ABSTRACT
The construction of compact county medical consortium is an effective way to integrate county medical resources, improve county diagnosis and treatment capabilities, and establish and improve the hierarchical diagnosis and treatment system. It is the guidance of national policy and the demand of social practice. Based on the reality of Jiangyin′s developed local economy, sufficient overall high-quality medical resources and high health demand of residents, Jiangyin People′s Hospital Medical Group explored the construction practice of compact county medical consortium according to local conditions. The group focused on implementing the functional positioning of medical institutions, improving the primary service ability, and straightening out the two-way referral process. Through the four major measures of establishing mechanism, strengthening the primary level, optimizing the process, and focusing on convergence, the group improved the organization structure and operation mechanism, continuously improved the management level and service connotation of the medical consortium. The goal of establishing an overall management mode, improving primary service capabilities, and forming an up-down cooperation mechanism had been initially realized.
ABSTRACT
Objective:Based on the unreasonable structure,fragmentization and insufficient resources of medical and health service system in China,the literature review was conducted on the analysis of integrated medical and health service system.Methods:It sorted out and analyzed the existing related literature in the academic field.Results:The integrated health system was developed by their elements and methods,which lacked the evaluation and analysis on the responsibility among different stake holders and effects after the integration.Conclusion:Further research should be developed into the implementation of dual referral based on integrated health system;the responsibility relationship among different stakeholders in the integration progress,the integration and optimization of medical and health service system under the background of Internet+,etc.
ABSTRACT
Based on literature review determining evaluation dimensionality,and with the relevant policies,the original index system is determined.Through using two rounds of focus group discussion and two rounds of expert consultation method,a set of county hospitals comprehensive reform of index system,which consists of 3 primary,14 secondary indicators and 64 tertiary indexes,is established.The analytic hierarchy process is used to determine the weight of evaluation index.At the same time,the reliability and validity of index system are tested.This proves that the established evaluation index system can give scientific and reasonable assessment results for comprehensive reform of county-level hospitals.
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Objective To analyze the effects of adenohypophysis function after treating with thyrotropin releasing hormone and its clinical significance in patients with brain trauma. Methods There were 22 cases with traumatic brain injuries from July 2010 to September 2012 in Chinese people's Liberation Army nine eight hospital,after injuried within 4 to 12 hours,then 1 1 cases who were given thyrotropin-releasing hormone(TRH)were selected as experimental group,while 1 1 cases who were given the same amount of isotonic saline were selected as control group,then the score of GCS, ICS,RLS85 and the improvement of adenohypophysis function were observed. Results After treatment,the score of glasgow coma scale (GCS ), innsbruck coma scale (ICS),and the reaction level scale (RLS85)between two groups were significantly increased in three days compared with before treatment,and within three days after injury situation,the improvements of ICS and RLS85 in experimental group were better than control group(P<0.05 ). Compared with control group,the levels of each gland pituitary hormone in experimental group were significantly increased(P<0.05 ),and on the third day,the growth hormone (GH)was reduced significantly,finally 50%of that in control group. Conclusion Patients with brain injury treated with thyrotropin releasing hormone,has no significant adverse reactions,with the characteristics of safe and effective.