Localization Practice and Enlightenment of Medical Social Work in Shanghai / 中国医学伦理学

By reviewing the development context of medical social work in Shanghai, this paper summarized the practical experience in the development process of medical social work in Shanghai, and provided summary and suggestions for the long-term healthy development of medical social work from four aspects that basic path, key guarantee, important boost, and social image. It is suggested to carry out interdisciplinary cooperation and deepen patient service to build harmonious doctor-patient relationships, pay attention to talent training and improve institutional mechanisms to promote the stability of talent team, develop continuing education and meet different needs to upgrade modern service levels, emphasize brand building and carry out cooperation and co-construction to continuously expand social influence.

Modelos de atención en salud en enfermedades raras: revisión sistemática de la literatura / Healthcare Models for Rare Diseases: A Systematic Review of the Literature / Modelos de atenção em saúde em doenças raras: revisão sistemática da literatura

Resumen Las enfermedades de baja prevalencia requieren modelos de gestión diferentes a los de otras condiciones. Este trabajo buscó recoger las experiencias internacionales. Se realizaron búsquedas en numerosas bases de datos de literatura indexada y de documentos grises. Un panel de expertos de diferentes disciplinas revisó los resúmenes de la literatura y su posible adaptación al contexto colombiano. La búsqueda inicial arrojó 5604 referencias; la búsqueda manual adicionó 31 referencias, finalmente 78 artículos aportaron información útil para el análisis. Los resultados permiten afirmar que existen varios componentes de un modelo de gestión, estos son: políticas, legislación y aspectos administrativos; definición y codificación de enfermedades; investigación y educación; centros especializados, centros de excelencia y redes de atención; diagnóstico, tamizaje, prevención y promoción; inclusión de medicamentos huérfanos; rehabilitación y manejo paliativo; organizaciones de pacientes, grupos o redes de apoyo; y apoyo sociosanitario (inclusión laboral y educativa).

Abstract Low prevalence diseases require management models different from those used in other conditions. This work was intended to gather international experiences on this issue. Searches were made in many indexed literature databases as well as in those with gray literature. A panel of experts from different disciplines checked the abstracts and their potential adaptation into the Colombian context. The initial search retrieved 5604 references and the manual search added other 31 references. At the end, 78 articles provided useful information for the analysis. The results allow to state that a management model consists of several components, to wit: policies, legislation and administrative aspects; definition and coding of the diseases; research and education; specialized centers; excellence centers and service networks; diagnosis, screening, prevention, and promotion; orphan drug inclusion; rehabilitation and palliative care; organizations of patients and support groups or networks; and social-sanitary support (labor and educational inclusion).

Resumo As doenças de baixa prevalência requerem modelos de gestão diferentes aos de outras condições. Este trabalho visou coletar experiências internacionais. Realizaram-se pesquisas em numerosos bancos de dados de literatura indexada e documentos cinza. Um painel de expertos de diferentes disciplinas revisou os resumos da literatura e sua possível adaptação no contexto colombiano. A procura inicial resultou em 5604 referências; a procura manual adicionou 31 referências, por fim 78 artigos forneceram informações úteis para a análise. Os resultados permitem afirmar que existem vários componentes de um modelo de gestão, quais são: políticas, legislações e aspetos administrativos; definição e codificação de doenças; pesquisa e ensino; centros especializados, centros de excelência e redes de atendimento; diagnóstico, triagem, prevenção e promoção; inclusão de medicamentos órfãos; reabilitação e cuidados paliativos; organizações de pacientes, grupos ou redes de apoio; e apoio sócio-sanitário (inclusão laboral e educativa).

Practice Study of Reading Promotion in Hospital Libraries / 医学信息学杂志

The paper elaborates the practice of reading promotion inside and outside hospital libraries,mainly introduces the situation of reading group held for patients and their families,and summarizes co-reading experience of patient groups from aspects of book selection,participation of hospitals' psychologic counselors,patient reading guides and libraries,etc.

