Surgical Suites' Operations Management

Surgical suites are a key driver of a hospital's costs, revenues, and utilization of postoperative resources such as beds. This article describes some commonly occurring operations management problems faced by the managers of surgical suites. For three of these problems, the article also provides preliminary models and possible solution approaches. Its goal is to identify open challenges to spur further research by the operations management community on an important class of problems that have not received adequate attention in the literature, despite their economic importance.     

Taiwan's path to national health insurance (1950–1995)

This study explores the evolution of statutory health insurance in the Republic of China on Taiwan from its inception in 1950 through to the inauguration of the National Health Insurance Programme in 1995. The main focus of the study is the timings of the adoption of the different statutory health insurance schemes targeted to the various segments of the population. It is argued that Taiwan's adoption of Labour Insurance for workers in 1950 could be best explained by the country's specific historical circumstance. The then-ruling Nationalist government was keen to build up Taiwan as a showcase for the whole of China. The inauguration of the National Health Insurance Programme in 1995 was predominantly subjected to the Nationalist government's adjustment to its changing political position.     

Mortality after care among young adult foster children in Sweden

This exploratory study looks at mortality after care among 13,100 former Swedish foster children, placed before their teens. Sources used are two national databases, on child welfare interventions and causes of death. Risk ratios of death for foster children are compared with those of their peers in the general population and with a comparison group, consisting of 10,668 young adults from adverse home backgrounds, who never entered foster family care before their teens. Both ex-foster children and the comparison group were young adults (19–26 years old) at time of follow-up. Results show a moderately elevated risk ratio for both groups compared with peers in the general population, mainly due to more frequent unnatural deaths, especially suicides. Time at first placement was not related to mortality among men, but there was a weak tendency of a higher risk ratio for girls placed at age 7–12. Information on time spent in care is used with caution, due to possible problems with reliability. Almost all comparisons between the foster care and the comparison group fell short of statistical significance. For foster children who had spent more than five years in care, the risk ratio tended to be higher than for foster children with shorter care experience, and similar to that of the comparison group. Foster children who had been in care for less then six years thus tended to have a lower risk ratio than the comparison group.     

扶贫实践与扶贫文化的提出

扶贫文化产生于扶贫实践 ,作用于扶贫实践。扶贫文化具有文化所有的文化特征 ,有其内部完整层面、亚文化的动态性和边缘性以及多维的亚结构体。扶贫文化对扶贫实践具有十分重要的指导意义     

扶贫攻坚与民族地区的贫困动态——以四川省为例

本文采用实证分析方法,以民族贫困人口集中的四川省为例,从绝对贫困、相对贫困和社会发展三个方面,对扶贫攻坚以来民族地区的贫困动态作了较为系统的考察,结果显示扶贫攻坚使民族贫困地区的绝对贫困状况有了实质性缓解,但比较发展差距(相对贫困状况)有扩大趋势。据此,提出了加快民族贫困地区整体脱贫步伐的两项对策建议。     

泰国的计划生育/生殖健康目标管理

善用目标管理的知识和技能是泰国计划生育和生殖健康工作成功的重要因素。文章介绍了泰国在这方面的经验。     

儿童运动看护家庭嵌入支持策略探索

学龄前儿童的身体健康与家庭教育一直是国家和社会的关切焦点,通过家庭嵌入的运动看护可以更好的促进学龄前儿童身心健康发展。本文运用文献资料法及系统科学思想,提出了相应的支持策略：重视家庭教育与看护培训,构建儿童运动看护发展动力源;提供心理支持与健康监督,保障儿童运动看护整体科学性;推进家校共育与信息共享,搭建儿童运动看护家校平台;完善社区参与与家庭融合,促进儿童运动看护持续协调发展。     

Socially disadvantaged women's views of barriers to feeling safe to engage in decision-making in maternity care

BackgroundAlthough midwifery literature suggests that woman-centred care can improve the birthing experiences of women and birth outcomes for women and babies, recent research has identified challenges in supporting socially disadvantaged women to engage in decision-making regarding care options in order to attain a sense of control within their maternity care encounters.ObjectiveThe objective of this paper is to provide an understanding of the issues that affect the socially disadvantaged woman's ability to actively engage in decision-making processes relevant to her care.Research designThe qualitative approach known as Interpretative Phenomenological Analysis was used to gain an understanding of maternity care encounters as experienced by each of the following cohorts: socially disadvantaged women, registered midwives and student midwives. This paper focuses specifically on data from participating socially disadvantaged women that relate to the elements of woman-centred care-choice and control and their understandings of capacity to engage in their maternity care encounters.FindingsSocially disadvantaged women participants did not feel safe to engage in discussions regarding choice or to seek control within their maternity care encounters. Situations such as inadequate contextualised information, perceived risks in not conforming to routine procedures, and the actions and reactions of midwives when these women did seek choice or control resulted in a silent compliance. This response was interpreted as a consequence of women's decisions to accept responsibility for their baby's wellbeing by delegating health care decision-making to the health care professional.ConclusionThis research found that socially disadvantaged women want to engage in their care. However without adequate information and facilitation of choice by midwives, they believe they are outsiders to the maternity care culture and decision-making processes. Consequently, they delegate responsibility for maternity care choices to those who do belong; midwives. These findings suggest that midwives need to better communicate a valuing of the woman's participation in decision-making processes and to work with women so they do have a sense of belonging within the maternity care environment. Midwives need to ensure that socially disadvantaged women do feel safe about having a voice regarding their choices and find ways to give them a sense of control within their maternity care encounters.     

老年人社区医养融合养老模式选择意愿影响因素分析--基于ISM-AHP方法

老年人社区医养融合养老模式选择意愿受众多因素的影响,这些因素涉及范围广且关系复杂。为厘清各影响因素之间的层次关系和影响程度,本文从身体特征、家庭特征、认知特征和环境特征四个方面构建了影响因素指标体系。首先采用解释性结构模型分析得到由表层直接影响因素、中层间接影响因素和深层根本影响因素组成的3级多层递阶有向图,然后应用层次分析法对各因素指标的影响力进行排序,建立指标综合权重体系。结果表明：表层直接影响因素包括ADL、医疗支出能力、健康自评等8个,中层间接影响因素包括慢性疾病数量、社会关注度、医疗保障水平等8个,深层根本影响因素包括家庭收入水平、政府支持力度和发展阶段3个。其中,家庭收入水平、ADL、医疗保障水平、慢性疾病数量、政府支持力度等是老年人社区医养融合养老模式选择意愿的主要影响因素。     

设立国有医药公司降低虚高药价

公立医疗机构对医疗资源的垄断、政府对药品流通市场监管的不到位、广大消费者对相关政策法律及药品知识的无知是造成当前药价虚高的核心原因;在市场经济条件下,政府应该更多地运用经济和法律手段来解决这一问题,由地方政府设立国有医药流通公司,同时运用互联网等媒介扩大消费者对医药信息的了解,从而通过消费者对药品理性选择的市场力量和政府规范市场的法制力量来解决药价虚高这一社会问题。