Characteristics and implications of curriculum for PHD students of health service management in the world / 中华医学教育探索杂志

Five universities with health policy and management ranked top level worldwide, including Harvard University, John Hopkins University, Stanford University, University of North Carolina at Chapel Hill and National University of Singapore were selected in our study. From above universities, we found that the curriculum of PHD students was focused on research concentration, methodology courses, and numerous elective courses. Hence, in China, the curriculum of PHD students should be improved with emphasis on course studying, management courses and highlighting curriculum content according to research area to enhance the quality of doctoral education.

Management of bed availability in intensive care in the context of hospitalization by court order / Gestão da disponibilidade de leitos na terapia intensiva no contexto da internação por ordem judicial / Gestión de disponibilidad de camas en terapia intensiva en el contexto de internación por orden judicial

Abstract Objective: to identify, from the nurse perspective, situations that interfere with the availability of beds in the intensive care unit in the context of hospitalization by court order. Method: qualitative exploratory, analytical research carried out with 42 nurses working in adult intensive care. The selection took place by non-probabilistic snowball sampling. Data collected by interview and analyzed using the Discursive Textual Analysis technique. Results: three categories were analyzed, entitled deficiency of physical structure and human resources; Lack of clear policies and criteria for patient admission and inadequate discharge from the intensive care unit. In situations of hospitalization by court order, there is a change in the criteria for the allocation of intensive care beds, due to the credibility of professionals, threats of medico-legal processes by family members and judicial imposition on institutions and health professionals. Conclusion: nurses defend the needs of the patients, too, with actions that can positively impact the availability of intensive care beds and adequate care infrastructure.

Resumo Objetivo: identificar, a partir da perspectiva de enfermeiros, situações que interferem na disponibilidade de leitos em unidade de terapia intensiva no contexto de internação por ordem judicial. Método: pesquisa qualitativa exploratória, analítica, realizada com 42 enfermeiros atuantes em terapia intensiva adulto. A seleção aconteceu por amostragem não probabilística, do tipo bola de neve. Dados coletados por entrevista e analisados pela técnica de Análise Textual Discursiva. Resultados: analisaram-se três categorias, intituladas deficiência de estrutura física e de recursos humanos; falta de políticas e critérios claros para admissão de paciente e alta inadequada da unidade de terapia intensiva. Nas situações de internação por ordem judicial há alteração nos critérios de alocação de leito de terapia intensiva, mediante a credibilidade dos profissionais, ameaças de processos médico-legais por parte de familiares e imposição judicial às instituições e aos profissionais de saúde. Conclusão: enfermeiros defendem as necessidades dos pacientes, também, com ações que possam impactar positivamente na disponibilidade de leitos de terapia intensiva e de infraestrutura adequada de atendimento.

Resumo Objetivo: identificar, desde la perspectiva de los enfermeros, situaciones que interfieren en la disponibilidad de camas en unidad de terapia intensiva en contexto de internación por orden judicial. Método: investigación cualitativa exploratoria, analítica realizada con 42 enfermeros que prestan servicios en terapia intensiva de adultos. La selección se realizó por muestreo no probabilístico de bola de nieve. Recolección de datos por medio de entrevistas y análisis mediante la Técnica de Análisis de Texto Discursivo. Resultados: se analizaron 3 categorías a saber: deficiencia de infraestructura y de recursos humanos; falta de políticas y criterios claros para admisión de pacientes y alta inadecuada en unidades de terapia intensiva. En situaciones de internación por orden judicial, se advierten alteraciones respecto de los criterios de asignación de camas de terapia intensiva, mediante la credibilidad de los profesionales, amenazas de interposición de acciones médico-legales por parte de los familiares e imposiciones judiciales a instituciones y a profesionales de la salud. Conclusión: los enfermeros abogan por las necesidades de los pacientes mediante acciones que puedan impactar de manera positiva en la disponibilidad de lechos de terapia intensiva y de una infraestructura adecuada de atención.

