紧密型城市医联体模式下基层首诊意愿及影响因素

为了解安徽省紧密型城市医联体内居民就医首诊意愿及其影响因素,对安徽省皖北、皖中、皖南三个地区的紧密型城市医联体就诊居民进行调查。在纳入分析的 513 名调查对象中, 16.8%的居民听说过双向转诊;78.4%的居民首诊选择基层医疗机构;82.8%的居民选择该医院的原因是离家或单位近。进一步分析发现,文化程度、年龄、月收入、健康状况、对基层医疗机构信任水平、认为双向转诊是否有必要是影响居民就医行为的重要因素。需要优化转诊程序,引导居民有序就医;加强对基层医疗机构的政策倾斜,提高基层医务人员福利待遇,通过人才引进、继续教育等方式提高基层医疗机构的服务水平;加快推进城市医联体建设,合理引导优质医疗资源有序下沉,优化医疗资源配置布局。     

An Empirical Study of the Relations Between Hospital Volume,Teaching Status,and Service Quality

This paper contributes to research on quality drivers in healthcare settings by examining the relationships between patient volume, teaching mission, and process quality in US hospitals. To develop a model that accurately assesses the impact of patient volume and teaching status on quality, we draw on three related research streams pertaining to the volume–quality relationship, the comparative quality of care in teaching and non‐teaching hospitals, and quality drivers in service institutions. We propose the impact of patient volume on process quality varies across hospitals with different teaching intensities. The test of this proposition uses a large data set that measures process quality for treatments for heart attacks and heart failures in all major US hospitals. Our results suggest that, as hospital teaching intensity increases, greater patient volume is associated with decreased process quality. Never before was such a relationship uncovered. This initial finding has important practical implications. First, the regionalization policy of hospitals should be re‐evaluated in light of their teaching function. Second, the root causes for the lower quality scores of large, high resident‐to‐bed ratio teaching hospitals, compared with smaller versions, must be found.     

Comparative assessment of analytical approaches to quantify the risk for introduction of rare animal diseases: the example of avian influenza in Spain

Trade of animals and animal products imposes an uncertain and variable risk for exotic animal diseases introduction into importing countries. Risk analysis provides importing countries with an objective, transparent, and internationally accepted method for assessing that risk. Over the last decades, European Union countries have conducted probabilistic risk assessments quite frequently to quantify the risk for rare animal diseases introduction into their territories. Most probabilistic animal health risk assessments have been typically classified into one-level and multilevel binomial models. One-level models are more simple than multilevel models because they assume that animals or products originate from one single population. However, it is unknown whether such simplification may result in substantially different results compared to those obtained through the use of multilevel models. Here, data used on a probabilistic multilevel binomial model formulated to assess the risk for highly pathogenic avian influenza introduction into Spain were reanalyzed using a one-level binomial model and their outcomes were compared. An alternative ordinal model is also proposed here, which makes use of simpler assumptions and less information compared to those required by traditional one-level and multilevel approaches. Results suggest that, at least under certain circumstances, results of the one-level and ordinal approaches are similar to those obtained using multilevel models. Consequently, we argue that, when data are insufficient to run traditional probabilistic models, the ordinal approach presented here may be a suitable alternative to rank exporting countries in terms of the risk that they impose for the spread of rare animal diseases into disease-free countries.     

国家转型、中立性国家与社会稳定

中国正处在一个国家转型的关键时期.国家的转型,从经济领域起始,进入社会领域,最后坐实在政治领域.中国的国家转型,明显遭遇到国家偏执地提倡权力型治国理念、治国方略的阻碍.对于一个稳定的现代国家来讲,国家应当呈现出一种超越完备的宗教、哲学与道德学说的中立性,从而具备整合国内多元文化价值偏好的个人与群体的政治观念与制度前提.对一个多元社会的稳定来讲,国家站在不偏不倚的公正立场,平等对待每一个体和所有群体,国家才能发挥出为社会解压、稳定秩序的强大作用.     

民法视野下产权型保障房退出机制的分析——以“有限产权”向“共有产权”理论的过渡为视角

当前,我国产权型保障房的退出方式可区分为主动退出和强制退出,构建公平、合理的退出机制是使产权型保障房回归"公共产品"价值属性的保证。完善产权型保障房的退出机制,须从分析退出机制的现存问题入手,以"有限产权"向"共有产权"理论的过渡为视角,重塑产权型保障房的物权属性,建立政府回购体系,推行交易的"内部循环"并制定统一的退出事由和多元化的退出措施。     

科学与死亡 ——星新一微型小说《殉教》之主题探究

科学文明的发展,消除了人们对许多未知事物的恐惧。但与此同时,科学技术的飞跃带来的副作用也越发凸显,有时甚至会把人们导向死亡和毁灭的境地。在日本学界尚未给予明确评价的"日本微型小说之神"星新一的文学创作,短小隽永,质朴易读,充满奇思妙想;其对人类生存方式的深刻剖析,更是一针见血地揭露所描绘事物的本质。通过具体分析微型小说《殉教》的主题表现方法,阐释星新一文学关注及忧虑人类未来命运的一贯性创作思想。     

基于DSP2812的光伏MPPT控制系统

光伏电池的输出特性存在一个随外界环境变化而变化的最大功率点。为了能够最大限度地利用光伏转化出来的电能,必须进行最大功率点跟踪。采用DSP2812芯片用于最大功率点跟踪的主控制器并选择Boost拓扑作为主电路结构,介绍了采样电路和驱动电路等硬件电路的设计、软件与控制策略的设计。最终用实验验证了该控制系统能够快速稳定地跟踪光伏电池的最大功率点。     

创新人才培养模式下的研究生课程体系研究

在查阅大量国内外相关文献基础上,以东北农业大学为主要基点,对包括东北农业大学在内的八所高校进行问卷调查和座谈,将获得的数据进行整理和分析后,总结目前高校研究生课程体系中存在的问题,最后结合创新人才的素质特征,提出有利于创新人才培养的研究生课程体系优化策略。     

论公共服务动机与激励

公共服务动机是个人基于公共制度与文化所驱使的公共服务信念、价值与态度,着重揭示公共服务行为中自利动机之外的利他动机。公共服务动机与激励的关系体现在公共服务人员对激励项目的反应以及公共部门与公共服务激励等方面。对公共服务动机的有效激励,需要强化内在激励功能,注重外在激励的内化,提高公共制度与文化的影响力。     

以国家利益视野回顾建国初期“苏联援华”始末

国家利益是一个国家制定对外政策的基础和依据,也是处理与其他国际社会行为主体关系的重要参考因素。以国家利益视野回顾建国初期"苏联援华"始末,并从中确认中苏两国因利益趋同而走向合作的动因,以及导致中苏双边关系破裂的国家利益分歧所在。