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.
Objective To investigate the diabetic knowledge of primary hospital doctors and diabetes patients, and to explore the way to improve the capability of primary hospitals in preventing and treating diabetes. Methods Between January 2013 and June 2014, we set questionnaires to learn the profiles of diabetes knowledge of 328 internal and general medicine doctors including 43 chronic disease management workers from fifteen township hospitals and two community health centers, 152 doctors from village clinics, and 575 diabetes patients in Xindu District of Chengdu City. We made questionnaires for doctors and patients respectively to investigate their knowledge on diabetes and blood sugar control in the patients. Finally, we made plans to train doctors in primary hospitals according to the results of the investigation. Results For township hospitals, 328 questionnaires were given out with 319 retrieved, and the valid retrieval rate was 97.3%; 152 questionnaires were given out to village doctors and 149 were retrieved, with a valid retrieval rate of 98.0%; and we gave out 575 questionnaires to the diabetes patients and retrieved 539, with a valid retrieval rate of 93.7%. Primary hospitals were insufficient in their drug varieties. Among doctors in township hospitals, 7.8% had bachelor’s degree, 53.6% had received post-secondary education, and 38.6% had received secondary vocational education. Most of the village doctors had not received any professional medical education, among whom, 89.9% had a certificate of village doctors and 10.1% had a certificate of assistant doctors. The diabetes questionnaire score of primary hospital doctors was low, while the score of chronic disease management workers was relatively higher (P<0.05). For diabetes patients, medical investment was inadequate, treatment rate was low, common sense of diabetes was insufficient, and glycosylated hemoglobin control rate was only 13.5%. Conclusions Diabetes patients in primary hospitals have a poor disease control, which is probably associated with the insufficient publicity and education from doctors. It is necessary to train primary hospital doctors at all levels. In order to get the best therapeutic effect, we advocate that diabetes should be managed by doctors of chronic disease management, although they should receive systematic training for a long time.
【摘要】 目的 探討顱內原發生殖細胞瘤的臨床特征。方法 收集華西醫院腦外科2000年1月—2009年3月119例顱內原發生殖細胞瘤的臨床資料進行回顧性分析。結果 發病率約占同期顱內腫瘤的 1.1%。男〖DK〗∶女=1.64〖DK〗∶1,平均發病年齡15.4歲。臨床表現主要為顱內高壓癥狀及視力視野改變,分別為61、56例；腫瘤主要來源于松果體區及鞍區；64例患者行放療或放療加化療,隨訪45例。55例患者行手術治療(其中術后行單純放療19例,放療加化療5例),隨訪36例。隨訪時間3~94個月,平均29.7個月。行放療和放化療的患者3、5年生存率明顯高于單純行手術治療的患者。結論 顱內原發生殖細胞瘤多見于兒童及青少年,男性多見,腫瘤大多位于松果體區及鞍區。臨床表現位于松果體區者主要為顱內高壓癥狀等,位于鞍區者主要為視力視野改變、尿崩等。放療聯合化療是主要治療手段。