Analysis on operational status of the New Rural Cooperative Medical Scheme：Based on the field survey in 14 counties of 6 provinces / 中国卫生政策研究

Objective:To Compare the operational status of the New Rural Cooperative Medical Scheme( NCMS) in 14 Counties of 6 provinces. Methods:Two provinces were selected from eastern, central and western areas respec-tively and then two counties were chosen randomly from each province, but each of Jiangsu and Guangxi Provinces pro-vided 3 to reach the sample number of 14 counties. Excel 2007 was used for descriptive and comparative analysis of fund and in-patient service for NCMS. Results:The average funding standard was about 300 and 350 Yuan for 2012 and 2013. Hospitals outside county were frequently used and the ratio was over 40% in county I. Except Jiangsu and An-hui, the rate of enrollees who get compensation for inpatient service was over 10% and the actual compensation rate more than 50%, Fujian being an exception. Average hospitalization costs per time were different among counties and significantly rose in 2013. The ratio of out of pocket inpatient service expenses to the net rural household income was diverse among counties and it declines in some of them in 2013. The rate of fund for hospitals outside county was high and that of G counties was more than50%. The fund surplus rate was negative in that same year and was accumulatively ranging between 1 and 2%. Conclusions:The NCMS financing level was low and the personal financing responsibility was lighter;the enrollees didn’t contribute enough. In-patient service utilization structure was not rational in different level hospitals. The actual compensation rate for inpatient service didn’t increase a lot and the medical expenses burden didn’t alleviate apparently. The funds supervision was weak and it probably leaded to a high risk fund deficit.

A comparative evaluation of parenting styles for children diagnosed with conduct disorder at the out-patient service (OPS) of the National Center for Mental Health (NCMH) and for students studying at Malabon High School, April-Dec 2008

OBJECTIVES: This research aimed at showing the difference in parenting style of parents whose children were out patients diagnosed with conduct disorder at NCMH (clinical group) and those of parents with children studying at Malabon high school (non-clinical group).METHODOLOGY: Using a Parenting Scale translated in Filipino, 11 respondents from each group selected purposively were made to answer a 30 item questionnaire within 10- 15 minutes. The questions were grouped according to laxness, overreactivity and verbosity with corresponding factor loading.RESULTS: There was a mean of 2.66 for laxness, 2.54 for overreactivity and 1.92 for verbosity, with a total of 4.55 for the clinical group while the non clinical group had 2.5, 2.45 and 1.74 respectively for laxness, overreactivity and verbosity with a total of 3.95. Using the T test, it was determined that both clinical and non clinical group data had equal variances; without any significant differences noted between variances.CONCLUSION: Although parenting styles in families with children diagnosed with conduct disorder was dysfunctional, there was no statistical significance compared to that of parents from the non clinical group.   

Una perspectiva bioética a la relación médico-paciente / A bioethical perspective of the physician-patient relationship in a commercial competition environment / Uma perspectiva bioética da relação médico-paciente em um ambiente de concorrência comercial

Tras un recorrido histórico a la relación médico-paciente, este escrito desea indagar en la pregunta de cómo una profesión como la medicina, en donde se procura el bienestar de quienes se acercan a los servicios de salud, y sin desconocer su misma individualidad disciplinaria, puede mantener el lugar de confianza en la sociedad dentro de un sistema mercante en donde lo importante es la producción de réditos en un ambiente de competencia comercial. La revisión teórica está basada en la búsqueda de lo que han sido las exigencias morales y científicas que se le han atribuido tradicionalmente al profesional de la salud, en particular a los médicos, y en la influencia que esto tuvo en la forma de interacción del personal sanitario y los enfermos. Y, cómo a tal punto, esta relación se ha venido transformando, luego del intento legislativo por optimizar los escasos recursos económicos de las naciones en vías de desarrollo, y en particular el caso de Colombia. Finalmente, una vez identificadas algunas de las posibles causas del deterioro de la confianza en las relaciones humanas en el ámbito de la atención clínica, se aborda el tema de cómo el incumplimiento de lo ofrecido por la ciencia, la inclusión de herramientas económicas y la falta de privacidad en el contexto de la consulta médica, resultan la piedra angular en el cambio de escenario donde se da la relación médico ¿ paciente, puesto que éstas condicionan la posibilidad de entablar una comunicación abierta y sincera, y no permite la construcción de una condición de "amistad" entre el clínico, el afectado y su familia...

After a historical journey to the doctor-patient relationship, this paper wishes to inquire into the question of how a profession like medicine, where it seeks the welfare of those who come to health services, while acknowledging his own individuality disciplinary can keep the place in society of trust in a system where the important merchant is producing revenues in an environment of commercial competition. The theoretical review is based on the search for what have been the moral and science that have been traditionally attributed to healthcare, in particular doctors, and the influence it had on the form of staff interaction health and sick. And how to the point, this relationship has been transformed, then the legislative intent to optimize the limited economic resources of developing nations, and in particular the case of Colombia. Finally, once identified some of the possible causes of the deterioration of trust in human relations in the field of clinical care, addresses the issue of how the breach of that offered by science, including economic tools and lack privacy in the context of medical practice, are the cornerstone in the changing scenario where there is the doctor - patient relationship, since they condition the possibility of instituting an open and honest communication, and does not allow the construction of a condition of “friendship” between the clinician, the victim and his family...

