主题框架分析法是一种建立在表格基础上的分析方法,主要包括资料整理及分析两个步骤,其中资料整理过程又包括确定分析主题、资料标记、资料归类以及资料的总结或综合等内容。由于主题框架分析过程具有严密性和透明性的特点,目前被认为是兼顾科学性和可操作性的较好的定性资料分析方法。该文结合实例对该方法进行了介绍。

This paper analyzed not only the forming and characteristic of new medical service system but the function and relationship among the subsystem at different levels and systemically analyzed the economic characteristic of health resources allocation and its main influencing factors. It also put forward the objectives and principles of constructing new medical service system, the theory and methods of health resources allocation. Thus the reference basis could be provided which is helpful of scientifically constructing and making development plan of new regional medical organization.

With establishing new urban medical care system at two level which has suitable on size and composition, optimized structure, higher efficient operational medical center and community health service center.The multiple recombination of medical institution emerged.This paper aimed at summarizing on several forms and effect of the united recombination occurred in Shanghai health systems reform.Some principles which should be followed during the development of constituting medical care system were discussed and the suggestions on modified adequate policy.

From the characteristics of medical insurance, its high risk and main risk factors were discussed and analyzed in this paper. After major risks that Shanghai social medical insurance is presently confronted with were explored,risk defense system was put forward.

Government has a responsibility to take leadership to overcome obstacles, such as insufficient input, arbitrary approach, vested interests, relevant policy hindrance, barriers between different sectors, irrational industry structure to the industrialization of medical and healthcare sector, to promote the management system reform of medical institutions, to increase the efficiency of medical services for the people's maximized utmost interest.

目的 预测我国31个省（自治区、直辖市）医院卫生资源的短期配置情况。方法 用一般线性回归模型拟合2010—2018年各省（自治区、直辖市）的床位数、医师数、护士数和常住人口数，用均数法估计床位使用率，用比例法预测2019—2021年综合重症监护室（intensive care unit，ICU）的床位数、医师数、护士数、呼吸机数和体外膜氧合（extracorporeal membrane oxygenator，ECMO）数。结果 2021年，我国每千常住人口床位数为5.42张，每千常住人口医师数为1.64人，每千常住人口护士数为2.54人。区域床位配置差异较大，东北、西北及中部地区的床位数高于南部地区，医师、护士分布较为均匀。每10万常住人口综合ICU床位数为4.37张，地区综合ICU床位配置数量与地区人口密度成正比，综合ICU的医护数、呼吸机数和ECMO数明显不足。结论 我国医院卫生人力资源较为缺乏。综合ICU的资源缺口较大，应加强综合ICU的资源配置，并将综合ICU作为新型冠状病毒疫情防控及未来其他新发、突发传染病防控的重点对象。

本文概述“新医科”背景下医学影像学学科特色和教学挑战,以复旦大学附属肿瘤医院为例,通过夯实师资队伍建设、深耕临床科研实践、优化教育教学体系等举措,培育“新医科+”课程思政、打造“多学科+”导学团队、提高“全影像+”人才培养,并结合国家政策文件要求和新医科发展趋势,展望未来医学影像教育教学发展提出策略建议,以期为我国医学影像人才培养提供一定的借鉴参考。

Recently the application of qualitative methodology in public health field is becoming popular. There is essential difference between qualitative representative" and reach a complete construction through research on several purposively selected samples.

