development Center in its problem-based reform of such hospitals.The measures include promotion of capital construction,enhanced discipline human resources,and accelerated informationization,as well as overall budget management and hospital director performance appraisal,which enhanced their service capacity and operational efficiency.
ABSTRACT
Objective To explore the correlation between epicardial adipose tissue(EAT) thickness and cardiovascular risk factors in patients with coronary artery disease.Methods According to the results of coronary angiography,84 cases of patients undergone coronary angiography were divided into the normal control group(28 patients),coronary artery disease group with single-vessel lesion (28 patients),coronary artery disease group with multi-vessels lesion(28 patients),respectively,then measured the EAT thickness and carotid intima-media thickness(IMT) by high-frequency ultrasound.A correlation analysis was carried out between the EAT and IMT and cardiovascular risk factors.Results In either coronary artery disease group with single-vessel lesion or multi-vessels lesion,the thicknesses of EAT and IMT were significantly higher than those in the normal control group(P ＜0.01),and the difference between group of single-vessel lesion and multi-vessels lesion was also statistically significant (P ＜0.01).A correlation analysis between the EAT and IMT and cardiovascular risk factors showed that there were significantly positive correlations between EAT and the IMT,age,weight,waist circumference,body mass index,low-density lipoprotein,Creactive protein (r = 0.124～0.790,P ＜0.05 or P ＜0.01),and the significantly negative correlation between EAT and high-density lipoprotein (r = - 0.203,P ＜ 0.05).Correlation between EAT and the IMT was 0.678,0.713,0.737 in the normal control group,group with single-vessel lesion,group with multivessels lesion,respectively.Conclusions There were favorable correlation between EAT and carotid IMT in cardiovascular risk factors.The more severity of coronary heart disease,the more high correlations of EAT and IMT.EAT can be a valuable index in evaluating coronary artery disease.
ABSTRACT
Objective To explore the predictive value for coronary heart disease by epicardial adipose tissue(EAT) thickness and carotid intima-media thickness(IMT) measured with high-frequency ultrasound.Methods According to the results of coronary angiography, the cases were divided into the normal control group (29 patients),coronary artery disease group with single-vessel lesion (43 patients),coronary artery disease group with multi-vessels lesion (28 patients), respectively. EAT and IMT were measured by high-frequency ultrasound. Results The EAT in the three groups were (4.8 ± 1.3) mm, (7.6 ± 1.8) mm,(10.1±2.6) mm respectively, and the IMT were (0.8±0.1)mm,(1.0±0.2)mm,(1.1 ± 0.2)mmrespectively. In either coronary artery disease group with single-vessel lesion or multi-vessels lesion, the EAT and IMT were significantly higher than those in the normal control group ( P＜ 0.01 ). And the difference between groups of single-vessel lesion and multi-vessels lesion was also statistically significant (P＜ 0.01). The areas under receive operating characteristic(ROC) curve to predict coronary heart disease by EAT and IMT was 0.947 and 0.917, respectively, there was no significant difference between the two areas. For patient with coronary artery stenosis＞50%, the sensitivity and specificity of EAT＞6 mm were 90.1% and 86.2% ,respectively,the sensitivity and specificity of IMT＞0.85 mm were 87.3% and 82.8%,respectively. Conclusions EAT and IMT measured by high-frequency ultrasound can precisely predictcoronary heart disease. EAT can be a new predictor to diagnose coronary heart disease.
ABSTRACT
Objective The study was to provide evidence for the development of local community health services through the analysis of patiems' expectations for community health services. Methods The expectations were indirectly evaluated by investigating the patients in the willingness-to-pay. Results The patients had a generally high expectation for health community services and they would be highly disappointed once their expectations fall short. Conclusions Those expectations that could be realized with short-term efforts ought to attract high attention of community health service providers and made important goals to achieve in the near future.