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。

回顾上海市预防接种网络预约接种服务（以下简称“网约服务”）的发展历程，成绩斐然，网约服务方便接种门诊规划工作，方便受种者，特定疫苗预约功能方便紧缺疫苗管理和接种、助力完成新型冠状病毒疫苗接种。针对已建成的上海市预防接种网约服务系统的局限性提出改进建议方案，旨在未来进一步优化上海市预防接种网约服务，提高疫苗接种可及性及用户服务满意度。

目的 了解我国省级普惠式健康险（普惠险）发展现状，厘清基本医疗保险、普惠险和百万医疗险的区别，分析普惠险当前存在的问题并对其未来发展提出可行性建议。方法 在31个省（自治区、直辖市）人民政府网、医疗保障局、卫生健康委员会、民政厅、人力资源和社会保障厅等政府官网以“普惠险”“惠民保”“补充医疗保险”为关键词检索相关政策文件和信息，同时配合各地的“本地保微信公众号”及各普惠险投保平台，搜集省级普惠险的参保信息以及具体的保障内容，时间截至2021年10月15日。结果 截至2021年10月15日，31个省级行政区中有19个地区共推出26款省级普惠险，保障责任集中于医疗保险目录内住院费用和特殊药品费用。普惠险的区域性、普惠性品以及特殊药品的保障是其与百万医疗险的主要区别。当前普惠险发展的问题体现在“两高一低一同”，即免赔额高而赔付限额虚高、可持续性低以及产品同质化严重。结论 建议医疗保障部门对普惠险进行背书和指导，合理设置省级普惠险的赔付标准和保障内容，提高普惠险产品的可持续性和抗风险能力；商业保险公司应加速迭代产品，适应市场需求，脱离同质化。

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。

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.

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。

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.

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 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.

目的 调查上海某区区属公立医疗卫生机构在岗护理人员的离职倾向并分析其影响因素，为提升护理队伍的稳定性提供参考。方法 采用一般情况调查表和离职倾向量表对上海某区区属公立医疗卫生机构中一半的护理人员进行匿名问卷调查，共收集问卷3 756份，最终纳入分析3 206份。结果 调查对象的离职倾向得分中位数（第25百分位数，第75百分位数）为11.0（6.0,14.0）分，离职倾向总体较高。不同机构类型、年龄、婚姻状况、最高学历、工作年数、聘用形式、职称、月均收入的护理人员的离职倾向得分差异分别有统计学意义（P ＜ 0.05）。多因素分析结果显示，机构类型、年龄和月均收入是影响护理人员离职倾向的主要因素（P ＜ 0.05）。结论 上海某区区属公立医疗卫生机构在岗护理人员离职倾向总体较高。就职于二级综合医院、年轻、低收入的护理人员应成为重点关注人群。建议二级医疗机构结合政策导向发展自身：营造良好的组织氛围，变革领导方式；合理开源，公平分配绩效，以提升护理人员的职业认同感、拓宽护理人员的发展路径，提高护理人员的收入。

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。

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.

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.

德国政府对DRG制度最早的研究始于1984年,当时联邦政府委托Emst和Whinney教授以及一个合作医院共同学习美国的DRG制度。Emst和Whinney教授经研究后,认为DRG制度在医院的接受程度较低,而且将医疗过程与成本、费用等经济因素过分地结合,因此认为德国在近年内不宜实施。

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.

"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。

During recent years, there are many reports and debates regarding the unreasonable higher prices of hospital drugs compared with the prices in retail pharmacy. In order to find out whether it is the case and how much the difference is, this report drew comprehensive comparison between drug prices and categories in hospital outpatient pharmacies and in retail pharmacies in 4 provinces. Policy recommendations were proposed by the writer based on the comparison.

It is necessary for making allocation standard of hospital bed and health planning to calculate the number of rational hospital beds in an area.The allocation number of hospital bed is unrational without high bed utility efficiency and rational bed allocation structure as a prerequisite for calculation.In this study according to analyzing the survey data and statistics data in Wei Hai, we calculate theoretical allocation number of hospital bed with the above prerequisite and adjustment number based on theoretical value and demand method forecast in order to provide information on calculation method and process of hospital bed allocation and analysis.

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.

Health material resources include hospital bed, health equipment and health premises et al. Hospital beds are the basic and the most important part of health material resources which are also used as a key criterion for calculating health resources allocation. The authors identified the method of calculating hospital bed allocation and its mathematical model and calculate the standard amount of hospital bed allocation in Sichuan province from year 2001 to 2005. The method mentioned above is also applied to calculate the standard hospital bed allocation in 21 cities or municipalities.