众所周知,新出台的医改方案引起了全社会的广泛关注和热议。这次采访是希望都教授能作为一名政策研究者,谈谈对新医改方案的总体看法。

This paper reviews the health economic reforms in the las 15 years in Shanghai and summarizes its achievements. It points out that social and economic benefits are rising gradually, and health care service is entering the phase of harmonious develop-ment with the social economy by reforms of health care pricing and policy of "Global budgt and structure adustment". Secondly, the paper analyzes the main problems existing in health economics. These problems mclude chiefly the following three points. They are:1) coexistence of insufficien health input and wastage; surplus global health resources and uneven struture; 2) lack of awareness on concept of charge and cost in traditional pratice behavior; 3) the aftereffect of hospital-department profit-accounting system, distribu-tion of bonus for overwork and incomes from profit on drugs. Finally, some suggestions to deepen reform are put forward to solve the above problems. 1) To implemen policy of "raising effciency by depletion of staff numder and re-assigment of those off from post" in health facilities combined with regional health planing. 2) To set up clinical guldelines, stanard charges An expenditures for essen-tial health care of diseases. 3)To cancel bonus for overwork, and to perfect the hospital-department profit-accounting system. 4)To implenlent poicy of separae management of medical services and drugs, and to perfect the reimbursement mechanism.

"二战"结束前,英国的一些政客就已开始考虑如何建立战后新秩序的问题。作为设想之一,1944年他们提出了建立国家卫生服务制度的口号和建议,核心思想是:(1)应对每个人提供广泛的医疗服务;(2)卫生服务经费应该全部或大部分从国家税收中支出;(3)卫生服务体系应由初级服务、社区服务和专科服务三个部分组成。

Concern with human and financial consequences of disease has increased over the past three decaeds as the aging of population has led to a greater prevalence of disability in developed countries and spiraling health care costs have made it difficult to meet the increasing needs for services Traditional analyses based on mortality and morbidity are in adequate to assess the situation in which people who are not ill are limited in their abilities to function in a manner considered to be normal. Thus this article discusses DALY in detail, which is a new indicator to measure the burden of disease.

经济合作和发展组织(Organization for Economic Cooperation and Development,OECD)的成员国包括了主要的工业化国家。经济合作和发展组织每年都会公布其成员国卫生保健体系的统计数据,这是研究国际卫生服务的很好材料。《OECD卫生统计数据1999:29个国家的比较分析》已在巴黎出版,其中提供了1998年23个国家的卫生统计信息(缺匈牙利、韩国、墨西哥、波兰、葡萄牙和土耳其6国的资料)。本文扼要地介绍OECD国家卫生费用和卫生服务的最新信息和变化趋势。

Pharmacoeconomic guidelines come as a response by some governments to solve problem of rising pharmaceutical expenditure and could be seen as an approach to contain costs and improve resource allocation under a restricted health resource. By a comparative study on background, similarities and differences among four countries' guidelines for pharmacoeconomic evaluation in Europe, we figure that the making of pharmacoeconomic evaluation guideline should meet the needs of country backround, health care system and policy targets. Guidelines need revising and developing.

Experience on payment of innovative health technology in the national health insurance system of South Korea was summarized,especially innovative drugs and innovative health technology under diagnosis related groups(DRGs) payment method. On this basis,some suggestions on perfecting the policy of pricing and payment for innovative health technology in China were put forward:introducing health technology assessment concept and methods,establishing multisectoral cooperation on decision-making conversion in health technology assessment,and adding drugs in use that were not cost-effective or not sufficiently evidence-based(orphan drugs and anti-cancer drugs for instance)to risk-sharing agreements to ensure patients' accessibility to drugs.

Objective:The quality of life in chemotherapeutical patients with lung cancer was measured by the FACT-L Chinese version 4.0 in order to evaluate its reliability, validity and responsiveness as well as the influence of chemotherapy for those patients.Methods: QOL data was measured three times from 28 in-patients with lung cancer by using the FACT-L Chinese version 4.0.The factor analysts combined with the cluster analysis were used to evaluate the structural validity of the Scale.Results & Conclusions:The instrument had better reliability, validity and responsiveness and could be used to measure QOL for Chinese patients with lung cancer.The results showed significant difference in quality of life during the chemotherapy.

This paper summarized the development models of private hospitals in Shanghai.This models were evaluated through SWOT method.The existing issues were identified based on focus group discussion and case study.Then the determinant factors were discussed.

That paper analysis the health care system of America, Canada and Australian.Compare to the contained service, finance income,transmit system to the U.K, France, Germany and New Ireland. Then we get the health care system reformatory advice in China.

