Estresse ocupacional e enfrentamento em enfermeiros de um Hospital do Exército Brasileiro: abordagem qualitativa / Occupational stress and coping among nurses at a Brazilian Army Hospital: a qualitative approach

Este estudo buscou compreender os estressores ocupacionais percebidos por enfermeiras militares e os seus modos de enfrentamento. Pesquisa de abordagem qualitativa, realizada em um hospital do Exército Brasileiro. A coleta de dados ocorreu de agosto a outubro de 2019 por meio de entrevista com uso de gravador eletrônico. Os dados foram analisados de forma descritiva, e utilizou-se como referencial o Método Hermenêutico-Dialético com fundamentação na teoria dos sistemas de Betty Neuman. Com base nas unidades de significação dos discursos das participantes, foram identificadas três categorias de análise: (1) Estressores ocupacionais percebidos; (2) Percepção das enfermeiras sobre as repercussões do ambiente de trabalho na vida cotidiana; e (3) Enfrentamento dos estressores ocupacionais. A percepção das enfermeiras militares sobre o estresse ocupacional evidenciou que esse cenário é constituído de estressores típicos da profissão, do ser enfermeiro e do ser militar, podendo haver respostas diversas ao enfrentamento do estresse percebido.

This study aimed to understand the occupational stressors perceived by military nurses and their ways of coping. A qualitative research was carried out at a Brazilian Army hospital. Data collection took place from August to October 2019 through an interview by using an electronic recorder. The data were analyzed in a descriptive way, and the hermeneutic-dialectical method was used as a reference based on Betty Neuman's systems theory. Based on the units of signification of the participants' discourses, three categories of analysis were identified: (1)Perceived occupational stressors; (2) Perception of nurses about the repercussions of their work environment in everyday life; and (3) Coping with occupational stressors. The military nurses' perception of occupational stress showed that this scenario consists of stressors typical of the profession, of what it is like to be a nurse and to be in the military. There may be several responses to coping with perceived stress.

Oficiais enfermeiros no hospital militar no ano de 1995 / Oficiales enfermeros en el hospital militar en el año de 1995 / Nursing officers at the military hospital in the year of 1995

Resumo Objetivo analisar a lotação e distribuição da primeira turma de oficiais enfermeiros, ao término do Curso de Formação de Oficiais, com a patente de 2º Tenente, no Hospital Central da Polícia Militar do Estado do Rio de Janeiro, em 1995. Método estudo histórico em fontes documentais escritas e orais produzidas por meio de 19 entrevistas, sendo 18 oficiais enfermeiros e um civil. Os conceitos de poder simbólico e capital de Pierre Bourdieu consubstanciaram a análise dos achados. Resultados a classificação obtida no curso de formação de oficiais e a experiência profissional, embora com menor peso, foram preponderantes na distribuição nos setores do hospital. Considerações finais e implicações para prática os critérios de antiguidade da vida militar influenciaram na configuração da equipe de enfermagem no hospital militar. Destaca-se que a ocupação das chefias pelos oficiais enfermeiros foi determinada pelo capital incorporado no estágio probatório, o qual foi institucionalizado pela patente.

Resumen Objetivo analizar la capacidad y la distribución de la primera clase de oficiales enfermeros al término del Curso de Formación de Oficiales, con el grado de 2º Teniente, en el Hospital Central da Polícia Militar do Estado do Rio de Janeiro, en 1995. Método estudio histórico en fuentes de documentos escritos y orales producidos a través de 19 entrevistas, 18 de las cuales fueron enfermeras y una civil. Los conceptos de poder simbólico y capital de Pierre Bourdieu fundamentaron el análisis de los hallazgos. Resultados la clasificación obtenida en el curso de formación para oficiales y la experiencia profesional predominaron en la distribución en los sectores hospitalarios, aunque con menor peso. Conclusión e implicaciones para práctica los criterios de antigüedad en la vida militar influyeron en la configuración del equipo de enfermería. Se destaca que la ocupación de los comandos por oficiales enfermeros fue determinada por el capital incorporado en la etapa probatoria, institucionalizada por el grado.

