ABSTRACT
Objective:To acquire the impact of COVID-19 pandemic on the operation of tertiary maternal and child health(MCH) hospitals in China, for decision making support of health administrative departments and hospital managers.Methods:The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the resource allocation, workload, treatment quality, work efficiency and asset operation of the tertiary MCH hospitals in China in 2019(pre pandemic) and 2020(during pandemic). Statistical descriptions were made using median.Results:In 2019 and 2020, the number of tertiary MCH hospitals in China was 236 and 258, respectively, and their relevant data were analyzed. In terms of resource allocation, the number of health technicians in 2019 and 2020 was 560 and 548, respectively, and the actual number of available beds was 308 and 305 respectively. In terms of workload, the annual outpatient visits in 2020 were 337 990, a decrease of 23.6%from that in 2019; The total number of emergency visits was 28 997, a decrease of 32.5%; The total number of discharged patients was 13 673, a decrease by 20.5%; A total of 4 723 training sessions on MCH were held for primary institutions, an increase of 1.2 percent. A total of 1 953 724 primary-level health technicians were trained, an increase of 175.2 percent. In terms of work efficiency, the average length of hospital stay of discharged patients decreased from 5.56 days in 2019 to 5.00 days in 2020. Bed utilization rate decreased from 88.90% to 69.15%; Bed turnover decreased from 53.69 to 44.22. In terms of treatment quality, the critical illness mortality rate of inpatients was 0.37% in 2020, 0.11% lower than that in 2019. The in-hospital mortality rate for neonatal patients was 0.04%, a 0.03% drop. In terms of asset operation, the total revenue in 2020 was 248.355 million yuan, an increase of 4.46% compared with 2019, in which the proportion of financial subsidies increased from 11.26% to 15.72%.Conclusions:The in-hospital services and institutional health care services of tertiary MCH hospitals in China were downsized by the COVID-19 pandemic, while the work efficiency was relatively stable, along with acceptable resource allocation, good treatment quality and asset operation.
ABSTRACT
Modern medical quality management is characterized by professionalism, continuity and comprehensiveness. It is necessary to strengthen the communication and cooperation among health administrative authorities, medical institutions and professionals. Since 2011, based on the guidance of the interactive governance theory and the governance interface as a platform, Zhejiang Province had explored and established a relatively independent third-party quality evaluation service organization, which aimed to correct such setbacks as the imbalance and inadequacy of medical quality management. Through the interaction of organization interface, management interface, service interface, information interface and method interface, the province had initially achieved the multi-level diagonal governance in medical quality management, and transformed the traditional management relationship into an interactive relationship. This practice had achieved desirable results in improving the quality control work network, updating management methods, and improving medical quality and safety, serving as reference in upgrading the medical quality and safety management of medical institutions in China.
ABSTRACT
Objective: To evaluate the effect of standard management for hypertension in community population of Suzhou city. Methods: We conducted a prospective study of standard management for hypertension in community population of Suzhou city. The project included 3 groups: Standard group, the patients received standardized management,n=81 711, Control group, the patients received general management, n=38 944, and No-management group,n=1 644 249. The incidence rate of stroke and coronary artery disease (CAD) were compared among different groups according to 2010 chronic disease report of Suzhou city. Results: Compared with initial condition, the final average blood pressure drop in Standard group was (13.78/7.06) mmHg, which was better than that in Control group, X2=1852.91,P<0.01. The incidence rate of stroke in Standard group, Control group and No-management group were 1.72%, 2.41% and 3.59%, the incidence rate of CAD were 0.43%, 0.66% and 1.29% respectively. Conclusion: Standard management for hypertension was better than general management for preventing and controlling the incidence of stroke and CAD in community population.
ABSTRACT
Se evalúan 11 Hospitales rurales (tipo 4 o de baja complejidad) del Servicio de Salud Llanquihue Chiloé Palena mediante un instrumento de control de gestión basado en el análisis de Liderazgo, Usuarios, Recursos Humanos, Planificación Estratégica, Procesos, Información y Análisis, Compromiso Social y Resultados. Los establecimientos presentan deficiencias en las siguientes áreas: gestión de sus procesos clínicos, (incluyendo la gestión de nuevas prestaciones y de los procesos de apoyo), gestión del desempeño, medición y análisis del rendimiento organizacional y los resultados de la efectividad organizacional. Se identifican como áreas de buen desempeño, el liderazgo para la dirección superior, el conocimiento de los pacientes y usuarios, la gestión de esa relación, gestión del personal, educación y capacitación y el compromiso con la comunidad. Se concluye la utilidad de la herramienta y la necesidad de extender el análisis a todos los establecimientos similares, con algunas modificaciones, la importancia de introducir posibilidades reales para la gestión clínica en aspectos críticos (urgencia, cirugía, atención del parto, atención cerrada y abierta) y en procesos de apoyo (laboratorio, imagenología y traslados).
