scholarly journals 中國醫院經營面臨的主要問題及對策

Author(s):  
Hao WANG

LANGUAGE NOTE | Document text in Chinese; abstract also in English.即將到來的新世紀,使中國醫院經營面臨著許多新的問題和嚴峻挑戰。首先,醫學教育與知識經濟的發展很不適應。其次,醫院設備與社會需要很不適應。第三,醫院經營模式與市場運行很不適應。第四,醫療服務模式與人口結構變化很不適應。第五,醫務勞動補償模式與醫務勞動消耗很不適應。醫院經營面臨的上述問題是涉及國家與醫院兩個方面多層次的發展戰略與策略的問題,也是涉及全國各行各業和廣大人民切身利益的問題。解決問題的根本出路在於改革。首先,應真正解放思想和更新概念,擺正衛生事業在國民經濟和社會發展中的地位。第二,應改革醫學教育制度和內容,把醫學高科技教育作為學位教育和繼續教育的重點;同時搞好人事制度改革。第三,應積極地引進高新技術設備,努力提高醫院基本設施和診療儀器的現代化水平。第四,應盡快改革醫院經營體制,建立和完善新的經營模式與經營機制。為此,應着重搞好醫院布局和組織結構調整,以及醫療服務結構的調整;實行醫院的所有權與經營權分離,讓醫院法人組織和法定代表依法自主經營;按照市場經濟規律的要求,建立和完善醫院經營的動力機制、醫療技術機制、自我約束調控機制、法人領導機制。第五,應改革醫療衛生服務體制,建立適應人口結構和疾病譜變化的新的防治服務模式。為此,應擴大預防工作範圍和擴大保健人群範間,建立醫院、社區、家庭相結合的醫療衛生保健服務模式。At the threshold of a new millennium, China's hospitals face a series of problems in their management. This essay attempts to analyze these problems and explore appropriate solutions to them.First, the contemporary Chinese pattern of medical education is not suitable to the rapid growth of medical knowledge. Ever increasing new theories, methods, and technologies in diagnosis, therapeutics, and prognosis promote the quality of medical care tremendously. However, most health care professionals in China's hospitals are unable to follow up-to-date developments of medical information. Very few medical scientist s or physicians in China's medical care field are recognized as leading or authoritative in the world. The solution to this problem calls for an emphasis on and respect for the values of human resources in medicine, improvement of current medical education, and establishment of a mechanism for reeducating medical professionals.Second, the current pattern of hospital management is not suitable to the market. The manner of hospital management in China is the product of China's central-planning mode of economy. Each hospital belongs to a central or local government, or to a state-owned enterprise.It does not have power to make decisions about its own management. Neither does it care about cost-benefit balancing because hospital financing relics entirely on government revenue. However, new problems have occurred during Chin's transition to a free market economy from the centrally-planned economy since the 1980s. Though many enterprises have been allowed to manage themselves according to the circumstances of the market, hospitals have been emphasized as welfare providers that cannot be allowed to make money. The government continues to set strict low prices for medical services and, at the same time, does not provide sufficient financing to hospitals. As a result, hospitals have to make their ends meet by increasing unnecessary medication prescriptions and overusing high-technology diagnostic and therapeutic instruments. Overtreatment and waste in hospital care have generated universal complaints. Accordingly, serious reform must be made in the direction of appropriately adjusting the ownership of hospitals as well as changing the ways of hospital management so that they can adapt themselves to the need of the health care market.Finally, there are other serious problems involved in China's hospital management. These problems are multi-faceted. For instance, medical facilities and instruments have not been up-to--dated and cannot meet the needs of patients in medical care, the structure of hospital services does not suit the need of the ever-increasing numbers of senior citizens in China, etc. The only way to resolve these problems is reform. This requires ordinary Chinese citizens as well as Chinese leadership to free themselves from the restrictions of the previous centrally-planned economic theory and to seek a new health care model.DOWNLOAD HISTORY | This article has been downloaded 15 times in Digital Commons before migrating into this platform.

