Objective To evaluate the performance of emergency medical rescue (EMR) within 1 month after Lushan earthquake, and to prove and enrich the experience from Wenchuan earthquake, so as to provide useful references for global earthquake EMR with regard to decreasing death and disability rates. Methods All the following date published within 1 month after 4.20 Lushan earthquake were collected and analyzed, including official information, public documents, news release, relevant information from websites and victims’ medical records in the West China Hospital, then the relevant domestic and foreign literature about EMR (including EMR of Wenchuan earthquake). And then comparative analysis was conducted to evaluate the performance of EMR in Lushan earthquake. Results a) Being 87 km apart from each other, the main seismic zones of Lushan and Wenchuan located in the south west and middle north of Longmenshan fault zone, respectively. Although only 1 earthquake magnitude differed between them, the disaster area, and the number of affected population, deaths, disappearances, injured, severe injured and migration population in Wenchuan earthquake were 40, 23, 353, 853, 27, 14 and 51 times higher than those in Lushan earthquake, respectively. b) Learned from Wenchuan experience, the manpower scheduling in Lushan earthquake was quicker: the assembled medical personnel peak of Lushan vs. Wenchuan was 87.62% vs. 56.06 % in golden 72 hours post-quake. c) Supplies scheduling was more rational: the utilization rate was higher under the guidance of accurate information of demand. d) Medical treatment was more rational and efficient: the critical injured were treated following “Four concentration treatment principles”; saving life and restoring function at the same time; treatment and physical-mental rehabilitation at the same time; treatment and evidence production and implementation at the same time. e) Medical institutions and service returned to normal in time: 96.7% (440/455) of government owned township medical institutions in 21 affected towns returned to normal and provided medical services at their original sites. Conclusion By learning form Wenchuan experience, the following performance is implemented in Lushan earthquake: medical rescue guided by the accurate information; supplies scheduling guided by the accurate demand; both critical injured treatment,and physical-mental rehabilitation guided by the accurate assessment of injuries. So the medical rescue within 1 month after Lushan earthquake is quicker, more rational and efficient. After 20 days post quake zero death of critical injured was achieved. The early physical-mental rehabilitation fastens the functional reconstruction of the injured and helps them return to the society. So it suggests that the Lushan EMR enriches and develops the reference value of EMR experience of Wenchuan earthquake.
Objective To summarize and analysis the working experience of healthcare performance evaluation and reporting experience in local health administration department of Australia, and provide decision support to China on such work as establishing objective, scientific, effective healthcare performance evaluation system, strengthening government’s supervision over health service and improving healthcare system management efficiency. Methods Searching official networks and databases of Australia, and finding out relevant policy, reports, and documents on healthcare performance evaluation. Results Typical healthcare performance evaluation systems in Australian are as follos: National Health Performance Framework (NHPF), the National Healthcare Agreement（NHA）and Review of Government Service Provision. Conclusions These programs in Australian is enlightening to these work in China that performance evaluation should be the prior tool in health system to management and reform, the performance measurement indicators systems should emphasize the quality safety and health fair.We should set up scientific and flexible index inclusion criteria and open report and compare performance information.
Objective To summarize and analyze the working experience of hospital performance evaluation and reporting system in America, so as to provide decision support to China on such work as establishing objective, scientific and effective hospital performance evaluation system, strengthening government’s supervision to health service, and promoting hospitals’ sound development.Methods American official websites and databases were searched to include relative policies, reports and documents on hospitals’ performance evaluation. Results Typical hospital performance evaluation and reporting system in America included National Healthcare Quality Report (NHQR), Consumer Assessment of Healthcare Providers and System (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS), Leapfrog Group Evaluation System and Thomson Reuters 100 Top Hospitals. Conclusion The enlightenments of American performance performance evaluation systems to China include: a) more attention should be paid to performance evaluation; b) combined evaluation models and results application methods should be considered; c) comparatively scientific evaluation methods and comprehensive evaluation contents should be established.
