Steering Standardization of Pathology Services Through Centralisation and Consolidation of Laboratory Procurement

@#The expansion of healthcare services to serve as many people as possible has led to the decentralisation of laboratory testing. Many laboratory tests are now made available at district hospitals and rural health clinics for certain states or provinces. Consequently, there is a proliferation of laboratory tests, techniques, equipment, and other required commodities at the different medical laboratories. The lack of central governance has resulted in a widely-diverse and non-standardised laboratory services that may eventually affect the quality of healthcare delivery to patients. To ensure a high-quality and standardised healthcare delivery across a state or a province, it is important that the relevant stakeholders outline and implement the necessary strategies to establish a streamlined medical laboratory network. In this article, we discuss the significance of laboratory procurement consolidation and centralisation in the steering of the standardisation of laboratory operations leading to a high-quality and efficient chemical pathology services in a defined region.

Rental Service of Assistive Devices in China: Policy Research / 中国康复理论与实践

Objective:To sort out the current situation of rehabilitation assistive devices rental service in China, and suggest the policy for its development. Methods:Based on the four-dimensional social security policy analysis framework, with the combination of subject retrieval and field research, the market players, supporting systems, rental products, financial security and professionals in some pilot areas of community rental of assistive devices in China were summarized. Results:There were still some problems in the rental service of assistive devices in China, mainly as insufficience of main players of the rental market, supporting policies and systems, payment security system, professionals, and social recognition, etc. Conclusion:It is important to reasonably set up rental products, standardize service enterprises, cultivate market players, increase investment, promote talent training, and strengthen publicity, to promote the development of the rental of assistive devices.

Land tenure in tea farming and exploring factors influencing a rural households decision to exit or enter farming / Um exame da posse da terra na agricultura de chá e a exploração de fatores que influenciam a decisão de uma família rural de sair ou entrar na agricultura

ABSTRACT: Self-operated land and operated by tenure may affect the sustainability of farming in a region. This study planned to analyze how rural households switch away from tea farming even they have parental land, and how landless access the land for tea farming. For this a total of 138 tea growers were interviewed including 27 farmers who had just ownership of land and had left the tea farming. Logistic regression was applied to assess the determinants of rural household's decision to exit and enter the land market. Farmers were compared over their farm management practices and personal characteristics. The owned farmers were good in management and adoption of good practice in tea farming than those who accessed land as a shareholder and not had their own land. Rural households head as getting older, having high education and also having an off-farm occupation, having more university graduated family members, and family members having off-farm occupations are more likely to exit from farming and supply their land to rental markets. On the other side, an older and highly educated head of landless family is less likely to become a shareholder. Here also off-farm occupation has a negative and insignificant effect on the probability of landless household working as a shareholder. If the head of the landless family has a wish to become a successful farmer, then he is more likely to work as an owner. It implies that a person is less likely to work as a shareholder and more likely to get land with ownership rights not only land-using rights.

RESUMO: Propriedades auto-operados e operados pela posse podem afetar a sustentabilidade da agricultura em uma região. Este estudo planejou analisar como as famílias rurais se afastam da produção de chá, mesmo as que possuam terras parentais, e como os sem-terra acessam a terra para a produção de chá. Nesse total, 138 produtores de chá foram entrevistados, incluindo 27 agricultores que possuíam apenas a propriedade da terra e deixaram a lavoura. A regressão logística foi aplicada para avaliar os determinantes da decisão da família rural de sair e entrar no mercado de terras. Os agricultores foram comparados com suas práticas de gerenciamento agrícola e características pessoais. Os agricultores proprietários foram considerados bons em gestão e adoção de boas práticas na agricultura de chá do que aqueles que acessaram a terra como acionista e não possuíam terras próprias. Os agregados familiares rurais envelhecem, têm ensino superior e também uma ocupação fora da fazenda, tendo mais membros da família graduados na universidade e com ocupações fora da fazenda têm mais probabilidade de sair da agricultura e fornecer suas terras para os mercados de arrendamento. Por outro lado, um chefe de família sem terra, mais velho e altamente educado, tem menos chances de se tornar um acionista. Aqui também a ocupação fora da fazenda tem um efeito negativo e insignificante na probabilidade de famílias sem terra trabalharem como acionistas. Se o chefe da família sem terra deseja se tornar um agricultor bem-sucedido, é mais provável que ele trabalhe como proprietário. Isso implica que é menos provável que uma pessoa trabalhe como acionista e obtenha terras com direitos de propriedade e não apenas direitos de uso da terra.

A feasibility analysis and research of centralized lease management mode using for medical equipment in emergency medical equipment service center of hospital / 中国医学装备

Objective:To establish the emergency medical equipment rental center, not only can reduce the repeated purchase for medical equipment, but also can achieve resource sharing, reduce equipment maintenance cost, and improve utilization efficiency.Methods: To establish emergency medical equipment rental center, which adopted lease mode and centralized management mode to use equipment. Department of medical engineering managed this center and this department is responsible to ensure every clinical department can use equipment by lease method.Results: The center has optimized the resource allocation of hospital, obviously reduced equipment input cost, improved utilization rate of medical facility since it were established. This mode provided reliable service for clinical departments.Conclusion: The established rental center of emergency medical equipment has changed the traditional management mode to a new feasible mode which can improve centralized management for medical devices, reduce waste for medical resource and achieve resource sharing.