10.2196/16048 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e16048 ◽  
Author(s):  
Ketan Paranjape ◽  
Michiel Schinkel ◽  
Rishi Nannan Panday ◽  
Josip Car ◽  
Prabath Nanayakkara

Health care is evolving and with it the need to reform medical education. As the practice of medicine enters the age of artificial intelligence (AI), the use of data to improve clinical decision making will grow, pushing the need for skillful medicine-machine interaction. As the rate of medical knowledge grows, technologies such as AI are needed to enable health care professionals to effectively use this knowledge to practice medicine. Medical professionals need to be adequately trained in this new technology, its advantages to improve cost, quality, and access to health care, and its shortfalls such as transparency and liability. AI needs to be seamlessly integrated across different aspects of the curriculum. In this paper, we have addressed the state of medical education at present and have recommended a framework on how to evolve the medical education curriculum to include AI.


2019 ◽  
Author(s):  
Ketan Paranjape ◽  
Michiel Schinkel ◽  
Rishi Nannan Panday ◽  
Josip Car ◽  
Prabath Nanayakkara

UNSTRUCTURED Health care is evolving and with it the need to reform medical education. As the practice of medicine enters the age of artificial intelligence (AI), the use of data to improve clinical decision making will grow, pushing the need for skillful medicine-machine interaction. As the rate of medical knowledge grows, technologies such as AI are needed to enable health care professionals to effectively use this knowledge to practice medicine. Medical professionals need to be adequately trained in this new technology, its advantages to improve cost, quality, and access to health care, and its shortfalls such as transparency and liability. AI needs to be seamlessly integrated across different aspects of the curriculum. In this paper, we have addressed the state of medical education at present and have recommended a framework on how to evolve the medical education curriculum to include AI.


1995 ◽  
Vol 31 (2) ◽  
pp. 121-141 ◽  
Author(s):  
Maria M. Talbott

Complaints of older widows regarding their husbands' health care are investigated in this study. Sixty-four older widows were interviewed several years after their husbands' deaths. The deaths occurred in the early 1980s. Forty-six percent reported problems in the health care their husbands had received. Widows whose husbands had not known in advance that they were going to die were more likely to complain about their husbands' medical care than widows whose husbands had known in advance. Complaints were also related to the frequency of several symptoms of grief. The widows' complaints about their husbands' care focus on quality of care, perceived insensitivity on the part of health care professionals, lack of control over the death, and the organization of services.


2013 ◽  
Vol 5 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Sawsan Abdel-Razig ◽  
Hatem Alameri

Abstract Many nations are struggling with the design, implementation, and ongoing improvement of health care systems to meet the needs of their citizens. In the United Arab Emirates, a small nation with vast wealth, the lives of average citizens have evolved from a harsh, nomadic existence to enjoyment of the comforts of modern life. Substantial progress has been made in the provision of education, housing, health, employment, and other forms of social advancement. Having covered these basic needs, the government of Abu Dhabi, United Arab Emirates, is responding to the challenge of developing a comprehensive health system to serve the needs of its citizens, including restructuring the nation's graduate medical education (GME) system. We describe how Abu Dhabi is establishing GME policies and infrastructure to develop and support a comprehensive health care system, while also being responsive to population health needs. We review recent progress in developing a systematic approach for developing GME infrastructure in this small emirate, and discuss how the process of designing a GME system to meet the needs of Emirati citizens has benefited from the experience of “Western” nations. We also examine the challenges we encountered in this process and the solutions adopted, adapted, or specifically developed to meet local needs. We conclude by highlighting how our experience “at the GME drawing board” reflects the challenges encountered by scholars, administrators, and policymakers in nations around the world as they seek to coordinate health care and GME resources to ensure care for populations.


1929 ◽  
Vol 25 (5) ◽  
pp. 570-573
Author(s):  
R. A. Luria

The issues of raising the qualifications of doctors occupy a prominent place in the Soviet health care system and it can be said without exaggeration that improvement is currently the task of each individual doctor, both in the periphery and in the center. This task is given to him every day by life itself, starting with the exuberant growth of the population's needs for qualified and special medical care and ending with a huge network of preventive and medical institutions of the People's Commissariat for Health, constantly in need of not only doctors in general, but especially demanding specialists who are at the height of modern medical knowledge. The institutes for advanced training of doctors, numerous special scientific Institutes of the People's Commissariat of Health, various kinds of individual courses of all kinds are conducting intense and fruitful work to replenish the knowledge of a doctor and to develop scientifically educated specialists in all fields of medicine