Objectives Performance of critical injury treatment among extremely-hit areas after great earthquake was retrospectively analyzed to provide references for policy-making as reducing mortality and disable rate besides increasing rehabilitation rate for global post-quake medical relief. Methods Retrospective analysis, primary research and secondary research were comprehensively applied. Results 1.According to incomplete statistics datum, there were 30,620 self-save injured among extremely-hit areas in 72 post-quake hours. And, the number of critical injured took 22% of the total inpatient injured. 2. Mortalities decreased successively from that of municipal healthcare centers in extremely-hit areas to that municipal medical units in peripheral quake-hit areas and then to those of municipal, provincial and MOH-affiliated hospitals as 12.21%, 4.50%, 2.50% and 2.17% respectively. 3. Injured with fractures on body, limbs or unknown-parts, severe conditions as well as other kinds of non-traumatic diseases received in second-line hospitals were much more than those treated in first-line hospitals with more severe injuries. 4. Among 10,373 injured in stable conditions transferred to third-line hospitals, 99.07% were discharged off hospitals with mortality as 0.017% during 4 post-quake months. Conclusions The medical relief model as “supervising body helping subordinate unit, severely-stricken areas assisting extremely-hit ones, quake-hit areas supporting both extremely-hit and severely-stricken ones, and save-saving amp; mutual assistance applied between extremely-hit areas” is roughly established for injured from severely-stricken areas after Wenchuan earthquake. 2. “Four concentration treatment” principle for those injured in critical conditions did effectively reduce mortality（15.06%→2.9%）. 3. Timely, scientific and standard on-site triage and post-medical transfer under guidance of accurate injury information determine rescue effect for the injured, while there is large space to fulfill as for treatment for critical diseases among extremely-hit areas under extreme conditions after Wenchuan earthquake.
In order to establish objective, scientific, effective performance assessment system and strengthen government’s supervision on health service in our country, this research retrieved literature on relevant official UK websites and databases to get the whole picture of NHS (National Health Service) performance assessment policy, documents and reports. Based on the introduction of NHS Performance Assessment Framework (1999), NHS Performance Assessment Framework: Implementation Guidance (2009) and NHS Performance Rating, it summarized and analyzed the experience and measures of NHS Performance Assessment, which enlightened us in the following aspects: a) We should pay more attention to the performance assessment of national healthcare system and spread out the relevant work in China; b) Performance assessment is closely linked with national health policy and its strategic focus; c) Performance assessment centers on quality; d) We should take performance assessment as a strategic tool to improve the healthcare system performance.
战略联盟理论被众多的医院重视和认同，越来越多的医院通过“网络+联盟”的方式组建战略联盟；尽管企业战略联盟的理论和实践已取得了深入的发展，但医疗行业战略联盟的理论还很不完善，尤其是缺乏对医院战略联盟绩效评价方面系统和深入的研究。本文从联盟外部环境因素、成员自身特性、成员关系特征以及信息传递方式等方面对医院战略联盟绩效的影响因素进行了分析，建立了一个较为完整的理论评价模型，并在此基础上提出了相关建议。
With the continuous development of health system, more and more countries recognize that the health system performance evaluation is an indispensable part of improving government management and health system. Some developed countries have already set up comparatively perfect evaluation systems. This paper compared and deeply analyzed the history of establishment, evaluation framework, evaluation index, and evaluation data of the health system performance evaluation systems of Britain, Australia and the United State, and some suggestions for improving the evaluation of new medical reform in China were given.
ObjectiveTo systematically review the comprehensive evaluation methods applied to estimate the medical service performance based on diagnosis-related groups (DRGs) in China and to provide suggestions for the promotion of methods in further studies.MethodsLiterature published before May 2019 were searched in China National Knowledge Infrastructure, WanFang Data, CQVIP and PubMed for studies about DRGs-based comprehensive evaluation. After literature screening and information extracting by two reviewers independently, qualitative approaches were used to describe the application of DRGs-based comprehensive evaluation methods in the performance evaluation of medical services.ResultsA total of 24 articles were included in the systematic review. Different indexes were used to evaluate the medical service performance. Delphi Method, expert discussion, Saaty’s Method and some other means were applied to determine the weights of indexes in 8 articles. Rank-sum ratio method, Technique for Order Preference by Similarity to an Ideal Solution and synthetic index method were proposed for the comprehensive evaluation in 9, 7 and 9 articles, respectively; besides, analytic hierarchy process and combination evaluation were also used.ConclusionsBased on DRGs, the choose of indicators, weighting approaches, and calculation methods of comprehensive values vary richly in different studies. More attention should be paid to weight using and combination of comprehensive evaluation methods in further studies. Meanwhile, the quality of information source used for estimation and the rationality of results application are supposed to be emphasized.