Pharmaceutical economics mainly studies the supply and demand of pharmaceuticals, pircing, policies and interventions, which provides the theory basis and international experiences for pharmaceutical policy reform in developing countries.

该文统计了上海市首次鉴定的177例医疗事故,对引发医疗事故的诸多原因进行了分类,认为手术不当、漏诊误治、未查常规、告知不当等是引发医疗事故的主要原因,并从医疗技术、职业责任和医院管理等三个方面进行了探讨。

Objectives: To assess the economic burden of type 2 diabetes mellitus in Shanghai.Methods: Economic burden of type 2 diabetes mellitus includes direct medical cost, direct nonmedical cost and indirect cost.Results: Direct medical cost of type 2 diabetes mellitus per capita in Shanghai in 2003 was about 2349.56 yuan including 1413.88 yuan for outpatient services. Average hospitalization expenditure arrived 5641.57 yuan. Economic burden of type 2 diabetes mellitus was estimated 2.896 billion yuan in Shanghai in 2003.

This paper mainly analyzed the characters of moral hazard after matter occurrence, and relationships between moral hazard, medical service utilization and medical insurance price. The concept of welfare lost on moral hazard has been presented. The author thinks that the ways of overcoming moral hazard include of administrative medical treatment and the design of payment system.

以色列基本情况以色列人口720万(2006年以色列中央统计局数据,包括约旦河西岸、加沙地带和东耶路撒冷犹太居民),其中犹太人为500多万,占人口的绝大多数,还有阿拉伯人、德鲁兹人及其他人。人口自然增长率1.7%,人口密度为294人/km²。其社会是由各种各样的宗教、文化及社会传统组成。

Performance assessment is an important approach in the hospital management.Based on the guidelines "Shanghai comprehensive hospital management and assessment criteria" and "hospital category assessment criteria" combine with their own practice,the author proposed " key Performance Indicators"(KPI),it has played an important role in the field of hospital assessment of sustainable development.

Author explained the definition and connotation of equity and introduced the categorizations of equity in health care and their criteria.Based on the situation analysis on health care development, author indicated the social-economic reforms and development made the inequity in health and health care increasingly extruding in China and put forward the importance and necessity of research on equity in health care.

Through literature review, this paper illustrates the emergence and development of DRGs around the world. As a conclusion, some advanced experiences of DRGs are also provided.

In order to compare the expenditure and effect of homodialysis and peritoneal dialysis,the study team investigated some dialysis patients in First Affiliated hospital of Zhejiang University and Hangzhow Chinese Traditional Hospital.The results showed that:(1) The annual and total expenditure of peritoneal dialysis is less than the hemodialysis;(2) It takes a longer time interval for the patients of peritoneal dialysis to visit the hospital than the hemodialysis patients which means more convenience to the patients;(3) The peritoneal dialysis improves their quality of life is better than the hemodialysis patients;(4) The hospitalization rate of complications caused by peritoneal dialysis is higher than hemodialysis.It had proposed that actively apply peritoneal dialysis and improve quality to reduce the rate of complications.

Objective: To find out the relationships between input and output in the health inspection and supervision system;Methods: Structural equation model;Results: It suggests that the resource allocation plays a positive role in capacity building and function fulfillments.The path coefficients respectively are 1.03 and 0.74;Conclusions: Government should pay more attention to the input in health inspection and supervision system.The results applying SEM could achieve that with traditional methods.

The methods of focus group discussion,literatures review and case study were employed to explore the crucial problem and its causes concerning the nursing resources allocation in China.The study results showed that the crucial problem concerning nursing resources managements is the deficiency of nurses in the nursing post,which resulted from four factors:1.To some extent,the human resources allocation of nursing was ignored by the hospital managers;2.The standards to determine nursing workload has been greatly changed since 1980's;3.There was a great variation in direct nursing time between different medical departments;4.The indirect nursing time has been greatly increased as patients demand.Suggestions:In order to solve the problem of nurse deficiency,it should be highlighted that we should scientifically calculate current nursing workload.It was crucial to make clear the contents of direct nursing and indirect nursing service, take the department difference into account,rationalize nursing grading,and set nursing post by need.To take non-technique works and low-level technical works away from the nursing working content should be considered as a good way to increase the effective supply of nursing manpower.

