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Objective:To construct a social loss indicator system based on the perspective of epidemic prevention and control against background of emerging major infectious diseases at the national, hospital, and individual levels, and to provide decision-making basis for public general hospitals to formulate prevention and control strategies for emerging major infectious diseases.Methods:Literatures published before December 23, 2020 were retrieved from CNKI, Wanfang, VIP, Web of Science, Google Scholar with such keywords as " infectious diseases" " public health emergencies" " social losses" " COVID-19" " evaluation". Then a preliminary social loss indicator system of public general hospitals for emerging major infectious diseases was constructed from such dimensions as country, hospital, and individual, by implementing literature analysis and expert consultation. Based on such a preliminary system, three questionnaires were designed for the country, hospitals, and individuals and the corresponding data were collected from December 25, 2021 to May 20, 2022. In the end, a factor analysis was made on the questionnaire data to optimize the social loss indicator system and determine the weights of each indicator.Results:The social loss indicator system consists of 14 level-1 indicators and 60 level-2 indicators. Level-1 indicators at country aspect consisted of government governance capacity, direct economic losses, social security, online public opinion, indirect economic losses, and international cooperation; indicators at hospital aspect consisted of hospital manpower, material resources, and information resources, hospital services, and hospital operations; indicators at the individual aspect consisted of physical health, psychological and social health, and external environment. Level-1 indicators of the highest weight at all aspects were social security, manpower, material and information resources, as well as physiological health. And the level-2 indicators of the highest weight were high medical expenses, overwork for staff other than doctors and nurses and medical insurance.Conclusions:The social loss indicator system for emerging major infectious diseases constructed in this study proves scientific and reasonable, helpful for the formulation of prevention and control strategies of public general hospitals.
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Objective:To establish a graded post management system for specialist nurses in medical institutions, so as to provide a reference for the selection, stratification, employment, and promotion of specialist nurses in China.Methods:Through literature review and brainstorming, the primary screening indicators of the graded post indicator management system for specialist nurses were constructed. Two rounds of Delphi method were used to consult 25 experts to construct the graded post management system for specialist nurses.Results:The effective recovery rates for two rounds of consultation were 100% and 96%, respectively, with expert authority coefficients of 0.86 and 0.89, and Kendall harmony coefficients of 0.31 and 0.54. The final establishment of a specialist nurses graded post management indicator system included 8 first level indicators, 31 second level indicators.Conclusions:The graded post management indicator system for specialist nurse could provide theoretical support for the management of specialist nurse. It was conducive to clarifying the admission standards and hierarchical framework for specialist nurses, standardizing the establishment of positions and responsibilities, and improving the competition and incentive mechanism.
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At present, the experimental examination of medical morphology courses in most medical colleges and universities still adopt traditional specimen examination or PPT examination, and there are many disadvantages. This paper introduces how to build a system with B/S architecture based on the local area network, and how to set up an examination system to realize the functions of user management, online examination database updating, free examination paper formation, examination running and automatic marking. Through its application in Chengdu Medical College in recent years, the medical morphology online picture exam system has effectively promoted the reform of the examination methods, the style of study and the effect of experimental teaching. However, there are still some problems, such as high investment cost and limited examination room.
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With the continuous promotion of the comprehensive reform of public hospitals, public hospitals urgently need to change the management mode, achieve connotative development, and seek benefits from their own management, which has become an urgent task than ever. The authors expounded the construction and application practice of the hospital intelligent operation management platform, took the information construction as a tool, built the operation data warehouse, established the department accounting model, and explored the construction path of the hospital intelligent operation management, so as to provide a reference for promoting the scientific, refined and informatization of the hospital operation management, and improving the operation management level.
