医院融资方式改革刍议

从国外医院管理的经验与国内医院的发展现状及目前面临的问题来看 ,大规模的医疗服务要素重组形成集团化运作 ,与医院的资本运营是一种必然趋势。经过 2 0多年的卫生改革 ,医院的融资主渠道已经是市场而不是政府财政 ,医院产权制度的改革也已经拉开帷幕 ,医院资本运营的条件与环境正在逐步形成。本文系统阐明了在深化医院管理模式与融资机制的改革中引入资本运营的必要性 ,同时 ,以资本运营的基本模式阐述了资本运营的基本原理与方法 ,以助于医院资本运营的发展。     

压力型体制下乡镇治理的特点及负面影响

压力型体制下 ,乡镇治理的特点主要表现为“目标责任”管理、“选择性激励”泛滥、“正式权力的非正式运用”以及“政绩工程”与“造假”等。这些做法“虚化”了政权 ,制约了村民自治的成长 ,并有可能引起治理危机。因此 ,必须加以解决。     

中国乡镇企业崛起的多维分析

乡镇企业随着中国社会变革和现代化进程的深入应运而生,其产业特征并不符合标准的转轨型经济模式,它诞生之初面对的是市场交易和私产受到严格限制的计划经济体制,贫困且对现代工业技术一无所知的农民是如何创办工业企业的,需要从多重角度分析。     

农业主导型财政下的乡镇治理--以河南刘乡为例

对于财政收入主要来源于农业经济的农村地区 ,乡镇财政的压力既推动了乡镇政权组织发展本地经济 ,同时也导致了乡镇政权组织加大财政提取力度 ,甚至为此不惜违反国家有关法律和政策 ,从而削弱了基层政权的合法性基础 ,加剧了农村社会矛盾。要改善农业地区的乡镇治理状况 ,必须结合农业主导型乡镇财政的特点改革农村管理体制。     

六西格玛方法与医院管理

在加入WTO后,中国的企业必将面临日益激烈的竞争,同时信息化的飞速发展,将从根本上改变经济的组织结构和消费行为。如何在这种新的经济环境中生存、成长、壮大是对每一个企业领导人的挑战。六西格玛,由于其严谨的方法和实施步骤、以面向最终用户来建立营运体系的管理思想,对于中国企业建立卓越的管理体系、获取并保持在国际市场上的竞争优势提供了一个非常有效的管理思想和实践。它可以广泛应用于制造业、服务行业等各个领域。近年来,医疗服务行业逐渐引进企业管理的六西格玛方法,重视加强医院管理,不断提高医院服务水平。     

我国远程医疗的现状、问题及发展对策

随着信息技术及网络通信技术的发展,远程医疗的内涵在不断演变和丰富。我国远程医疗经过近30年的发展,尤其在新冠肺炎疫情促进下,政策体系逐渐完善,远程医疗协作网和互联网医院建设均取得一定成绩,但与此同时也暴露出一些问题,如法律法规不健全、服务定价和补偿机制不完善、系统平台功能不完善、医患双方认识不足、远程医疗专业人才缺乏等。结合发达国家远程医疗发展经验,应进一步加强我国远程医疗法律法规建设、健全财政补偿机制、完善远程医疗系统功能、加快远程医疗人才队伍建设,以促进远程医疗的持续健康发展。     

The Limitations and Opportunities of Business Process Re-engineering in a Politicized Organizational Climate

This paper is concerned with the organizationalchange and project management issues raised by theimplementation of a business process re-engineering(BPR) approach in the politicized hospital context. This is a report of research in progress,focusing on the issues arising at the problem definitionand project planning stages of a BPR application in anoperating theaters department experiencing problems with scheduling and delays. The research designrelies on a case study approach, with the researcher asparticipant observer, as both an adviser to the projectteam and as field interviewer. The paper argues that an ambitious BPR agenda is compromised inat least two regards. First, the lack of precisionsurrounding the focus and methodology of BPR givespolitically motivated actors considerable influence with respect to defining terms of reference in wayswhich will shape potential outcomes in their favor.Second, the complexity and indeterminacy of the businessprocess or patient trail can also diluteredesign attempts. The principal limitations of theapproach thus concern the impracticality of embarking onrapid and radical change working from a blanksheet of paper with respect to organizational and job design. BPR, unlike other organizationdevelopment interventions, is not a contextsensitive approach. The role of project manageris critical in establishing a working balance betweenindividual, occupational, and organizational goals in a manner perceivedto be legitimate in the context. Effective BPR projectmanagement thus requires a combination of political andprocess analysis skills. The principal opportunities of BPR derive from its process orientation,which brings a fresh perspective to a traditionally andfunctionally fragmented organizational setting, andwhich presents a potentially valuable platform for anevolutionary approach to process improvement.     

基于医疗质量的公立医院绩效体系构建研究

目的：运用德尔菲法构建一套科学、可操作的公立医院绩效评价体系。方法：采用文献法研究国内外绩效评价理论,结合问卷结果形成初始量表。通过德尔菲法对指标进行两轮筛选及优化。结果：初步形成由“社会效益”、“质量安全”、“运行效益与效率”为基本结构的指标体系,包括3个一级指标、13个二级指标和72个三级指标。结论：该指标体系重点关注医院公益性及内涵质量,对公立医院绩效评价具有一定参考意义。     

Danish and Norwegian hospital social workers’ cross-institutional work amidst inter-sectoral restructuring of health and social welfare

Starting in the 2000s, Denmark and Norway have undergone extensive restructuring of their health-related social benefit programmes, including how they are governed. Several reforms have sought to enhance inter-sectoral collaboration. Aiming at ensuring patients’ faster return to work, policy-makers have instituted economic incentives to both individuals and the health and welfare organisations who handle them. Through an institutional logics approach, this paper explores how hospital social workers in these countries are experiencing these changes. The ‘social’ part of post-treatment care and rehabilitation receives more attention in the Norwegian institutional set-up than in the Danish, and whilst challenges are experienced in both countries, in group interviews Danish social workers in particular express concerns about the implications of the accelerated return-to-work focus. In both countries, they report increasing difficulties in ‘making their way through’ the state-municipal bureaucracy. However, by drawing on the formal health knowledge derived from medical settings and the symbolic capital it bestows on them, they often manage to negotiate the work-and-welfare services, thereby transforming the social context for the patients.     

浅谈洁净手术部在医院基建工程中的特殊需求

随着现代医学的发展,洁净手术部成为各手术学科建设与发展的重要前提与支柱,对原有手术室功能进行改造势在必行。为了实现医院洁净手术部向信息化、智能化、集约化发展,从洁净手术部的选址、功能等方面介绍了当前省内部分二级以上医疗单位洁净手术室建设的新进展,总结近年来在洁净手术室规划、建设过程中的经验,为现代医院基建工程管理提供借鉴,保障医院医疗、教学、科研工作的顺利开展。