目的 了解基层村卫生室门诊处方费用情况.方法 于2022年采用多阶段分层抽样的方法,在临沂市某县抽取村卫生室31家.以纳入机构的2022年门诊处方为研究对象,分析基本药物制度背景下村卫生室的门诊处方费用情况.结果 共纳入村卫生室门诊处方795张.该县村卫生室门诊处方费用中位数为20.3元,"大处方"费用中位数为23.3元,抗生素处方费用中位数为22.5元,激素类处方费用中位数为24.5元,注射剂处方费用中位数为21.8元,中成药处方费用中位数为26.2元.经济发展水平较好地区的处方、中成药处方、肌肉骨骼系统和结缔组织疾病患者与内分泌、营养和代谢疾病患者的处方费用水平相对较高.结论 村卫生室门诊处方费用有所回升,不同性别、年龄患者的处方,不同用药特征处方(是否抗生素处方、是否激素处方、是否注射剂处方、是否"大处方")的费用水平差异无统计学意义.区域经济水平、中成药使用情况是处方费用的主要影响因素.

目的:对国内三级医院患者门诊和住院医药费用构成情况进行分析,为宏观政策制定和三级医院治理提供决策依据.方法:利用结构变动度、结构变动值、结构变动贡献率以及拉动力等指标综合分析2012-2018年三级医院患者次均门诊和住院医药费用构成变动趋势.结果:三级医院患者次均门诊和住院医药费用中药费比例不断降低,费用中医疗费、护理费等比例不断增加;医药费用中药费占比较大,卫生材料费增长趋势需要引起重视.结论:医改以来三级医院患者次均医药费用构成不断优化,在控制住院费用过快增长方面取得一定效果,但还需持续控制和引导.此外,还需加大力度完善医保制度,提升医疗服务可及性.

[目的]研究医生的职业特征与职业枯竭的关系及其在医生职业枯竭形成中的作用,从而为医生创造更好的执业环境.[方法]按照分层随机抽样原则分别从济南、潍坊、德州抽取公立医院医生,采用课题组自编的“职业枯竭”和“职业特征”分量表进行调查.共发放量表2102份,有效量表1910份,有效率回收率为95.07％.[结果]分层回归分析的结果显示,在控制了人口统计学变量之后,职业特征所解释的方差变异量,在情感枯竭维度、去人性化维度、职业承诺维度和成就感维度4个维度分别增加了37.4％,14.1％,13.3％和9.1％.[结论]职业特征可以有效的预测医生的职业枯竭,工作负荷重、长时间情绪压抑、职业风险高、学习占用休息时间较长可增加职业枯竭的产生.

Objective: To investigate the organizational and social factors which cause doctors' job burnout.Methods: 2102 doctors from public hospitals in Jinan,Weifang,Dezhou were selected by stratified random sampling to receive a self-compiled scale which involves job burnout,organizational resources and social resources and the valid samples were 1910.The effective return rate is 95.07%.First,factor analysis is used to extract factors as the organizational and social factors which influence doctors' job burnout.Then the important quadrant model is used to find out the factors needed to be solved preferentially.Results: Among the 7 organizational and social factors,institutional environment,regulations support and social evaluation are the key factors.Conclusion: Theinstitutionalenvironment,regulationsupportandsocialassessmentarethefactorsneedtobeimprovedfirstlywhensmoothingdoctors'jobburnout.

The article defined the new rural cooperative medical system basic elements of the long-term effective mechanism from five aspects,such as equity,efficiency and stability,and analyzed its basic characteristics.Through researching in Weifang City,problems and causes of new rural cooperative medical system analysis are explored,and then targeted comments are taken.

This paper investigated current situation of the new rural cooperative medical system fund management in Shandong province.It analyzed the achievements and shortcomings,put forward the corresponding suggestions to promote the healthy and continuous development of new rural cooperative medical systems.

[目的]了解公立医院医生职业枯竭与离职倾向之间的关系。[方法]按照分层随机抽样原则分别从济南、潍坊、德州抽取公立医院医生作为调查对象。采用课题组自编"职业枯竭"和"离职倾向"分量表进行调查。共发放量表2102份,有效量表1910份,有效率回收率为95.07%。[结果]性别、年龄、学历、医院级别等人口学统计变量对医生职业枯竭和离职倾向有着不同的影响,职业枯竭的三个维度:情感耗竭、成就感、去人性化均对离职倾向的回归效果明显。[结论]医生职业枯竭能够有效的预测医生离职倾向。

Objective To understand the human resources situation of township health centers in Weifang City,government departments for the rational allocation of human resources for health and medical institutions to provide reference for comprehensive reform.Methods 148 township health centers in Weifang City in 2010 were conducted by a questionnaire survey.The whole of township health centers'overall situation,age structure,educational structure,composition of professional titles and composition analysis are done.Results In township health centers in Weifang City,the preparation on the number of personnel and personnel quality are low in general.Conclusion Effective measures should be adopted to train and introduce talent to improve the health technical personnel's quality and ability.