目的:探讨根本原因分析法(root cause analysis, RCA) 在我国医疗安全质量管理中应用的研究现状、热点与前沿,为未来RCA 在医疗安全质量领域更广泛的应用提供参考.方法:检索2000-2022 年CNKI数据库收录的RCA 在医疗安全质量管理应用的相关文章,运用CiteSpace 6.1.R 2 对发文量、作者、发文机构、关键词等进行可视化分析.结果:共纳入文献507 篇,发文量可分为孕育期、发展期和平稳期3 个阶段.对文献进行作者及发文机构共线分析发现,作者和发文机构分散,无高产作者与机构.作者间和机构间合作少,未形成稳定的合作团体.对关键词进行共现、聚类和突现分析发现,研究热点聚焦在安全管理、护理、跌倒、原因分析、不良事件、手术室、依从性等方面,研究范围逐步扩大,内容由单一不良事件发展至类别事件分析.结论:RCA正在逐步应用于医疗安全质量管理领域,研究内容有待拓展,质量有待提高,未来应进一步加强应用范围的延伸,创造出更有价值的医疗安全质量管理理念与方法.
Objective:This study aims to conduct bibliometric and visual analyses on commercial health insurance research in China,understanding the current research landscape and shortcomings,providing insights for future development.Methods:CNKI was used as the literature data source to retrieve articles related to commercial health insurance from January 1,1998 to March 7,2023.CiteSpace 6.1.R4 software was applied for co-occurrence analyses of authors and institutions,and for keyword analysis.Results:The search yielded a total of 1373 articles,contributed by 306 authors across 261 research institutions.However,connec-tions among authors and institutions were observed to be sparse.The top ten keywords by frequency include"basic medical insur-ance(frequency 266),premium income(frequency 67),influencing factors(frequency 37),moral hazard(frequency 35),tax incentives(frequency 28),risk control(frequency 27),health management(frequency 25),Huimin Insurance(frequency 15),adverse selection(frequency 14),business model(frequency 8)".The emerging keyword of note was"Huimin Insurance"with a strength of 4.94.Conclusion:Articles on commercial health insurance in China have been increasing,but a core author group has not yet emerged,indicating a lack of collaboration among research institutions.Research focuses on the integration of basic and commercial health insurance,demand,business models,and supervision."Huimin Insurance"is emerging as a future research hotspot.
Objective:To comprehensively evaluate the law enforcement effectiveness of county-level health supervision insti-tutions in Henan province,to understand the current situation of law enforcement effectiveness,and propose corresponding improve-ment measures,so as to enhance the enforcement effectiveness of health supervision and promote the sustainable development of health supervision.Methods:Ten county-level health supervision institutions in Henan province were selected as the evaluation objects.The weighted sum comprehensive evaluation method,TOPSIS method,and RSR method were collectively used to compre-hensively evaluate and rank the law enforcement effectiveness of health supervision agencies in 2021 from four dimensions:supervi-sion capacity,supervision efficiency,supervision effect,and supervision benefit.Accordingly,the main factors affecting the law enforcement effectiveness were studied and explored.Results:Among the four dimensions,supervision efficiency had the highest score(0.80),followed by supervision capacity(0.56),and supervision effect had the lowest score(0.32).Among them,the scores for human resources,funding input,facilities and equipment,emergency response capability,law enforcement and case handling,departmental evaluation,health benefit and social benefit were relatively low.The TOPSIS evaluation results showed that among the ten county-level health supervision agencies,County A ranked first in the law enforcement effectiveness.Combined with the RSR method,the evaluation results were divided into three levels,with County A and County F rated as"excellent",County G rated as"poor",and the remaining seven counties rated as"average".Conclusion:There are significant differences in the law enforcement effectiveness of county-level health supervision institutions in Henan province,the effect and beneficial result of law enforcement should be improved,and more investment is needed to bolster weak spots.
Objective:To understand the turnover intention of TCM practitioners in grassroots medical institutions in Guangxi,and explore the influence of work pressure,personal development satisfaction and social support satisfaction on turnover intention,so as to provide basis for improving the stability of TCM practitioners in grassroots medical institutions in Guangxi.Methods:The turnover intention of 1959 TCM practitioners in grassroots medical institutions was investigated by multistage sampling method.This study analyzed the related factors of turnover intention by using binary logistic regression analysis method.Results:Among the 1959 TCM practitioners,570(accounting for 29.10%)had the turnover intention.Gender,spouse status,income level,education lev-el,professional title level,work pressure,welfare satisfaction,interpersonal satisfaction,job satisfaction,personal development satisfaction and social support satisfaction(P<0.01)had significant effects on turnover intention.Conclusion:The turnover inten-tion of men and unmarried people is stronger than that of women and married people.Education,professional title level and work pressure are positively correlated with turnover intention.Income level and related job satisfaction factors are negatively correlated with turnover intention.It is suggested to improve the management system of TCM practitioners in grassroots medical institutions,improve wages and benefits,and enhance the career development space,and reduce the turnover willingness of TCM practitioners in grassroots medical institutions.
Objective:To explore the influence of Internet game addiction on undergraduate and junior college students'sub-jective well-being in Hunan and Chongqing,so as to provide references for improving students'subjective well-being.Methods:The Internet game addiction scale,UCLA loneliness scale,sense of emptiness scale,index of well-being were used to study 768 undergraduate and junior college students in Hunan and Chongqing.Results:The subjective well-being score of students was 10.36±2.84.The subjective well-being of students was significantly negatively correlated with Internet game addiction,loneliness and emptiness.Internet game addiction significantly and negatively predicted subjective well-being(β=-0.156,P<0.001),lone-liness mediated the relationship between Internet game addiction and subjective well-being(effect value-0.091,95%CI:-0.113,-0.072),and emptiness mediated between Internet game addiction and subjective well-being(effect value-0.023,95%CI:-0.041,-0.004).Conclusion:Internet game addiction significantly affects undergraduate and junior college students'subjective well-being,and loneliness and emptiness play parallel mediating roles between Internet game addiction psychology and subjective well-being.
