RESUMEN
The relationship between antagonism and symbiosis exists not only in the biological world,but also among the subspecialties of large tertiary grade A general hospitals.In the context of symbiosis theory,the following recommendations based on the four basic elements of subspecialty symbiosis systems were proposed to provide a theoretical basis for exploring the path of high-quality development of subspecialties:enhance the capacity of the symbiosis unit itself and clarify the role of the unit;establish efficient information system and make full use of management platform;improve interest coordination mechanism and strengthen inter-subspecialty ties;implement relevant support policies and solid sense of symbiotic to synergy provide a theoretical basis for exploring pathways for high quality development of subspecialties.
RESUMEN
The cross regional loose medical alliance is an important carrier in the current integrated development process of medical services in the Yangtze River Delta region. Smith policy implementation process model was used to analyze the development difficulties of cross regional loose medical alliances from idealized policies, policy implementation institutions, policy target groups, and policy implementation environment. Such medical alliances were formed under the background of integrated development in the Yangtze River Delta, with Shanghai′s tertiary public hospitals as leading units and medical institutions in Jiangsu, Zhejiang, and Anhui provinces as member units. Analysis showed that the policies for such medical alliances development had not yet clearly defined the organizational management mode, operational mechanism, and implementation path, and the corporate governance structure of medical alliance was immature; The policy implementation agencies were relatively lagging behind in the support of special funds and the formulation of related supporting policies; Participation of policy target groups was insufficient and their incentive mechanisms was imperfect; There were problems in the policy implementation environment, namely inconsistent medical and health service regulations and systems in different regions, different health financing capabilities of local governments, insufficient coordination of medical institution management concepts, and a lack of unified standards in information systems. Based on the above difficulties, this study proposed to strengthen the development planning and layout of cross regional loose medical alliances, and improve the corporate governance structure; To strengthen the government′s main responsibility and improving policy implementation capabilities; To improve the internal cooperation and operation mechanism of cross regional loose medical alliances, and enhance the sense of identity of the target group; To optimize the policy implementation environment and implement various support measures, so as to provide references for further promoting the coordinated development of high-quality medical resources in the Yangtze River Delta region.
RESUMEN
Objective:To build the performance appraisal index system for scientific research teams in tertiary public hospitals, so as to stimulate creative vitality of scientific researchers and improve high quality construction of research teams.Methods:Combined with literature review and hospital management practice, the performance appraisal index system of hospital scientific research team was initially constructed by using the structure-process-result model.From July to December 2021, the performance appraisal indexes and their weights were determined through two rounds of expert consultation and analytic hierarchy process. The index system was used to evaluate the performance of the National Clinical Medical Research Center for Geriatrics.Results:A scientific research team performance appraisal index system has taken shape, comprising four level-1 indexes, 12 level-2 indexes and 47 level-3 indexes. The weights of the level-1 indexes of scientific and technological innovation, operation management, sustainable development and satisfaction evaluation were 0.407, 0.223, 0.223 and 0.147 respectively. The corresponding level-2 indexes with the highest weights were scientific research output(0.302), management cooperation(0.268), talent training(0.356) and assessment of department satisfaction(1.000). The index judgment matrix passed the consistency test( CR value<0.1), and the weight consistency was good. Applying this index system to evaluate the performance of the National Clinical Medical Research Center for Geriatrics, the total score was 73.40, and the scores of scientific and technological innovation, operation management, sustainable development and satisfaction evaluation indicators were 29.74, 16.14, 14.34 and 13.18, respectively. Conclusions:The performance appraisal index system of scientific research teams constructed in this study is feasible, which can be used as an important tool for building scientific research teams in the hospital.
RESUMEN
Objective To investigate the prevalence of anxiety and depression among the persons with disabilities in Shanghai and the factors related to them. Methods From November to December, 2014, 731 persons with disabilities were consecutively enrolled in this cross-sectional study. They were assessed with Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Binary Logistic regression analysis was employed to reveal potential related factors of anxiety and depression. Results The prevalence rates of anxiety and depression among the disabled in Shanghai were 9.58%and 8.48%, respectively. The duration (OR=0.967, P<0.05) and severity (OR<1, P<0.05) of disability were associated with depression, whereas retiral (OR=2.047, P<0.05), living alone or in care unit (OR=3.073, P<0.01) and duration of disability (OR=0.956, P<0.01) were associated with anxiety. Conclusion The frequency of anxiety and depression is mild among the persons with disabilities in Shanghai, and a special intervention is needed.