The shortage of nursing human resources allocation in hospital is serious,which affects the quality of nursing care as well as the stability of the nursing staff team.The paper described the current situation of the nursing human resources and analyzed the reasons that have caused.At last,it proposed strategies that can improved the situation of nursing human resources allocation in hospitals.

随着大数据、云计算、人工智能及语义网等信息技术的日趋成熟,基于数据驱动的信息挖掘及信息资源整合成为各领域信息化探索的方向,也推动档案领域管理方法的创新。面对内容庞杂的医院医疗专家档案信息资源,研究运用人工智能及语义分析等技术,进行信息挖掘,通过本体建模、知识抽取、知识融合等,构建以医院医疗专家档案为中心的知识图谱,不仅能进一步实现医疗专家档案的信息化管理,也可为顺应信息化时代智慧医院的发展趋势,推进医疗领域人才建设、医疗事业高质量发展服务。

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。

目的:探索对基层医院医疗质量监管的方法。方法:对近几年医院医疗质量监管的做法进行回顾性分析,结合文献进行总结。结果:通过健全完善和落实各项制度,依托质控网络,发挥专家专业优势,采用定期和不定期的突击检查,确保医疗质量。结论:医疗质量管理是医院管理的核心工作,医疗质量监管已成为各级卫生行政管理部门必须长抓不懈的工作。

System reform of public hospital is an impotrant and difficult part of health service system reform. This article analyzes the system reform models of public hospital and its impact on the health service system. Furthermore, the corporation model was stressfully discussed.

目的 提高公共卫生干预研究知情同意书的完整性和规范性,保障研究参与者的合法权益。方法 汇总整理本机构2016年1月—2023年8月进行初始审查的公共卫生干预研究项目的伦理委员会审议决议,根据自拟的“知情同意书审查要素表”,对相关问题进行统计分析。结果 进行初始审查的39项公共卫生干预研究项目,知情同意书存在问题的项目共有36项（占92.3%）。主要问题包括干预试验内容告知不全（占91.7%）,干预试验费用承担者及补偿措施的告知模糊（占38.9%）,权益和风险的告知不充分（占55.6%）,个人信息和生物样本收集、使用及保护措施的告知不全（占30.6%）,知情同意书语言表达不规范（占27.8%）。结论 本机构公共卫生干预研究的知情同意书撰写仍存在很多问题,干预试验的相关各方可采取多种措施以提高知情同意书的完整性和规范性。伦理委员会可以向研究者提供知情同意书撰写模板,加强审查能力,根据审查要素表编写伦理审查指引,提高审查效率和质量,保护研究参与者的合法权益。

商品经济社会里,劳动者劳务价值的补偿是通过收入报酬来体现的。在西方的一些发达国家,例如:美国、加拿大,医疗制度实行的是多元型医疗保险,医疗机构绝大多数为私人企业经营型,医生大多属于私人开业,独立于医院之外,因而对医疗卫生服务费用偿付方法相应地也分为对医师和对医院的偿付方法。

The objective, background and implementation of the appointment management system for stomatology department of Shanghai Tenth People's Hospital are expounded. The efficiency and experience of 6 year's application are being discussed to propose suggestion for the issue present today.

应用实际案例对医院成本分析方法及通过分析改进管理进行了阐述,旨在为医院进行成本分析并据此完善管理提供参考。

This paper describes the distribution of obstetrician and pediatrician in rural eastern, central and western China and analyzes the existing equity problem and then puts forward three suggestions:(1) to constitute and implement the Regional Health Programming to allocate the health manpower resource appropriately, (2) to enhance the quality of obstetrician and pediatrician, (3) to accelerate health reform to ensure the vulnerable population to gain access to health services. This study provides reference for the policy making of health administration.

The equity of health care is a key issue in the health care reformation. The paper deals with concept and measurement of the equity of health care, explore the reasons of reducing equity of health care, and provide policy suggestions for improving equity of health care.

在现行的医疗机构中,绝大部分医院属于公立医院,购置固定资产的资金来源主要通过财政专项补助、贷款、自有资金(修购基金)等多种渠道筹措,在归属上属于国有固定资产。如何管理好固定资产,充分发挥固定资产在医疗服务过程中的最佳效益十分重要。在笔者从固定资产财、账、物管理的角度分析,固定资产管理工作中存在的问题,并提出解决问题的对策建议。

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.

日本人口1.27亿,国民生产总值(GDP)为507.45万亿日元(100日元约等于7.5元人民币)。日本人的平均寿命男性77岁、女性84岁,是世界各国最高的。