The recruitment and selection of hospital medical consultants

Abstract

The literature on selection has been dominated in recent decades by the ‘prediction’ paradigm. Such an approach requires a substantial number of positions to be filled in order to compute validity coefficients. There are other approaches, using a different paradigm, when concentrated on adjusting the organization and the employee. Here careful analysis of job demands is essential. This article describes such an analysis, taking the medical consultant as an example. The method can be used in an iterative way. It is useful when one has to work with small numbers of positions.     

试论满族入关前饮食文化特点

满族入关前 ,正是女真兴起时期 ,战争频仍 ,奴隶制、封建制国家不断发展的时期 ,作为特定时期的满族饮食文化表现出等级性、政策性、外来性和不断完善性等鲜明的时代特征。这些特征对入关后满族饮食文化的发展产生了深远影响 :一方面 ,其中许多因素深深积淀于满族传统饮食文化 ;另一方面 ,等级性的增强、诸种封建礼制的完备和对外来饮食文化接受 ,则为入关后满族饮食文化的进一步发展奠定了基础。     

关于医疗纠纷法律制度改革的思考

目前我国医疗纠纷法律制度严重滞后,改革呼声日趋高涨。但学界对改什么和如何改的问题缺乏细致深入的研究。本文在对现行医疗纠纷法律制度进行全面评析后,对消除该法内部固有矛盾、改革医疗鉴定体制、完善医疗诉讼程序等方面提出了新的思路与方法。     

Social Work and Complex Care Systems: The Case of People Hospitalised with a Disability

Health and hospital system reforms prioritise efficiency. However, initiatives can impact on people with new or existing disabilities who require time to maximise functional independence. With greater demands for shorter hospital stays social workers face increasing pressure to facilitate discharge. This paper reports findings from research identifying factors contributing to extended stays for adults with disabilities. We sought to better understand patient characteristics and discharge planning challenges by analysing a clinical dataset of 80 patients and qualitative interviews with five experienced hospital social workers. Three key factors are identified: issues around rehabilitation services; assessment and planning for community care; and availability of and access to discharge options. Strategies to reduce length of stay are reported. We argue that building collaborative partnerships and working across multiple, complex systems and disciplines are vital to ensure these patients access appropriate community-based resources within the current health reform environment.     

户籍类型与城乡居民医疗服务利用 ——基于Andersen模型的经验分析

本文利用中国社会科学院经济研究所2018年城乡居民入户调查数据,从户籍改革角度分析户口类型改变对城乡居民医疗服务利用的影响。研究发现:与户口类型未发生改变的城乡居民相比,户口类型发生过改变(农转非)的城乡居民门急诊服务利用的可能性更高,住院医疗服务支出水平更低。从户籍改革与参保类型交互效应看,相对于户口类型未发生过改变的居民医保参保人群,户口类型发生改变(农转非)会显著提高居民医保参保人群门急诊服务利用,同时降低其住院服务利用。进一步采用PSM方法进行稳健性检验,户籍改革对提高城乡居民门急诊服务利用,降低住院医疗服务利用的结论依然成立。此外,本文还发现,直接结算提高了城乡居民门急诊和住院的就诊概率;健康自评状况越差,门急诊和住院医疗服务利用可能性越高,门急诊医疗支出、住院医疗支出和跨省异地就医支出也越高。本文认为,相对于推行基层分级诊疗制度,以户籍改革推动农村居民自由流入医疗资源更丰富的城镇地区,改革基层卫生院制度,以及改变基层医疗服务提供激励机制,可能更有助于改善农村居民健康状况。     

财政扶持政策对西部地区农民参加新农村合作医疗的影响——基于自然实验的研究途径

本文将对西部农民参加新农村合作医疗的财政扶持政策的实施作为一个自然实验,应用微观经济计量方法分析了财政扶持政策对西部农民参加新农村合作医疗的影响。研究结果表明,与2004年相比,2006年西部农民参加新农村合作医疗的概率增加了96.46%,说明针对西部农民参加新农村合作医疗的财政扶持政策作用效果显著。     

区域的“城市性”与中国新型城市化道路

本文提出区域的“城市性”,对城市化涵义作出新的认识.考察中外城市化的演变史发现,城市化道路有两种类型:一是人口转移型城市化道路,二是结构转换型城市化道路,从中国的国情出发,借鉴中外城市化的经验教训,如今中国城市化发展道路的转型方向,应该是走人口转移和结构转型并存的“双轨”发展的新型城市化道路.     

哈萨克斯坦医疗保险制度改革问题研究

医疗保险制度改革是哈萨克斯坦医疗改革的重要组成部分。独立以后,在全民免费医疗无法维持的情况下,哈萨克斯坦政府先后实施了强制医疗保险制度和自愿医疗保险制度。然而,这两种医疗保险制度的运行效果远远没有达到政府和民众的预期。目前,哈萨克斯坦又出现了恢复强制医疗保险制度的倾向。纵观哈萨克斯坦医疗保险制度的发展过程,可以认为,这种改革缺乏持续性的政策和明确的目标。另外,如何妥善解决社会公平和效率之间的关系,以及转变民众的医疗卫生观念,是未来哈萨克斯坦医疗保险改革亟待解决的深层问题。     

Linking Electronic Medical Records Use to Physicians’ Performance: A Contextual Analysis

Electronic Medical Records (EMR) studies have broadly tested EMR use and outcomes, producing mixed and inconclusive results. This study carefully considers the healthcare delivery context and examines relevant mediating variables. We consider key characteristics of: (i) interdependence in healthcare delivery processes, (ii) physician autonomy, and (iii) the trend of hospital employment of physicians, and draw on theoretical perspectives in coordination, shared values, and agency to explain how the use of EMR can improve physicians’ performance. In order to examine the effects of physician employment on work practices in the hospital, we collected 583 data points from 302 hospitals in 47 states in the USA to test two models: one for employed and another for nonemployed physicians. Results show that information sharing and shared values among healthcare delivery professionals fully mediate the relationship between EMR use and physicians’ performance. Next, physician employment determines which mediating variable constitutes the pathway from EMR use to physicians’ performance. Finally, we highlight the impact of shared values between the hospital and physicians in enhancing information sharing and physicians’ performance, extending studies of these behaviors among network partners in industrial settings. Overall, our study shows that EMR use should be complemented by processual (information sharing), social (shared values), and structural (physician employment) mechanisms to yield positive effects on physicians’ performance.     

Letter to the editor comments on Groparu-Cojocaru and Doray (2013)

Although estimating the five parameters of an unknown Generalized Normal Laplace (GNL) density by minimizing the distance between the empirical and true characteristic functions seems appealing, the approach cannot be advocated in practice. This conclusion is based on extensive numerical simulations in which a fast minimization procedure delivers deceiving estimators with values that are quite far away from the truth. These findings can be predicted by the very large values obtained for the true asymptotic variances of the estimators of the five parameters of the true GNL density.