推动精神生活共同富裕是迈向共同富裕的重要内容,也是一个复杂的矛盾体.它不是精神生活的平均或同一,而是使每一个体实现精神生活的自由全面发展,即以精神境界充分提高为内核带动精神财富极大丰富和幸福感的最大获得.矛盾论视域下,主体、客体和环境构成推动精神生活共同富裕的主要矛盾,而主体精神素养的培育则构成矛盾的主要方面,因为精神生活不同于物质生活的根本前提在于人必须要有相应的主体精神素养,否则即使给予也享受不了,而且满足精神生活的物质条件未必能实现相应的精神生活主体素养,高水平的精神生活也未必依赖物质条件的满足.进一步看,要以心理特征、理想信念、人生哲学等关键因素作为提升主体精神素养的先导,同时嵌入客观对象和环境使其更好地支撑前者,通过有机结合最终真正助力精神生活共同富裕.

利用不用极限的初等微积分原理,尝试解决物理发展初期和微积分密切相关的几个问题,给出高中生可以接受的讲法,使得高中物理讲授的内容更成体系,更具有一般性.同时有助于高中生在学微积分之前就能够生动形象地理解微积分的核心思想与具体应用,为今后学习微积分奠定良好的基础.

目的 调查我国公立医院患者满意度情况,为提高医院医疗服务质量提供依据.方法 以微信为载体,调查2019年1月1日-12月31日全国二级及以上公立医院门诊和住院患者满意度.采用得分描述数据结果.结果 共调查了7145家二级及以上公立医院,共采集门诊患者有效样本262.10万份,住院患者有效样本276.21万份.门诊患者总满意度得分为84.69分,对"护士沟通"和"医生沟通"满意度相对较高,对"环境与标识"满意度最低;住院患者总满意度得分为90.18分,对"对亲友态度""医务人员回应""医生沟通"和"护士沟通"满意度相对较高,对"餐饮服务"满意度最低.不同地区、等级、类型医院患者满意度存在差异.结论 我国公立医院患者总满意度较高,人文关怀得到加强.但后勤服务能力需进一步提升,妇幼保健院需进一步加强患者疼痛管理.

Objective:To analyze the changes in the number and workload of pediatricians, for evidences in further optimizing the allocation of pediatrician resources and formulating relevant policies in China.Methods:According to data from the National Bureau of Statistics and the " China Health and Health Statistics Yearbook", descriptive analysis was made to investigate the changes in the number and workload of pediatricians in China from 2010 to 2019.Results:During 2010 and 2019, the number of pediatric practitioners(assistants) increased from 115 800 to 158 500, and the growth rate was faster than that of the children aged 0-14 years, but slower than that of overall medical practitioners(assistants). The number of pediatric practitioners(assistants) per thousand children in China had grown steadily from 0.52 to 0.67, compared with the burden and the workload of medical practitioners nationwide, the workload of pediatricians was still relatively heavy.Conclusions:The number of pediatricians had increased gradually between 2010 and 2019, and the effects of various policies began to work, while the workload was still heavy. It is recommended to further develop a salary system and supporting policies in line with the characteristics of pediatrics sector, and focus on such problems as unbalanced and inadequate distribution of pediatricians.

在"强基层""大健康"背景 下,家庭医生签约服务作为基层医疗卫生服务的重要组成部分,对我国推进分级诊疗制度、建立合理就医秩序和完善医疗服务具有重要作用.本文通过对我国家庭医生相关政策颁布及推行进行讨论,分析其经验、问题与不足,为我国家庭医生签约服务的进一步推行提供借鉴.在文献综述及个案分析的基础上,对我国家庭医生相关政策发展和实践进程进行梳理,指出我国家庭医生政策大致经历了酝酿萌芽、试点探索、渐进推广和全面实施4个发展阶段,并对每个阶段家庭医生签约服务的政策内容及推行情况、实践结果 进行分析讨论.最后提出符合中国特色的六方面参考建议:推进家庭医生制度政策保障,借助医保支付调整医疗资源分配;加强家庭医生人才队伍建设,鼓励开设全科医学课程;建立合理激励机制,增强家庭医生工作热情;加快推进医疗信息共享平台建设;依托医疗联合体,推进双向转诊机制;建立合理的监督机制和评价指标体系.