Abstract Objective to analyze the capacity and distribution of the first class of nurse officers, at the end of the Officer Training Course, with the rank of 2nd Lieutenant, at the Hospital Central da Polícia Militar of the State of Rio de Janeiro, in 1995. Method historical study in written and oral documentary sources produced through 19 interviews, of which 18 are nurse officers and one civilian. Pierre Bourdieu's concepts of symbolic power and capital substantiated the analysis of the findings. Results the classification obtained in the training course for officers and professional experience, although with less weight, were preponderant for the distribution in the hospital sectors. Final considerations and implications for practice the criteria of seniority in military life influenced the configuration of the nursing team at the military hospital. It is noteworthy that the occupation of the heads by the nurse officers was determined by the capital incorporated in the probationary period, which was institutionalized by the patent.

Leadership Styles Of Military Hospital Managers In Malaysia And Its Influencing Factors

@#A good quality leader is vital in ensuring effective and efficient services rendered to patients. However, as to date, little is known on the leadership styles of managers in Military Hospitals in Malaysia and the region. The aim of this cross-sectional study was to determine the leadership styles and identify the influencing factors, among Military and Non-Military managers in five Military Hospitals in Malaysia. A pre-tested 20-item questionnaire was distributed to eligible managers in the hospitals. Based on the total score, the leadership style of managers was classified into Transformational (TS) and Non-Transformational style (N-TS). Among the 501 respondents, 375 (74.9%) of them were Non-military managers and 126 (25.1%) of them were Military managers. 46.8% (n=59) of the managers with military background practiced TS while only 27.7% (n=104) of Non-military managers have TS (X2 =15.662; p <0.001). Managers aged 40 years and above, male, with higher educational level, served longer in the service, attended in-service training and participated in other capacity building activities were more likely to practice TS. Analysis using stepwise multiple logistic regressions proved that predictors of TS style are educational level (AOR=2.319; 95% CI=1.300,4.134), working experience (AOR=1.075; 95% CI=1.049,1.102), Military managers (AOR=1.759; 95% CI=1.104,2.802) and attended in-service training (AOR=2.070; 95% CI=1.369,3.129). In conclusion, the Military Hospitals have the benefit of being managed by Military managers that practice TS. Educational level and in-service training are two most important elements that influence the practice TS among the managers in these Military Hospitals.

Sociodemographic and occupational aspects associated with burnout in military nursing workers / Aspectos sociodemográficos y ocupacionales asociados al burnout en trabajadores de enfermería militar / Aspectos sociodemográficos e laborais associados ao burnout em trabalhadores da Enfermagem Militar

ABSTRACT Objectives: to analyze association between burnout and sociodemographic and occupational features of military nursing workers. Methods: a cross-sectional study, developed in five military hospitals of the Army of Rio Grande do Sul State, among 167 workers from military nursing from December 2015 to May 2016. Sociodemographic and occupational questionnaires and the Maslach Burnout Inventory were applied. For the analysis, it was used descriptive statistics, Chi-Square Test and Poisson Regression. Results: the majority of participants were female; temporary military personnel, nursing technicians, with a median age of 34 years old. Burnout was related to the variables: Military Health Organization, time of practice in military nursing and accomplishment of leisure activities. Conclusions: burnout assessment may contribute to the Brazilian Army Command in organizing plans for prevention and handling of occupational diseases in military nursing, improving quality of life at work.

RESUMEN Objetivos: analizar las asociaciones entre el burnout y las características sociodemográficas y laborales de los trabajadores de enfermería militar. Métodos: un estudio transversal, desarrollado en cinco hospitales militares del Ejército de Rio Grande do Sul, con 167 trabajadores de enfermería militar desde diciembre de 2015 hasta mayo de 2016. Se aplicaron cuestionarios sociodemográficos y laborales, y el Maslach Burnout Inventory. Para el análisis, se utilizaron estadísticas descriptivas, prueba de Chi Cuadrado y regresión de Poisson. Resultados: en la mayoría, los participantes fueron mujeres, militares temporales, técnicos de enfermería, con una mediana de edad de 34 años. El burnout se asoció con las variables organización militar de salud, el tiempo dedicado a la enfermería militar y la realización de actividades de ocio. Conclusiones: la evaluación del burnout puede contribuir al Comando del Ejército Brasileño en la organización de planes de prevención y manejo de enfermedades profesionales en Enfermería Militar, favoreciendo una mejor calidad de vida en el trabajo.

