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解放军医院管理杂志

解放军医院管理杂志

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Hospital Administration Journal of Chinese People’s Liberation Army
《解放军医院管理杂志》是公开发行的中国科技论文统计源期刊（核心期刊），军队百种优秀期刊，是全军唯一的医疗卫生管理专业期刊，目前为双月刊。多年来，杂志宣传军队医疗卫生政策，发布卫生系统权威信息，传播相关管理前沿理论，引导医院管理发展潮流，研究医院管理热点问题，交流医院管理成功经验，在医院管理界具有重要影响。
  • 发文量：9535
  • 被引量：3139
  • H指数：1
  • 开始收录时间：1994(1)
  • CNKI综合因子：0.701
  • 维普期刊影响因子： 1.49
  • 万方期刊影响因子：1.25
  • 创刊时间：1994
  • 国内刊号/CN：31-1826/R
    国际刊号/ISSN：1008-9985
  • 发行周期：月刊
    邮发代号：4-662
  • 主管单位：总后勤部卫生部
    主办单位：第二军医大学
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  • 地址：上海市翔殷路800号
  • 邮编：200433
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解放军医院管理杂志 >2021年第S01期

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  • 摘要：目的 构建高效新型军地一体化交通伤救治网络体系,提高交通伤救治成功率.方法 应用信息化手段桥接交警事故现场,120转运及县、乡镇初级急救单位的急救网络和三甲医院为核心的交通伤一体化体系,建立现场、转运、初级急救单元及院内专科的一体化创伤救治体系,同时协调整合院内各专科力量组建创伤协作组,实施急救高级医疗资源对各级一线救治的远程支撑.以此构建核心的一体化救治体系,达到最优的救治效果.结果 以一体化救治体系的建立,通过信息化手段桥接现场到手术室及ICU的交通伤新型急救网络,最大限度地提高救治的成功率.结论 通过信息系统实现信息的实时传递,高级急救专业技能前伸配置,后方平台提前预警完善一体化交通伤诊治流程,促进区域性急救水平的提高.%Objective To construct an efficient new type of traffic injury first-aid network by civil-military collaboration in order to improve the success rates of traffic injury treatment.Methods We establish the integrating trauma care platform for traffic injuries which has a close connection with scenes of traffic accidents,120 emergency systems,the first aid network of counties and towns and top three hospitals to integrate scene,transfer,primary rescue unit and professional subjects.Meanwhile,the advanced emergency medical resources could be used to support the frontline treatment,achieving the optimal treatment effect.Results The network whose core is the integration of trauma care platform,connecting scene,operating room and ICU with Internet maximizes the success rates of treatment.Conclusion The platform improves the treating and curing rate through the real-time transmission of information by Internet,supported by the advanced emergency medical resources and early warning from the rear,perfecting the treatment platform and promoting the first aid level in area.
  • 摘要：Case-based teaching method is an important comprehensive teaching mode,and case library is the basis for the successful implementation of case teaching.This paper starts from the analysis of the demand situation of the training case database of the naval warfare prevention and treatment skills,expounds the basic idea of the case.design principle and the case library construction.Finally,the paper summarizes the construction process of the case library,and puts forward the thinking of the case-based teaching,to provide methods and tools for the skills training of naval combat casualty treatment.%案例教学法是一种重要的综合性教学模式,案例库是顺利实施案例教学的基础.文章从海战伤救治技能模拟训练案例库的需求分析人手,阐述案例设计原则、案例库构建的基本思路,最后对案例库构建过程进行总结提炼;提出针对案例教学的思考,为提升海军部队开展战伤救治技能训练提供方法与工具.
  • 摘要：医师科研能力是指从事医学研究中,以科学的思维和方法,对未知领域进行科学探索的能力.当前住院医师规范化培训对其科研能力的培养还相当薄弱,科研习惯和能力的培养又有着十分重要的意义,直接关系到医师本人未来的发展.文章结合上海市皮肤病医院实际情况展开实践,强调科研培养的重要性,提出加强住院医师科研能力培养的对策.%The ability of scientific research refers to the ability of scientific exploration of unknowns in the field of medical research with scientific thinking and methods.At present,the cultivation of scientific research ability is quite weak on standardized training of residents.It is of great significance to cultivate the habit and ability of scientific research,which is direcdy related to the future development of doctors themselves.We combined with the actual situation of Shanghai Dermatology Hospital to practice,emphasized the importance of scientific research and training,and put forward the countermeasures to strengthen the cultivation of scientific research ability of residents.
