Mercury-Added Products Management: Challenges In Developing Countries And Lessons Learned From Medical Facility

The risks of mercury use have prompted the establishment of Minamata Convention on Mercury which placed strong emphasis on management of mercury-added products. This convention aims to reduce and phase out the use, manufacturing and trade of mercury-added products including batteries, switches and non-electronic measuring devices. This commitment will cause significant impacts especially in the developing countries in designing the right approach to achieve it. This is also true for medical industry which is well known for the utilization of mercury-added devices and dental amalgam in its services but had embarked on efforts in eliminating mercury for many years. The experiences learned within a medical facility can be useful in efforts to meet this global ambition of mercury phase out. This paper aims to provide conceptual discussion on the challenges faced by developing countries and lessons learned from medical facility that can helps the formulation of appropriate approaches to manage mercury-added products. The paper adopted medical industry as a case study and used document analysis to discuss the issue. The main challenges identified for developing countries include lacks of capacity, funding, data and newer technologies. Based on analysis of previous studies, this study proposed a mercury management framework in medical facility and identified the recommended practices, namely technological application, policy instrument, capacity building and guidelines development. These identified approaches are found to have specific relationships between cost and potential impacts, hence giving flexibility for adoption based on the available resources in promoting better mercury management system

A comprehensive evaluation of war injury care and treatment capacity in field medical facilities based on the analytic hierarchy process(AHP)method / 军事医学

Objective To establish a comprehensive war injury care and treatment capcity evaluation index system. Methods The Delphi method was used for establishing the evaluation index system and the analytic hierarchy process was used for the calculation of the index weight.Finally,the fuzzy comprehensive evaluation method was used to test the effectiveness of the index system.Results The evaluation model was formulated with 4 dimensions and 16 indicators,which provided reference for the evaluation of war injury care and treatment capacity in field medical facilities.Conclusion The result shows that this evaluation index system is characterized by high credibility and sensitivity,which can satisfy the need of war injury care and treatment capcity evaluation in field medical facilities.

The use and supply of medical equipment for emergency rescue / 中国医学装备

Objective: To find a method of the use and supply of medical equipment for emergency rescue. Methods:In the process of rescue, the equipment department establishs the emergency operation mode and first-aid equipment supply system under the unified leadership of the hospital rescue headquarters. Results: By establishing the emergency operation mode and first-aid equipment supply system, the unified deployment of medical equipments has been implemented. Conclusion: Sudden catastrophic events occur suddenly, injure many people, use the method of centralized supplement of medical equipment, the clinical equipment can be assembled in a short time to guarantee the need of clinical rescue.

Analysis on DEA-Malmquist efficiency index of medical facilities in Zhejiang province / 中华医院管理杂志

Objective To measure the changes of total factor productivity (TFP)of Zhejiang medical facilities for decision makers to promote their service efficiency.Methods Collecting the panel data of 2005-2010(four input indexes and five output indexes)from medical facilities in Zhejiang province and measuring with Malmquist index of DEA programs of DEAP2.1.Results The average annual TFP growth rate in the period is 2.0％.A further decomposition found that the average annual growth rate of technology progress is 1.8 ％,while that of technical efficiency and pure technical efficiency is only 0.2％respectively.In the meantime,no scale efficiency growth was found.Conclusion The average annual growth of total factor productivity of Zhejiang medical institutions is substantially low in the period,with technology recession found as well.To maximize productivity of the medical sector,the allocation and internal management should be strengthened to stimulate technical efficiency and scale efficiency while encouraging technology innovation.

A Study on the Status of Utilization and Criteria for Selection of Medical Care Facilities of Elementary School Children

PURPOSE: The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. METHODS: We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. RESULTS: The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father(10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. CONCLUSION: Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.

A Study on Epidemiologic Characteristics of Recurrent Abdominal Pain in Elementary School Children / 대한소아소화기영양학회지

PURPOSE: The aims of this study are to examine clinical characteristics, patterns of medical care utilization, and factors which determine medical care utilization of elementary school children with recurrent abdominal pain (RAP), to find possible factors influencing the onset and the course of the disorder. METHOD: We performed questionnaires in Kwangju on children from two primary schools from June, 1 1998 to June 30 and carried out statistical analysis. RESULT: 1) Total number of questionnaires were 1417. 715 were male and 702 were female and the ratio of male to female was 1.02 : 1. Average age was 10.3 years. 2) 268 children had RAP (18.9%), boys 132 (18.4%), girls136 (19.2%). 3) The duration of the pain within 10 minutes was 68.5%. 178 children with RAP (66.3%) visited the doctor, The utilization pattern of medical facilities of the pupils with RAP; the most frequently utilized medical facility was pediatrics (35.2%) and the order ran as infernal medicine (31.5%), and pharmacy (29.25). The utilization pattern of medical facilities for the older students; the utilization rate of pediatrics decreased, but internal medicine increased. The major factors affecting the selection of the medical facility were geographic accessibility, kindness of the personnel, good results and traffic convenience. 4) Symptoms which were accompanied with abdominal pain were headache (44.5%), chest pain (28.2%), dizziness (26.6%), vomiting (9%), and 119 children (44.5%) had no accompanied symptoms. 5) In 95 children (35.3%) abdominal pain, occured at postprandial time, in 55 children (20.5%) before meal and in 39 children (14.7%) at school. The highest incidence rate of RAP was observed on Monday (21.4%), and the lowest on Saturday (8.7%). 6) The most frequent involved part of the abdomen was periumbrical area (38%) and the order ran as epigastrium and suprapubic area. The most frequent characteristics of abdominal pain were burning pain (36.9%) and the order ran as dull, cramping and colicky pain. CONCLUSION: RAP is a frequent disease entitiy in children. Too many times children with RAP are treated by other departments instead of Pediatrics. A child has a peculiar growth and development which is different to those from an adult with advancing years. So, it is necessary to choose special medical care and an adequate medical facility.

Cost control of medical facilities / 中华医院管理杂志

The cost effectiveness of medical facilities has been followed with great interest since the adoption of full cost accounting in hospitals. In order to help departments using the facilities enhance their managerial expertise and to provide hospital leaders and the department responsible for the facilities with decision making basis in the introduction of facilities, the author gives an account of what is included in the cost of medical facilities: facility depreciation, space, maintenance, consumable supply, water, electricity and gas expenses, salaries, indirect cost expenditure, et al. At the same time the author explains the operating profits of facilities and the methods of assessment and analysis.

Investigation of large-size medical facility allocation in Tangshan City / 中华医院管理杂志

Objective To find out about the allocation of large size medical facilities in Tangshan City so as to make rational use of its health resources. Methods On the spot investigations were combined with surveys through questionnaires to find out about the allocation of large size facilities in second tier hospitals and above in the city. Results There are altogether 109 large size medical facilities in the city, averaging 15.60 per million people. The allocation number is pretty high, and yet the distribution is quite irrational, with the city proper owning 70.67% of the facilities while its population and land area account for only 24.06% and 8.10%. Conclusion The allocation number has been increasing rapidly and the level of grade is rather high, and yet there lacks equity in distribution.