RESUMO Objetivos: analisar associações entre burnout e características sociodemográficas e laborais dos trabalhadores da Enfermagem Militar. Métodos: estudo transversal, desenvolvido em cinco hospitais militares do Exército do Rio Grande do Sul, com 167 trabalhadores da Enfermagem Militar no período de dezembro de 2015 a maio de 2016. Foram aplicados questionários sociodemográfico e laboral, e o MaslachBurnoutInventory. Para a análise, utilizaram-se a estatística descritiva, Teste Qui-Quadrado e regressão de Poisson. Resultados: na maioria, os participantes eram do sexo feminino, militares temporários, técnicos de enfermagem, com mediana de idade de 34 anos. O burnout foi associado às variáveis organização militar de saúde, tempo de atuação na Enfermagem Militar e realização de atividades de lazer. Conclusões: a avaliação do burnout poderá contribuir com o Comando do Exército Brasileiro na organização de planos de prevenção e manejo de doenças laborais na Enfermagem Militar favorecendo uma qualidade de vida melhor no trabalho.

Sociodemographic and occupational aspects associated with burnout in military nursing workers / Aspectos sociodemográficos y ocupacionales asociados al burnout en trabajadores de enfermería militar / Aspectos sociodemográficos e laborais associados ao burnout em trabalhadores da Enfermagem Militar

ABSTRACT Objectives: to analyze association between burnout and sociodemographic and occupational features of military nursing workers. Methods: a cross-sectional study, developed in five military hospitals of the Army of Rio Grande do Sul State, among 167 workers from military nursing from December 2015 to May 2016. Sociodemographic and occupational questionnaires and the Maslach Burnout Inventory were applied. For the analysis, it was used descriptive statistics, Chi-Square Test and Poisson Regression. Results: the majority of participants were female; temporary military personnel, nursing technicians, with a median age of 34 years old. Burnout was related to the variables: Military Health Organization, time of practice in military nursing and accomplishment of leisure activities. Conclusions: burnout assessment may contribute to the Brazilian Army Command in organizing plans for prevention and handling of occupational diseases in military nursing, improving quality of life at work.

RESUMEN Objetivos: analizar las asociaciones entre el burnout y las características sociodemográficas y laborales de los trabajadores de enfermería militar. Métodos: un estudio transversal, desarrollado en cinco hospitales militares del Ejército de Rio Grande do Sul, con 167 trabajadores de enfermería militar desde diciembre de 2015 hasta mayo de 2016. Se aplicaron cuestionarios sociodemográficos y laborales, y el Maslach Burnout Inventory. Para el análisis, se utilizaron estadísticas descriptivas, prueba de Chi Cuadrado y regresión de Poisson. Resultados: en la mayoría, los participantes fueron mujeres, militares temporales, técnicos de enfermería, con una mediana de edad de 34 años. El burnout se asoció con las variables organización militar de salud, el tiempo dedicado a la enfermería militar y la realización de actividades de ocio. Conclusiones: la evaluación del burnout puede contribuir al Comando del Ejército Brasileño en la organización de planes de prevención y manejo de enfermedades profesionales en Enfermería Militar, favoreciendo una mejor calidad de vida en el trabajo.

RESUMO Objetivos: analisar associações entre burnout e características sociodemográficas e laborais dos trabalhadores da Enfermagem Militar. Métodos: estudo transversal, desenvolvido em cinco hospitais militares do Exército do Rio Grande do Sul, com 167 trabalhadores da Enfermagem Militar no período de dezembro de 2015 a maio de 2016. Foram aplicados questionários sociodemográfico e laboral, e o MaslachBurnoutInventory. Para a análise, utilizaram-se a estatística descritiva, Teste Qui-Quadrado e regressão de Poisson. Resultados: na maioria, os participantes eram do sexo feminino, militares temporários, técnicos de enfermagem, com mediana de idade de 34 anos. O burnout foi associado às variáveis organização militar de saúde, tempo de atuação na Enfermagem Militar e realização de atividades de lazer. Conclusões: a avaliação do burnout poderá contribuir com o Comando do Exército Brasileiro na organização de planos de prevenção e manejo de doenças laborais na Enfermagem Militar favorecendo uma qualidade de vida melhor no trabalho.