Retos del sistema general de seguridad social y salud: prospectiva para el desarrollo social en la Costa Atlántico de Colombia / Challenges of the general system of social security and health: Prospective for social development in the Atlantic Coast of Colombia

Introducción: Concepción interdisciplinaria de la gestión del sistema de salud en el contexto latinoamericano, de acuerdo con lo establecido por la Organización Mundial de la Salud/ Organización Panamericana de la Salud. El artículo propone una estrategia prospectiva de desarrollo social en la Costa Atlántica de Colombia, para afianzar el funcionamiento, desde lo preventivo y asistencial, del Sistema General de Seguridad Social y Salud colombiano. Objetivo: Definir, desde una visión prospectiva para el desarrollo social colectivo, los retos del Sistema General de Seguridad Social y Salud colombiano. Método: Estudio exploratorio, fundamentado en el análisis teórico conceptual que permite derivar el sistema de relaciones de las categorías: gerencia del sistema de salud y desarrollo social colectivo. Se aplica la prospectiva estratégica, mediante el componente empírico-analítico, a través del cual se visualizan escenarios futuros que direccionen el desarrollo del sistema de salud a partir de la interacción entre sus actores representativos. Resultados: Se determinaron debilidades relacionadas con la gestión integral del Sistema General de Seguridad Social y Salud colombiano, específicamente en la Costa Atlántica. En esta región del país el escaso uso de técnicas prospectivas debilita la estrategia gerencial y minimiza la posibilidad de asumir retos y prever incertidumbres en uno de los sistemas que, a través de la efectividad de servicios de salud y calidad de vida, supone un indicador de desarrollo social colectivo. Conclusiones: Necesidad de visionar retos y escenarios para modelar la gestión del Sistema General de Seguridad Social y Salud en la Costa Atlántica de Colombia para afianzar la equidad, la inclusión y la calidad de vida e incrementar los estándares de gestión de la salud en colectivos y comunidades vulneradas(AU)

Introduction: There is an interdisciplinary basis conceived for the management of the health system in the Latin American context, in accordance with the provisions of WHO/PAHO and that is linked with related disciplines, such as management and education. This article proposes a prospective strategy of social development in the Atlantic Coast of Colombia to consolidate its functioning from the preventive and welfare perspectives in the Colombian's General System of Social Security and Health (SGSSS, by its acronym in Spanish). Objective: To define the challenges of the SGSSS from a prospective point of view for the collective social development. Method: An exploratory study, based on the conceptual, theoretical analysis to derive the relations´ system of the following categories: management of the health system, and collective social development. Strategic prospective is used by the empirical-analytical component to visualize future scenarios of probable occurrence that address the development of the health system from the interaction between its representative actors. Results: The weaknesses identified were related to the comprehensive management of the Colombian SGSSS, specifically on the Atlantic Coast, where the limited use of prospective techniques weakens the management strategy and minimizes the possibility of assuming challenges and anticipating uncertainties in one of the systems that through the effectiveness of health services and quality of life warrants responding to collective social development. Conclusions: There is a need to view challenges and scenarios for modeling the management of the SGSSS on the Atlantic Coast of Colombia to strengthen the equity, inclusion and quality of life, and to increase the standards of health management in vulnerable groups and communities(AU)

Practice and effect of improving the efficiency of medical services in Hangzhou / 中华医院管理杂志

Higher service efficiency and better medical experience are main goals of the healthcare system reform.The article explained the logical framework, main actions, initial results of the " one visit for all" reform, which aims at promoting the efficiency of medical services and management in Hangzhou.Policy suggestions are raised, namely involving more people into the governance mechanism, collaboratively optimizing the working process of medical staff, improving the information security mechanism, and perfecting the effectiveness evaluation system.These measures are designed to accelerate the construction of modern hospital management system, and to build a scientific and orderly hierarchical medical system.

Bureaucracy and public management: Ministry of Health analysis / Burocracia e gestão pública: uma análise do Ministério da Saúde

Abstract This article aims to an analysis of the level of bureaucratization of the Ministry of Health, based on its organizational structure, the composition and formation of the administrative staff, the forms of their recruitment and the career structure, in a way linked to the management capacity of the health policy. The study references are elements of the theoretical approach of New Weberian of bureaucracy and the ramifications of theories on public management. This is a descriptive cross-sectional qualitative study conducted in the 1990-2014 period. The data collection instruments were semi-structured interviews conducted with those who hold technical and technical/political position in the Ministry and in some administrative bodies, as well as research in documents. The results show that the implementation of the public service exams indicates an institutional advancement in the meritocratic sense, expressed in the increasing of the effective based staff in the Ministry of Health. However, the opening of exams dissociated from an increased investment in professional training and incentives for career employees, have not act in reducing the organizational instability of MS, given the high turnover of newly passed in the public exams and the permanence of a demobilized administrative staff. There were no advances in the adoption of internal cohesion mechanisms, such as the modernization of career plans, or the adoption of innovations in management.