  • 摘要：Objective To research the key performance evaluating index and incentive threshold for the management of diabetic patients in community health service institutions. Methods The key performance evalua-ting index for the management of diabetic patients in community health service institutions was established by the methods of literature research and expert consultation. To determine the incentive threshold, a questionnaire was administered to the persons who knew the related information among 52 community health service institutes in Bei-jing and Shanghai. Results The key performance evaluating index and incentive threshold for the management of diabetic patients in community health service institutions were built. Conclusion The key performance evaluating index and incentive threshold could provide references for payment according to performance in the management of diabetic patients in community health service institutions.%目的 研究社区卫生服务机构糖尿病患者管理绩效评价关键指标及激励阈值.方法 通过文献研究和专家咨询,确定社区卫生服务机构糖尿病患者管理的绩效评价关键指标,对北京和上海共52家社区卫生服务机构相关知情人进行问卷调查,确定各指标激励阈值.结果 建立社区卫生服务机构糖尿病患者管理的绩效评价关键指标,并确定各指标的激励阈值范围.结论 建立的绩效评价关键指标体系及激励阈值,可为社区卫生服务机构糖尿病患者管理的绩效支付提供依据.
  • 摘要：U.S Military published the first Tactical Combat Casualty Care Guidelines in 1996. The guide-lines classified the tactical combat casualty care into three stages:care under fire,tactical field care and tactical e-vacuation care,and the descriptive treatment strategies were specified for each stage in the guidelines. In October 2014,U.S. military updated the guidelines and in the meantime the new content of the guidelines was incorporated into the eighth edition of Pre-hospital Trauma Life Support. Compared with the seventh edition, the new guide-lines had significant changes in hemorrhage control, fluid resuscitation, pain management, and burn care. The present paper introduced the background, updated mechanism of the guidelines as well as the main changes that were made in the new guidelines.%美军于1996年发布首个《战术战伤救治指南》,将战术战伤救治分为三个阶段:火线救治、战术战场救治和战术后送救治,针对三个阶段制定详细的救治策略.2014年10月,美军更新《战术战伤救治指南》,更新的内容也列入美国《院前创伤生命支持手册》第八版.与2011年第七版手册相比,新版《战术战伤救治指南》对止血、液体复苏、止痛、烧伤管理等内容做出较大更新.文章介绍指南的制定背景、更新及更新的主要内容.
  • 摘要：文章对舰艇长远航中遇到的卫勤保障难点,以及远程医疗在应对这些难点时所具有的优势进行总结阐述.回顾远程医学的发展历史,结合我国远程医疗的发展现状探索适应我海军远程医疗发展的新方向,为提升海军卫勤保障能力和卫生单位建设提供建议.%The difficulties of ocean-going medical support and the advantages of telemedicine in dealing with these difficulties were summarized and elaborated in this article. The development history of telemedicine was reviewed and the new direction of the development of naval telemedicine combined with the development of telemed-icine in China was explored. Suggestions on improving the ability of naval medical support and the construction of health units were provided.
  • 摘要：Under the restriction of geographical location, social conditions and the challenge of rapid de-velopment of local hospitals,how to identify the characteristics and laws of the development of frontier military hos-pitals and promote the scientific and healthy development of the hospital have become urgent problems to be solved. Combining with the practice of hospital development,this paper put forward some methods,such as adhering to the right direction and planning scientifically, highlighting the key points of construction and implementing the basic work firmly,integrating all kinds of resources and strengthening the overall advancement and so on.%在地理位置、社会条件等因素限制和地方医院快速发展的挑战下,找准边疆军队医院发展的特点规律,推动医院科学健康发展,已成为医院迫切需要解决的问题.文章结合医院发展实践,提出坚持正确方向,科学统筹谋划;突出建设重点,狠抓基础性工作落实;整合各种资源,强化整体推进等方法.
  • 摘要：文章结合贴近实战特点及战伤救治原则,探讨医院野战医疗队与旅卫生队混编后,在演习中大批量伤员快速分类后送的人员组织、具体方法、实施流程,总结一套行之有效的具体方案,为伤员救治赢得宝贵时间提供参考.%Based on characteristics and principles of treatment for the wounded,this paper analyzed ques-tions of triage and evacuation in the combat exercises which mixed brigade with field medical team participation,and summarized characteristics of triage and evacuation of the batch wounded,and proposed some recommendations for improving triage and evacuation in the combat exercises in the hope of providing some guiding significance with re-gard to developing triage and evacuation in the wartime.
