通过对国内外价值医疗的探索和经验的总结,阐明以价值医疗为导向推动支付方式改革的必要性和具体路径,明确了公立医院面临支付方式改革新时期下,公立医院应重点从提升患者就医体验、建立价值医疗考评框架、强化医疗数据支持作用等维度入手,改革管理模式,提升管理效能.

Objective To analyze the impact of the comprehensive reform of public hospitals in Tianjin on the cost structure of inpatients at a tertiary general hospital.Methods Homepage data of the medical records from January 2015 to June 2018 were selected from a tertiary general hospital in Tianjin.The Beijing version of diagnosis related groupings(BJ-DRGs) was used to compare the expense structure of these inpatients before and after such a reform.Wilcoxon signed rank sum test,Z test and Pearson correlation analysis were performed for each index.Results Since the reform,the number of hospital discharges and that of DRGs had remained basically stable,while the case mixed index(CMI) weight increased slightly(from 1.0065 to 1.0386);the total hospitalization expenses,medical expenses,nursing expenses,management expenses and consumables expenses had increased.On the other hand,the expenses of medication and medical technology decreased,and the differences of these expenses were statistically significant (P ＜0.05).The time consumption index (0.87) and drug consumption index (0.80) were always lower than average,but the cost consumption index (1.38) remains above average with a slight rise.Conclusions The reform of public hospitals in Tianjin has encouraged such hospitals to improve their service procedures by adjusting such measures as pricing of medical services,and promoted their proactive management of hospitals.Hence the initial goal of "controlling costs,adjusting structure,and reducing costs" has been met.However,cost rise control still deserves major attention.

目的 分析老年患者压疮治疗中集束化理念的应用意义.方法 选择2016年4月～2017年12月期间收治的106例老年压疮患者,随机抽选53例设为对照组,给予常规治疗,余下53例设为干预组,治疗中应用集束化理念,评价两组治疗效果,调查患者满意度.结果 干预组总有效率为96.2％(51/53),对照组总有效率为81.1％(43/53),干预组效果更好(P<0.05).干预组满意度评分为(94.2±3.49)分,对照组为(82.4±7.93)分,干预组显著高于对照组(P<0.05).结论 老年压疮患者治疗中应用集束化理念,疗效显著,且患者满意度高.

医疗保险相关专业是近年来新兴专业,关乎我国社会保障体系中医疗卫生保险制度改革的顺利开展。为规范医疗保险专业建设,明确专业发展方向,适应社会需求,就京津地区医疗卫生行业、保险公司和社保结算中心等机构对医疗保险专业人才的需求,开展科学调查,依据结果进行分析,为医疗保险专业人才培养模式改革提供依据。

ObjectiveTo evaluate a hospital from 2003 to 2012, the quality of medical work for the hospital administration to provide the scientific basis for decision making.MethodsTOPSIS method in a hospital with the trends in health care quality data and normalized.ResultsThe quality of medical care generally increased year by year, in 2003 less, in 2012 the best evaluation Results broadly in line with the actual situation.Conclusion The evaluation of medical quality TOPSIS method for small sample size and flexible, feasible, accurate quantitative Results with high practical value.