Research on the allocation efficiency of primary medical and health institutions in China based on data envelopment analysis / 中华医院管理杂志

Objective:To analyze the input and output status of health resources in primary medical and health institutions and their allocation efficiency in different regions of China, and to provide an empirical basis for optimizing the allocation of primary medical and health resources in China among regions.Methods:The input index data (number of beds and number of health personnel) and output index data (number of primary medical and health institutions visits, number of family health services, number of hospital admissions) of primary medical and health institutions in China in 2020 were extracted from the China Health Statistical Yearbook 2021. Based on the BCC ( Banker, Charnes, Cooper) model of data envelopment analysis ( DEA), the Bootstrap- DEA method was used to correct bias, the allocation efficiency of primary medical and health resources in 31 provinces was calculated and the regional differences were analyzed. Results:After bias correction, the technical efficiency (TE) of resource allocation in primary medical and health institutions decreased by 0.102. The average TE score of all 31 primary medical and health institutions was 0.669, indicating a serious problem of ineffective use of technology. The TE of the eastern, central and western regions was 0.694, 0.663, and 0.649 respectively. There was obvious polarization in the central regions.Further analysis of the efficiency improvement of non DEA efficient provinces showed that 2 DEA weakly efficient provinces and 16 DEA ineffective provinces had several reference provinces for efficiency configuration improvement; The provinces that have been referenced more than 10 times were Zhejiang, Chongqing, Sichuan, and Ningxia, while the provinces that were listed as the first reference by other provinces were Ningxia, Chongqing, Zhejiang, and Tibet.Conclusions:The resource allocation efficiency of primary medical and health institutions in China is relatively low, and regional differences are obvious. The balance between different inputs and outputs should be considered when allocating the resources. Non DEA effective provinces can use DEA analysis to find the most suitable reference object and make reference improvements in the short term.

New Thoughts on the Construction of Hospital Ethics Review Committee / 中国医学伦理学

Advanced technology not only brings good news to patients, but also causes a series of ethical issues. Subject risk/benefit assessment is the core of ethical review in clinical research. By combing the development status of China ethics review committee, analyzing the problems existing in the current ethical review, this paper proposed to standardize the establishment and independence of ethics review committee, improve the relevant laws and regulations of the ethics review committee, establish the administrative access and evaluation mechanism of the ethics review committee, build a multi-center mutual recognition alliance, improve the standardized operating procedures of the ethics review committee, set up an ethical personnel training system, and strengthen the review capacity building of the ethics review committee, so as to provide new ideas for the review work of the committee, then better protect the rights and interests of subjects and promote the development of medical science.

Investigation on medical radiation protection of medical and health institutions in Tibet Autonomous Region, 2020 / 中国职业医学

@#Abstract: Objective （ ） To investigate the current status of medical radiation protection in medical and health institutions MHI Methods - （ ） in Tibet Autonomous Region. Sixty one MHIs in seven prefectures cities of Tibet Autonomous Region were selected as the study subjects by stratified random sampling. The radiological protection equipment and personal protective ， equipment were investigated and the quality control of radiological equipment and radiation protection monitoring in Results ， radiological workplace were monitored. There were 368 radiation workers in 61 MHI institutions accounting for 4.8% （ ） ∶ ， 368/7 701 of the total number of radiation workers. The ratio of male to female was 2 1 and the average was six people/ institution. The quantity of radiation monitoring equipment and personal protective equipment at all levels of MHI was less than ， 1.00 sets/person. Among them tertiary MHI had the lowest number of personal protective equipment configurations. The （ monitoring qualified rates of radiation equipment quality control and radiation protection in radiation workplace were 73.3% 88/ ） （ ）， 120 and 95.8% 115/120 respectively. The lowes tmonitoring qualified rate of radiation equipment quality control was 55.2% （ ） ， （ ， ）Conclusion 32/58 with digital radiography and the second was computed tomography 84.8% 28/33 . The monitoring ， qualified rate of radiation protection in MHI workplaces at all levels in Tibet Autonomous Region is high. However radiation monitoring equipment and personal protective equipment should be increased.

