目的:对MRI设备扫描序列指标体系进行约简优化.方法:运用德尔菲法在全国东北、华北、华中、华南、华东、西北、西南七大区域范围内选取10个省份的58名专家,采用函询的形式发放MRI设备综合评价指标体系咨询表,由专家对各指标的重要性和可行性进行评分,确定MRI综合评价指标体系.选取临床功能评价(一级指标)下扫描序列(二级指标)这一维度的59个指标(三级指标),利用ROSETTA粗糙集数据分析工具集进行约简.结果:59个扫描序列维度的指标经优化,有8个指标权重为0,包括自旋回波序列T1WI、STIR脂肪抑制T2WI、时间飞跃法磁共振血管成像(平扫)、对比增强磁共振血管成像、磁共振动态增强扫描、弥散加权成像、多b值弥散加权成像(IVIM)和灌注加权成像,可以删除,最终获得包含51个指标的优化体系.结论:运用粗糙集理论约简并计算权重可实现指标体系的优化.

目的 评价2011-2015年河南省中医医院医疗服务资源配置效率.方法 采用DEA和Malmquist指数对河南省中医医院医疗服务资源配置效率从静态和动态两方面进行分析与评价.结果 河南省中医医院医疗服务资源配置效率整体水平偏低.除郑州、开封、周口外,其余地市的DEA综合效率均小于1;2011-2015年全要素生产率总体呈上升趋势,但效率提升并不稳定,5年仅增长了0.7个百分点.结论 河南省应统筹规划中医医疗服务资源的布局,加大中医人才培养与引进力度,从而实现中医医疗资源的优化配置.

Objective To explore the current situation and evaluate the equity of the health and family planning resources allocation from 2011 to 2015 in Henan.Methods Gini coefficient and Lorenz curve were applied to evaluate the equity of health and family planning resources allocation by population and geography.Theil index was applied to evaluate the inter-regional and regional equity.Results The Gini coefficients of the health and family planning resources in Henan based on population all bellow 0.31 were superior to the equity based on geography,which was between 0.26 and 0.4.Theil indexes were on a decline,indicating that the internal inequity among different areas was the main influencing factor of the equity of health and family planning resources allocation in Henan.Conclusion The equity of health and family planning resources allocation in Henan was quite good,and more attention should be paid to the inequity between regions.The guiding function of health planning needs to be enhanced to improve the equity of the health and family planning resources allocation.

Objective:To explore Operation Efficiency and influencing factors of specialized hospitals in Henan.Methods:Using the Malmquist index and Tobit model to analyze operation efficiency and influencing factors of different types of specialized hospitals.Results:The input and output of specialized hospitals in Henan were unbalanced.The overall operation efficiency of public and private hospitals was different.The influencing factors of operation efficiency in specialized hospitals included economic development level,the proportion of health technicians,average annual medical treatment of physician and average length of stay.Conclusion:Allocating medical service resources reasonably,investing more in specialized hospitals,playing the synergy between government and market,improving two-way referral system,strengthening medical technology support and improving the hospital management level to improve the operation efficiency of specialized hospitals.

目的 研究河南省脑卒中患者直接经济负担的影响因素.方法 采用二步模型法测算患者的直接经济负担.运用单因素秩和检验和卡方检验对组别间脑卒中直接经济负担的差异进行比较.运用多元线性回归分析患者直接门诊医疗费用、直接住院医疗费用的影响因素.结果 年收入、首诊机构类型、住院机构类型、是否手术和住院天数均为影响卫生服务费用的主要因素.结论 推进分级诊疗,实行脑卒中患者在基层首诊,完善医疗保险补偿机制,合理缩短住院天数,实施"三级预防",加强脑卒中防治教育.

目的 了解并分析河南省医疗卫生机构的床位利用效率.方法 应用秩和比法分析河南省不同类型和不同专科医疗卫生机构的床位利用效率.结果 社区卫生服务中心(站)的床位利用效率较低,综合医院床位利用效率较高;公立医院、县级医院床位利用效率较高,社会办医疗卫生机构床位利用效率较低;肿瘤医院、儿童医院床位利用效率较高,康复医院、美容医院床位利用效率较低.结论 政府应大力实行分级诊疗制度,实现资源下沉,鼓励和扶持社会力量办医,调整医疗卫生机构床位配置,实现卫生资源的优化配置和利用.

Objective To analyze and compare the economic burden of nephrosis patients at terminal stage in hemodialysis and peritoneal dialysis treatment in Henan province.Methods Obtain the economic burden of the ESRD dialysis patients by questionnaire and follow-up with the help of pilot hospital.Calculate and analyze the economic burden of the disease through the method of economic burden calculation in multiple centers.Results The direct medical costs of hemodiatysis and peritoneal dialysis were 70712.00 RMB and 58261.50 RMB per patient per year.The costs of hemodialysis patients were higher than that of peritoneal dialysis patients,and there were statistical significance between them (Z =-5.876,P ＜0.001).In the main non-medical costs,hemodialysis patients' nutrition fee was 1539.00 RMB,higher than peritoneal dialysis patients' 1140.00 RMB,(Z =-2.385,P ＜0.017).In terms of transportation cost,the former one was 1013 RMB,while the latter one was 982 RMB (Z =-1.092,P ＜ 0.275).Conclusion The patients with end stage renal disease can choose peritoneal dialysis treatment to save medical costs and lighten the economic burden.