2015 ◽  
Author(s):  
Elizabeth G Nabel

The role of a physician as healer has grown more complex, and emphasis will increasingly be on patient and family-centric care. Physicians must provide compassionate, appropriate, and effective patient care by demonstrating competence in the attributes that are essential to successful medical practice. Beyond simply gaining medical knowledge, modern physicians embrace lifelong learning and need effective interpersonal and communication skills. Medical professionalism encompasses multiple attributes, and physicians are increasingly becoming part of a larger health care team. To ensure that physicians are trained in an environment that fosters innovation and alleviates administrative burdens, the Accreditation Council for Graduate Medical Education has recently revamped the standards of accreditation for today’s more than 130 specialties and subspecialties. This chapter contains 6 references and 5 MCQs.


2002 ◽  
Vol 8 (3) ◽  
pp. 131-137 ◽  
Author(s):  
Michael Allen ◽  
Joan Sargeant ◽  
Eileen MacDougall ◽  
Michelle Proctor-Simms

Videoconferencing has been used to provide distance education for medical students, physicians and other health-care professionals, such as nurses, physiotherapists and pharmacists. The Dalhousie University Office of Continuing Medical Education (CME) has used videoconferencing for CME since a pilot project with four sites in 1995–6. Since that pilot project, videoconferencing activity has steadily increased; in the year 1999–2000, a total of 64 videoconferences were provided for 1059 learners in 37 sites. Videoconferencing has been well accepted by faculty staff and by learners, as it enables them to provide and receive CME without travelling long distances. The key components of the development of the videoconferencing programme include planning, scheduling, faculty support, technical support and evaluation. Evaluation enables the effect of videoconferencing on other CME activities, and costs, to be measured.


2000 ◽  
Vol 6 (2-3) ◽  
pp. 367-371
Author(s):  
B. Larijani ◽  
O. Ameli ◽  
K. Alizadeh ◽  
S. R. Mirsharifi

We aimed to provide a prioritized list of preventive, diagnostic and therapeutic procedures and their appropriate classification based on a cost-benefit analysis. Functional benchmarking was used to select a rationing model. Teams of qualified specialists working in community hospitals scored procedures from CPTTM according to their cost and benefit elements. The prioritized list of services model of Oregon, United States of America was selected as the functional benchmark. In contrast to its benchmark, our country’s prioritized list of services is primarily designed to help the government in policy-making with the rationing of health care resources, especially for hospitals


2021 ◽  
Vol 65 (5) ◽  
pp. 411-417
Author(s):  
Sergei S. Budarin ◽  
Andrei V. Starshinin ◽  
Andrei A. Tyazhelnikov ◽  
Elena V. Kostenko ◽  
Yulia V. Elbek

Introduction. The study of public opinion as the basis for strategic planning of the activities of medical institutions is more relevant than ever, as it allows finding ways to solve the problems of ensuring the availability and satisfaction of citizens with medical care. Purpose. Comparative assessment of the availability of primary health care based on the results of a sociological study of public opinion and data from the Unified Medical Information and Analytical System of the City of Moscow (UMIAS). Material and methods. To study public opinion, the practice of population survey was used, which was conducted through direct interviewing with filling out questionnaires of visitors to Moscow polyclinics and the method of questioning doctors based on a questionnaire developed by researchers. To analyze the data, the authors used general scientific methods of cognition, including the dialectical method, a systematic approach, logical correspondence and harmonization, detailing and generalization. As part of the study, the index value of the patient loyalty to the medical institution (MI) was calculated according to Net Promoter Score (NPS) method as the difference between the share of the “Promoters” group and the share of the “Critics” group in the total number of responses. Results and discussion. The established correlations indicate the opinions of doctors and citizens to coincide and the UMIAS data on the issue of assessing the accessibility of admission of level 1 doctors for citizens. Based on the results of a sociological survey, the number of dissatisfied patients is mainly affected by managing medical care and its availability. The study confirmed that the higher the availability of an appointment with a level 1 doctor, the lower the number of visits the doctor on duty. Conclusion. The conducted research has shown the practicality of an integrated approach to evaluating the activities of medical organizations based on the results of public opinion research and UMIAS data.


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