充分利用医疗行为和业务处理过程中产生的海量数据,既有利于医疗临床科研工作和公共卫生事业的发展,也将有利于医疗行业治理方式的改善.科学地运用、分析健康医疗大数据,可以充分地评价医生个体、部门、医疗机构、区域等不同层级临床、运营、管理方面的情况,从而为管理决策提供有效支撑.高质量数据的采集、应用和分析是使用数据对医院进行科学管理的前提和难点,需要通过顶层设计统筹部署、完善相关政策、加强专业人才培养等方式予以解决.

2019年国家二级、三级公立医院绩效考核启动,这标志着我国公立医院绩效考核体系基本成型.通过总结梳理我国公立医院绩效考核政策的演进历程,将政策发展分为理论探索期、试点实践期、全面实施期三个阶段,并从基本理念、功能定位和发展趋势三个方面分析公立医院绩效考核政策的发展特点,提出加强绩效辅导、合理运用结果、提高数据质量等建议,以期为完善我国公立医院绩效考核体系提供参考.

英文摘要是医学论文的重要组成部分.作者以某双核心医学期刊2018年全部252篇文章的中英文摘要为研究对象,采用系统随机抽样法抽取10篇作详细分析,发现样本存在六类典型问题:时态和语态错误,悬垂修饰语,修饰语错位,名词肿胀,名词单复数误用,词语搭配不当.这六类问题须认真对待,方能有效提高医学论文英文摘要的质量.

职称制度是专业技术人才评价和管理的基本制度,对于党和政府团结凝聚专业技术人才,激励专业技术人才职业发展,加强专业技术人才队伍建设具有重要意义. 卫生专业技术人员是我国专业技术人才队伍的重要组成部分.2020年末,我国卫生专业技术人员数量已达1066万,是新时代实施健康中国战略的中坚力量.临床实践能力是卫生专业技术人员技术水平和专业能力的重要体现.但在以往的职称评价工作中,由于临床实践工作缺乏统一的、可获取的衡量指标和参照标准,多以论文、科研项目、获奖情况等作为主要考察内容,导致职称评价出现唯论文、唯学历、唯奖项、唯"帽子"的"四唯"倾向,给卫生专业技术人员造成负担和困扰,并在一定程度上出现了重视科研成果而轻视临床诊疗能力的问题.

在公共管理的发展变革过程中,绩效考核作为一项重要的管理工具,在其中发挥了重要作用.目前,绩效考核已经被引入医疗行业,作为行政部门对医疗机构进行监督、管理、引导的重要手段.该文对公立医院绩效考核涉及到的目的、结果应用、内容和方法等进行了理论探讨,同时结合三级公立医院绩效考核的具体工作分析了公立医院绩效考核的实践应用情况.

回顾了目前患者满意度调查通常采用的方法及其各自的优缺点.介绍了以微信为载体在统一时间、统一方法、统一标准、统一路径下,对全国二级及以上公立医院开展满意度调查,实现了“一把尺子量全国”.相比其他常用的调查方法,采用微信对患者满意度进行调查,具有经济、高效、同质、动态等优点.

公立医院绩效考核是检验公立医院改革发展成效的重要标尺.2019年1月,国家启动三级公立医院绩效考核工作,通过一年的考核实践,国家卫生健康委已建立起标准化、信息化绩效考核支撑体系,统一了绩效考核所需的编码规则,建成并开放国家公立医院绩效考核管理平台,各省份已自建省级绩效考核平台或依托国家平台开展属地化考核工作,为全面推进公立医院绩效考核工作奠定了基础、积累了经验.

Analysis of staff satisfaction at public hospitals across China [Abstract] Objective To measure the job satisfaction of healthcare workers in public hospitals nationwide, and to find out ways that can improve healthcare. Methods Using the data obtained from " A Mobile Technology-based Satisfaction Survey of Public Hospitals across China" , this paper analyzed the engagement of public hospital employees by categorizing them according to sex, educational level, workplace and academic rank title. Five dimensions including their salary and benefits, career development, work environment, communications between superiors and subordinates, and peer relationships were taken into consideration. And descriptive statistics were used to describe the basic features of the data in this study. Results With an employee satisfaction of 76.83 points, hospitals that were involved in the study report a positive working relationship among their employees, particularly a harmonious one between superiors and subordinates. But the paper also found that healthcare workers were usually less satisfied with their income and their work environment. Conclusions To further motivate health professionals, we should make efforts to establish a salary system that is in line with their expectations, to improve their work environment, and to focus more on the career development of junior staff.