Perfil do usuário e demanda protética do serviço de odontologia de uma Policlínica Militar / The profile of dental service users and demand for prosthetic care in a military polyclinic

Objetivou-se avaliar o perfil dos usuários e identificar os trabalhos protéticos realizados em um serviço odontológico de uma policlínica militar. Foram incluídos prontuários abertos durante os anos de 2014 a 2016 com indicação de tratamento no serviço de prótese dentaria. Foram coletados dados sócios-demográficos e informações referentes ao tipo de trabalho protético planejado, o status do tratamento, o número de consultas clínicas e informações relacionadas a satisfação do usuário frente ao tratamento realizado. Dados relativos ao Índice de Desenvolvimento Humano (IDH) das cidades cujos usuários residiam também foram analisados. A classificação de cada trabalho protético foi dada a partir da sua aplicabilidade. A amostra foi composta por 203 prontuários em que foram descritos 320 procedimentos protéticos. Destes prontuários avaliados, a maioria era de dependentes (34%), do sexo feminino (58,6%), casados (63,5%) com média de idade de 50 anos (±17,08). Em relação ao nível de escolaridade, a maior parte dos usuários (33,5%) tinha o 2º grau completo e era natural da região sudeste (80,8%). O município de Niterói, com IDH médio, era a residência de 47,3% da amostra (96 indivíduos). O principal motivo pela procura do atendimento protético foram as consultas de rotina (89,2%) e houve a conclusão dos trabalhos em 68,1% dos prontuários, predominando a prótese fixa seguida da prótese removível. Em relação a queixas durante o tratamento, em 71,9% dos prontuários não haviam relatos de pacientes insatisfeitos. O número médio de consultas para a realização dos procedimentos foi de 4 (±2,73), variando entre 1 e 15 consultas. Diante dos resultados deste estudo, pode-se concluir que a maioria dos usuários do serviço são dependentes, do sexo feminino, casados, com o 2º grau completo, com média de idade 50 anos, residentes na sua maioria em Niterói-RJ e em municípios com IDH médio e que receberam prótese fixa seguida pela prótese removível.

The aim of this study was to evaluate the profile of dental service users and to identify the prosthetic work performed at the Dentistry Division of the Military Polyclinic. Open charts were included during the years 2014 to 2016 with indication of treatment in the dental prosthesis service. Socio-demographic data and information regarding the type of planned prosthetic work, the status of the treatment, the number of clinical consultations and information related to the user's satisfaction with the treatment performed were collected. Data on the Human Development Index (HDI) of the cities whose users resided were also analyzed. The classification of each prosthetic work was given from its applicability. The sample consisted of 203 dental records in which 320 prosthetic procedures were described. Of these records, the majority were dependent (34%), female (58.6%), married (63.5%) and mean age 50 years (± 17.08). Regarding education level, the majority of users (33.5%) had a high school degree and were from the Southeast region (80.8%). The municipality of Niterói, with average HDI, was the residence of 47.3% of the sample (96 individuals). The main reason for the demand for prosthetic care was routine consultations (89.2%) and work was completed in 68.1% of the medical records, with fixed prosthesis predominating followed by removable prosthesis. Regarding complaints during treatment, there were no reports of dissatisfied patients in 71.9% of the records. The mean number of visits to the procedures was 4 (± 2.73), ranging from 1 to 15 visits. Considering the results of this study, it can be concluded that the majority of the users of the service are dependent, female, married, with a high school diploma, with a mean age of 50 years, residing mostly in Niterói-RJ and in municipalities with average HDI and who received fixed prosthesis followed by the removable prosthesis.

