ABSTRACT
In order to clarify the research directions of medical facilities' data analysis and decision in operation and maintenance management,the paper illustrates current functions of medical facilities operation and maintenance from the following aspects:building hospital intelligent management,power supply and distribution system's safety,energy consumption's optimization,network's optimization and complex medical equipment's operation guarantee.The problems of data analysis and decision about hospital facilities' operation and maintenance management are summarized.Four kinds of data decision models are put forward,including risk identification,health assessment of equipment,faults prediction and diagnosis,and management optimization.These methods could provide reference for the development of medical facilities' operation and maintenance.
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Objective To analyze the regional management policies for the configuration and utilization of medical facilities before the issuing of Regulations for the Supervision and Administration of Medical Devices in May 2017, so as to provide reference for relevant policy-making in the future. Methods Regional policies in 15 provincial-level administrative regions such as Zhejiang, Shanghai and Hunan were collected and analyses were conducted on regulations of the configuration management, application and discard of large-scale medical facilities. Results While regional policies played a crucial role in the configuration and administration of medical facilities, problems still existed, and proposals were made on future policy-making accordingly. Conclusion Policies for the configuration and administration of medical facilities require to be improved.
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Objective:To analyze losses and gains (L&G) of basic medical institutions induced by the Essen-tial Medicines Policy.Methods: Choosing some poverty-stricken county in western China as sample area to conduct field research,using 2009 as baseline year,to calculate L&G and L&G ratio of basic medical institutions caused by adjustments of drug policy,medical services prices, and government subsidies from 2009—2015. Results: Medical facilities have gained after the implementation of the Essential Medicines Policy as a whole. Gains were on an upward trend from 2009—2015,and L&G ratio increased from -2.15% in 2009 to 47.70% in 2015. For medical facilities at different levels, their gains attributed to different causes. Gains for medical facilities at village and town levels mainly attributed to government subsidies;gains for medical facilities at county level mainly attributed to adjustment of medical services prices. Conclusions:Implementation of the Essential Medicines Policy has helped adjust composi-tion of losses and gains of medical facilities. Moving forward,functions and development of medical facilities should be strengthened with a focus on adjusting medical services prices for medical facilities at town level.
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Objective:Setting up a queuing simulation model to study the allocation and usage of MRI in certain regional hospital in East China. To find out the causes and put forward suggestions. Methods: Statistical method was used for statistical analysis of MRI inspection time. Queuing simulation model was used to analyzing MRI allocation and used in 7 top hospitals. The waiting queue length, average queue length, sojourn time and waiting time was calculated.Results: The average MRI examination waiting time of the 7 top hospitals in the whole region is 0.403 h. The waiting time of 2 hospitals is more than 40 min while which is less than 20 min in 3 hospitals. The equipment utilization rate is higher in 2 hospitals (vacancy rate is 11.9%-16.4%) while which is lower in 2 other hospitals (vacancy rate is 52.3%-58.9%).Conclusion: The problem of health allocations of resources could be solved by establishing regional MRI examination center radiation regional around.
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In our medical district, home care physician-led liaison system has not yet been established for pain relief using a patient-controlled analgesia（PCA）pump. Therefore, it has been difficult to perform continuous opioid infusion at home. We investigated the liaison system based on our experience with breast cancer patients in whom oral drug administration became difficult during palliative care at home and thus continuous opioid subcutaneous infusion was started in cooperation with a palliative care hospital team and based on the discussion among home care study group physicians of the medical association. Based on the results of our study, we established the system called“Home PCA Raku-raku（Easy）Pack”that are characterized by the following：（1）opioids are prescribed by a home care physician；（2）a certified cancer pain management nurse accompanies a nurse to visit the patients’ home, assesses their conditions, and changes the drug solution；（3）the pump rental fee is paid by the home care physician, and the cost of consumables is paid by the hospital；and（4）the home care physician calculates the fee for home management of malignant tumors, and the hospital calculates the collaborative medical management fee and the visiting nursing management fee. This system was applied to 6 patients during a period of approximately 2 years. The result of a questionnaire survey for home care physicians and visiting nurse stations using this system showed that the system was generally beneficial.
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Objective : The aim of this study was to examine the influence of a liaison-clinical pathway for stroke rehabilitation. Methods : We initiated the pathway in January 2008. The patients enrolled in this study included 82 patients with acute stroke sustained during the 4 months after the initiation of the pathway and 151 patients with acute stroke sustained during the same period in the following year. Results : The mean length of stay in acute stroke centers was significantly reduced in the second year of employing the pathway. However, an evident reduction of the functional independence measure gain was observed in the convalescent rehabilitation wards, especially in severely physically handicapped patients. Conclusion : The liaison-clinical pathway is an effective approach for advancing a regional cooperation network among hospitals and for shortening the stay in acute stroke centers. On the other hand, the clinical outcome of stroke patients can deteriorate if enough efforts are not made to improve the medical management of severely physically handicapped patients in convalescent rehabilitation wards.