  • 摘要：目的 对某市公立医院的运行效率进行评价,以期为相关部门决策提供参考.方法 运用数据包络分析(DEA,Date Envelopment Analysis)中的CCR(A·Charnes&W·W.Cooper&E·Rhodes)和BCC(Banker Charnes Cooper model)模型,计算公立医院的技术效率、综合效率、规模效率;并运用Tobit回归分析,从财务管理视角出发分析影响医院经营效率的主要因素并提出改善建议.结果 19家公立医院中有7家达到运营效率DEA有效、占总体37%,12家医院非DEA有效,其中综合效率值中医类医院(0.971) >专科类医院(0.800) >综合性医院(0.785),7家医院规模报酬递减,12家医院规模报酬不变.影响医院总体经营效率的主要财务指标是发展能力和资本运营能力,这些指标的提升对改善医院经营效率有显著效应.结论 运用DEA模型可以有效评价医院的运营效率,为医院管理者和相关部门提供科学的决策参考信息,运用Tobit回归结果,提示各医院应注重内部精细化管理,加强自身内涵建设,提升医疗业务发展能力和资本运营能力.%Objective To evaluate the operation efficiency of public hospitals in a certain city so as to pro-vide reference for the relevant departments. Methods CCR (A·Charnes & W·W.Cooper & E·Rhodes) and BCC (Banker Charnes Cooper model) model in Date Envelopment Analysis(DEA)was used.The technical efficien-cy,comprehensive efficiency of the public hospital and scale efficiency were calculated. Tobit regression analysis was conducted from the perspective of financial management to analyze the main factors affecting the efficiency of hospital management and suggestions were put forward for improvement. Results 7 hospitals in the 19 public hos-pitals met the requirement for the operational efficiency of DEA effectiveness, accounting for 37% of the overall hospitals.The other 12 hospitals turned out to be DEA ineffective.The efficiency value of traditional Chinese medi-cine hospital was 0.971 followed by specialist hospital (0.800) and general hospital (0.785). 7 hospitals de-creased in returns and scales and 12 hospitals remained unchanged in their returns and scales. The main financial indicators affecting the overall efficiency of the hospital were the ability to develop and the capacity of capital opera-tion. These indicators had significant effects on the efficiency of hospital operation. Conclusion DEA model can effectively evaluate the operational efficiency of the hospital,and provide reference for the scientific hospital man-agement and relevant departments of the decision. The hospital should pay attention to the internal management, strengthen their connotation construction,and improve the ability of medical service development and capital opera-tion.
  • 摘要：After reviewing the military operations and focusing on future combat needs,the U.S. army found that the existing methods of medical readiness evaluation have many shortcomings and can not meet the actual needs. Therefore,the US military put forward the concept of essential medicalcapabilities (EMCs) and data-driven ap-proach,based on Joint Capacity Integration and Development Systems,Dreyfus skills acquisition model to explore the theoretical exploration and development of EMCs. Through the analysis of the EMCs of the US military,this paper hoped to give some enlightenment to the construction of our military medical force in terms of ideas and specific methods.%美军在反思历次军事行动和着眼未来作战需要后发现,现有的医学战备评价方式具有诸多不足,无法满足现实需求.因此,美军提出核心医学能力概念并以数据驱动的方式,基于联合能力集成与开发系统、Dreyfus 技能获取模型等理论探索性开发及评估核心医学能力.通过对美军核心医学能力进行解析,希望能在理念和方法方面对我军医学队伍的能力建设有所启示.
  • 摘要：战术战伤救治是美军提出并倡导的一种先进的战场急救原则和方法,在卫勤建设中具有较高的学习与借鉴价值.我军院校和基层部队对于该内容的教学经验有限,首次将基于微课的翻转课堂教学模式引入战术战伤救治教学中;探讨该模式较传统模式的优势及具体实施方案,探索适合我军的战术战伤救治教学新模式.%Tactical combat casualty care is an advanced battlefield first aid principle and method that was advocated by the US military,so the principle has a high learning and reference value in the construction of medical service. However,the training experience of the military colleges and troops is limited. For the first time,we intro-duced the teaching model of the reverse classroom based on the micro-course into the teaching of tactical combat casualty care. The advantages of the model were compared with the traditional model and a new model of tactical combat casualty care that is suitable for our army was explored.