Resumo Este artigo tem como objetivo analisar o nível de burocratização do Ministério da Saúde (MS), a partir da sua estrutura organizacional, compreendida pela composição e formação do quadro administrativo, pelas formas de seu recrutamento e pela estrutura de carreira, de forma vinculada à capacidade de gestão da política de saúde. O estudo tem por referência teórica elementos neoweberianos da burocracia e os desdobramentos das teorias sobre gestão pública. Trata-se de um estudo qualitativo descritivo transversal relativo ao período de 1990 a 2014. As técnicas de coleta de dados utilizadas foram entrevistas semiestruturadas realizadas com ocupantes de cargos técnicos e técnico/políticos do Ministério e de órgãos colegiados gestores, e pesquisa documental. Os resultados mostram que o concurso público é um indicativo de avanço institucional no sentido meritocrático, e se expressa no aumento do pessoal efetivo lotado na sede. Todavia, a abertura de concursos dissociada de um maior investimento em profissionalização e incentivos aos servidores de carreira não atuou na redução da instabilidade organizacional do MS, dada a alta rotatividade dos recém-concursados e a permanência de um quadro administrativo desmobilizado. Não se avança em mecanismos de coesão interna, como a modernização dos planos de carreira, nem na adoção de inovações na gestão.

Analysis on employment directions of the graduates majoring in health service management: A case study of Nanjing Medical University / 中华医学教育探索杂志

Objective To understand employment directions and levels of the graduates majoring in health service management, so as to provide reference for talent cultivation and employment guidance for future graduates. Methods Collecting the data of employment directions of 244 graduates from 2014 to 2016 majoring in health service management from Nanjing Medical University and analyzing the dynamic trend of employment directions. Data were analyzed by SPSS 22.0. Results There was no significant dif-ference in the employment rate among graduates from 2014 to 2016. The proportion of female graduates choosing to do postgraduate work in mainland China was 19.7%( 34/173), higher than that of male 12.7% (9/71). The proportion of female graduates choosing directly to work was 65.3% (113/173), lower than that of male 76.1% (54/71), and the differences were statistically significant. The proportion of graduates working in upper first-class hospitals was relatively higher 39.1% (45/115), and the employment rate of that working in non-public general hospitals increased year by year. Conclusion In order to effectively ease the problem of employment imbalance, the related departments of the university should strengthen employment guidance, timely update the mentality about employment among graduates, and abandon the inherent employment orientation of large public hospitals and economically developed areas.

Organization and policy system of American emergency drug and its enlightenment / 中华医院管理杂志

By means of literature review and comparative study, the paper studied the organization and policy system of emergency drug administration in the U.S. As found by the authors, that the U.S. has established a horizontal and vertical organizational structure system centering on the Department of Health and Human Services. This system covers a series of policy and legal regulations, such as the research and development, procurement, storage, emergency use, and clinical treatment of emergency medical products. In consideration of the experience of emergency drug administration in the U.S. and problems existing in China's current system in command and management, departmental coordination, resource allocation, and legal system construction of emergency drug, it is suggested that China should establish a core organization for emergency drug command and management, and improve relevant legal system. China also needs to focus on enhancing capabilities of local medical emergency rescue and information transmission, in order to establish a coordinated, well-organized, resource-sharing system of drug emergency administration in the country.

Construction of innovation ability training system for postgraduates of health service management in higher medical colleges and universities / 中华医学教育探索杂志

Targeting the common fact that colleges and universities of traditional Chinese medicine neglect management post practice,are lack of cutting-edge,cross-disciplinary and methodological courses,fail to reflect the traditional Chinese medicine's singularity and update courses slowly during the process of cultivating their graduate students,Heilongjiang University of Chinese Medicine innovates its culture system of graduate student in related major.It is also devoted to developing problem-based learning,introducing bitutor system,reforming course system,which may hopefully improve their graduate students' innovative thoughts and abilities,strengthen their innovative knowledge theory system to finally discover an appropriate reform model for the culture system which can be perfectly replicable.