In 2016，Shanghai was listed in the second batch of pilot cities to practice the national comprehensive health reform at the provincial level. To deepen the health reform，enhancing health service capability of grassroots medical institutions is a basis，transforming mechanism is a key，and establishing collaboration is a support.

Payment according to categories of illness is a strategy in order to alleviate the issue of difficult and expensive access medical care. This reform system it is in the pilot stage under most of the hospitals. Low prices payment is a serious challenge for maintaining the normal operation of hospital.

The Healthy China strategy puts forward new requirements for the training of medical talents. Medical education must also focus on people's health and resonate with the development of the times. Under the vision of comprehensive health,multi-disciplines should be deeply integrated and "combination boxing" should be played for the training of medical talents. This paper analyzes the "three changes" of medical personnel training,namely,the training objectives of medical education are from "treating diseases as the center" to "health as the center",the training plan of outstanding doctors is from "version 1.0" to "version 2.0",and the training of top-notch innovative medical personnel is from "medicine" to "medicine+X". Summarizings the three first-class achievements of medical training mode reform in Fudan University in recent years,namely,first-class discipline construction,undergraduate major and teaching achievements, the author puts forward three modes of training top innovative talents in medicine in China,namely "strong medical plan", "talent youth plan" and "MD+PhD" dual degree plan.

本文参考医学门类一级学科评估结果,选取北京大学、北京协和医学院、上海交通大学、四川大学、浙江大学和中山大学等顶尖医学院校,以复旦大学为切入点,比较分析研究我国顶尖医学院校近年来医学人才培养质量和学术影响力。

Based on training objectives, specialty setting of training disciplines, talent training and scientific research, education and teaching reform as well as service requirements, etc., the strategies and paths in training talents are analysed. Centering around “strengthening the national public health emergency management system”, the objective for training public health emergency management talents is set；the equal emphases are laid on the graduate training both for academic degrees in public health emergency management and for professional degrees；the talent training, scientific research and serving the society are strengthened by integrating them into a joint action；and “four measures” of formulating training programs, preparing curriculum materials for training courses, unveiling education-practice platforms, and selecting research subjects in line with key demands are launched.

建设什么样的现代医院管理制度和如何建设现代医院管理制度是推进现代医院管理制度中必须反复思考、不断深究的两个基本问题。在我国背景下，现代医院管理制度是一种与社会主义市场经济体制相适应的公立医院制度安排，亦是我国公立医院改革的目标模式。制度化放权、治理有效、管理科学是其三个突出的特征和要求。具体而言，在组织形式上，它是一种特殊的公法人制度，由此实现制度化的放权；在制度装置上，它包括一系列相互关联的治理机制，由此实现有效治理；在管理行为上，它意味着公立医院管理的科学化、精细化和专业化，由此实现管理科学。

This paper analyzed the basic theory and operate process of root cause analysis for medical adverse events.The authors proposed a viewpoint that medical adverse event is a part of medical cultural.It had advocated that to solve the problem of medical adverse events in a system thoughts.It is needed to build a sustaining patient safety environment for improving medical quality in root cause analysis.

Social marketing is the use of marketing principles and techniques to impact a target audience to accept,reject,modify or abandon their behavior for the benefit of individual,groups or society as a whole.The methods of social marketing are applied in tobacco control in Changqiao community.According to the market focus principle,the study applied different strategy among target population and made some effects in tobacco control.

该文通过对50多个民营医院发展资料的搜集和分析,归纳出了民营医院发展的六种模式,即民营企业资本向民营医院延伸、投资机构购并国有医院、公立医院整体转让给民营企业、公有医院托管给投资集团、村办民营医院及以拍卖、有偿转让为主要内务的产权过渡,并提出应尽快将民营医院的发展推上改革前台的建议。