2011年6月24日
Barack Obama
2011年6月19日
Small-Area Analysis(小地域分析)
Small-Area Analysis:
A method of analyzing the variation in utilization of health care in small geographic or demographic areas. It often studies, for example, the usage rates for a given service or procedure in several small areas, documenting the variation among the areas. By comparing high- and low-use areas, the analysis attempts to determine whether there is a pattern to such use and to identify variables that are associated with and contribute to the variation.
Synonym: small-area variation analysis, small-area variations, small-area variation, small-area study.
2011年6月17日
范畴经济 VS. 规模经济
economies of scope --范畴经济 or 范围经济，又可叫做"外部规模经济"（External Economy of Scale）
定义：因同时生产(经营)几种相关的产品或服务而引起的经济效益提高。 透过营运范畴的扩大，两个以上的事业单位共同分担研发、营销、生产等成本，而享有的经济效益，使总成本下降。
单一厂商同时生产两项以上物品和服务的成本比分别由专业厂商生产的成本更低廉导致厂商生产出现范畴经济的原因，可能是来自多元化的经营策略、营运范畴的扩大、资源的分享、投入要素的共同、统一管理的效率、财务会计的优势，导致生产成本降低的效果规模经济是相对于专业化而言，范畴经济则是相对于多元化而言，两者并没有直接的关联
范畴经济也就是多样化经济，即企业在生产不同的产品时，若出现成本递减的现象，则就可称之为范畴经济。
(1) 当q1，q2代表不同产量，C(q1+ q2) < C(q1) + C(q2)表示联合生产的总成本小于分别生产的成本总和，亦即存在「规模经济」。
(2) 当q1，q2代表不同产品，C(q1+ q2) < C(q1) + C(q2)表示不同产品"一起"生产的总成本低于分别生产的成本总和，亦即存在「范畴经济」。
2011年6月16日
2011年6月14日
Hospitalist
Robert M. Wachter 1996年他第一个在NEJM上的一篇文章coined这个名词 hospitalist -- 这近20年在美国迅速发展的医疗科系（Hospital Medicine）从业人士名称。Hospital Medicine 和 Hospitalist几乎是密不可分的，同时这两者也是我最关注的health workforce development的组成部分。
-----Wikipeida的释义：
Hospital medicine in the United States is the discipline concerned with the medical care of acutely ill hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists; this type of medical practice has extended beyond the US into Canada. The practical effect of the hospitalist is to act as transition coordinator and case manager, due to the tremendous growth in medical knowledge and resultant number of medical specialists.
The term hospitalist was first coined by Robert Wachter and Lee Goldman in a 1996 New England Journal of Medicine article. Hospitalist activities may include patient care, teaching, research, and leadership related to hospital care. Hospital medicine, like emergency medicine, is a specialty organized around a site of care (the hospital), rather than an organ (like cardiology), a disease (like oncology), or a patient's age (like pediatrics).
--------Wikipeida的历史说明：
Hospital medicine is a relatively new phenomenon in American medicine. Almost unheard of a generation ago, this type of practice arose from three powerful shifts in medical practice:
- Nearly all states, as well as the national residency accreditation organizations, the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA), have established limitations on house staff duty hours, the number of hours that interns and residents can work. This effectively reduces by 10-25% the amount of inpatient coverage provided per[citation needed]. Many hospitalists are coming to perform the same tasks formerly performed by residents; although this is usually referred to as a House Officer rather than a Hospitalist[citation needed]. The fundamental difference between a Hospitalist and a House Officer is that the Hospitalist is the Attending Physician of a patient while that patient is hospitalized. The House Officer admits the patient for another Attending Physician and cares for that patient until the Attending Physician can see the patient.
- Most primary care physicians are experiencing a shrinking role in hospital care. Many primary care physicians find they can generate more revenue in the office during the hour or more they would have spent on inpatient rounds, including traveling to and from the hospital[citation needed].
Hospitalists represent one of the most rapidly growing forms of medical practice in the US. Currently a large proportion of hospitalists are recently-graduated residents, who continue familiar duties for a few years. As residency programs are encouraged to limit inpatient duty hours and provide more outpatient education, this pattern may shift. If this specialty evolves as emergency and intensive care medicine did, it will become a formal specialty with its own residencies and board certification within a decade or two. A few distinct residency and fellowship training programs are currently operating at major universities[citation needed].
In addition to patient care duties, hospitalists are often involved in developing and managing aspects of hospital operations such as inpatient flow and quality assurance. The formation of hospitalist training tracks in residency programs has been driven in part by the need to educate future hospitalists about business and operational aspects of medicine, as these topics are not covered in traditional residencies[citation needed].
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