Discriptive systematic review for the application of problem-based learning in education of health service management / 中华医学教育探索杂志

Objective To systematically evaluate the application of problem-based learning (PBL)in the teaching process of health management major in China.Methods Databases including CNKI (1979 to December the 2015),VIP (1989 to December the 2015),Wanfang (1982 to December the 2015) and PubMed were systematically retrieved.Any literature about PBL of health management major was included.Seffdeveloped data extraction form was used for collecting the information.Data were input and analyzed using Excel 2007.Results 15 papers were included in the analysis.The first author mainly came from the northeast region of China (7).Most (10) papers did not get the funding support.No paper was published in the journals contained in the Guide to the Core Journals of China.6 papers of experimental studies compared the performance difference of students of the PBL and lecture-based learning (LBL),which was statistically significant.Conclusion PBL is superior to the LBL.However,due to the large difference in the quality of literature,more studies were needed to determine the effect of PBL.Moreover,we should pay attention to the combination of PBL and LBL.

Research on the reform of curriculum system of health service management / 中华医学教育探索杂志

Objective To understand the needs to reform curriculum for the graduate students in health management, and to provide evidence for the reform of the curriculum system. Methods From Jan-uary 2015 to May from China's colleges and universities carrying out health management professional post-graduate education, graduate students and supervisors from 3 universities were selected, and self-designed questionnaires were used to investigate their views on training objectives, abilities and curriculum settings, as well as the needs and suggestions for curriculum reform. The questionnaire survey data were collected and analyzed by SPSS 17.0. Results 120 questionnaires were issued and 100 were recovered in the study, with a recovery rate of 83.3％. 84.0％ of the graduate students did not manage relevant work experience before entering the school. The graduate students thought that we should focus on the research and teaching ability training related to the management of health services, and then the cultivation of management ability. There were 60 questionnaires for instructors, and 51 were recovered, with a recovery rate of 85.0％. With regard to the demand for ability training , teachers and graduate students tended to agree on the goal and focus of the training. 100.0％instructors believed that learning was an important course, only 11.2％ of the students thought that the course of study was not important, but to the current status of health manage-ment professional postgraduate courses, 79.3％ instructors believed that the current curriculum was reasonable, and only 53.5％of the students thought it reasonable. Conclusion The emphasis should be given to optimizing the course setting, adding practical and innovative courses, and strengthening the training of scientific research, etc., which is the only way to improve the quality of health management postgraduate education and meet the needs of health development.

Opportunity and challenge of big-data driven health service management / 中华医院管理杂志

Our research is focused on the emerging public health management supported by big-data,which has just come into horizon in this field.We thoroughly analyzed and compared the big-data technology as well as the latest development on theories and methods in public health management. Stream processing,batch processing,distributed database and non-relational database were applied to solve problems and meet demands and challenges in public health management.Furthermore,it should become the strategic choice of innovative public health management driven by big-data.

Design of health service resources management based on GIS / 医疗卫生装备

Objective To design a data management solution based on geographic information system for health service units to deal with health resources of subordinate medical institutions.Methods The whole solution was developed with layer logic function of data service, application and presentation. Storage, transformation and relationship of both spatial data and health service data were totally managed by relational database.Results The system was able to import, export, maintain, sum, query and analyze geography spatial information and health service information.Conclusion A new method is provided to improve capability of health support and health service management efficiency.

Gestão do ambiente organizacional na expansão e desenvolvimento do mercado de serviços de saúde no Brasil / Internal environment management for expansion and development of the health care market in Brazil

