论社区卫生服务机构与城市大中型医院的协调发展

对当前社区卫生服务机构与城市大中型医院协调发展中存在的问题及原因进行了分析,在功能定位、制度层面、筹资及服务提供机制、社区卫生服务机构自我建设以及综合配套改革等方面提出改进建议,并对社区卫生与医院协调发展的现有模式进行了探讨,以期构建科学合理、切实维护群众健康的城市卫生服务体系.     

医院集团内社区卫生服务中心管理初探

探讨如何发挥三级医院的资源优势,创建一种新型的城市中心医院内社区卫生服务中心管理模式,通过这种模式充分整合城市卫生资源,在三级医院与社区卫生服务中心之间形成良好的互动,资源互补,短期内带动社区卫生服务健康持续发展,完善社区卫生服务功能.同时提出了当前社区卫生服务机构运行过程中亟待解决的一些政策问题.     

医院集团内社区卫生服务中心管理初探

探讨如何发挥三级医院的资源优势,创建一种新型的城市中心医院内社区卫生服务中心管理模式,通过这种模式充分整合城市卫生资源,在三级医院与社区卫生服务中心之间形成良好的互动,资源互补,短期内带动社区卫生服务健康持续发展,完善社区卫生服务功能。同时提出了当前社区卫生服务机构运行过程中亟待解决的一些政策问题。     

城市社区卫生服务机构服务功能与运行机制研究分析

采用立意抽样的方法,在济南、青岛、烟台3个城市共调查社区卫生服务中心46个,社区卫生服务站91个,对城市社区卫生服务机构服务功能、运行机制等方面现况进行分析,发现问题,分析产生问题的原因以及影响因素,为完善社区卫生服务政策提供参考依据.     

社区变迁、信任与城市社区卫生服务的发展

城市社区卫生服务利用率不高,居民对社区卫生服务机构及其工作人员的信任不足是主要原因。基于社区变迁和信任源理论,认为只有在加强机构内涵建设的同时,充分认识到转型时期中国社会结构与文化特征,利用社区整合等手段,使机构与居民之间增加信任并能维持,才能保证社区卫生服务的健康发展。     

社区变迁、信任与城市社区卫生服务的发展

城市社区卫生服务利用率不高,居民对社区卫生服务机构及其工作人员的信任不足是主要原因.基于社区变迁和信任源理论,认为只有在加强机构内涵建设的同时,充分认识到转型时期中国社会结构与文化特征,利用社区整合等手段,使机构与居民之间增加信任并能维持,才能保证社区卫生服务的健康发展.     

医学生到社区卫生服务机构实践的探讨

《国务院关于发展城市社区卫生服务的指导意见》明确医学院校应将培养医学生社区卫生服务技能作为医学教育的重要内容,并将此项作为卫生工作的重点。分析了医学生临床实习现状,论述其进行社区医学实践的意义,并着重结合国外医学生社区临床实践情况的基础上,对我国医学生到社区卫生服务机构进行临床实践提出建议。     

社区卫生服务机构实施品牌战略的构想

"看病难"、"看病贵"两大问题,阻碍和谐社会建设、影响人民群众生命健康.大力发展社区卫生服务,将成为在城市缓解老百姓"看病难"、"看病贵"问题的重要举措,但由于种种问题与困难,降低了老百姓对它的信任度.在社区卫生服务机构实施品牌战略,塑造品牌形象,无疑是提升老百姓信任度的一剂良方,社区卫生服务必将迎来飞速发展.     

社区卫生服务机构实施品牌战略的构想

"看病难"、"看病贵"两大问题,阻碍和谐社会建设、影响人民群众生命健康。大力发展社区卫生服务,将成为在城市缓解老百姓"看病难"、"看病贵"问题的重要举措,但由于种种问题与困难,降低了老百姓对它的信任度。在社区卫生服务机构实施品牌战略,塑造品牌形象,无疑是提升老百姓信任度的一剂良方,社区卫生服务必将迎来飞速发展。     

美国社区卫生服务运行机制和管理模式研究

美国的卫生服务系统由社区卫生服务和医院服务两大部分组成.通过从组织形式、筹资机制、人力资源、动力与约束机制以及管理几个方面,对美国社区卫生服务的运行机制与管理模式进行分析,以期对我国社区卫生的发展有所借鉴与帮助.     

综合性大医院与社区卫生服务中心合作切入点的分析

通过时沈阳市沈河区9个社区卫生服务中心进行调查和相关资料分析,探讨大型综合性院与社区卫生服务中心合作的可行性,如人员培训和技术支持,临床检查结果互认,实行“双向转诊”等,为建立新型城市医疗卫生服务体系参考依据。     

‘Someone to talk to who'll listen’: addressing the psychosocial needs of children and families

The paper presents the Lewisham Community Child and Family Service (LCCFS), a community‐based intervention providing psychosocial help for children, young people, parents and families. The service is focused on early intervention, prevention and promotion in the improvement of local health. It works under a service framework based on inter‐agency collaboration, and a counselling model based on community and interpersonal partnerships, grounded in personal construct theory (Kelly, 1955). The policy demands and local need for accessible and acceptable mental health are discussed, and quantitative and qualitative findings of the needs assessment preceding the establishment of the LCCFS are presented, supporting the need for community mental health provision. The feasibility for the LCCFS to reconcile and meet the policy demands and the needs of parents with respect to child psychosocial help and services are discussed. Copyright © 2001 John Wiley & Sons, Ltd.     