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Objective:To monitor and collect data information through failure mode and effect analysis (FMEA) and establish a data information system for nursing quality sensitive indicators.Methods:From July 2019 to July 2021, FMEA was used to evaluate the formation process of nursing quality sensitive index data, formulate specific improvement measures, and compare the proportion of risk priority index (risk priority number, RPN) value and index data informatization before and after the implementation.Results:Before the application of FMEA in nursing quality sensitive index data information management, the RPN value of index data element confirmation, index definition understanding, record specification, problem solving limitation, information communication and system data integration were (362.00 ± 101.56), (539.90 ± 174.39), (603.20 ± 128.71), (395.10 ± 184.83), (448.90 ± 185.58), (334.80 ± 107.74) points, while those after the intervention were (17.10 ± 9.96), (30.90 ± 31.66), (42.40 ± 28.99), (30.30 ± 33.94), (16.30 ± 17.02), (18.90 ± 19.27) points, with statistical significance ( t values were 9.11 to 14.74, all P<0.05). The proportion of sensitive index data informatization increased from 46.43% (39/84) to 95.51%(85/89). Conclusions:Using FMEA mode to manage the data information is effective and feasible for the realization of sensitive index information data.
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Medical laboratories in China have gained advances to some extent in recent years, and played an important role in prevention and control of COVID-19 epidemic. This paper analyzed their opportunities and challenges in the new era by means of SWOT analysis. Recommendations made by the authors are that medical laboratories should integrate into the national prevention and control system against major infectious diseases, to safeguard biosecurity and public health safety. Meanwhile, medical laboratories should enhance their high-end testing ability, seize the opportunity of DRG payment reform, and carry out various forms of cooperation with public hospitals of all levels, and play a more important role in county-wide medical system development.
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Objective:Faced with the current new situation of clinical research, a new mode of information management is explored in order to comply with relevant national policies, along with the trend of industry development, to assure the efficient conduct of clinical research, as well as the quality of clinical research.Methods:The hospital mainly developed the clinical research management system, the clinical research application module based on HIS and a clinical research drug management system. All these systems were integrated to be used as the basis for the construction of the clinical research information management system.Results:The construction and application of the information system can effectively guarantee the standardization of clinical research management in the hospital, comply with national laws and industry requirements, improve the management efficiency and quality, at the same time make sure clinical research can be conducted safely and smoothly even in the situation of public health emergency.Conclusions:The clinical research management system makes diversified review possible, shorten the review time, and create a new model of efficient, accurate and record-keeping clinical research review. The clinical research informatization module based on the hospital information system can fulfill the quality standard and data traceability advantage in the whole process of the project. The drug management system can be used to realize the remote visualization, the pre-warning of over temperature and the intelligent management of drug trajectory tracking. During the public health emergency, the three-in-one informatization strategy helps the safety and orderly conduct of research projects, improves the quality of clinical research, and can effectively deal with the complex and severe new challenges under the new situation.
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Objective To collect and summarize the opinions of experts on the improvement of China's disease prevention and control system published in the public media, so as to provide reference for the relevant construction planning of the government. Methods: Articles were collected from January to May, 2020, which were published on Chinese mainstream media. Based on the analysis of literature and the basic characteristics of experts, Analytic hierarchy process (AHP) was used to summarize the construction points of experts in different construction fields. Results: A total of 19 opinion articles were finally included in the study and 29 experts were involved. The suggestions of experts on the construction of China's disease prevention and control system were summarized into four aspects. Conclusion: The COVID-19 pandemic is a challenge to the existing public health epidemic prevention and control system in China, and also an important opportunity for the development and construction of the related system.
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One of the important part for ensuring maternal and child safety is to strength maternal and child health service supervision.A comprehensive supervision system for that guarantees its implementation.However, at this stage, the work faces the problems of insufficient effectiveness of laws and regulations, insufficient professional capacity of health supervisors, and insufficient supervision of emerging issues in maternal and child health service.With the implementation of "double random" spot check model in post-event supervision, primary health supervisors are facing some difficulties with the professional tasks.Combined with the situation, Shanghai municipal health supervision department established a key control point monitoring model for maternal and child health services, improving the training efficiency of primary health supervisors, offering guidance for health supervisors, which provides useful exploration in building and reforming the maternal and child health service supervision system.