Comparative analysis of performance evaluation indexes of public medical institutions in China / 中华医院管理杂志

The reform of public medical institutions is a critical and difficult breakthrough in furthering the healthcare system reform in China, for which the performance appraisal of public hospitals can serve an important role. The performance policy documents of tertiary public hospitals, secondary public hospitals and primary medical and health institutions in China since 2019 were compared and analyzed, to systematically identify the similarities and differences and development rules of the three evaluation index systems. The study analyzed the impacts of the three systems on the management of medical institutions and provided reference suggestions for improving their performance evaluation. It was found that all the three systems aim at guiding tertiary public hospitals to evolve from the pattern centering on scale expansion to that on quality and benefits, guiding secondary ones to improve their capacity of medical services, and guiding primary medical institutions to focus on basic medical and public health services. However, these systems lack indexes on hierarchical diagnosis and treatment for secondary hospitals and application of examination results, while national surveillance indexes on primary ones accounted for only 23.8% of all. It is recommended to dynamically adjust both the performance evaluation index system and the surveillance methods, and to enhance the application of examination results and development of supporting policies as well.

Investigation and Analysis of Current Situation of Human Research Ethical Management in Beijing Medical and Health Institutions / 中国医学伦理学

Through the questionnaire survey on the current situation of human research ethical management in Beijing medical and health institutions, this paper analyzed the problems existing in ethical management of Beijing medical and health institutions and put forward corresponding countermeasures and suggestions. The results showed that overall status of human research ethical management in Beijing medical and health institutions was satisfying. But the ethical management levels of different types of medical and health institutions were quite different, and medical and health institutions, health family planning administration departments and academic teams should all make corresponding contributions.

Policy framework of the compensation mechanism reform for primary medical and health institutions in Zhejiang province / 中华医院管理杂志

Based on an analysis of the compensation policy and its problems of the primary medical and health institutions, this paper put forward the corresponding reform framework in Zhejiang province. It proposed to change the compensation policy of " predefining revenue and expenditure, subsidizing its gap after performance appraisal" into " a mixed system of special subsidy and pay for performance". Related policies were also described including governmental functions, special subsidies for input-based payments, classified payments for output services, precautions against financial risks, etc. This paper also suggested that we focus on dealing with the six pairs of balance, such as that between subsidy for the supply and demand sides, and that between internal market and external market.

Thoughts on Application of Evaluation Index System on Human Research Ethics Management in Beijing Medical Institutions / 中国医学伦理学

Objective:This thesis aims to construct the evaluation index system ethics management in Beijing medical institutions for application research.Method:The author applied the evaluation system which was agreed and adjusted by expert groups in four medical and health institutions.Result:After three rounds of expert groups have reached the agreement,the Evaluation Index System on Human Research Ethics Management in Beijing Medi-cal Institutions is established,which contains 6 first-class indicators,16 second-class indicators and 39 third-class indicators.The application on four medical and health institutions show that the evaluation index system is practical,operable and is of high degree of distinction.Conclusion:The evaluation index system is scientific,rea-sonable,practical and is of high degree of validity,credibility and distinction.

Investigation on the Status Quo and Cognition about the Cultural Construction of TCM in Chongqing / 中国药房

OBJECTIVE:To provide reference for strengthening the cultural construction and promoting the cultural develop-ment of TCM in Chongqing. METHODS:Questionnaire was adopted to investigate the status quo and cognition of some citizens, staffs in medical and health institutions for the cultural construction of TCM in public TCM medical and health institutions above Grade Two in Chongqing,and the data was statistically analyzed. RESULTS:Totally 45 questionnaires were sent out for TCM med-ical and health institutions,45 were effectively received with effective recovery of 100%;3 500 were sent out for the citizens,2 250 were effectively received with effective recovery of 64.29%;1 100 were sent out for the staffs in TCM medical and health institu-tions,702 were effectively received with effective recovery of 63.82%. In terms of cultural construction in surveyed institutions,or-ganization,principles and unit markings carried out a relatively high proportion in the core cultural soft power construction,the de-velopment of behavioral norms system carried out a relatively low proportion;and the proportion was higher in the hardware envi-ronment construction. In terms of the cognition of surveyed citizens for the TCM culture,62.98% believed in TCM;the first rea-son for choosing TCM was its less side effects(24.76%);89.42% thought it was necessary to keep in good health. In terms of the cognition of surveyed staffs for the cultural construction of TCM,81.91%thought the TCM culture was taken seriously in their hos-pital;60.54% showed great satisfaction with the cultural construction of TCM;only 23.08% was very familiar with the concept of TCM core values;the surveyed staff thought the main problems in the cultural construction of TCM were lack of facilities (69.09%)and talent personals(44.59%). CONCLUSIONS:The organization,principles,unit markings and facilities in Chongq-ing TCM medical and health institutions are taken seriously,while the behavioral norms system needs to be strengthened;the citi-zens’cognition for TCM culture should to be improved,as well as the staffs’TCM cultural awareness in TCM medical and health institutions.