Avaliação da produtividade, dos custos e da satisfação dos usuários do setor odontológico de um hospital militar / Evaluation of productivity, costs and users' satisfaction of the dental service from a military hospital

Introduction: the evaluation of health services can be considered as a manner to promote the continuous improvement of attention, providing the user with a service of better quality. Being the Hospital of Military Police of Santa Maria (HBM/SM) a public service offered to the corporation, it should also be evaluated, so that measures can institute to its expansion. Objective: to analyze the service provided and the public's satisfaction attended by the HBM/ SM. Methods: three hundred and seventy monthly production maps were evaluated from 2010 to 2016 in order to verify the dental procedures performed and the patients treated. The satisfaction surveys answered by users were also appraised. The monthly expenses were determined by adding: salaries, dental material, emergency expenses, depreciation and estimated fixed costs. The working hours for dentists were calculated annually according to the working arrangements of each professional. Results: the total cost was R$ 6.866.119,03 being performed 103.075 dental procedures, resulting in an average cost of R$ 66,61 per procedure. The monthly average of dental procedures (preventive and curative) was 1.207,74 ± 328,49. Dependents represent 48.03% of the users and the military staff, 44.87%. The vast majority of users considered the dental service excellent or good in relation to the different aspects evaluated. The average number of procedures/hour exceeded SUS goal (3 procedures/hour) to achieve maximum economic efficiency in 5 of the 7 years evaluated. Conclusion: even being more economically advantageous to maintain a proper dental care center for the corporation's members and their dependents, economic measures can be adopted, such as renegotiation of outsourcing contracts, direct contracting of professional or implementation of the Temporary Military Health Program.

Introdução: sendo o Setor Odontológico do Hospital da Brigada Militar de Santa Maria um serviço público oferecido para corporação, este deve ser avaliado para que se instituam medidas de ampliação. Objetivo: analisar o serviço prestado e a satisfação do público atendido pelo referido setor. Metodologia: foram avaliados 370 mapas mensais de produção de 2010 a 2016, nos quais constam os procedimentos odontológicos realizados e os pacientes atendidos, e as pesquisas de satisfação respondidas pelos usuários. Os gastos mensais foram determinados somando-se salários, material odontológico, despesas emergenciais, depreciação e custos fixos estimados. As horas de trabalho dos dentistas foram calculadas de acordo com o regime de trabalho de cada um. Resultados: o custo total foi de R$ 6.866.119,03, sendo realizados 103.075 procedimentos odontológicos, resultando num custo médio por procedimento de R$ 66,61. A média mensal de procedimentos odontológicos foi de 1.207,74 ± 328,49. A grande maioria dos usuários considerou o serviço ótimo ou bom em relação aos diferentes aspectos avaliados. A média de procedimentos/hora superou a meta do SUS, de 3 procedimentos/hora para atingir máxima economicidade, em 5 dos 7 anos avaliados. Conclusão: mesmo sendo mais vantajoso economicamente manter um centro de atendimento odontológico próprio para os integrantes da corporação, pode-se propor medidas de economicidade a serem adotadas, como renegociação dos contratos terceirizados, contratação direta dos profissionais ou implementação do Programa de Militares Estaduais de Saúde Temporários.

Factores asociados al grado de satisfacción del usuario del consultorio externo de gastroenterología del Hospital Central de la Fuerza Aérea del Perú. Mayo, 2014 / Associated Factors to the satisfaction degree of the user of the external gastroenterology clinic of the Central Hospital of the Peruvian Air Force. May, 2014 / Fatores associados ao grau de satisfação do usuário do consultório de gastrenterologia do Hospital Central da Força Aérea peruana. Maio, 2014

Resumen Se desarrolló un estudio observacional, descriptivo y transversal para determinar los factores asociados al grado de satisfacción del usuario del consultorio externo de gastroenterología del Hospital Central de la Fuerza Aérea del Perú, debido a que la insatisfacción del paciente se asocia con el nivel de excelencia profesional, uso eficiente de los recursos y mínimo riesgo para el paciente. La muestra incluyó 221 pacientes. Se halló que 21.3 % de pacientes estaban satisfechos con la atención, 26,7 % en el componente fiabilidad, 31.2 % en el componente responsabilidad, 48 % en el componente seguridad, 38.9 % en el componente empatía y 32.6 % en el componente tangibles. La insatisfacción se observó en 75 (70.8 %) de los varones, 99 (86.1 %) de las mujeres (p = 0.005), en 65 (70.7 %) de los beneficiarios directos y 109 (84.5 %) de los familiares (p = 0.013). Asimismo, conforme aumentaba el tiempo de espera para la atención, disminuía la satisfacción del paciente (r = -0.316; p = 0.000).