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Based on the new mission of public health conferred by the Healthy China Strategy and insufficient response to COVID-19, this article pointed out the problems of the current public health and preventive medical system from the macro system level, the meso organization level, and the micro individual level: including insufficient strategic planning , Resource input, institutional coordination, talent training and team building. This article creatively proposed to set up the health and health commission to implement the top-down vertical management at the national - provincial – municipal - county level. The Centers for Disease Control and Prevention system should be build by a strategic research institute, CDC, a human resources training base, and a scientific research institute. Enhance the functions of strategic planning, overall coordination, and evidence-based decision-making in the original system; emphasize the foresight and continuity of scientific research; allow the CDC to focus more on health management and the responses to emergencies. This will protect public health, improve the health and quality of life of the entire population, and ensure social stability and development.
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Preventing and mitigating major risk exposure is an important task for modern countries to maintain sustained and healthy economic development and overall social stability. In this manuscript, the authors introduced Israel′s current medical and health care risk prevention system, including the regional health emergency response coordination mechanism, hospital′s external emergency rescue capacity building and hospital′s internal security system. Israel′s risk prevention system has been tested by wars and terrorist attacks, as well as many infectious diseases outbreaks. Thus the authors expected that its successful experiences can be introduced as a reference for improving China′s medical and health care risk prevention system.
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Digital healthcare empowers optimization of medical services.This article introduced the practices and achievements of Hangzhou in the following aspects: the construction of a hierarchical medical system guided by " people-oriented integrated service" ; development of the five digital platforms, namely regional health information platform, integrated medical care platform, remote consultation platform, intelligent supervision platform and doctor-patient remote interaction platform; development of " Smart Medicine" to promote institutional cooperation, service integration, management coordination, quality improvement and doctor-patient interaction.The paper also analyzed the supporting role of digital healthcare construction in promoting the hierarchical medical system, and put forward corresponding countermeasures and suggestions.
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Objective Taking the Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals (hereinafter referred to as the "Digestive Medical Coordinated Development Center") as an example ,this paper aims to ex-plore the idea of building a collaborative development system of medical disciplines dominated by advantageous disciplines .Methods Summarizing the construction experience of the Digestive Medical Coordinated Development Center to illustrate the significance ,identify existed challenges and construction pathways of the center .Results The Digestive Medical Coordinated Development Center has built a series of public service platforms for its member institutions ,and improved the system and incentive mechanism to gather the develop-ment synergy of the center .Conclusions Based on the advantages of the collectivized management of Beijing Municipal Administration of Hospital ,the Digestive Medical Coordinated Development Center advances synchronously in the dimensions of scientific research , medical treatment ,information construction and talent ,as well as formed its own development characteristics and accumulated valuable experience for the construction of discipline collaboration center of municipal hospitals .
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Objective To explore new models for interhospital transfer and provide theoretical basis for the interhospital transfer system construction through analyzing the clinical features of the patients transfered by "Qilu" interhospital transfer center.Methods Totally 258 patients aged over 18 years who were transferred to or from Qilu Hospital of Shandong University from August 2014 to December 2016 were analyzed.The data including sex,age,transport index,modified early warning score (MEWS) and outcome of patients with successful transport were collected.According to the results,the transferred patients were divided into the improved group and the non-improved group,and the differences of the above indicators between the two groups were analyzed.In the numerical variable analysis,Student's t test or Mann-whitney non-parametric test was applied,and the categorical variable was applied with x2 test.The correlation between clinical indicators and outcomes of the patients was analyzed by logistic regression analysis.Results The total transfer success rate was 98.5％.The transported male patients were more than female patients.Patients transferred to Qilu Hospital were mainly diagnosed with nervous system disease,trauma and circulatory system disease,and patients transferred from QiLu Hospital were respiratory disease,circulatory system disease,and nervous system disease.Tracheal intubation,tracheotomy,and invasive mechanical ventilation rates were 11.9％-22.2％.The patients ratio of transferred from Qilu Hospital with vasoactive drugs and the ratio of patients with deep venous catheter were three times and five times than those transferred to Qilu Hospital.Eighty-one percent patients transferred to Qilu Hospital recovered,and 45.5％ patients transferred from the hospital recovered.The age,heart rate,MEWS score,length of stay,ICU ratio,mechanical ventilation ratio and tracheal intubation ratio were significantly different between the improved group and the non-improved group (P＜0.05).Among the critically patients transferred to ICU,the length of stay was correlated with the outcome of the improvement.(OR=1.213,95％CI:1.085-1.357).Conclusions "Qilu" Interhospital Transfer Center has a high success rate and high recovery rate of patients,and can be a new model for the construction of interhospital transfer system.