  • 摘要：In June 2012,the Ministry of Health issued the 2011 version of 3A cancer hospital accreditation standards. After rounds of discussion and revise,this standard was officially released in November 2012. Our hos-pital has started preparatory work since September,2012,after more than half a year's careful preparation,the re- inspection of 3A Cancer Hospital was carried out in April,2013. During the preparation,we've learned that ap-plying SPDCA to instruct the operation of top 3A Cancer Hospital is really practical and effective. This essay elabo-rated on SPDCA for other hospitals' reference.%2012年6月,原卫生部发布《三级肿瘤医院评审标准(2011年版)实施细则征求意见稿》.经过反复讨论修改,《三级肿瘤医院评审标准(2011年版)实施细则》终于在2012年11月正式出台.医院自2012年9月正式启动三甲复评工作,经过半年多的精心准备,于2013年4月顺利迎接三甲复评检查.在复评准备工作中,总结出以SPDCA循环指导三甲肿瘤医院复评工作的经验,收到较好的实际效果.文章对SPDCA循环进行详细说明,以供其他医院参考.
  • 摘要：文章阐述军队医院战斗力实质和内涵,结合该院卫勤保障能力建设现状,就进一步提升军队医院战斗力提出思考和建议.%This paper explored the essence of military hospital's combat power,and offered some proposals and thinking on further improving the combat force of the military hospital according to the current situation of the construction of medical support capability in our hospital.
  • 摘要：目的 探讨BIS联合RASS监测下的目标性镇静护理在心脏外科监护室中的应用效果.方法 选取2016年6—12月在该科行心脏手术的64例患者,随机分为对照组和观察组各32例.对照组采用在BIS监测下的常规镇静护理,观察组采用BIS联合RASS共同监测下的目标性镇静护理,比较两组患者术后在CICU内的镇静效果、镇静后生命体征变化,以及患者术后机械通气时间和ICU留滞时间.结果 观察组患者术后在CICU内镇静效果明显高于对照组,差异具有统计学意义(P<0.05);两组患者术后镇静过程中生命体征变化均平稳,差异无统计学意义(P>0.05);观察组患者术后机械通气时间和ICU留滞时间均明显低于对照组,差异具有统计学意义(P<0.05).结论 在CICU内运用BIS联合RASS监测对心脏术后患者进行目标镇静性护理安全可行,能提高患者的镇静效果,减少患者术后机械通气时间及ICU留滞时间,确保医疗及护理工作的有效性,值得临床推广.%Objective To explore the effect of target sedation care by BIS combined with RASS monitoring in CICU.Methods A total of 64 patients who underwent cardiac surgery from June to December in 2016 were ran-domly divided into the control group and the observation group(n=32).The control group was treated with routine sedation under BIS monitoring. The observation group was treated with BIS combined with RASS to monitor the sed-ative effect,when the changes of vital signs and the postoperative mechanical ventilation time and ICU retention time were compared between the two groups.Results The sedative effect of the observation group was significantly better than that of the control group(P<0.05). There was no significant difference in the vital signs between the two groups(P>0.05). The time of mechanical ventilation and ICU stay in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of BIS combined with RASS in CICU to monitor the sedationof patients receiving cardiac surgery is safe and fea-sible.It can improve the patient's sedative effect,reduce the patient's postoperative mechanical ventilation time and ICU stay time,ensure the effectiveness of medical and nursing work,which is worthy of clinical promotion.
  • 摘要：目的 提升一体化医护工作站数据库使用效率及安全性.方法 通过在数据库和客户端间加入"中间层",构筑三层架构,将身份校验、业务审定、数据访问等工作皆放在该层完成.结果 客户端间接通过中间层与数据库进行交互.结论 有效优化新版一体化医护工作站的访问效率,降低数据库负荷,并且提升相关数据的安全性.%Objective To enhance the efficiency and security of the database of the integrated medical work station. Methods The middle layer between the database and the client was added. The three-tier archi-tecture was built,and the identity check,business validation,data access and other work were done on this layer. Results The client interacted indirectly with the database through the middle layer. Conclusion It can effective-ly optimize the access efficiency of the new integrated medical workstation, reduce the load of the database, and improve the security of the related data.
