The outpatient multi-disciplinary team (MDT) model is an important measure to improve the quality of medical services and enhance patients’ medical experience. The Second Affiliated Hospital of Zhejiang University School of Medicine has explored three types of outpatient MDT models, namely specialized disease model, self-service model, and professor team model, in order to improve the accessibility and coverage of outpatient MDT. Through practice, it has been found that the implementation of multi-type outpatient MDT models can further leverage the advantages of MDT in society, hospitals, and patients. This article will share the experience of building multi-type outpatient multi-disciplinary team models mentioned above.
Patient satisfaction is regarded as a key component of measuring and reporting quality of medical services. It is also an important indicator in performance appraisal for public hospitals in China. Based on the literature review on the theories and practices of patient satisfaction assessment in China and other countries and areas, this paper performed an in-depth analysis on the theoretical frameworks and instruments for patient satisfaction assessment, as well as their applications in management practices. Further research and improvements are needed.
Objective To analyze the impact of removing medicine makeups and two rounds of medical service price adjustment reform on inpatient expenses, and to provide reference for policy-making and adjustment of hospital management strategy. Methods Select the front page data of medical records of the case hospital medical record management system from 2016 to 2018. According to the time of cancellation of drug addition and two rounds of medical service price adjustment reform, the data on the first page of medical records in the hospital medical record management system are divided into two groups, including before the implementation of the policy (2016) and after the implementation of the policy (2017-2018). Interrupted time series (ITS) was used to analyze the changes of hospitalization expenses before and after the adjustment of the policy. Results Before the implementation of the policy, the average hospitalization expenses in 2016 was (17 863.35±334.73) yuan; After the implementation of the policy, the average hospitalization expenses in 2017 was (18 066.16±398.42) yuan, and the average hospitalization expenses in 2018 was (18 238.95±258.28) yuan. ITS analysis showed that before the implementation of the policy, the average hospitalization expenses of patients increased by 26.616 yuan per month, but there was no statistical significance (P=0.323). In the month when the policy was implemented (December 2016), the average hospitalization expenses of patients decreased by 141.212 yuan, but there was no statistical significance (P=0.547). After the implementation of the policy, the slope of average hospitalization expenses of patients 22.363, and the inpatient expenses showed an upward trend, but there was no statistical significance (P=0.881). In the past three years, the drug expenses has decreased by 13.64%, the material expenses has decreased by 3.69%, and the labor expenses has increased by 12.25%. Conclusions After the removing medicine makeups and two rounds of medical service price adjustment reform, the drug expenses and material expenses decreased during hospitalization, and the labor expenses increased, but no change in hospitalization expenses.
Objective To summarize and analyze the experience of Canadian hospital report, including report contents, indicators system and result application, so as to provide basis for improving Chinese hospital information report and enhancing healthcare regulation. Methods Official networks and databases in Canada were searched, and relative policies, documents, research reports and information reports were included. Results Canadian Hospital Report Project carried out by Canadian Institute for Health Information was effective for gathering and comparing hospitals’ information, and regulating healthcare service. Ontario Hospital Report Project, as a local policy based on national hospital report project, was a good example of local government to improve healthcare service regulation. Conclusion Canadian Hospital Report and Ontario Hospital Report enlighten us that, carrying out the comparison of hospitals in the same type, ensuring the comparability of data, setting comprehensive and scientific report contents and indicators, and emphasizing the self-evaluation function and self-improvement function of the hospital performance evaluation.