Depois de um percurso histórico na relação médico-paciente, este trabalho deseja indagar sobre como uma profissão como a medicina, onde se busca o bem-estar de quem procura os serviços de saúde, e sem desconhecer sua própria individualidade disciplinar, pode manter um lugar de confiança na sociedade dentro de um sistema mercantil onde o importante é a produção de réditos em um ambiente de concorrência comercial. A revisão teórica está baseada na busca do que têm sido as exigências morais e científicas tradicionalmente atribuídas ao profissional de saúde, particularmente aos médicos, e de sua influência na forma de interação entre o pessoal sanitário e os doentes, e aque ponto esta relação vem se transformando após a tentativa legislativa de otimizar os escassos recursos econômicos das nações em vias de desenvolvimento, particularmente no caso da Colômbia. Finalmente, uma vez identificadas algumas das possíveis causas da deterioração da confiança nas relações humanas no âmbito do atendimento clínico, é abordado o tema de como o descumprimento do que oferece a ciência, a inclusão de ferramentas econômicas e a falta de privacidade no contexto da consulta médica acabam sendo a pedra angular na mudança do cenário onde ocorre a relação médico–paciente, pois condicionam a possibilidade de ser estabelecida uma comunicação aberta e sincera e não permitema construção de uma condição de “amizade” entre o clínico, o afetado e sua família...

The effect of one station style in the reform of out-patient service flow / 医学研究生学报

The human-based and patient-centered notion is a significant breakthrough of the management conception of modernized hospitals.The service mode of one station style was first adopted in health examination center in the reform of out-patient service flow.Based on the humanized service notion,we can provide health examination service with high quality and efficiency to various patients by taking multifarious measures such as reforming the department locations,optimizing the health examination course and setting convenience-stations.The service mode of one station style was demonstrated to have not only elevated the quality and efficiency of health examination service,but also increased both the patients satisfaction and the profit and reputation of the hospital.

Digitizing procedure in out-patient service and service process rebuilding / 医疗卫生装备

Bases on the changing idea and management policy,the out-patient service process rebuilding focuses on the patient,makes use of the information technology,imports the theory of operation process reforming,reconsiders and redesigns the operation process of the out-patient department,and improves the medical quality and service.The digitizing procedure in out-patient service is the important base of process rebuilding.In the paper,we try to discuss how to improve the digitizing procedure in out-patient service and rebuild the service process.

Factor analysis of quality guidelines for medical treatment / 医学研究生学报

Objective: To explore the potential influencing factors of the quality guidelines for medical treatment by factor analysis.Method: We analyzed with the SPSS package 9 quality guidelines for medical treatment in the department of integrated TCM and Western medicine of a hospital,including the out-patient person-time,the number of discharges,the average days of hospitalization,the rate of bed utilization,the frequency of bed rotation,the rate of cure and improvement,the case fatality rate,the coincidence rate of diagnoses at admission and discharge,and the success rate of emergency treatment.Results: Four common factors were extracted,namely,the quantifiable factor,determined by the out-patient person-time,the number of discharges,the average days of hospitalization and the frequency of bed rotation;the treatment factor,determined by the cure and improvement rate and case fatality rate;the diagnostic factor,determined mainly by the rate of bed utilization and the coincidence rate of diagnoses at admission and discharge;and the emergency treatment factor,determined by the success rate of emergency treatment.The cumulative contribution rate of the 4 factors was 85.1%.Conclusion: The amount of medical work,the techniques of treatment,the ability of diagnosis and the efficiency of emergency rescue are the main influencing factors of quality guidelines for medical treatment.

The Relation between Mental Factors and Outpatient Service Utility / 中国心理卫生杂志

Objective:To find out the relationship between mental factors and outpatient service utility. Method: Stratum-based random sampling method was used to select samples. The sample was interviewed with both self-made questionnaire and Kessler 10 rating scale.Results:The survey covered 11652 persons aged 15 and above. The incidence within two weeks was 10.38% (10.87% in rural areas and 7.73% in urban areas), the average rate of outpatient service seeking within two weeks was 4.83% (4.97% in rural areas and 4.11% in urban areas), 63.59% of the patients selected mainly the basic health service institution when they sought outpatient service; the primary mental factor affecting utility of outpatients was the mental state (K10 score), and the OR value of the high K10 group (scored 30-50) was 2.258 (95% CI: 1.265-4.032).Conclusions:Poor mental health is associated with higher utility of out-clinic service.