对外交流与合作是推动医院发展的重要工作,相关负责部门作为协作交流的纽带和窗口,是提高协作效率的重要支撑.本文拟通过对A医院对外协作单位的运行和管理现状进行分析和研究,结合医院协作单位管理工作的主要工作内容和实际情况,找出协作医院管理中存在的问题和协作壁垒,并借鉴成熟规范的系统化管理模式和经验,为新形势下更科学有效管理医院间合作提供依据和参考.

新冠肺炎疫情的爆发对全国卫生系统应对重大突发性公共卫生事件能力提出重大考验和更高要求.复旦大学附属儿科医院作为儿童新冠肺炎定点收治医院,运用4R危机管理理论,通过在缩减阶段、预备阶段、反应阶段及恢复阶段对疫情防控进行科学、有序、规范的处理,从而降低新冠病毒传播风险,为其他医疗机构提供参考经验.

通过对某医院国际合作与交流工作进行系统的分析,总结该医院国际化发展战略的实施效果及其对医院发展的推动作用,为我国医院开展国际交流与合作提供参考经验.

Objective To know the health status of the disabled in Shanghai and to provide scientific basis for health intervention and management of disabled persons. Methods Through the ” Comprehensive Information Platform for Rehabilitation” of Shanghai Disabled Persons' Federation,93 267 health examination data of the disabled were collected from Shanghai Sunshine Rehabilitation Center from January 2011 to August 2014,and from Shanghai Training Center of Vocation and Rehabilitation from January 2013 to June 2014 ( 61 969 in the former institution and 31 298 in the latter) . The basic demographic information,disability type,and physical examination data were primarily collected,and the detection status of disease,positive signs and abnormal indicators in laboratory of the disabled were calculated and analyzed. Results Among the 93 267 disabled persons,the top 3 types of disability were limbs disability(49. 71% ,46 361 / 93 267),visual disability (21. 09% ,19 672 / 93 267),and mental disability(12. 89% ,12 021 / 93 267). The top 3 detection rate of diseases were fatty liver(38. 22% ,21 877 / 57 243 ),fundus atherosclerosis( 37. 37% ,28 153 / 75 336 ) and pharyngitis( 31. 90% , 14 716 / 46 126);the top 3 detection rate of positive signs were high blood pressure(44. 23% ,40 853 / 92 364),increased and thickened lung markings(43. 04% ,33 539 / 77 928)and overweight(35. 43% ,32 276 / 91 097)respectively;the top 3 detection rate of abnormal indexes in laboratory were urine specific gravity(34. 83% ,27 007 / 77 524),red cell distribution width( 31. 32% , 28 939 / 92 389 ), and the amount of basophilic granulocyte ( 30. 53% , 24 710 / 80 941 ) respectively. Conclusion The health status of the disabled in Shanghai is poor and complex. It is suggested that the relevant departments should pay more attention to the status of the disabled so as to achieve the standardization health information collection of the disabled.

Objective To understand the usage of causes of action in public health administrative punishment cases of Shanghai in 2013 and provide suggestions. Method Data were collected from health supervision integrative application platform of Shanghai and analyzed by Excel 2007. Results The percentage of using causes of action of public health admin?istrative penalty was 46.05%, the percentage of using causes of action of public places, drinking water sanitation, disinfec?tion hygiene, radiation health, school health, infectious disease control were 71.43%、70.00%、66.67%、47.83%、33.33%and 31.34%respectively;the cumulative frequency of the top four causes of action in public places was 86.34%, the top three in drinking water sanitation was 91.54%,the top five in disinfection hygiene was 90.36%, the top five in radiation health was 80.12%, the top three in infectious disease control was 61.46%.Conclusions The using ratio of causes of action among professional lines of public health in 2013 was different, each professional line were not balanced and focus on small part.