Introdução: diante do aumento dos gastos com saúde, uma questão importante diz respeito às dificuldades para efetivação dos investimentos nas unidades hospitalares (UHs), com vistas a evitar a deterioração dos serviços. Em face da escassez de recursos para investimento, ainda maior entre as UHs da rede pública de saúde no país, vislumbra-se a busca de solução alternativa, melhorando a gerência do ambiente hospitalar. Objetivos: este estudo testa a associação entre a gerência do ambiente hospitalar e as seguintes funções de organização da acreditação hospitalar (AH): o treinamento; a educação do paciente e do familiar; a governabilidade e a gerência da informação. Métodos: a amostra de conveniência é composta de 33 relatórios da AH, concluídos entre 2004 e 2009. Para tratar o material empírico, foram usados o modelo de regressão múltipla e a análise fatorial, com vistas a avaliar a influência daquelas funções de organização na gerência do ambiente hospitalar. Resultados: os testes da hipótese revelaram associações positivas e significativas entre as funções organizacionais selecionadas, o tipo de propriedade da UH e a gerência do ambiente hospitalar. Conclusões: como contribuição teórica, este trabalho esclareceu os fundamentos econômicos das relações existentes entre funções organizacionais e ambiente hospitalar. Como contribuição metodológica, o modelo estatístico utilizou dados de relatórios da AH, uma fonte de dados inédita na pesquisa sobre economia da gestão. Como contribuição gerencial, identificou fatores que influenciam o desempenho da gerência do ambiente hospitalar, contribuindo para o compromisso de gestores e profissionais de saúde com a mudança na organização.

Introduction: Given the increased expenses on health care, it is important to overcome difficulties in effectively applying investments in hospital units in order to avoid quality degradation of care services. The search of an alternative solution relying on improved management of the organizational environment is crucial to tackle issues of scarce investment resources, especially in public hospitals. Objectives:This study tests the association of hospital environment management with the following functions related to hospital accreditation: training; patients’ and family members’ education; governability; and information man agement. Methods:The convenience sample comprises 33 hospital accreditation reports from 2004 through 2009. The empirical data was analyzed using multiple regression and factorial analysis, with a view to assessing the influence of the organizational function on the management of the hospital environment. Results:The hypothesis tests pointed to positive and significant correlations involving the selected organizational functions, the type of hospital ownership, and the management of the hospital environment. Conclusions:As a theoretical contribution, this paper sheds a light into the economical grounds of the associations between organizational functions and the hospital environment. As a methodological contribution, the statistical model relied on data collected from hospital accreditation reports, an original source of data in studies on management economics. As a managerial contribution, this paper identifies factors influencing the management performance within the hospital environment, supporting managers and health professionals to fulfill their commitment to organizational change.

Discussion on the necessity of providing leadership course for health service management students / 中华医学教育探索杂志

Effective leadership is crucial for health organizations' performance and numerous western universities thus offer leadership courses or modules to their students.However,such education practice has not started in China.In order to optimize knowledge and skills of health service management practitioners,to content with requirements of health service organizations,to cope with dynamic organization environment,to implement health reform successfully and to realized sustainable development of health organizations,it is necessary to provide leadership course for students of health service management at Chinese universities.

Constructing cultivation mode for health service management professionals based on self-organization system theory / 中华医学教育探索杂志

With medical system reform advancing,social requirement on comprehensive capability for health service management professionals enhances unceasingly.However,health service management in our country is a new branch of edge-crossed and needs to be improvd and perfected constantly to reduce the shortage in mode construction for talent cultivation. It is meaningful to explore and construct innovative cultivation mode for health management professionals from three aspects,management capability,learning capability and information feedback based on system self-organization principle.

The Development of Profession of Health Services Management in the United States / 中国康复理论与实践

Health services managers are responsible for management and financing of health care in a variety of delivery models. This article provides information about the profession of health services management. It includes a brief historical overview of the profession, describes the various job roles that health service managers can assume, and outlines the educational curriculum to prepare and qualify for a career as health services manager. Educational preparation is available at the baccalaureate, masters, and doctoral levels. Finally, the article discusses future prospects for employment in the profession.

Discussion of Teaching Reform in Undergraduate Course for Health Service Management / 中华医学教育探索杂志

To bring up teaching quality of health service management and students' integrated ability,the author advanced his thoughts and opinions for teaching reform in teaching contents,teaching methods,examination modes and teachers ability based on the characteristics of health service management and combined with teaching practice.

The mechanism innovation and practical exploration about training post-graduate research capacity / 中华医学教育探索杂志

The research capacity in post-graduate education process is an important content,also an important indicator of educational outcomes.School of Medicine and Health Management of Hangzhou Normal University has done a bold exploration at this area,making the integration and innovation,from the management system to the practical operation,from the school management to the society support.Considering the compound characteristics of Social Medicine and Health Service Management specialty,the school has designed the "ladder" training research capacity programs by playing the school system,teacher roles and social support,and many other forces,in order to ensure and enhance the research capability of post-graduates.