目的 了解近年四川省基层医疗卫生机构医疗服务的变化情况。 方法 对“四川省卫生统计数据采集与决策支持系统”收集的2002年－2011年年报数据进行分析。 结果 10年来，四川省基层医疗卫生机构医疗服务数量增加，效率提高，药费占医药费用的比例下降。 结论 10年卫生改革的有关政策特别是新医改的实施，对基层医疗卫生机构医疗服务起到较大的推动作用，四川省“保基本，强基层”的战略目标正在逐步实现。
At present, the conclusion of technical appraisal of medical malpractice is the key to decide and deal with medical malpractice. The initiation mode of technical appraisal may be entrusted by both parties involved, handed over by the healthy administration department, or designated by the People＇s Court. Because it exerts a direct impact on the result of medical dispute, the conclusion of technical appraisal must undergo examination by the medical association, the health administration department, and the court. The conclusion plays different roles in cases of compensation for medical personal injury and of medical service contract disputes. To interpret and apply the technical appraisal and its conclusion correctly, we have to understand clearly the nature of technical appraisal of medical malpractice, recognize and handle skillfully the relation among identification-related issues such as the judge＇ s personal discretion, signature of the appraiser, the appraiser＇ s being present at the hearing and questioned, and the expert witness.
提高医疗服务质量、确保病人安全是当前医学教育及培训面临的巨大挑战。今天的医生及医务工作者 应具备良好的沟通能力,掌握如何在临床实践中鉴别、预防和处理不良事件及接近过失事件(near misses),如何使 用当前获得的证据及相关信息,如何安全有效地在团队中工作,如何在实践中教授和学习病人安全知识,如何根据 认可的伦理原则服务公众。
This article takes the regional cooperative medical service practice provided by the West China Hospital of Sichuan University as example, analyzes several problems with regional medical service practice in western region based on the introduction of the general situation and system of regional cooperative medical service provided by the West China Hospital. The problems are:lack of motivation to promote regional collaborative medical care, serious lag of policies, and lack of stratified configuration of tests/exams quality standards and construction standards of medical information system platform. This article puts forward the key point to promote western regional medical collaboration:strengthening government dominance, and establishing suitable medical insurance system and regional laboratory examination centre.
ObjectiveGiven the relatively limited resources available for tumor radiotherapy, the reengineering theory to the tumor radiotherapy process of a tertiary hospital is applied to improve the efficiency of medical service, shorten patient waiting time and improve patient satisfaction. MethodsThe tumor radiotherapy process of a tertiary hospital was studied from January 2017 to September 2018. The indicators such as efficiency and satisfaction were analyzed before reconstruction (from January to December 2017) and after reconstruction (from January to September 2018). ResultsAfter radiotherapy process reengineering, on the one hand, the medical efficiency was improved: the number of new patients for radiotherapy per month rose by 16.58% (P<0.05), and the number of daily radiotherapy increased by 5.80% (P<0.05). On the other hand, the patient treatment process became more concise: the preparation time was shortened from 2-3 days to 1 day, while the waiting time for radiotherapy was shortened by nearly 10 days, and the overall satisfaction of patients increased from 64.17% to 83.55%. ConclusionIt can improve the operation efficiency of tumor radiotherapy and improve patient satisfaction under the condition of relatively fixed resources through the reconstruction of the information-based tumor radiotherapy process.
Objective To understand the residents’ demands and utilization of the community health services and provide a basis for the construction of reasonable medical service system. Methods From July to September 2015, a purposive sampling questionnaire survey on general team mode service to bring benefits to the community residents was conducted in 20 provincial-level administrative regions of the country. SPSS 13.0 software was used for data analysis. Results A total of 1 300 questionnaires were distributed, and 1 273 valid questionnaires were recovered. In the 221 residents who were aware of the composition of general team, the awareness rate of general team composed of traditional Chinese medical doctors and gynaecologists/pediatricians was low (70.14%, 75.11%, respectively). The awareness rate of medical services including disease diagnosis and treatment, health consultation, health education and prescription in the 1 273 residents was 70.46%, 61.19%, 59.62% and 67.56%, respectively; the residents’ top five willing to accept medical services was prescribing medicine (77.77%), infusion (74.08%), health consultation (73.21%), health education (70.54%), and planned immunization (64.49%). The biggest change of the 433 patients with chronic diseases before and after treatment in the community was the increase in self-health management (70.67%) and the healthy lifestyle improvement (56.35%). Conclusion Community general team should be oriented by the objective needs and real demands of the residents; based on the ability of medical services supply, the adjustment of the key points of medical services should be made and the rational use of medical services should be guided for the residents.