Objective To measure the job satisfaction of healthcare workers in public hospitals nationwide, and to find out ways that can improve healthcare. Methods Using the data obtained from A Mobile Technology-based Satisfaction Survey of Public Hospitals across China , this paper analyzed the engagement of public hospital employees by categorizing them according to sex, educational level, workplace and academic rank title. Five dimensions including their salary and benefits, career development, work environment, communications between superiors and subordinates, and peer relationships were taken into consideration. And descriptive statistics were used to describe the basic features of the data in this study. Results With an employee satisfaction of 76.83 points, hospitals that were involved in the study report a positive working relationship among their employees, particularly a harmonious one between superiors and subordinates. But the paper also found that healthcare workers were usually less satisfied with their income and their work environment. Conclusions To further motivate health professionals, we should make efforts to establish a salary system that is in line with their expectations, to improve their work environment, and to focus more on the career development of junior staff. Key words: Health manpower; Hospital staff; Work satisfaction; Online survey

Objective To get an understanding of the patient experience in public hospitals nationwide, and to evaluate the implementation of the Action Plan to Improve Health Care. Methods Supported by the mobile technology, from September 6, 2017 to December 15, 2018, the authors conducted an online survey that measured the satisfaction of both inpatients and outpatients at secondary and tertiary hospitals across the country. 15 questions from six dimensions including registration experience, patient-doctor communication, nurse-patient communication, the healthcare signage system, responsiveness of care providers and privacy protection were prepared for outpatients, while 20 questions from nine aspects such as nurse-patient communication, patient-doctor communication, pain management, medication communication, admission and discharge information, responsiveness of care-givers, food service, friendliness to patient family, and the healthcare signage system were directed at inpatients. Descriptive statistical analysis was used to describe the basic features of the data. Results 9.18 million valid responses from outpatients and another 5.38 million from inpatients were obtained. The overall satisfaction rate with outpatient services had reached a score of 90.45 points where nurse-patient communication stands out as the top-rated dimension and privacy protection gets the lowest rating. On the other hand, the inpatient satisfaction stands at a score of 93.01 with friendliness to patient family receiving the top score and patient-doctor communication the lowest. Conclusions Despite the positive feedback Chinese patients give on the outpatient care they receive, we should make efforts to improve the outpatient care environment, the wayfinding system, privacy protection, and responsiveness of care-givers.

《“健康中国2030”规划纲要》明确提出要“优化多元办医”.如何发挥社会力量举办医疗卫生机构是值得思考的问题.通过分析国内社会办医现状以及面临的困境,提出相应的对策建议,为促进社会办医、实现健康中国提供借鉴.

According to the requirement of public hospital reform,further implementation was needed to for current public hospitals compensation mechanism to improve the hospital establishing a new mechanism and modern hospital management system to maintain public welfare,mobilize enthusiasm and ensure sustainability.By optimizing the development circle of public hospitals,establishing a dynamic price adjustment mechanism for medical services,perfecting medical insurance system to control the medical expense,fully implement the supervision and accountability in the reform of compensation mechanism,the overall promotion of China's health care reform would be contributed.

通过对国内医养结合相关政策进行梳理及分析,指出医养结合政策大致经历了酝酿萌芽、起步探索、落实发展和深化完善等阶段.目前,国内医养结合的实践工作已经取得了较大进展,但是还存在一定不足,可以在下一阶段的政策制定工作中予以完善.同时,从注重将医养结合延伸至家庭和社区、加强对重点人群的关注、引导社会力量发挥积极作用、加强监督评价及其应用等方面提出了进一步加强医养结合工作.

With the development of social and economy and the reform of healthcare,there is common phenomenon that tertiary hospital gets too large scale which has caused a series of problems.Causes and countermeasures of scale expansion of tertiary hospitals has been analyzed.It shows that medical resources allocation standard such as beds,drug,medical staff and the mode of charge are the main influence factors for scale expansion and implementing regional health planning,carrying out DRGs payment system and revising resources allocation standard can improve current situation.