  • 摘要：A total of 716 papers in research-oriented hospitalsincluded in China National Knowledge In-frastructure(CNKI) from 2006 to 2015 were visually analyzed with CiteSpaceⅢ visualization software.We summa-rized the present development status of research-oriented hospitals and analyzed the trends in the future to give a reference for the further development of research-oriented hospitals.%运用可视化软件CiteSpaceⅢ,对2006—2015年收录在中国知网(CNKI)中的716篇"研究型医院"相关论文进行可视化分析,总结现阶段研究型医院的发展状况并对其未来趋势展开分析,为其未来发展提供参考.
  • 摘要：Quality is the key to healthcare success in the 21st century. Literature indicates that great chal-lenges exist in improving healthcare quality. We introduced some globally used care quality frameworks(Donabedi-an model,IOM six aims and OECD model). The approaches of quality indicator development fall into three broad categories:deductive approach (from concept to database), inductive approach (from database to concept) and joint use of both. The reliability, validity as well as the maintenance of quality indicators should be carefully as-sessed. The implementation of quality frameworks and indicator development approaches should depend on research purposes and local context.%医疗质量管理是卫生工作的永恒主题,持续提高医疗质量是21世纪医疗管理取得成功的关键.文章以医疗质量的内涵为出发点,系统介绍国际上用于解读医疗质量的经典理论模型(Donabedian模型、IOM模型和OECD模型),并将医疗质量评价指标构建方法概括为三大类:归纳法、演绎法和综合运用法,医疗质量评价指标需要进行信度和效度检验,以及定期的维护与更新.研究者应根据研究背景和目的,选择适宜的医疗质量模型和评价指标构建方法.
  • 摘要：Objective To study the application value of pediatric outpatient service by optimizing process based continuing nursing intervention.Methods By referring to the random sampling method,500 cases of children from pediatric clinic during the period of January 2015 to January 2017 were selected.The children were divided in-to observation group and control group by random number table method,each with 250 cases. Children in the con-trol group were given optimizing pediatric outpatient service process,the observation group children were given team cooperation mode based nursing intervention on the basis of control group. Results Compared with the control group,the clinic time and waiting time of children in the observation group were much shorter(P<0.05),and the nursing disputes incidence rate and waiting accident incidence rate were obviously lower than the control group(P<0.05). The nursing satisfaction rate in sufferings process,clinic time,booking service,and nursing service of ob-servation group children were significantly higher than the control group(P<0.05).Conclusion The application value of pediatric outpatient service by optimizing process based continuing nursing intervention is significant, and it can improve nursing quality,so it is worthy of clinical popularization and application.%目的 探讨基于优化流程的延续护理干预在儿科门诊服务中的应用价值.方法 参照随机抽样方法抽取2015年1月至2017年1月期间儿科门诊患儿500例,采用随机数字表法将患儿分为观察组与对照组,各250例,对照组患儿采用儿科门诊服务,观察组患儿在对照组基础上采用基于优化流程的延续护理干预.结果 与对照组比较,观察组患儿就诊时间与候诊时间明显缩短(P<0.05),护理纠纷发生率与候诊意外发生率明显降低(P<0.05),患儿家长对就诊流程、就诊时间、预约服务与护理服务的护理满意率明显增高(P<0.05).结论 基于优化流程的延续护理干预在儿科门诊服务中的应用价值显著,有助于提升护理质量,值得临床推广应用.
  • 摘要：目的 了解海军某片区部队医院与基层医疗机构间双向转诊情况.方法 选取9个部队900名官兵、4所基层医疗机构24名医务人员和2所医院35名科室负责人,对就医顺畅程度、就医行为,医疗机构水平和医疗服务体系构建模式进行问卷调查和访谈.结果 78.2%的医务人员认为就医流程较为顺畅,71.8%的官兵选择基层医疗机构首诊,基层医疗机构与医院水平差距较大,58.2%的医务人员认为从体制上融合基层医疗机构和医院是最有效的医疗服务体系.结论 转上容易转下难较为普遍,需要从构建医疗一体化保障模式、加强制度建设与宣传、建强基层医疗机构和完善考核力度等方面予以完善.%Objective To explore dual referral between naval primary medical institutions and hospitals. Methods 900 service men from 9 units,24 military surgeons from 4 primary medical institutions and 35 military surgeons from 2 hospitals were investigated into smoothness of process for medical service,medical seeking behav-ior,medical and technical level of primary medical institutions and hospitals,and structuring of medical service sys-tem.Results 78.2% of all medical surgeries believe that process for medical service is smooth and 58.2% of them believe that system integration of primary medical institution and hospital is the most effective medical service system,71.8% of serviceman would choose primary medical institution for first diagnosis,medical and technical lev-el of primary medical institution and hospital has a great distance.Conclusion Upward referral is common but downward referral is difficult.Efforts should be made to establish the integration mode of medical service,strengthen dual referral system construction and publication,improve ability of primary medical institutions and perfect exami-nation system of dual referral.
