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Objective:To study the problem of the interests decision-making about sharing medical resources between private hospitals and public hospitals research,and to explore the internal symbiosis mechanism of private hospitals and public hospitals.Methods:The maximization method was applied to study in depth the decision-making and benefit distribution mechanism of private bospitals and public hospitals.Results:The symbiotic cooperation of private hospitals and public hospitals could bring the total additional benefits of the medical service market when the supply of the sharing medical resources was greater than demand.Collaborative decision was better than independent decision-making between private hospitals and public hospitals.When the supply of sharing in medical resources was less than demand situation,the symbiotic cooperation decisions of both hospitals could not bring additional benefits from the medical service market.Conclusion:In order to make full use of medical resources,provide better service to the residents and maximize the total benefit of the medical service market,it was recommended to build the information platform,form effctive coordination mechanism and establish collaborative performance evaluation.
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The objective of this article is to review the health decision support system and improve scientific decision-making and service. Based on the population and health data resources, the article designed the health deci-sion support system, covering public health, primary health, medical services, drug administration, and medical in-surance, with five core functions and function model, such as information support, monitoring, analysis and evalua-tion, forecast, and comprehensive optimization. It has also designed a system framework comprising data layer, busi-ness layer, presentation layer, as well as decision support databases including data warehouse, model base, method base and knowledge base were designed. Meanwhile, Taking medical insurance as an example, aiming at decision-making needs, the auxiliary decision making function was designed and successfully implemented.
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This paper attempts to utilise clinical scenarios where ethical issues are embedded and requires appropriate application of the steps of the framework mentioned. A step by step sequential approach is adopted to illustrate how the ‘ethical decision model ‘can be used to resolve ethical problems to arrive at a reasonable conclusion. The UNESCO ethical method of reasoning is used as the framework for decision making. Physicianeducators should be competent to use ethical decision models as well as best available scientific evidence to be able to arrive at the best decision for patient care as well as teach health professional trainees how reasonable treatment decisions can be made within the perimeter of medical law and social justice.
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Obstetrics , Education, MedicalABSTRACT
The management of influenza has dramatically changed since the introduction of the rapid influenza diagnostic test, or RIDT, and neuraminidase inhibitors (NI). However, it is still far from optimal due to low RIDT sensitivity and problems involving NI such as side effects and the potential emergence of resistant virus.Therefore, we developed a decision-making model for the management of influenza, which includes Kampo medicines in its strategies. First, the severity of patients is evaluated. If a patient is judged at severe or high-risk, intravenous NI would be the main component of treatment. If a patient has neither a severe condition nor is at high-risk, the patient would be asked to choose either NI or Kampo medicine. In the former, RIDT would be used if pretest probability was less than 50%, but it would not be used if it was more than 50%, based on the lack of influence on the post-test probability. For the latter, RIDT would be not used in general as Kampo targets “phenomena”, not the virus <i>per se</i>. This model enables us to optimize the use of RIDT by appropriately selecting patients based on the characteristics of RIDT, and by avoiding unnecessary tests and their misinterpretation.
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OBJECTIVE: To explore a research path and statistical analytical method for cost-utility analysis suitable for gallstone surgery patients.METHODS: A decision-making model for the treatment of cholelithiasis surgery was established;the costs(C) and utility values at each nodal point(? U) were collected,with the results subjected to sensitivity analysis and threshold analysis.RESULTS: The cost-utility ratios(CUR) of laparoscopic operation and open surgery were 4 605.6(? 30%) yuan/QALY and 5 979.7(? 30%) yuan/QALY,respectively.One dimension sensitivity analysis of each( every) parameter reveals that the former CUR value is greater than the latter one.C1 and ? U1 showed the biggest impact on the CUR of laparoscopic operation,while C5 and ? U5 did on the CUR of open surgery.When C1=10 205.6 yuan,or ? U1=1.303 or C5=10 979.8 yuan or ? U5=3.095,CUR of laparoscopic operation was equal to CUR of open surgery,which means that the conversion of threshold was achieved.CONCLUSION: The designed research path and statistic analytic methods are suitable for the cost-utility analysis of cholelithiasis surgery patients.
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PURPOSE: This study was conducted to study on 1) What is nursing students' experience of ethical problems involving nursing practice? 2) What is nursing students' experience of using ethical decision-making models? METHOD: In order to answer these two questions, we selected 97 senior baccalaureate nursing students from two Korean universities using a conceptual framework and method of content analysis. RESULT: From 97 ethical problems emerged five content categories, the largest being ethical problems involving health professionals (69%); the basic nature of the nursing students' experience of ethical problems consisted of conflict, resolution, and rationale; 94% of the students stated that using an ethical decision-making model was helpful. CONCLUSION: Although additional research is needed, these findings have important implications for nursing ethics education and practice.
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Humans , Education , Ethics, Nursing , Health Occupations , Nursing , Students, NursingABSTRACT
The purpose of this study was to describe decision making model of 180 public health nurses in Korea and their knowledge structure for decision making. The differences of decision making models by nurse's knowledge structure were also tested. Research concepts were measured using the instrument based on systemic and interpretive decision making approaches that were developed by Lauri & Salantera (1995). The results were as follows. 1. The public health nurses turned to, most commonly, a mixed practical-theoretical knowledge structure (45.9%), followed by practical knowledge (32%) and theoretical knowledge (22.1%). 2. The six different decision making models were identified. These were named for decision making theories and nursing process. These were client-oriented decision making, rule-oriented systemic decision making, wholistic and intuitive decision making, decision making depending on subjective view and experience, systemic decision making for defining problems, and hypotheticodeductive decision making for defining problems. 3. The public nurses who had practical and practical-theoretical knowledge structure and community health practitioner (CHP) retold that decision making depends on subjective view and experience. Also the public health nurses who had 5~19 years clinical experience represented hypothetico-deductive decision making for defining problems.
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Decision Making , Korea , Nurses, Public Health , Nursing Process , Public HealthABSTRACT
Adopting the comprehensive fuzzy judgment method,multi-attribute decision-making model of maintenance scheme is achieved based on the principle of maximum subordinate,so as to solve the uncertainness and fuzziness affections of RCM logical decision during the decision-making of maintenance method. Finally,the practical maintenance of high voltage generator illustrates that the model is useful in supplying the effective instruction to the optimal maintenance scheme in practice.