Analysis of the Use of Essential Medicines in 20 Medical and Health Institutions in Beijing from 2013 to the First Half Year of 2014 / 中国药房

OBJECTIVE:To provide reference for the promotion of rational use of essential medicines and further implementa-tion of essential medicines system. METHODS:Depended on the data (including the number of species,the amount of prescrip-tion and prescription departments,etc)of essential medicines(chemical drugs and biological drugs)use in outpatient and emergen-cy departments and wards of 20 sample medical and health institutions fromThe Hospital Prescriptions Cooperation Project,statis-tical analysis was performed by using Excel and Access software. RESULTS:The proportion of the amount of essential medicines included in National Essential Medicines List(2012 edition)or Beijing Essential Medicines(Supplementary list)(2012 edition)to the amount of total medicines(hereinafter referred to as the essential medicines use ratio)in medical and health institutions of Bei-jing from 2013 to the first half year of 2014 was small and showed a slight downward trend. The essential medicines use ratio of grade 2 and grade 3 general hospitals did not reached the required ratio by former Health Department. The essential medicines use ratio in different departments showed great differences,the essential medicines use ratio in imaging department was 100%,while chemotherapy departnent was 4.04%. The essential medicines use ratio in different medicines also showed great differences,5 kinds of drugs(including sulfani lamides)was 100%,while there were 16 kinds of drugs that was less than 0.1%. CONCLUSIONS:The essential medicines use ratio is relatively low in medical and health institutions of Beijing from 2013 to the first half year of 2014 and shows great differences in different departments and different medicines. It is suggested to further improve the essential medi-cines use ratio to better benefit the majority of patients by changing the prescribing habits of physicians,strengthening the advocacy of essential medicines policy and optimizing the use of essential medicines in different departments.

Thinking on the requirement of integratSion inspecting equipment for basic medical and health institution s / 中国医学装备

Objective:To understand the requirements of inspecting equipment for basic medical and health institutions, and put forward suggestions for the development of service ability of basic medical and health institutions. Methods: To adopt the method of empirical research and literature retrieval. Results:To put forward the requirements of the integration inspecting equipment for basic medical and health institutions according to the service pattern and content of basic medical and health institutions. Conclusion: To take comprehensive measures to promote the ability of basic medical and health institutions, and integrate the medical equipment construction, staff training and the development of domestic medical equipment industry.

Disinfection and Isolation in Basic Medical and Health Institutions:Current Situation Issues and Countermeasures / 中华医院感染学杂志

OBJECTIVE To develop the countermeasures how to strengthen disinfection and isolation in the basic(medical) and health institutions.METHODS Through investigation,to analyze the current situation and problem of disinfection and isolation in the basic medical and health institutions.RESULTS There were some problems of the(disinfection) and isolation in the basic medical and health institutions and some possibility for patient catching(nosocomial) infection.CONCLUSIONS It is very important for strictly observing Medical Instrument Surveillance and Management Regulations published by the State Council and Hospital Infection Management Standards,Disinfection Technology Standards and Disinfection Management Methods published by Ministry of Health,and strengthening the management of disinfection and isolation in the basic medical and health institutions.

Discussion on the Defects of National Essential Drug System in Our Country and Its Improvement / 中国药房

OBJECTIVE:To provide suggestion for full implementation and improvement of the national essential drug system in our country. METHODS:To analyze the defects of the Implementation process of national essential drug system in our country, and make recommendations for improvement. RESULTS & CONCLUSON: The system has been put into effect for one year; There were some performances and obvious defects in the national essential drug system in our country. Obviously, the problems of bid inviting and circulation were serious. And because of the low level of primary medical institution, it obstructed the pursue of system, we must vigorously promote and improve it, and to meet the people's demand of drugs.