Physical activity is a recognized preventive health measure for seniors and an important focus for senior centers. This paper employs the Andersen Behavioral Model to explore increased physical activity and participat...Physical activity is a recognized preventive health measure for seniors and an important focus for senior centers. This paper employs the Andersen Behavioral Model to explore increased physical activity and participation in three types of senior center activities: physical fitness, dance/aerobic classes, and chair exercises. Data were collected in 2006 on 798 and in 2007 on 742 participants at 21 multipurpose senior centers in a large urban county. Logistic regression analysis (PROC RLOGIST in SAS-callable SUDAAN) was employed to predict increased physical activity, with modes of center participation in physical activity as mediating factors. Predisposing and enabling factors predicted both engaging in center-based exercise programs and increases in physical activity;but the strongest predictors of increases in physical activity were needed factors: physician recommendations to increase exercise and to lose weight. Implications are that both SCs and healthcare providers are important to promote physical activity in the older population.展开更多
目的:系统分析各类医生薪酬支付方式对医疗服务提供行为及结果的影响。方法:采用范畴综述法,以Web of Science和中国知网、维普及万方为数据源,“医生”“薪酬”“支付方式”和“医生行为”等为主题词,检索到相关文献2255篇,通过制定严...目的:系统分析各类医生薪酬支付方式对医疗服务提供行为及结果的影响。方法:采用范畴综述法,以Web of Science和中国知网、维普及万方为数据源,“医生”“薪酬”“支付方式”和“医生行为”等为主题词,检索到相关文献2255篇,通过制定严格的筛选程序最终纳入70篇相关研究。结果:按项目支付激励医生提供足量服务,但易导致过度医疗;固定薪水与按人头支付有助于控制成本,但易引发服务不足;DRG/DIP在医疗服务数量与质量方面的优势随患者病情加重而减弱。混合支付方式能够有效平衡医疗服务数量与成本,而按绩效支付在医疗质量提升方面总体表现突出。结论:医生薪酬单一支付方式难以实现医疗服务提供行为及结果最优化,且质量导向不足,多种支付方式与质量激励相融合的混合支付体系亟待构建。同时,建议深化医保结余薪酬转化机制改革,充分落实公立医院分配自主权,加快建立与医保支付和绩效考核协同的医生薪酬混合支付方式。展开更多
目的探究基于置信职业行为(entrustable professional activities,EPAs)的实践教学模式在住院医师规范化培训中的应用。方法选取2021年9月—2023年9月齐齐哈尔医学院附属第一医院住院医师规范化培训的90名住院医师为研究对象。根据医师...目的探究基于置信职业行为(entrustable professional activities,EPAs)的实践教学模式在住院医师规范化培训中的应用。方法选取2021年9月—2023年9月齐齐哈尔医学院附属第一医院住院医师规范化培训的90名住院医师为研究对象。根据医师接受的不同培训方式进行分组,将接受常规规范化培训的医师纳入常规培训组(n=43),将接受基于EPAs的实践教学模式的医师纳入EPAs组(n=47)。对比2组的教学质量(学习态度、兴趣水平、学习思维、学习能力、操作水平),最终考核成绩(理论知识、实践操作、病理分析),专业知识掌握水平(要点掌握水平、疾病诊断水平、疾病推理水平、疾病治疗水平)及教学满意度。结果EPAs组教学质量各维度评分及总分均高于常规培训组,差异有统计学意义(P<0.05)。EPAs组的理论知识成绩为(93.61±1.78)分,实践操作成绩为(94.77±1.98)分,病理分析成绩为(92.58±1.91)分,均高于常规培训组的成绩[(91.48±2.02)分(、92.34±1.88)分(、89.49±1.74)分],差异有统计学意义(P<0.05)。EPAs组专业知识掌握水平各维度得分及总分均高于常规培训组,差异有统计学意义(P<0.05);EPAs组的教学满意度高于常规培训组(95.74%vs.81.40%),差异有统计学意义(P<0.05)。结论基于EPAs的实践教学模式能够提高住院医师规范化培训的教学质量,帮助医师掌握专业知识,提高考核成绩。展开更多
文摘Physical activity is a recognized preventive health measure for seniors and an important focus for senior centers. This paper employs the Andersen Behavioral Model to explore increased physical activity and participation in three types of senior center activities: physical fitness, dance/aerobic classes, and chair exercises. Data were collected in 2006 on 798 and in 2007 on 742 participants at 21 multipurpose senior centers in a large urban county. Logistic regression analysis (PROC RLOGIST in SAS-callable SUDAAN) was employed to predict increased physical activity, with modes of center participation in physical activity as mediating factors. Predisposing and enabling factors predicted both engaging in center-based exercise programs and increases in physical activity;but the strongest predictors of increases in physical activity were needed factors: physician recommendations to increase exercise and to lose weight. Implications are that both SCs and healthcare providers are important to promote physical activity in the older population.
文摘目的:系统分析各类医生薪酬支付方式对医疗服务提供行为及结果的影响。方法:采用范畴综述法,以Web of Science和中国知网、维普及万方为数据源,“医生”“薪酬”“支付方式”和“医生行为”等为主题词,检索到相关文献2255篇,通过制定严格的筛选程序最终纳入70篇相关研究。结果:按项目支付激励医生提供足量服务,但易导致过度医疗;固定薪水与按人头支付有助于控制成本,但易引发服务不足;DRG/DIP在医疗服务数量与质量方面的优势随患者病情加重而减弱。混合支付方式能够有效平衡医疗服务数量与成本,而按绩效支付在医疗质量提升方面总体表现突出。结论:医生薪酬单一支付方式难以实现医疗服务提供行为及结果最优化,且质量导向不足,多种支付方式与质量激励相融合的混合支付体系亟待构建。同时,建议深化医保结余薪酬转化机制改革,充分落实公立医院分配自主权,加快建立与医保支付和绩效考核协同的医生薪酬混合支付方式。
文摘目的探究基于置信职业行为(entrustable professional activities,EPAs)的实践教学模式在住院医师规范化培训中的应用。方法选取2021年9月—2023年9月齐齐哈尔医学院附属第一医院住院医师规范化培训的90名住院医师为研究对象。根据医师接受的不同培训方式进行分组,将接受常规规范化培训的医师纳入常规培训组(n=43),将接受基于EPAs的实践教学模式的医师纳入EPAs组(n=47)。对比2组的教学质量(学习态度、兴趣水平、学习思维、学习能力、操作水平),最终考核成绩(理论知识、实践操作、病理分析),专业知识掌握水平(要点掌握水平、疾病诊断水平、疾病推理水平、疾病治疗水平)及教学满意度。结果EPAs组教学质量各维度评分及总分均高于常规培训组,差异有统计学意义(P<0.05)。EPAs组的理论知识成绩为(93.61±1.78)分,实践操作成绩为(94.77±1.98)分,病理分析成绩为(92.58±1.91)分,均高于常规培训组的成绩[(91.48±2.02)分(、92.34±1.88)分(、89.49±1.74)分],差异有统计学意义(P<0.05)。EPAs组专业知识掌握水平各维度得分及总分均高于常规培训组,差异有统计学意义(P<0.05);EPAs组的教学满意度高于常规培训组(95.74%vs.81.40%),差异有统计学意义(P<0.05)。结论基于EPAs的实践教学模式能够提高住院医师规范化培训的教学质量,帮助医师掌握专业知识,提高考核成绩。