  • 摘要：Based on policy background of full termination of paid service,adverse effects and opportunities of full termination of paid services on small and medium-sized military hospitals were analyzed. Ideas and counter-measures for the military hospital development were put forward from strengthening the sense of mission,controlling security risks,focusing on security needs,and close contact with troops.%基于全面停止有偿服务的政策背景,分析停止医疗合作项目对军队中小医院发展带来的不利影响和机遇,并从强化使命意识、把控安全风险、聚焦保障需求、密切联系部队等方面,提出新时期军队中小医院发展的思路和对策.
  • 摘要：Main objects of military health care are responsible for the national defense and the overall mili-tary modernization construction in the new era, which requires intensive work load and enormous work strength. Therefore,the medical health care of the military construction objects is the key of the military health care work. Health care nurse is a critical component of health care work, and there are great differences between military health care nurses and the clinical nurses given the distinctiveness of health care objects. The emphasis of cultiva-ting military health care nurses'ability is the key to the military health care tasks in the new era,which is beneficial to the comprehensive and scientific improvement of the collective level of health care nurses,as well as to promote the comprehensive and sustainable development of health care system.%军队重点保健对象肩负着新时代国防和军队现代化全局建设,工作任务重、工作强度大,因此军队重点保健对象的医疗保健是军队保健工作的重中之重.保健护士是保健工作的重要组成部分,军队保健护士因保健对象的特殊性与临床护士相比有很大差别.重视和培养军队保健护士的能力是新时代强军保健任务的关键,有利于全面、科学地提高保健护士整体水平,促进保健护理的全面可持续发展.
  • 摘要：Based on the analysis of the domestic and international think tank and think tank database de-velopment status,aiming at the current lack of hospital management think tank database design scheme,this paper proposed a hospital management think tank database architecture model,Focusing on the construction content and function design,provides a reference for the construction of hospital management think tank database.%文章分析国内外智库和智库数据库发展现状,在对国内智库数据库的研究内容进行总结分析的基础上,针对缺乏医院管理智库数据库设计方案的现状,提出一种医院管理智库数据库的架构模型,着重阐述建设内容和功能设计,为医院管理智库数据库的建设提供参考方案.
  • 摘要：目的 通过对近6 年发表的卫勤文献进行计量分析,揭示该领域的研究热点和前沿,为后续研究提供思路。方法 全面检索CNKI(中国知网),收集2011—2016 年间发表的卫勤或战勤相关研究,提取题目、摘要和关键词等相关信息。采用CitespaceⅢ对相关信息进行可视化计量分析,并绘制相应的科学知识图谱。结果 共纳入研究2 727 项。结果共发现两个大型的研究合作群,分别为军科院研究集群和第二军医大学研究集群;关键词共现分析认为卫勤保障、军队医院和军事医学等为研究热点;聚类分析结果认为机动卫勤分队、应急医学救援和多样化军事任务为主要研究内容;突变词分析结果认为实战化、区域一体化和医疗保障模式为研究前沿。结论 本次研究分析国内卫勤领域研究的热点和趋势,为后续研究和卫勤管理提供参考。%Objective Through visualization quantitative analysis of research literatures on military health service published in recent years,the paper discussed the research focus and research frontiers in this research field at present so as to provide rational exploration thinking for the follow -up study. Methods Through searching CNKI comprehensively, collecting related researches on military health service (civilian war service) published from 2011 to 2016, and extracting topic, abstract and keywords, the paper adopted CitespaceⅢ for visualization quantitative analysis of relevant information and drew corresponding map of scientific knowledge. Results The pa-per incorporated 2,727 researches and found two large research cooperation clusters, including Military Academy Research Cluster and Second Military Medical University Cluster. The research development trend focused on mili-tary hygiene guarantee, military hospitals and military medicine, etc. The main research field included mobile medical service units, emergency medical rescue and various military tasks, etc. The research frontiers included actual combat,regional integration and medical security model were the research frontiers. Conclusion This study analyzes hot spots and trends in the field of military health service to provide a reference for subsequent study and research.
