老年流动人口的就医行为及影响因素研究

近年来,我国老年流动人口的规模持续上升。文章使用2015年全国流动人口动态监测调查数据,从门诊治疗和住院治疗两个方面出发,使用Logit模型和Heckman两步法检验分析老年流动人口的就医行为及其影响因素。结果显示,在患小病时,70岁及以上、以家庭其他成员收入为主要收入来源、家庭人均月收入水平较高、患有高血压或糖尿病的流动老年人选择门诊就医的可能性更高,差异有统计学意义(P<0.05)。在患需要住院治疗的疾病时,以离退休金/养老金为主要收入来源、自评身体健康的老年流动人口更有可能选择住院治疗。参加医疗保险的类型也对老年流动人口的就医行为存在着显著的影响。此外,外出务工、依靠子女和退休养老三类老年流动人口在门诊就医行为及其影响因素方面也存在显著差异。     

医院青年文化品牌塑造的路径探析

青年是医院的未来,引导青年医务人员树立坚定而充沛的文化自信是激发其积极性、主动性和创造性的重要方式。常州市第一人民医院以涵养文化自信为着力点打造青年文化品牌“青之源”,通过营造学习创新氛围、建设团日活动体系、搭建阅读分享平台、探索涵养青年文化自信的品牌塑造路径等方式,动力、活力、能力三源合流,为青年成长提供正向激励和人文滋养。     

The case of vegetovascular dystonia: inventing the most common Soviet disease

ABSTRACT

The paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general.     

‘Unfit for reform or punishment’: mental disorder and discipline in Liverpool Borough Prison in the late nineteenth century

This article examines how Liverpool Borough Prison, opened in 1855 as one of the largest local prisons in England to adopt the separate system, categorized and dealt with mental distress and disorder amongst its prison population in the late nineteenth century. High prison committal rates in Liverpool, alongside high levels of recidivism, especially among female prisoners, led to severe overcrowding and encouraged a harsh disciplinary regime. Exacerbated by the poor physical and mental condition of the prisoners, this produced a challenging environment for maintaining the separate system of confinement and prisoners’ mental well-being. While official figures for the rates of mental disorder in local prisons are not readily available, Liverpool Prison’s diverse and under-exploited archives and official reports indicate that insanity caused prison officials and visiting justices great concern, and many prisoners were declared unfit for the rigours of prison discipline. Our article explores the implications of the ever more punitive, deterrent and physically taxing penal policy implemented in the late nineteenth century on the minds of prisoners. Despite the heavy toll on prisoners’ mental well-being, such cases were often retained by prison medical officers reluctant to acknowledge the failure of the prison to deter, reform and redeem.     

Alarmed: sensory approaches to improving medical alarm systems

Medical alarms sound incessantly, loudly, and dissonantly, contributing to an already noisy ICU and OR soundscape, and ultimately harming both patients and staff. Sometimes triggered in error, the sheer number of alarms distracts health care professionals and results in sensory overload that contributes to hospital staff’s alarm fatigue. In turn, staff become increasingly likely to ignore alarms instead of acting on them. Furthermore, the patients’ sensitivity to alarms disturbs their hospital stay, raises their stress levels, and impedes their recovery process, with sometimes lasting effects. This article considers the sensory effects of hospital alarms and possibilities for redesigning future alarm systems, with the goal of eventually creating a more calming, less stressful, and safer hospital soundscape environment for all.     

多元医疗背景下藏族民众择医实践的人类学分析——以甘孜藏族自治州C村为例

择医实践是指当一个人感到不适，为了证实是否有疾病和为了减少疾痛为目的寻求帮助的行为，是医学人类学研究主要课题之一。由于社会文化背景、地理条件等因素，藏族聚居地区医疗模式显现出多元共存，与之对应，当地民众的择医实践也呈现出一种多元状态。正是由于人们多元择医实践的诉求、固守与调适，才推进着多元医疗模式在发展中适应区域群体的文化变迁、需求改变而日趋完善，由此医疗模式与择医实践形成了互动、互构关系。     

城市医疗集团发展远程医疗的SWOT分析

远程医疗作为一种新型医疗模式,突破了医疗资源在时间与空间上的限制,为优化医疗资源配置、实现优质医疗资源下沉、提高基层医疗服务能力提供了有效途径,具有良好的经济效益与社会效益。在国家相关政策的有力推动下,城市医疗集团结合自身发展需求开始大力发展远程医疗。文章运用文献研究法和态势分析法(SWOT analysis,SWOT分析),探讨了城市医疗集团发展远程医疗的内部优势(S)、劣势(W)以及外部机会(O)、挑战(T)。最后运用SWOT矩阵分析得出如下结论:抓住发展契机,发挥政策导向(SO策略);增加财政投入,促进多方参与(WO策略);完善政策法规,加强宣传力度(ST策略);线上线下结合,尝试差异化服务(WT策略)。     

医疗保险对老年人身体机能健康和心理健康的影响及其机制研究

随着我国人口老龄化不断加剧,切实保障好老年人健康格外紧迫。基于此,文章采用中国健康与养老追踪调查数据从身体机能健康和心理健康两个维度实证考察了医疗保险对老年人健康的影响及其作用机制。研究发现,医疗保险能够显著提高老年人身体机能健康和心理健康。机制研究表明,医疗保险能够显著提高老年人医疗服务利用、降低老年人慢性病发生率进而影响到老年人健康。因此,进一步扩大老年人医疗保险覆盖面、提高医疗保障水平、促进医疗服务公平性和可及性,是我国人口老龄化不断加剧状况下保障老年人健康的重要途径。     

构建医院医疗纠纷预警机制

医疗安全形势严峻、医患关系紧张已经成为不争的事实,通过分析医疗纠纷现状、医疗纠纷发生原因,提出构建医院医疗纠纷预警机制的理念,并对集医疗安全监测系统、医疗纠纷预警处理系统、以及反馈学习系统为一体的医疗纠纷预警机制进行了初步探讨。