Pub Date : 2019-11-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.11.019
Di Tian, H. Xu, Bowen Wang, Yuanzhong Zhou, Dian Zhou
Objective To evaluate the scale, efficiency and quality of secondary and tertiary public hospitals in Anhui province, and analyze the degree of coupling and coordination among the three dimensions. Methods Thirty-two hospitals′ data were extracted from the direct reporting system of Anhui Health Commission. Hospital efficiency was evaluated by DEA model, hospital quality was evaluated by TOPSIS model, and coupling coordination degree was analyzed by coupling function. Results In the single-dimension evaluation, there were significant differences in the distribution of the three dimensions among different levels of hospitals, and the efficiency and quality of secondary hospitals were better than those of tertiary hospitals. In the coupling evaluation, the average degree of coupling coordination in Anhui was 0.637, which was in the " primary coordination" level. The overall coupling and coordination degree of the tertiary hospitals were better than that of the secondary hospitals, and the highest score was in central Anhui. Conclusions Single-dimensional evaluation method cannot objectively represent a general picture of the hospitals. On the other hand, coupling coordination degree evaluation can provide a more comprehensive and objective result. The development strategy of hospitals should be made to fit local conditions and to coordinate the development of scale, efficiency and quality. Key words: Hospital, public; DEA; TOPSIS; Coupling and coordinative degree; Scale
{"title":"Research on the coupling and coordination of scale, efficiency and quality of public hospitals in Anhui","authors":"Di Tian, H. Xu, Bowen Wang, Yuanzhong Zhou, Dian Zhou","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.11.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.11.019","url":null,"abstract":"Objective \u0000To evaluate the scale, efficiency and quality of secondary and tertiary public hospitals in Anhui province, and analyze the degree of coupling and coordination among the three dimensions. \u0000 \u0000 \u0000Methods \u0000Thirty-two hospitals′ data were extracted from the direct reporting system of Anhui Health Commission. Hospital efficiency was evaluated by DEA model, hospital quality was evaluated by TOPSIS model, and coupling coordination degree was analyzed by coupling function. \u0000 \u0000 \u0000Results \u0000In the single-dimension evaluation, there were significant differences in the distribution of the three dimensions among different levels of hospitals, and the efficiency and quality of secondary hospitals were better than those of tertiary hospitals. In the coupling evaluation, the average degree of coupling coordination in Anhui was 0.637, which was in the \" primary coordination\" level. The overall coupling and coordination degree of the tertiary hospitals were better than that of the secondary hospitals, and the highest score was in central Anhui. \u0000 \u0000 \u0000Conclusions \u0000Single-dimensional evaluation method cannot objectively represent a general picture of the hospitals. On the other hand, coupling coordination degree evaluation can provide a more comprehensive and objective result. The development strategy of hospitals should be made to fit local conditions and to coordinate the development of scale, efficiency and quality. \u0000 \u0000 \u0000Key words: \u0000Hospital, public; DEA; TOPSIS; Coupling and coordinative degree; Scale","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"961-965"},"PeriodicalIF":0.0,"publicationDate":"2019-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69749727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.11.016
Lu Lu, Xiang Jing, Yali Wang, Y. Xia, Yaozu Li, An′an Jiao, Lingzhong Xu
Objective To investigate the utilization of inpatient health care among the elderlies in Shandong province, and to analyze the factors affecting the inpatient services utilization, so as to provide reference for the elderlies to utilize the inpatient services reasonably. Methods The survey was conducted in Shandong province in August 2017. Multi-stage stratified cluster random sampling method was used to select 7 070 residents aged 60 and above in 6 counties and districts of Shandong province as the objects of the survey. The survey included the basic family and personal information of the elderlies as well as the utilization of hospitalization services. Chi-square test and rank sum test were used for univariate analysis, and logistic regression was applied for influencing factors. Results The annual hospitalization rate of the elderlies in Shandong province was 18.1%, and 9.6% of those in need of hospitalization failed to enjoy the service. The annual hospitalization rate of the elderlies aged 80 years and over was 19.9%, and 5.5% of the patients in need had not been hospitalized. Among the inpatient institutions, the proportion of township health centers/community health service centers, county-level(district) medical institutions, prefecture-level medical institutions and provincial-level medical institutions was 29.2%, 29.1%, 37.7% and 1.4%, respectively.Factors influencing the utilization of hospitalization services for the elderlies included age, self-assessment of health, physical examination, chronic diseases, type of medical insurance and income level. Conclusions More attention should be paid to the hospitalization services for the elderlies aged 80 years and over. Effective measures should be taken to guide the elderlies to fully use primary medical resources. The prevention and control of chronic diseases should be strengthened to promote the rational use of inpatient health services among the elderlies. In addition, more attention should be paid to low-income elderlies to meet their hospitalization needs. Key words: Healthcare survey; Elderlies; Hospitalization; Service usage; Influencing factors; Shandong province