  • 摘要：临床试验协议是保障临床试验顺利开展并有效防范风险的重要法律文书,本研究对该院72份临床试验协议进行梳理,总结临床试验协议中协议不完整、权责不明确、语言笼统、违背相关法规和费用无成本核算等常见问题,以及临床试验协议管理中人员法律意识淡薄、部门职责不清、无协议审核标准原则和未实现电子信息化管理等常见问题.提出应通过建立健全临床试验协议管理制度、加强协议规范化建设、建立临床试验成本核算体系、实现临床试验协议电子化管理和加强人才队伍专业化建设等应对策略,高效管理临床试验协议,有效防范合同风险,保障医院合法利益.%Clinical trial agreement is an important step to ensure the smooth development of clinical trials and to effectively prevent the risk. The article reviewed and summarized common problems from 72 clinical trials agreements from Beijing Chest Hospital,and proposed to strengthen institution, organization, standardization, cost accounting system,electronic file system and personal construction of clinical trial agreements.
  • 摘要：Objective To explore the correlation between the quality of medical students and the compre-hensive quality of graduation in military medical colleges, and to guarantee the intervention management of the quality of the enrolled students. Methods Using the background questionnaire and symptom checklist, all the clinical students between 2010 and 2012 in a military medical university were investigated to track the graduation comprehensive quality evaluation scores,and analyze the statistical correlation. Results There was a positive cor-relation between college entrance examination scores and examination results, honorary credits of humanities and social sciences. Non-only children performed better in exams,and only children got higher honor credits. Inter-personal sensitivity factor had positive correlation with exam scores,but hostility factor had negative correlation with test scores. Conclusion There is a correlation between the quality of students and the comprehensive quality of graduation. Attention should be paid to different groups of students and psychological intervention should be carried out in time.%目的 初步探索军队医学院校生源质量与毕业综合素质的相关性,针对性地做好入口生源质量的干预性管理.方法 采用背景调查问卷、SCL-90症状自评量表对某军医大学2010—2012级临床医学专业全部男性青年学员进行调查,追踪其毕业综合素质考评成绩,进行统计学相关分析.结果 生源高考成绩与考试课成绩、人文社科类荣誉学分正相关;非独生子女的考试课成绩更好,独生子女的荣誉学分更高;SCL-90各因子中,人际敏感因子与考试课成绩正相关,敌对因子与考试课成绩负相关.结论 生源质量与毕业综合素质存在相关性,应关注不同生源群体,及时进行心理干预.
  • 摘要：Objective To explore whether the punctuality rate of doctors for first surgery can be improved by Quality Control Circle (QCC) group activities. Methods QCC team was established with the theme of impro-ving the punctuality rate of doctors for first surgery to analyze the status causes for the issues, develop and imple-ment the proposed countermeasures to maintain the continuous quality improvement. Results The punctuality rate of doctors for first surgery was improved. The satisfaction of anesthesiologists,nurses in the operation room and oth-er surgery physicians was improved,and patients' satisfaction was significantly improved. For the medical person-nel,team spirit, professional knowledge, communication and coordination, confidence, responsibility and honor and team cohesion were improved significantly. Conclusion QCC management activities optimizes the work flow of operation room,improves the first surgery arrival punctuality rate,improves the doctor and patient satisfaction,the circle team spirit,the ability of communication and coordination,and the quality management of the hospital.%目的 运用品管圈的管理方法,提高日首台手术医师准点到达率.方法 组建品管圈活动小组,以"提高日首台手术医师准点到达率"为主题,进行原因分析,制定改进措施,分析改进成果.结果 通过品管圈活动,日首台手术医师准点到达率提高,麻醉医师、手术室护士、其他接台手术医师满意度提高,患者满意度明显提高.医务人员在QCC手法运用、团队精神、专业知识、沟通协调、活动信心、责任荣誉、凝聚力7个方面,均有不同程度的提高.结论 品管圈管理活动在优化手术室工作流程、提高日首台手术医师准点到达率、提高医患满意度方面发挥重大作用,同时增强圈员的团队精神,提高沟通协调能力,提升医院质量管理水平.
  • 摘要：The significance of the joint service hospital that serves the army is emerging along with the de-velopment of military reform. On the basis of military reform and local improvement,this paper analyzed the current issue of joint service hospital on the process of facing the new era,summarized some effective measures and experi-ence of establishing service ability of joint service hospital and provided some reference for other hospitals.%伴随着军队改革的不断深入,联勤保障部队医院做好为部队服务工作的重要性日益显现.文章从军、地改革的大背景出发,分析当前联勤医院面临的新形势新问题,总结医院为部队服务能力建设的有效措施,为联勤医院系统做好为部队服务能力建设工作提供借鉴.