Objective To understand the features of health administrative punishment cases in Shanghai from 2009 to 2013 and provide the suggestions. Method Our data were collected from health supervision integrative application platform of Shanghai and analyzed by Microsoft Excel 2007 Software. Results The number of the cases was totally 51 249 within five years, which came from supervision accounted for 92.23%,complaint or report accounted for 5.31%, especially the medical practice cases that came from social report accounted for 18.71%;multiple causes of action cases was 7.7%of all, 9.53%of public health cases, only 0.73%of medical practice cases;the cases that given warning, penalty, warning and fine were 32.86%,33.13%and 33.71%respectively of public health cases, 25.45%,63.15%and 2.17%respectively of medical licensed cases, the penalty amount were respectively ￥37 301 601 and￥37 018 310, the average penalty amount were￥1 341 and￥5 110,summary procedure cases accounted for 24.51%of public health cases and medical licensing only 3.75%,the hearing cases were 75 and 29 respectively. Conclusions Supervision was the main source of the cases, com?plaint or report was important source of medical practice cases compared with public health cases;multiple causes of action cases focus on public health cases;the proportion of summary procedure cases of public health cases was higher, the aver?age penalty account lower than medical practice cases.

Objective To know ophthalmic testing status of the disabled in Shanghai and provide information of prevention,treatment and health guidance of eye disease for the disabled. Methods Through the ” Comprehensive Information Platform for Rehabilitation” of Shanghai Disabled Persons' Federation,75 336 ophthalmic examination data of the disabled were collected from Shanghai Sunshine Rehabilitation Center from January 2011 to August 2014,and from Shanghai Training Center of Vocation and Rehabilitation from January 2013 to June 2014(45 084 in the former institution and 30 252 in the latter). The basic demographic situation of the disabled, disabled characteristics and ophthalmologic examination data were mainly collected. The detection results of ophthalmological abnormalities of the disabled with different genders,ages and disease characteristics were compared and analyzed. Results 145 kinds of ophthalmologic abnormalities were detected,and the top three detection rate of ophthalmologic abnormalities were fundus arteriosclerosis(37. 37% ,28 153 / 75 336),ametropia(16. 47% , 12 406 / 75 336),and cataract(15. 77% ,11 879 / 75 336) respectively. ( 1 ) There were significant differences in the detection rate of fundus arteriosclerosis,ametropia,cataract,pterygium,vitreous opacity,macular degeneration,retinopathy and fundus lesions of the disabled with different genders(P < 0. 05);there was no significant difference in the detection rate of blindness and strabismus(P > 0. 05). (2)There were significant differences in the detection rate of fundus arteriosclerosis, ametroia ametropia,cataract,pterygium,vitreous opacity, blindness, macular degeneration, retinopathy, strabismus and fundus lesions among the disabled with different ages(P < 0. 05). (3)There were significant differences in the detection rate of fundus arteriosclerosis,ametropia,cataract,pterygium,vitreous opacity,blindness,macular degeneration,retinopathy, strabismus and fundus lesions among the disabled with different disability types( P < 0. 05). (4) There were significant differences in the detection rate of fundus arteriosclerosis,ametropia,cataract,pterygium,macular degeneration and strabismus among the disabled with different levels of limbs disability(P < 0. 05);there were significant differences in the detection rate of fundus arteriosclerosis, ametropia, cataract, pterygium, vitreous opacity, blindness, macular degeneration, retinopathy, strabismus and fundus lesions in the disabled with different levels of vision disability( P < 0. 05 );there were significant differences in the detection rate of fundus arteriosclerosis,cataract,pterygium and strabismus among the disabled with different levels of intellectual disability( P < 0. 05);there were significant differences in the detection rate of fundus arteriosclerosis, cataract,ametropia,pterygium,vitreous opacity and macular degeneration among the disabled with different levels of hearing disability(P < 0. 05);there were significant differences in the detection rate of fundus arteriosclerosis and ametropia among the disabled with different levels of mental disability( P < 0. 05 );there were significant differences in the detection rate of ametropia,vitreous opacity,macular degeneration,retinopathy and fundus lesions among the disabled with different levels of multiple disability(P < 0. 05). Conclusion The detection rate of ophthalmic abnormalities of the disabled in Shanghai is high, and there are differences in the detection rate of ophthalmologic abnormalities among the disabled with different demographic characteristics. It is suggested that ophthalmological health examination should be carried out to help the disabled to form good living habits.