Abstract An observational, descriptive and cross-sectional study was performed to determine the factors associated with the degree of user satisfaction at the outpatient Gastroenterology Service in the Air Force´s Central Hospital from Peru, because the patient's insatisfaction is associated to the level of professional excellence, the efficient use of resources and very low risk for the patient. The sample consisted of 221 ​​patients. It was found that 21.3 % patients were satisfied with the care provided, 26.7 % in the reliability component, 31.2 % in the liability component, 48 % in the security component, 38.9 % in the empathy component and 32.6 % in the tangible component. Insatisfaction was observed in 75 (70.8 %) of males, 99 (86.1 %) of females (p = 0.005), 65 (70.7 %) of direct beneficiaries and 109 (84.5 %) of the family members (p = 0.013). Also, as the waiting time for care increased patient´s satisfaction decreased (r = -0.316, p = 0.000).

Resumo Desenvolveu-se um estudo observacional, descritivo e transversal para determinar os fatores associados ao grau de satisfação do utente da clínica médica ambulatória de gastrenterologia do Hospital Central da Força Aérea de Peru, devido a que a insatisfação do paciente é associada com o nível de excelência profissional, uso eficiente dos recursos e mínimo risco para o paciente. A amostra incluiu 221 pacientes. Achou-se que 21.3 % de pacientes estavam satisfeitos com o atendimento, 26,7 % com o componente fiabilidade, 31.2 % no componente responsabilidade, 48 % no componente segurança, 38.9 % no componente empatia e 32.6 % com no componente tangíveis. A insatisfação observou-se em 75 (70.8 %) dos homens, 99 (86.1 %) das mulheres (p = 0.005), 65 (70.7 %) dos beneficiários direitos e 109 (84.5 %) dos parentes (p = 0.013). Além disso, à medida que aumentava o tempo de espera para o atendimento, diminuía a satisfação do paciente (r = -0.316; p = 0.000).

Design and implementation of remote medical consultation system for integrated civil-military uses / 医疗卫生装备

Objective To design a civilian-military remote medical consultation system to realize the networking between military and civilian hospitals.Methods Based on the remote consultation platforms of the PLA and Xinjiang Medical University the system was developed with B/S architecture,Java and C ++.Results The system realized the networking between civilian and military hospitals,which facilitated the outpatient diagnosis,hospitalization,operation planning,postoperative nursing,health education and etc.Conclusion The system enhances medical services and advances medical sources to flow to the elementary facilities,and thus is worthy promoting practically.

Influencing factor analysis of hospitalization expense and hospitalization day of soldiers in a navy hospital in the past 9-years / 第二军医大学学报

@#Objective To explore the variation tendency and influencing factors of the hospitalization costs and hospital day of soldiers in a navy hospital,so as to provide reference for the health resource allocation of military hospitals.Methods The data of 16 278 military patients who were hospitalized and treated from Jan.2008 to Dec.2016 were extracted from the military health system.The hospitalization costs and status,variation tendency and influencing factors of hospital stay were analyzed by descriptive analysis,Mann-Whitney U test and Kruskal-Wallis H test.Results The average age of admission was (28.33± 13.40) years,and the hospitalization period showed a shortening trend,while the hospitalization costs showed an increasing trend during 2008-2016.The polytomous variables,including services,patient's condition,hospitalized times,hepatitis B surface antigen,hepatitis C antibody,human immunodeficiency virus (HIV) antibody,military appointment,age and outcomes,and the dichotomous variables,including severe condition,critical condition,ICU admission,special-grade nursing care,first-grade nursing care,allergies and operation,were the influencing factors of hospitalization expenses (P＜0.05).The polytomous variables,including services,patient's condition,hospitalized times,HIV antibody,military appointment,age and outcomes,and the dichotomous variables,including gender,severe condition,critical condition,special-grade nursing care,first-grade nursing care and operation,were the influencing factors of hospitalization stay (P＜0.05).Conclusion The decreasing hospitalization day of military patients and increasing hospitalization costs suggest that the medical technology and hospital management efficiency are continuously improving,but facing the pressure of increasing medical costs.From a cost-effective perspective,we should strengthen the graded referral and control hospitalization costs and length of hospital stay.