{"title":"Utilization of inpatient health care and its influencing factors among elderlies in Shandong province","authors":"Lu Lu, Xiang Jing, Yali Wang, Y. Xia, Yaozu Li, An′an Jiao, Lingzhong Xu","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.11.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.11.016","url":null,"abstract":"Objective \u0000To investigate the utilization of inpatient health care among the elderlies in Shandong province, and to analyze the factors affecting the inpatient services utilization, so as to provide reference for the elderlies to utilize the inpatient services reasonably. \u0000 \u0000 \u0000Methods \u0000The survey was conducted in Shandong province in August 2017. Multi-stage stratified cluster random sampling method was used to select 7 070 residents aged 60 and above in 6 counties and districts of Shandong province as the objects of the survey. The survey included the basic family and personal information of the elderlies as well as the utilization of hospitalization services. Chi-square test and rank sum test were used for univariate analysis, and logistic regression was applied for influencing factors. \u0000 \u0000 \u0000Results \u0000The annual hospitalization rate of the elderlies in Shandong province was 18.1%, and 9.6% of those in need of hospitalization failed to enjoy the service. The annual hospitalization rate of the elderlies aged 80 years and over was 19.9%, and 5.5% of the patients in need had not been hospitalized. Among the inpatient institutions, the proportion of township health centers/community health service centers, county-level(district) medical institutions, prefecture-level medical institutions and provincial-level medical institutions was 29.2%, 29.1%, 37.7% and 1.4%, respectively.Factors influencing the utilization of hospitalization services for the elderlies included age, self-assessment of health, physical examination, chronic diseases, type of medical insurance and income level. \u0000 \u0000 \u0000Conclusions \u0000More attention should be paid to the hospitalization services for the elderlies aged 80 years and over. Effective measures should be taken to guide the elderlies to fully use primary medical resources. The prevention and control of chronic diseases should be strengthened to promote the rational use of inpatient health services among the elderlies. In addition, more attention should be paid to low-income elderlies to meet their hospitalization needs. \u0000 \u0000 \u0000Key words: \u0000Healthcare survey; Elderlies; Hospitalization; Service usage; Influencing factors; Shandong province","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"947-951"},"PeriodicalIF":0.0,"publicationDate":"2019-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42366030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.11.015
Xiaoyun Ye, Lili Zhang, Jian Ma, Xiaoyan Yang, Yongmei. Yuan
Simplified outpatient service flow and higher service efficiency can save back-and-forth trips and queuing time of outpatients and better their medical experience. The authors introduced the hospital′s experience in establishing a one-stop multi-functional outpatient service center. This center integrated such departments as outpatient office service, medical insurance office service, and registration & fee payment. Such a " multifunctional post" provided a one-stop service for the patients, hence optimizing the workflow for creating a convenient and fast outpatient service. Key words: Services administration; Outpatient management; Multifunctional post; One-stop service; Workflow optimization
{"title":"Setup and management of the multi-functional post for outpatients","authors":"Xiaoyun Ye, Lili Zhang, Jian Ma, Xiaoyan Yang, Yongmei. Yuan","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.11.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.11.015","url":null,"abstract":"Simplified outpatient service flow and higher service efficiency can save back-and-forth trips and queuing time of outpatients and better their medical experience. The authors introduced the hospital′s experience in establishing a one-stop multi-functional outpatient service center. This center integrated such departments as outpatient office service, medical insurance office service, and registration & fee payment. Such a \" multifunctional post\" provided a one-stop service for the patients, hence optimizing the workflow for creating a convenient and fast outpatient service. \u0000 \u0000Key words: \u0000Services administration; Outpatient management; Multifunctional post; One-stop service; Workflow optimization","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"944-946"},"PeriodicalIF":0.0,"publicationDate":"2019-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42111893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the market-oriented application of new technologies and the development of various subjects in hospitals, more and more point-of-care test(POCT) devices appear in medical institutions, as an important method for rapid clinical acquisition of test results. As introduced by the authors, the hospital since 2017, established based on the hospital′s total quality management system, the POCT management committee, and built the hospital′s POCT quality management system. Thanks to its efforts, the hospital has fully standardized the POCT management from equipment procurement, test, maintenance, personnel training and examination, thus further ensuring medical quality. Key words: Total quality management; Safety management; Point-of-care testing; Standardized management; Management system
