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With the intensification of global aging trends,the health needs of the elderly are becoming increasingly prom-inent.As one of the main forces in implementing the Healthy China strategy,medical and health institutions play a crucial role in building a scientific,systematic,and targeted health popularization system to improve the health status of the elderly and delay the aging process.However,medical institutions face numerous challenges in constructing a health popularization system for the elderly.Based on the perspective of aging,this article focuses on the hot and difficult issues encountered by the elderly when see-king medical treatment,pays attention to the blind spots and hot issues in elderly health,explores the importance and construction methods of health popularization systems for the elderly in medical and health institutions,in order to enhance the health aware-ness of the elderly,promote health behavior changes,and ultimately improve the health status and quality of life of the elderly.
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Purpose/Significance Based on the typical use scenario of sensitive personal information in medical and health institu-tions,the implementation of the secure use of sensitive personal information is explored.Method/Process For user registration,internal utilization and interaction,medical device/wearable device collection and information disclosure and other scenarios,the paper analyzes the risk of sensitive personal information leakage,explores the application scenarios,advantages and disadvantages of various technical means such as identity authentication,access control,data encryption,data desensitization and detection audit.Result/Conclusion The application of technical means can assist medical and health institutions to further protect the security of patients'personal information.
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Objective:In order to strictly prevent academic misconduct, effectively improve the understanding and judgment ability of researchers on medical ethics issues involved in papers, and ensure scientific and standardized research results, strict ethical review is crucial.Methods:It mainly reviews whether the clinical research paper to be submitted has obtained an ethical approval certificate, whether the content of the paper exceeds the scope of ethical approval permission or violates research ethical standards, etc., and establishing a sound paper ethics review mechanism.Results:This paper summarizes the issues, points and considerations of ethical review before submission of clinical research papers, hoping to provide some practical methods and references for the ethical review of clinical research papers in China.Conclusions:Medical and health institutions mostly carry out biomedical research involving humans, and should pay more attention to ethical norms and requirements, educate and guide researchers to strengthen ethical awareness, and improve their attention and judgment ability to medical ethical issues in papers.
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Objective:To analyze the current situation of Investigator-Initiated Trials in medical and health institutions in Shandong Province, the problems in the process of conducting clinical research, and put forward proposals for the establishment of a clinical research management system with effective supervision, sound systems and supporting services, taking into account the progress of the projects since the pilot work was carried out.Methods:A questionnaire was created, an online survey was conducted, a database was set up, a status analysis was conducted and a post-launch analysis of the progress of the pilot was carried out using the National Medical Research Registry Information System, culminating in recommendations using the literature summary method and empirical analysis.Results:Statistical analysis of the questionnaire found that 29.39% of the institutions have a dedicated clinical research management department, and 75.97% of the institutions have a management approach. 25.52%, 40.30%, and 43.07% of institutions established biobanks, clinical research centers, and follow-up centers. There was a statistically significant difference in the establishment of clinical research centers, biobanks, and follow-up centers in secondary and tertiary medical institutions ( P<0.05). The number of general clinical research projects filed, the number of submissions and the number of ethics committees filed in the filing system have all increased significantly after the pilot work, with growth percentages of 126%, 141% and 62% respectively. Conclusions:Shandong Province clinical research pilot work has begun to bear fruit, the current clinical research project still exists in the lack of special funding support, perfect service platform and system support and training system to be improved and other issues.
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Objective:To explore the problems of medical and preventive integration at primary healthcare institutions in China, for references for promoting the development of medical and preventive integration in China.Methods:This study searched for literatures covering the integration of medical and preventive at primary healthcare institutions on CNKI, Wanfang, and VIP databases(from the establishment of the database until March 1, 2023), and extracted text mentioning problems of the medical and preventive integration in primary healthcare institutions. The macro model of the health system was used for problem classification analysis, while the social network analysis method was used to measure the network density, point centrality, and intermediary centrality of the problem, and determine the key issues.Results:A total of 25 papers were included, and 28 problems of medical and preventive integration at primary medical and health institutions were extracted, including 6 problems at the external environment level, 15 problems at the structural level, 6 problems at the process level, and 1 problem at the result level. The results of social network analysis showed that the network density of these problems was 0.71. The point centrality and intermediary centrality of key problems were both high, including the lack of incentive mechanisms for medical and prevention integration (point centrality=69, intermediary centrality=21.44), fragmentation of health information systems(68, 15.70), insufficient awareness of medical and prevention integration among grassroots personnel(65, 17.47), shortage of talent at primary medical and health institutions(64, 11.69), weak service capabilities of primary medical institutions(50, 19.23), and insufficient information sharing(48, 15.80).Conclusions:A variety of problems were found in the integration of medical and preventive at primary medical and health institutions in China, which were closely interrelated. It was urgent to solve six key problems, including the lack of incentive mechanisms, talent shortage, and information system fragmentation, etc. It was suggested that primary medical and health institutions should further improve the incentive mechanism for medical and preventive integration, strengthen the construction of grassroots health talent teams, promote health information exchange and sharing, and enhance the awareness of medical and preventive integration.
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Objective:To analysis the incentive level of family doctors in primary medical and health institutions in Beijing, and to explore its influencing factors, so as to provide references for promoting family doctors′ contract service.Methods:From October to December 2021, 40 family doctors were randomly selected from 135 urban community health service centers in 8 districts of Beijing, and a survey was conducted on basic demographic information, institutional organizational capacity evaluation, and family doctor incentive level evaluation (including four dimensions of work value, organizational environment, personal development, and reward compensation), and the influencing factors of family doctor incentive level was analyzed. Chi-square test and Pearson correlation analysis were used for univariate analysis, and multiple linear regression analysis was used for multivariate analysis.Results:A total of 4 568 family doctors were included, and the score of family doctors′ incentive level was 3.75±0.81, among which the work value score was the highest(3.89±0.77), followed by the organizational environment score(3.69±0.92) and personal development score(3.75±0.90), and the lowest score was reward(3.75±0.90). Age, education, professional title, working years and average total working hours per week negatively affected the incentive level( P<0.05), while the average monthly income, the frequency of attending training and further study, and the organizational ability of the organization positively affected the incentive level( P<0.05). Conclusions:The overall incentive level of family doctors in primary medical and health institutions in Beijing needed improvement, and there were many factors that affect the incentive level of family doctors. It was recommended to appropriately increase the salary and benefits of family doctors, reasonably arrange the workload of family doctors, strengthen the training mechanism of family doctors, and strengthen the organizational capacity building of primary medical and health institutions.
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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.
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@#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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.