Influencing factor analysis of hospitalization expense and hospitalization day of soldiers in a navy hospital in the past 9-years / 第二军医大学学报

Objective To explore the variation tendency and influencing factors of the hospitalization costs and hospital day of soldiers in a navy hospital, so as to provide reference for the health resource allocation of military hospitals. Methods The data of 16 278 military patients who were hospitalized and treated from Jan. 2008 to Dec. 2016 were extracted from the military health system. The hospitalization costs and status, variation tendency and influencing factors of hospital slay were analyzed by descriptive analysis, Mann-Whitney U test and Kruskal Wallis H test. Results The average age of admission was (28. 33+13. 40) years, and the hospitalization period showed a shortening trend, while the hospitalization costs showed an increasing trend during 2008-2016. The polytomous variables, including services, patient s condition, hospitalized limes, hepatitis B surface antigen, hepatitis C antibody, human immunodeficiency virus (HIV) antibody, military appointment, age and outcomes, and the dichotomous variables, including severe condition, critical condition, ICU admission, special-grade nursing care, first-grade nursing care, allergies and operation, were the influencing factors of hospitalization expenses (P

Analysis of cooperation networks based on SCI papers from military hospitals / 军事医学

Objective To analyze the institutional cooperation networks of 137 military hospitals in terms of published papers, trends of cooperation and co-authorship in order to guide the cooperation between military hospitals.Methods The institutional cooperation, co-authorship, author-keyword co-occurrence and author-subject co-occurrence in the 137 military hospitals were analyzed with the Thomson data analyzer( TDA) software.Results and Conclusion The institutional coop-eration between military hospitals could be divided into 5 types and were based on the principle of proximity of locations and similiarity of research.The cooperaiton circle with Chinese PLA General Hospital as the center was expanded over time. The institutional cooperation between military and civilian hospitals was also based on the principle of proximity of locations and similiarity of research.Cooperation between productive authors mainly occurred in the same research group but co-au-thorship outside the research group was scarce.The potential competition or cooperation between research fields and authors can be analyzed by comparing co-authorship and author-keyword co-occurrence.

HRP- and BSC-based system for evaluating performance of military hospitals / 第二军医大学学报

Objective To set up an evaluation system for hospital performance, so as to meet the requirement of health system reform, to properly allocate health resources, to effectively standardize the administration of military hospitals, and to upgrade their overall performance. Methods According to the current situation, an evaluation system for performance of military hospitals, which including four domains-finance, patients, internal flow, and learning and progression, was established based on the balanced scorecard (BSC) ideology using the hospital resources planning (HRP) system, analytic hierarchy process (AHP) and Delphi method. Results We established an evaluation system for the performance of military hospitals, which including four first level parameters, 13 second level parameters, and 55 third level parameters. Conclusion HRP combined with BSC for evaluating hospital performance can help the proper allocation of health resources in military hospitals, contributing to the sound, cost-saving and highly efficient administration of hospitals. Adjustment should be made in actual application, and attention should be given to the time effectiveness and scientific nature of the parameters.