  • 摘要：目的 探讨影响体检者对健康体检机构选择的影响因素.方法 采用整群抽样的方法进行问卷调查,利用自行设计量表对2017年3—5月上海某社区居民健康体检情况进行调查.结果 调查者的性别对选择健康体检机构有影响(P<0.05),差异具有统计学意义.工作人员的专业水平、服务态度和人性化服务、体检报告质量、就医绿色通道、体检后续服务因素(P<0.05)对居民选择健康体检机构有影响,差异具有统计学意义.结论 医院健康体检中心在工作人员的专业水平、体检报告质量等影响居民选择体检机构的因素上占有优势,使大多数居民更偏好医院健康体检中心.专业体检机构提供良好的健康体检体验和人性化服务,对民众健康意识增强起到促进作用.%Objective To study the factors which influence the choice of physical examination institution. Methods A cluster survey was used to conduct a questionnaire survey.Using self-designed scale to investigate the health examination of a community resident in Shanghai from March to May in 2017. Results The gender of the subjects had an effect on the selection of healthy medical institutions(P<0.05),and the difference was statis-tically significant. The professional level of the staff, the service attitude and humanistic services, the quality of medical report, the consultation of green channel, and physical follow -up services (P <0.05) affected the residents' choice of health examination institutions,and the differences were statistically significant. Conclusion Good medical resources,qualified staff and professional physical examination report were the reasons why most resi-dents prefer hospital health examination centers. Professional physical examination institutions could provide good health examination experience and human services,which play a catalytic role in enhancing the health awareness of residents.
  • 摘要：China and US,with unique history and culture independently,share huge difference in educa-tion system,especially in medical education, according to the author`s own experience, who once worked in US medical school for several years. Such difference between the two countries in medical education was detailed dem-onstrated in this article,which may probably further benefit our domestic medical education in different ways.%中美两国历史文化迥异,教育体制差异也很大.本文阐述中美两国在医学教育和医学生培养上的不同之处,取其精华弃其糟粕,以期对国内临床医学生的培养有所借鉴和启发.
  • 摘要：Objective To find the main factors that affect the balance of research funding. Methods Preliminary questionnaire on influencing factors of the balance of scientific research funds in Affiliated Hospitals of Xinjiang Colleges and Universities was designed using literature research and expert interviews methods. Scientific researchers and financial management and clinical experts were invited to modify the questionnaire to form a final questionnaire for the purpose of research and to evaluate the importance of the questionnaire entries. 431 valid questionnaires were collected and the effective regaining rate was 95.8%. The data were analyzed by SPSS 18.0, and the main influencing factors of scientific research fund balance were extracted by principal component analysis. Results Four major components were extracted from 12 influencing factors. The relationships between the use of research funds and the utilization rate of scientific research equipment, between the use of research funds and the subjective initiative of the project leader were the first principal component of scientific research fund balance. Age was the second principal component of scientific research fund balance. The length of service was the third princi-pal component of scientific research fund balance. Whether the research funding reimbursement approval process was sound or not was the fourth main component that affected the balance of the project funds. Conclusion In view of the factors that affect the balance of the project funds,this paper analyzes the main problems and causes in the current management of hospital research funds, so as to further explore the corresponding countermeasures to strengthen and standardize the management of scientific research funds.%目的 查找影响科研经费结余的主要因素.方法 采用文献研究及专家访谈法对影响因素进行分析,拟制新疆高校附属医院科研经费结余情况问卷条目,邀请科研、财务管理人员及临床专家对问卷条目进行修改,形成符合研究目的的最终问卷,并对问卷条目的重要程度进行评价,回收有效问卷431份,有效回收率为95.8%.调查数据采用SPSS 18.0进行统计分析,应用主成分分析法提取影响科研经费结余的主要因素.结果 在12个影响因素中提取出4个主要成分,科研经费的使用与科研设备利用率的关系、科研经费的使用与课题负责人主观能动性的关系是影响课题经费结余的第一主成分;年龄是影响课题经费结余的第二主成分;工龄是影响课题经费结余的第三主成分;科研经费报销审批流程是否健全是影响课题经费结余的第四主成分.结论 针对影响课题经费结余的因素,分析医院科研经费管理过程中遇到的主要问题和原因,探讨加强和规范科研经费管理的相应对策.

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