Exploration and practice of construction of medical equipment rental center / 中国医学装备

Objective: To establish medical equipment rental center, not only can reduce the duplication of medical equipment purchase, and can reduce equipment maintenance cost, and improve utilization and good rates of medical equipment. Methods: Emergency rescue equipment rental center is established, which is managed by the Equipment Division with responsible for managing shared management mode, and in which the equipment is leased by Clinical departments. Results: The establishment of emergency rescue equipment rental centers, on the one hand, optimized the allocation of resources hospitals, and saved investment and maintenance expenses for the hospital; on the other hand improved the utilization of medical equipment, and protected the integrity of the rate of the device, and provided the most reliable service for clinical departments. Conclusion:By establishing emergency rescue medical equipment rental centers and improving of management mode of medical devices, sharing of resources has been achieved, and the utilization of the equipment has been improved, and equipment performance has been guaranteed.

Protective effect of penehvclidine hvdrochloride on ischemia-reperfusion injury in rats

OBJECTIVE@#To investigate the protective effect of penehvclidine hvdrochloride on ischemia-reperfusion injury in rats.@*METHODS@#The model of ischemia-reperfusion injury was established in rats through clamping rental pedicles for 50 min followed by reperfusion. A total of 60 Wistar rats were randomly divided into 4 groups including fake surgery group, model group, low PHC dosage group and high dosage penehvclidine hvdrochloride (PHC) group. Seven days before the experiment, rats in fake surgery group and model group were given 10 mL/kg normal saline, while rats in low PHC dosage group and high dosage PHC group were given 200 and 50 mg/kg PHC, respectively. The urine volume, diet volume, Cre, PU, BUN, IL-6, IL-8, TNF-α, NO MDA concentration, SOD and GSH-Px were determined.@*RESULTS@#Compared with rats in model group, decreased urine volume, diet volume, Cre, PU, BUN, IL-6, IL-8, TNF-α, NO MDA concentration and increased SOD and GSH-Px activity could be seen in low PHC dosage group and high dosage PHC group (P<0.05).@*CONCLUSIONS@#Administration of PHC before ischemia-reperfusion injury can help protect ischemia-reperfusion injury.

Características de acceso al tratamiento con presión positiva en el síndrome de apneas del sueño y su relación con el cumplimiento y el abandono en un hospital de comunidad / Characteristics of access to treatment with positive pressure in the sleep apnea syndrome and its relationship to compliance and neglect in a community hospital

Objetivos: Describir las características de acceso al tratamiento con presión positiva y su cumplimiento en el síndrome de apneas del sueño (SAHOS), en un hospital de comunidad. Métodos: Datos obtenidos por encuesta telefónica a pacientes derivados para tratamiento en el período de dos años. Se interrogó acerca de: cobertura de salud, provisión, compra o alquiler de equipos, tipos, abandono y motivos del mismo. Resultados: Desde julio de 2006 a julio de 2008 se indicó tratamiento con presión positiva en la vía aérea superior a 58 pacientes con SAHOS severo o moderado. Fue posible encuestar a 54. Todos tuvieron cobertura de salud (13 obras sociales y 7 empresas de medicina prepaga). El 25 por ciento (14/54 pacientes) habían abandonado al momento de ser encuestados. El 51.8 por ciento (n=28) compró el equipo (refiriendo falta de cobertura por la empresa de salud) y en el 13 por ciento (n=7) el financiador cubrió el 50 por ciento. En el 18.5 por ciento de los pacientes (n=10) la cobertura entregó el equipo en comodato (todos correspondieron a obras sociales y ninguno a empresa de medicina prepaga), y 5 pacientes continuaban usando equipos en alquiler permanente. De aquellos que compraron el equipoo lo obtuvieron en comodato (n=38), 4 (10 por ciento) abandonaron, comparados con los 11 pacientes que lo hicieron mientras alquilaban, y con el 25 por ciento de abandono global. Conclusiones: El grupo equipo propio, por compra o comodato mostró menor abandono (p= 0.0001). La cobertura fue diferente para obras sociales que para empresas demedicina prepaga, y la tasa mas alta de abandono se presentó durante el alquiler del equipo (78 por ciento).

Objective: To determine the impact of factors which hamper the treatment of obstructive sleep apnea (OSA) in a private hospital. Methods: We conducted a retrospective telephonic survey of adults referred for treatment of OSA during a two year period. The questionnaire included data about health insurance system, type and methods of acquisition (purchase or rental) of the continuous positive airway pressure (CPAP) equipment, compliance with treatment and reasons for abandonment if it occurred. Results: From July 2006 to July 2008, treatment with CPAP was prescribed to 58 patients with severe or moderate OSA; 54 of them could be interviewed. All of them had healthinsurance coverage (with 13 labor union dependent systems and 7 different private health insurance systems). Twenty-five percent of the patients (n=14) had abandoned treatmentat the moment of being interviewed; 51.8 percent of the patients (n=28) had purchased the CPAP equipment (because it was not included in their health insurance coverage) and 13 percent (n=7) had paid 50 percent of the cost of the equipment. In 18.5 percent of patients (n=10) the health insurance system delivered the equipment as a loan (only labor union dependent systems) and 5 patients rented the CPAP equipment in a permanent way at their own cost. Among the patients who had purchased the equipment or obtained it as a loan(n=38), 4 patients abandoned treatment (10 percent) vs 11 patients (78 percent) in the group who had rented it (p= 0.0001).Conclusions: The patients who had paid for their own equipment or had received it as a loan had a significantly lower rate of abandonment . The benefit of the provision of the CPAP equipment differs between private and labor union health insurance systems. Renting the CPAP equipment results in the highest rates of abandonment of treatment.