DEA- and MPI-based analysis of total factor productivity of high level (level 3) comprehensive military hospitals / 第二军医大学学报

Objective To measure the changes of total factor productivity of high leveKLevel 3) comprehensive military hospitals, so as to provide evidence for improving the productivity of these hospitals. Methods The 2007 and 2010 panel data of 36 high level military hospitals, including 3 input parameters and 5 output parameters, were collected in the present study. The Malmquist productivity index (MPI)of data envelopment analysis (DEA) was used for analysis. Results The productivity of 28 (77. 8%) hospitals was increased during 2007-2010. Further analysis showed that the increased productivity was mainly attributable to technology progress in 11(30. 6%) hospitals, to improved efficiency in 2 (5. 56%) hospitals, and to both technology progress and improved efficiency in 15(41. 7%) hospitals. The 8 hospitals with decreased productivity were all due to technology backwardness. Conclusion The total factor productivity of high level comprehensive military hospitals has witnessed a noticeable increase, and the increase is mainly attributable to technology progress and improved efficiency. The decrease of productivity is mainly due to technology backwardness.

Analysis of drug revenues in military hospitals by principal component regression / 第二军医大学学报

Objective To establish a regression equation for drug revenues by analyzing the factors influencing drug revenues in seven military hospitals from 2007 to 2010. Methods The data were obtained from the financial and performance-effect data in 7 hospitals from 2007 to 2010; the database was created by Excel 2003 software. Principal component regression analysis was performed for variables including the hospital scale, amount of service, local economic level, drug add rate using SPSS 18.0 software. Results and Conclusion (1) Hospital scale and amount of service were the critical influencing factors of drug revenues in military hospitals; (2) Per capita cost of outpatient and inpatient also contributed to drug revenues; and (3) drug add rate and local economic level were negative influencing factors of drug revenues.

Development and Evaluation of a Transitional Care Program for Patients Discharged from Military Hospitals

PURPOSE: The purpose of this study was to develop and evaluate a transitional care program for patients discharged from military hospitals. The study consists of two phases: developing the program and evaluating its effectiveness. METHODS: The conceptual framework used to guide the development of the program was Meleis's transition theory. A quasi-experimental design was employed for this study. Participants were recruited from patients discharged from one military hospital, 72 in the control group and 56 in the experiment group. Data were analyzed using SPSS WIN 12.0 program with chi-square, Fisher's exact test, independent t-test, and mixed model. RESULTS: Participants in the transitional care program reported promoting a positive personal condition, and more healthy patterns of response in the first week after being discharged and a smoother discharge transition. CONCLUSION: The transitional care program developed for discharge patients from military hospital promoted discharge readiness and promoted smooth discharge transition.

Panel data-based study on economy of scale in military hospitals / 第二军医大学学报

Objective: To measure the economic scale of military hospitals locating to the north of Central China. Methods: We collected the 2005-2007 panel data of 57 military hospitals in 3 different regions, and there were 171 observations. These data were used to estimate the total variable cost function by fixed effected model. The coefficient estimates were used to calculate the economic scale of hospitals of different categories. Results: The general hospitals with 891-1 230 beds showed economy of scale, those with more than 1 300 beds displayed diseconomy of scale. There was no obvious relation between beds and scale economy for the numbered hospitals. Conclusion: Larger market scale and disposition of administrative resources lead to economy of scale on expanded level in the general hospitals. Scale is not the determining factor; optimized allocation of resources, division of labor, and rational specialization are important for economy of scale.

Empirical study on the economies of scope of military hospitals based on panel data / 第二军医大学学报

Objective: To measure the economies of scope of military hospitals in China. Methods: We collected the panel data of 2005 to 2007 from 57 military hospitals, based on which we constructed the pooled regression model and time fixed effect regression model. The best cost function model was selected according to the result of hypothesis testing, and the model of economies of scope was constructed according to the conception of economies of scope. Then the parameters were estimated by econometric methods, and the coefficient estimates were used to calculate the economies of scope of hospitals of each category. Results: The hypothesis testing results of the two models showed that the pooled regression model was superior to the time fixed effect model. All the military hospitals included in the present study showed economies of scope; the larger and higher level the hospitals, the stronger economies of scope was. Conclusion: Large-scale hospitals can achieve better economies of scope by developing highly relevant main bussiness.

Status of serving soldiers in military hospitals / 中华医学教育探索杂志

In order to serve soldiers in new period,the author summarized the effect of serving soldiers,analyzed the causes and proposed the countermeasures.