{"title":"Establishment and practice of a point-of-care testing management system in hospitals","authors":"Ge Qu, Zhao-kui Zhang, Zongjiu Zhang, Xudong Ma, Wei Zheng, Haiwen Lu, Jianmin Zhao, Junxiang Xiao","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.11.012","url":null,"abstract":"With the market-oriented application of new technologies and the development of various subjects in hospitals, more and more point-of-care test(POCT) devices appear in medical institutions, as an important method for rapid clinical acquisition of test results. As introduced by the authors, the hospital since 2017, established based on the hospital′s total quality management system, the POCT management committee, and built the hospital′s POCT quality management system. Thanks to its efforts, the hospital has fully standardized the POCT management from equipment procurement, test, maintenance, personnel training and examination, thus further ensuring medical quality. \u0000 \u0000Key words: \u0000Total quality management; Safety management; Point-of-care testing; Standardized management; Management system","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"932-935"},"PeriodicalIF":0.0,"publicationDate":"2019-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43045937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.11.009
Shuangxia Dong, Tao Yu, Zhi-jie Xia, Xuedong Xu, W. Fu
Objective To explore characteristics of general inter-departmental consultations in a hospital and put forward management strategy suggestions. Methods A large tertiary general hospital in Beijing was cited as the research object. Data were extracted from the EMR of the in-hospital inter-departmental consultations from July 1, 2017 to June 30, 2018, including information such as applying departments, submission time, invited departments, consultation completion time among others. Also collected were data such as discharges, case combination index(CMI), and preoperative average hospitalization days of clinical departments. Pearson and Spearman methods were used to perform correlation analysis, and independent sample Wilcoxon rank sum test was performed for the mean comparison. Results The ratio of consultations to discharged patients was 0.44, while consultation workload of cardiovascular medicine, ophthalmology and neurology was higher, and consultation applications issued by neurology, rheumatology and endocrinology departments were higher.For surgical departments, the correlation between demand of consultations and CMI was strong, r=0.63(P<0.05). The completion rate of consultation within 24 hours was 90.08%, and 64.79% of overtime consultations were caused by 35.63% of the consultation physicians. Conclusions It is imperative to enhance infrastructure support and information system construction to meet huge demands of inter-departmental consultations and to ensure patient safety; To further examinations of consultation purposes and improve doctors′ integrative abilities of diagnosis and treatment by introducing HIM mode to the training system, for the purpose of reducing unnecessary consultations; Optimize the process, shorten preoperative average length of stay by bringing forward inpatient-consultations to outpatient department; Inspire consultation enthusiasm and ensure consultation quality through performance appraisal mechanism. Key words: Case management; Consultation; Case mix index; Holistic integrative medicine; Efficiency
{"title":"Analysis and management strategy of inter-departmental general consultation","authors":"Shuangxia Dong, Tao Yu, Zhi-jie Xia, Xuedong Xu, W. Fu","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.11.009","url":null,"abstract":"Objective \u0000To explore characteristics of general inter-departmental consultations in a hospital and put forward management strategy suggestions. \u0000 \u0000 \u0000Methods \u0000A large tertiary general hospital in Beijing was cited as the research object. Data were extracted from the EMR of the in-hospital inter-departmental consultations from July 1, 2017 to June 30, 2018, including information such as applying departments, submission time, invited departments, consultation completion time among others. Also collected were data such as discharges, case combination index(CMI), and preoperative average hospitalization days of clinical departments. Pearson and Spearman methods were used to perform correlation analysis, and independent sample Wilcoxon rank sum test was performed for the mean comparison. \u0000 \u0000 \u0000Results \u0000The ratio of consultations to discharged patients was 0.44, while consultation workload of cardiovascular medicine, ophthalmology and neurology was higher, and consultation applications issued by neurology, rheumatology