Objective To know the features of medical practice administrative penalty cases in Shanghai from 2009 to 2013 and provide suggestions. Method Our data were collected from health supervision integrative application platform of Shanghai and analyzed by Microsoft Excel 2007 Software. Results During the 5 years, the number of medical practicing ad?ministrative punishment cases is 9799, cases from the supervision and inspection and complaint or reporting accounted for 78.70%and 18.71%respectively, complaints cases increased from 195 to 444 from 2009 to 2013;Brief of a case and brief cases accounted for 99.27% and 0.73% respectively; General procedure and summary procedure cases accounted for 96.25% and 3.75% respectively; Cases given warnings, fines and warnings + fines accounted for 25.45%, 63.15% and 3.17%;Medical practicing fine cases averaged 5110 yuan, maximum fines and minimum fines are 376134 yuan and 50 yu?an respectively. Conclusions Supervision and inspection is the main source of medical practice administrative penalty cases, the number of cases reported from the community has increased year by year;Cases are mainly composed of Brief of a case and general procedures;Penalty types are given priority to with fines and warning.

Objective To understand the features of public health administrative penalty cases in Shanghai from 2009 to 2013 and provide the suggestions. Method Our data were collected from health supervision integrative application plat?form of Shanghai and analyzed by Microsoft Excel 2007 Software. Results The number of public health punishment cases was totally 41450 within five years, decreased from 9029 in 2009 to 7640 in 2013;the cases from supervision and monitor?ing report accounted for 95.42%and 2.35%respectively;single cause of action and multiple cause of action cases account?ed for 90.65%and 9.35%respectively;summary and general procedure of cases accounted for 24.51%and 75.49%respec?tively;Warning, fine,warning and fine cases accounted for 32.86%, 33.13%and 33.71%respectively and the average fine was￥1341, the minimum fine was￥10 and the maximum fine was￥150000. Conclusions Public health administrative penalty cases showed a trend of decline, supervision and inspection was the main source, punishment cases was given prior?ity to single cause and general procedure, warning and fine was the main method of punishment case.

Objective To understand usage and characteristic of the cause of action of medical practice of administra?tive punishment in 2013 and provide a reference basis for improving health administrative penalty work. Methods To col?lect and organize the health administrative penalty cases data from the Shanghai health supervision integrated application platform of 2013, using Excel 2007 to analyze. Results The usage rate of available medical practice of administrative pun?ishment cause of action in 2013 was 30.33%, of which the highest usage rate of cause of action of professional was medical institutions (64.71%), followed by the maternal and infant health care professional (44.14%), and the lowest was blood health professional (2.13%);The usage rate more than 10%of the cause of action of medical institutions of administrative punishment cases is one kind with 62.00%;There are two kinds both in Medical staff and maternal and infant health care , which are 55.00%, 24.05%and 47.06%, 43.14%. Cause of action actually use in malpractice and blood health is both one kind. Conclusion Overall the use of the ratio of medical practice of administrative punishment cases available in 2013 was not high and the ratio of cause of action in each major existed imbalance.

Objective To deeply understand the status, achievements and issues of Health Supervisory system. Meth?ods Focus Group Discussion and questionnaire survey are used to collect views and suggestions about Health Supervision system development. Results The issues existing in the field of health supervision include:institutional nature is not clear;the name of institutions is not uniform;function of different levels of institutions is not clear;personnel is insufficient , and the quality needs to be improved;the funding is not enough, some agencies still charge for their livelihood;housing and equipment could not meet the requirements;institutional reform leading to weakening functions and unstable team;health laws and regulations lag behind;the lack of the necessary technical support in the enforcement process. So interviewees ex?pect a new round of institutional reform to solve these problems and to strengthen role of health supervision. Discussion Health Supervision system faces many problems, top-level design is very essential. Specifically, the nature of institution should be defined, the functions should be made clear, the personnel and the funding should be strengthened to further im?prove the Health Supervision system.