Community psychology in Hong Kong: Past,present, and future

The expansion of mental health services during the 1960s from a single remote mental hospital to centers and clinics in mainstream communities fostered the development of community psychology in Hong Kong. Few psychologists were initially involved in the local community mental health movement, but its momentum resulted in increasing numbers of practitioner psychologists working in community-based service settings. Community psychology in Hong Kong today consists primarily of service delivery, but also includes applied research, community organization/consultation, and community education. Despite having many parallels with the American situation, key concepts underpinning the practice of community psychology in the Territory possess their own character as a reflection of nuances in the local scene. Prospects for the continued development of community psychology in Hong Kong appear favorable. Of special relevance is the field's potential contribution to a better understanding of the psychological phenomena associated with the Territory's sociopolitical transformation in 1997.     

在社区卫生服务中引入第三方介入机制的探索

社区卫生服务是我国卫生体系的重要组成部分。从目前社区卫生服务中公共卫生服务发展缓慢、监督管理体制不健全等问题入手,通过借鉴国外适宜经验,提出在社区卫生服务中引入第三方机制的设想,以此推动社区卫生服务的可持续发展。     

The role of community context and psychological well-being for physical health: A dyadic study of military couples

Drawing from the social organizational theory of community action and change (SOAC) within a systemic biopsychosocial perspective, associations between community context (military community connections and satisfaction with military life), psychological well-being (depressive symptoms, anxiety, and self-efficacy), and physical health were examined for a sample of active duty service members and their civilian spouses (N = 236 couples) using an actor partner interdependence framework. Service members with higher levels of military community connections reported better psychological well-being. When civilian spouses were more satisfied with military life, both partners reported better psychological well-being. In turn, both spouses’ psychological well-being was related to their own reports of physical health. Statistically significant indirect effects were found between community contexts and spouses’ physical health. Enhancing community connections may be an important leverage point for supporting health and family readiness.     

The Age of Uncertainty: Parent Perspectives on the Transitions of Young People with Mental Health Difficulties to Adulthood

For young people aged 16–24, the transition from adolescence to young adulthood involves predictable and unpredictable changes and they may encounter challenges in their roles, relationships, and responsibilities. Young people with mental health difficulties face additional challenges as they and their families navigate this transition. As a result, families commonly experience anxiety, uncertainty, frustration, and turbulent relationships. After learning to become advocates to secure appropriate services for their children, in late adolescence and young adulthood, parents are likely to find themselves excluded from their children’s treatment planning and services. This article reports findings from a recent qualitative study of the experiences and perceptions of 42 family members supporting their children with mental health difficulties during the transition years. Family members described their goals for their children, their frustrations trying to access appropriate services for their children, and their strategies to provide the support their children needed. Recommendations are for service providers to connect transition age youth with practical assistance and supportive mentoring relationships. Family members requested service providers to consider them as resources and potential collaborators in supporting young people with mental health difficulties to live successful lives in the community.     

探讨三级综合医院基于信息交互体系的双向转诊

建立基于信息交互体系的双向转诊信息平台,通过大连市某三级综合医院与社区卫生服务中心双向转诊研究,着重于探索临床路径这一研究方向对双向转诊的意义。用同期非随机对照试验,收集大连市黄河路社区上转患者人次和医院下转患者人次,以及分别比较转诊费用和医患转诊认知度。结果,上转患者402人,下转患者179人,上转服务明显好于下转,试验组和对照组患者医疗费用（除诊疗费）差异有统计学意义（P〈0．05）,双向转诊认知度差异有统计学意义（P〈0．05）。目前双向转诊还处于单向流动状态,上转率明显高于下转率,双向转诊节省了医疗费用,在医患对其认知度方面,前者明显高于后者,制度上的支持是双向转诊顺利实施的关键。     

Bridging the Gap Between Hospital and Community-Based Mental Health Services

Depression and anxiety affect a person’s ability to move from hospital to community and engage in valued occupations. The purpose of this study was to understand the effectiveness of an occupational therapist-led transitional service for people with mood and anxiety disorders. Using a mixed-method design consisting of retrospective pre-post analysis of outcome measures and qualitative analysis of interviews with key stakeholders, statistically and clinically significant improvements were seen in depression and anxiety symptoms as well as occupational engagement after completion of the service. This study highlights the unique contributions of occupational therapist-led programing in mental health recovery.     

发挥中医药学优势,构建和完善小康社会卫生服务体系

全面分析和阐述了中医药学在我国社区卫生服务体系的理论建设和医疗实践中所具有的作用、意义和优势.提出利用中医药学优势,将促进社区卫生服务,确保小康社会卫生服务体系的完善.     

包医合同法律效力分析

虽然医疗行为存在多种风险与不确定性,但也不是所有的医疗行为都是不确定的。生活中经常有医方向患者承诺保证治疗效果的情形,从法律的角度来说,这时在医方与患者之间就形成了包医合同关系。论述了包医合同的性质及其法律效力。