and endocrinology departments were higher.For surgical departments, the correlation between demand of consultations and CMI was strong, r=0.63(P<0.05). The completion rate of consultation within 24 hours was 90.08%, and 64.79% of overtime consultations were caused by 35.63% of the consultation physicians. \u0000 \u0000 \u0000Conclusions \u0000It is imperative to enhance infrastructure support and information system construction to meet huge demands of inter-departmental consultations and to ensure patient safety; To further examinations of consultation purposes and improve doctors′ integrative abilities of diagnosis and treatment by introducing HIM mode to the training system, for the purpose of reducing unnecessary consultations; Optimize the process, shorten preoperative average length of stay by bringing forward inpatient-consultations to outpatient department; Inspire consultation enthusiasm and ensure consultation quality through performance appraisal mechanism. \u0000 \u0000 \u0000Key words: \u0000Case management; Consultation; Case mix index; Holistic integrative medicine; Efficiency","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"919-924"},"PeriodicalIF":0.0,"publicationDate":"2019-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41649194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.09.005
Xinchao Li, F. Bie, Shufeng Li, Y. Meng, A. Mao, W. Qiu, Kun Wang, Qing Wang, Hai Wen, Xiao-ling Yan
An assessment is a key to public health management. This article reviewed the experiences and researches of assessment on public-health system, as well as public health service quality of medical institutions in America, the United Kingdom and Australia among other countries. On such basis, suggestions were provided on assessments of public health service in China, in order to help the government to improve its indicator evaluation system. Key words: Public health; Hospitals, public; Assessment; Worldwide experience
{"title":"Public health service assessment: enlightenments from worldwide experience","authors":"Xinchao Li, F. Bie, Shufeng Li, Y. Meng, A. Mao, W. Qiu, Kun Wang, Qing Wang, Hai Wen, Xiao-ling Yan","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.005","url":null,"abstract":"An assessment is a key to public health management. This article reviewed the experiences and researches of assessment on public-health system, as well as public health service quality of medical institutions in America, the United Kingdom and Australia among other countries. On such basis, suggestions were provided on assessments of public health service in China, in order to help the government to improve its indicator evaluation system. \u0000 \u0000 \u0000Key words: \u0000Public health; Hospitals, public; Assessment; Worldwide experience","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"728-731"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44408611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.09.007
A. Mao, Kun Wang, Y. Meng, Yu-jie Yang, P. Dong, Guangyu Hu, Xiao-ling Yan
Objective To explore the establishment of an evaluation indicator system for disease prevention and control workload at public hospitals, based on the current situation of disease prevention and control work undertaken by public hospitals of and above secondary level in Beijing, and to provide evaluation assistance for them to do better in this regard. Methods This research was based on our pervious study of the current situation description of disease prevention and control work undertaken by public hospitals in Beijing, by which the contents of routine disease prevention and control work at hospitals have been initially established. The unit strength of each work was consulted, and the disease prevention and control work was classified according to the results. Meanwhile the consistency test of the work intensity within the category was carried out. After integration, the classification and evaluation indicator of disease prevention and control work in public hospitals of and above secondary level in Beijing was finally established. Results The workload evaluation indicator system was divided into eight parts: report work, report quality control work, monitoring work, training work, work of public health related clinical diagnosis and treatment, work of clinical examination and vaccination, work of sampling and testing and public health related consultation work. The work intensity of each category ranged from 4.78 to 7.34. Conclusions The evaluation indicator system of workload is suitable for the evaluation of basic works. The unified transformation of workload by using the value of work intensity is conducive to management evaluation, but the limitation of the indicators exists in time and region, making it necessary to adjust by the local specific situation at the promotion and application level. Key words: Hospitals, public; Disease prevention and control; Evaluation; Indicator system