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Under the construction of health and family planning comprehensive supervision system,the main problems hindering the development of the health family planning comprehensive supervision are summarized through the analysis of the present situation of legislation,executive system and health-law enforcement team.It is suggested to formulate the basic health law,and perfect the legal system;promote the construction of comprehensive supervision system,and consolidate the resources of administrative law enforcement;strengthen the construction of law-enforcing team,and improve law enforcement efficiency and service quality.
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Since the release of On the Promotion of Hierarchical Diagnosis and Treatment System Construction Guidance in 2015,the relevant supporting policies have been introduced.That whether the classification system can continue to implement effectively,still needs the adjustment and protection of legal level.Therefore,in view of the current problems in the construction of the classification and treatment system,the paper conducts an in-depth investigation and analysis,and puts forward the ideas and suggestions for legislation to promote the construction of the classification and treatment system.
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The three-level prevention and treatment system for chronic kidney disease has been introduced in Jing’an District and Minhang District in Shanghai as a pilot project. In this paper, we systematically introduced the background and implementation program of this prevention and treatment system, and analyzed the prospect of the system by combining the characteristics and current treatment of patients with chronic kidney disease in China, so as to provide reference for Shanghai as well as the whole country.
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Chronic kidney disease has become a global public health issue with high prevalence, low awareness, poor prognosis and high cost of medical care. In 2015, the Shanghai Municipal Health and Family Planning Commission approved the “Systemic Redesign and Demonstration for Early Detection, Evaluation and Management of Chronic Kidney Disease in Shanghai” as the fourth round of Shanghai 3-Year Action Plan for Public Health System Construction, and the initial results have been achieved in three years. In this program, we established a new system of three-level prevention and treatment for chronic kidney disease by combining medicine with prevention, hoping to achieve early detection, effective prevention and standardize treatment of chronic kidney disease in Shanghai, and to reduce the incidence, morbidity and mortality, so as to make a model for the prevention and treatment of chronic kidney disease in China.
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"Healthy China" is an important component of Chinese governance system.It is not a simple combination of piecemeal health policies,but a system where multiple organizations and policies perform coordinately and well-functionally.Its key components include health policy system,major participants,institutional arrangement and supporting measures.Medical policies,health promotion policies and social policies that influence population health are three subsystems of health policy system.Government,market (enterprise) and individuals are major participants of building a healthy China.An administrative system that protects health,a well-functioned market economy that promotes health,and a system of social mobilization that encourages individuals to improve health are all essential for "Healthy China".Accordingly,progress in legislation,financing,human resources and technology shoult be in place.Considering its complexity,it suggests that China should take advantage of policy experimentation to find out a feasible way to achieve the goals of "Healthy China".
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Objective To establish an objective health literacy evaluation index system of dementia care for scientific assessment.Methods Literature reviews,in-depth interviews,participatory rapid appraisal,and focus group discussion were adopted to developed a scale and checked its items.Then the scale was utilized to investigate 280 residents,and its reliability and validity were examined.Results The health literacy evaluation index system of dementia care included 56 items which belong to four dimensions of knowledge,attitude,behavior and skills.The total Cronbach α was 0.818,split-half reliability was 0.881,the correlation between the total score and each dimension were significant (r =0.417-0.747).KMO statistic in factor analysis was 0.739 and 8 factors predicted 46.305％ of total variance.What's more,the correlation between each items score and dimension were significant (r =0.221-0.717).Conclusions The health literacy scale presents acceptable reliability and validity in the surveyed sample,which can be used as a valid measure of health literacy in community health service centers and as the basis of health education.