Eleven hospitals classified as low complexity in Llanquihue Chiloé Palena Health Service were evaluated using components of a management control instrument. This instrument is based in the score of eight items: leadership, users, human resources, strategic planning, process, analysis and information, social agreements and results. These hospitals are underscored in management of clinical process, performance, measure and analysis of organizational performance. By opposition, leadership, users and patients knowledge, education and social agreements are well evaluated. In conclusion, the management evaluation tool is useful for these hospitals. Also it is necessary to extend analysis to other hospitals, with some modification. To improve the evaluation we suggest including clinical management of care, emergency services and supporting technical services (laboratory, imaging and transfers).
Subject(s)
Humans , Health Management , Hospitals, Rural , Management Indicators , ChileABSTRACT
En Venezuela hasta el año 1994 se manejaba un modelo de gestión y un sistema de registro fragmentado de forma centralizada, pero el inicio del proceso de descentralización impulso el Sistema de Información de Salud del Modelo de Atención Integral (SISMAI), que cumple un papel vital en la gestión de la red ambulatoria. Por esta razón, se planteó un estudio de tipo descriptivo cuanti-cualitativo y un diseño transversal, con el objetivo de evaluar el aprovechamiento del SISMAI, en la gestión de la red ambulatoria en el Municipio Santiago Mariño del estado Aragua durante el año 2006. Para ello fue seleccionada una muestra conformada por 6 establecimientos de salud, y 14 informantes claves, cuyo guión fue producto de la operacionalización de las variables. Para el análisis de resultados cualitativos se procedió a categorizar las áreas temáticas sobre el sistema evaluado y a la agrupación de los entrevistados por niveles de referencia y establecimientos de salud. Para el análisis cuantitativo se calcularon porcentajes. Al verificar el conocimiento y manejo de los instrumentos del SISMAI por parte del equipo de salud de los diferentes niveles de referencia de la red ambulatoria, se encontró que 78,6% de los entrevistados tenían un nivel de conocimiento inadecuado, escaso o nulo. En relación a la utilidad del SISMAI en la toma de decisiones en los diferentes niveles de la Red Ambulatoria, 71,4% lo utiliza como herramienta para la toma de decisiones, de lo que se deduce que existe aprovechamiento del sistema en los niveles de gestión de la Red. Finalmente, se concluye que los factores que favorecen el aprovechamiento del SISMAI en la gestión local de salud del municipio Santiago Mariño, están relacionados con la actitud de los usuarios, con la facilidad y rapidez del sistema para suministrar la información y con la voluntad política de la Dirección Municipal de Salud.
In Venezuela, until 1994 the model of administrative management and the fragmented registration system were centralized. The descentralization process which started after wards promoted the strenghtening of the Information Health System of the Integral Care Model (SISMAI) which performs a vital role in the action of the out-patients clinic network. The present research is descriptive quanti-qualitative cross sectional study, aimed to evaluate the achievements of SISMAI in the management of the out - patients network in Santiago Mariño Municipality, Aragua state, during 2006. The studied sample comprises 6 health centers and 14 key informers. Analysis of the qualitative results was carried on by subject grouping of different areas within the evaluated system and the group of informers according to the reference levels within the health care establishments. As for the quantitative analysis concerns information and knowledge concerning management in SISMAI by the health team in its different reference levels, showed that 78.6% of the interviewed have an inadequate level of knowledge; scarce or null. When usefullness of SISMAI as a tool for decision making in the different levels of the out-patients clinics network was evaluated, 71.4 of the interviewed answered positively. A conclusion on the profitable use of SISMAI can be conclude. Finally, its application for increasing the quality of local health management are closely linked with attitudes of patients, terms and speed of the system in supplying the proper information and services and finally the political will of the Municipality Health Direction.