{"title":"Study on evaluation indicator system of disease prevention and control workload for Beijing′s public hospitals","authors":"A. Mao, Kun Wang, Y. Meng, Yu-jie Yang, P. Dong, Guangyu Hu, Xiao-ling Yan","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.007","url":null,"abstract":"Objective \u0000To explore the establishment of an evaluation indicator system for disease prevention and control workload at public hospitals, based on the current situation of disease prevention and control work undertaken by public hospitals of and above secondary level in Beijing, and to provide evaluation assistance for them to do better in this regard. \u0000 \u0000 \u0000Methods \u0000This research was based on our pervious study of the current situation description of disease prevention and control work undertaken by public hospitals in Beijing, by which the contents of routine disease prevention and control work at hospitals have been initially established. The unit strength of each work was consulted, and the disease prevention and control work was classified according to the results. Meanwhile the consistency test of the work intensity within the category was carried out. After integration, the classification and evaluation indicator of disease prevention and control work in public hospitals of and above secondary level in Beijing was finally established. \u0000 \u0000 \u0000Results \u0000The workload evaluation indicator system was divided into eight parts: report work, report quality control work, monitoring work, training work, work of public health related clinical diagnosis and treatment, work of clinical examination and vaccination, work of sampling and testing and public health related consultation work. The work intensity of each category ranged from 4.78 to 7.34. \u0000 \u0000 \u0000Conclusions \u0000The evaluation indicator system of workload is suitable for the evaluation of basic works. The unified transformation of workload by using the value of work intensity is conducive to management evaluation, but the limitation of the indicators exists in time and region, making it necessary to adjust by the local specific situation at the promotion and application level. \u0000 \u0000 \u0000Key words: \u0000Hospitals, public; Disease prevention and control; Evaluation; Indicator system","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"738-742"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43534675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.09.009
S. Cheng, Tao Yuan, L. Yao, D. Wei, Xiuxia Li, Zhenggang Bai, Kehu Yang
Objective To systematically review the barriers and facilitators affecting the implementation of clinical pathways for the clinical pathways. Methods PubMed, Embase, CNKI, CBM, Wanfang, Cvip databases were searched to collect articles about clinical pathways implementation barriers and facilitators from inception to January 4th, 2019. The tool of confidence in the evidence from reviews of qualitative research(CERQual)was used to grade the confidence of each study. Results A total of 43 articles from 12 countries were included.There were 8 main categories and 31 subcategories of the barriers about clinical pathways, including content of the clinical pathways, negative outcomes of clinical pathways, physicians knowledge, physicians attitude, resource availability, implementation of activities, patients factors and social factors. The first three barriers of high confidence were lacking of time, capital, equipment, staff and other resources(15 articles, 34.9%), increasing workload(14 articles, 32.6%), unrecognizing pathways(12 articles, 27.9%). There were 6 main categories and 28 subcategories of the facilitators about clinical pathways, including pathways content related, physician related, resource factor and implementation activity. The first three facilitators of high confidence were communication, education and training(25 articles, 58.1%), supporting from managers and colleagues(21 articles, 48.8%)and establishing a clinical pathway facilitation committee(17 articles, 39.5%). Conclusions The successful implementation of clinical pathways connects with its development process, aftereffect evaluation and feedback. It will be implemented effectively only by the completely and environmentally acceptable pathways design, adequate resources, effective organizational activities, continuous audit, evaluation and feedback and physicians active cooperation. Key words: Clinical pathways; Implementation; Barrier; Facilitator; Systematic review
{"title":"Key factors affecting the implementation of clinical pathways: a systematic review","authors":"S. Cheng, Tao Yuan, L. Yao, D. Wei, Xiuxia Li, Zhenggang Bai, Kehu Yang","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.009","url":null,"abstract":"Objective \u0000To systematically review the barriers and facilitators affecting the implementation of clinical pathways for the clinical pathways. \u0000 \u0000 \u0000Methods \u0000PubMed, Embase, CNKI, CBM, Wanfang, Cvip databases were searched to collect articles about clinical pathways implementation barriers and facilitators from inception to January 4th, 2019. The tool of confidence in the evidence from reviews of qualitative research(CERQual)was used to grade the confidence of each study. \u0000 \u0000 \u0000Results \u0000A total of 43 articles from 12 countries were included.There were 8 main categories and 31 subcategories of the barriers about clinical pathways, including content of the clinical pathways, negative outcomes of clinical pathways, physicians knowledge, physicians attitude, resource availability, implementation of activities, patients factors and social factors. The first three barriers of high confidence were lacking of time, capital, equipment, staff and other resources(15 articles, 34.9%), increasing workload(14 articles, 32.6%), unrecognizing pathways(12 articles, 27.9%). There were 6 main categories and 28 subcategories of the facilitators about clinical pathways, including pathways content related, physician related, resource factor and implementation activity. The first three facilitators of high confidence were communication, education and training(25 articles, 58.1%), supporting from managers and colleagues(21 articles, 48.8%)and establishing a clinical pathway facilitation committee(17 articles, 39.5%). \u0000 \u0000 \u0000Conclusions \u0000The successful implementation of clinical pathways connects with its development process, aftereffect evaluation and feedback. It will be implemented effectively only by the completely and environmentally acceptable pathways design, adequate resources, effective organizational activities, continuous audit, evaluation and feedback and physicians active cooperation. \u0000 \u0000 \u0000Key words: \u0000Clinical pathways; Implementation; Barrier; Facilitator; Systematic review","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"746-751"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45792883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.09.014
J. Zhan, Zhou Xing, Hu Lu, Zebin Wang
The community-friendly program " Online mobile payment of medical insurance" , launched by Guangzhou Municipal Medical Insurance Bureau, poses new challenges to hospital medical insurance management and information intelligence. To this end, the Second Affiliated Hospital of Guangzhou Medical University staged from January 2017 to March 2019 kept upgrading its IT system and built an intelligent monitoring system for medical insurance. These efforts prepared adequately for the medical insurance mobile payment, and explored a mode of medical insurance management, evolving from extensive management to standard and fine management. Key words: Management information systems; Intelligent monitoring system; Mobile payment; Reform; Medical insurance
{"title":"Practice and effectiveness of intelligent monitoring system in the reform of medical insurance mobile payment","authors":"J. Zhan, Zhou Xing, Hu Lu, Zebin Wang","doi":"10.3760/CMA.J.ISSN.1000-6672.2019.09.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6672.2019.09.014","url":null,"abstract":"The community-friendly program \" Online mobile payment of medical insurance\" , launched by Guangzhou Municipal Medical Insurance Bureau, poses new challenges to hospital medical insurance management and information intelligence. To this end, the Second Affiliated Hospital of Guangzhou Medical University staged from January 2017 to March 2019 kept upgrading its IT system and built an intelligent monitoring system for medical insurance. These efforts prepared adequately for the medical insurance mobile payment, and explored a mode of medical insurance management, evolving from extensive management to standard and fine management. \u0000 \u0000 \u0000Key words: \u0000Management information systems; Intelligent monitoring system; Mobile payment; Reform; Medical insurance","PeriodicalId":56974,"journal":{"name":"中华医院管理杂志","volume":"35 1","pages":"770-773"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42183367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-02DOI: 10.3760/CMA.J.ISSN.1000-6672.2019.09.006
Y. Meng, W. Qiu, Kun Wang, Xiao-ling Yan, P. Dong, Guangyu Hu, Yu-jie Yang
Objective To investigate the implementation of disease prevention and control services at tertiary public general hospitals in Beijing for providing evidences to explore and build a scientific evaluation model of disease control service in medical institutions. Methods June to September 2018, through a questionnaire survey of 50 tertiary public general hospitals in Beijing, a descriptive analysis was made on the department setting, personnel allocation and service provision status of disease prevention and control at tertiary public general hospitals in Beijing. Results Among the 44 investigated public tertiary general hospitals, 26(59.1%) medical institutions have set up departments of disease prevention and control. The average staffing of 44 hospitals was 5.8 persons for the department. Professional composition of the staff was mostly nursing and clinical disciplines, and the academic and professional titles were mostly undergraduate and intermediate degrees respectively. Overall performance of disease prevention and control services in public tertiary general hospitals was satisfactory. The work was well carried out in communicable disease control and death-surveillance management, namely in immunoprophylaxis, chronic noncommunicable diseases and injury monitoring, which varies widely in mental health services, occupational health management, environmental and health monitoring and other functions. Conclusions Professional ability and management level of personnel still need to be improved. We should further clarify the joint prevention and control mechanism of the " Three-in-one" nature of disease control institutions, medical institutions and communities, promote the combination of medical treatment and prevention, and explore the classification and grading evaluation of disease control work based on the types and quantity requirements of disease prevention and control services undertaken by hospitals, so as to effectively improve the level of disease control services in hospitals. Key words: Hospitals, public; Tertiary general hospital; Disease prevention and control; Status analysis; Beijing
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