In a blink of an eye, a period of work has come to an end. Looking back on the work during this period, there are some problems. At this time, it is very necessary to write a self-inspection report. Is it impossible to write without a clue? The following is my self-inspection report on hospital management (generally 5 articles), for reference only. Welcome to reading.

Hospital Management Self-inspection Report 1 According to the spirit of the document "Notice on Submitting the Management of Potential Safety Hazards in Designated Medical Institutions" by the National Health and Wellness Committee, the leaders of our hospital attached great importance to it, and the dean in charge of logistics led the team, and the staff of general affairs department, hospital infection department, medical department and other departments investigated the potential safety hazards in our hospital. The report on the investigation and self-inspection of potential safety hazards found is as follows:

A, fire safety inspection

Then gradually check the fire safety passage, fire facilities, power distribution room, drug warehouse, etc. After investigation, all departments and the entrance of the building are equipped with fire extinguishers, and all lines of the power supply system have been inspected, and no aging or damage has been found.

Second, the fever clinic examination

With the completion of the renovation process of the fever clinic, the construction area of the renovated fever clinic is 70 square meters. The reformed fever clinic meets the requirements of three districts and two channels in secondary hospitals. The medical channel and the patient channel have access channels respectively, and the dressing rooms in and out of isolation gown are physically isolated, and each area is equipped with a air disinfection machine. There are two isolation beds in the isolation observation room of the fever clinic. House numbers and luminous signs at night in various regions are being made. Doctors and nurses in fever clinics have been trained in relevant procedures. It is necessary to continue to strengthen the registration of disinfection records and regularly check and supplement protective equipment.

Third, the pre-inspection triage desk inspection

The staff of the pre-inspection triage desk shall ensure the first-time monitoring and discovery in accordance with the requirements of the Emergency Notice on Fully Implementing the Responsibility System for First Diagnosis and Realizing the "Four Morning" of COVID-19 Epidemic Prevention and Control. As the first pass of prevention and control, the pre-inspection and triage department of our hospital has trained the staff in related processes, protection knowledge, epidemiological investigation and disinfection. For all patients, be sure to seriously ask if they have a history of traveling outside or in epidemic areas. Strictly pre-check and triage patients with fever, and report any abnormality as soon as possible. The person in charge of the outpatient department is required to continuously strengthen training and make various registrations at the same time. However, with the continuous improvement of the epidemic situation, the work of the pre-inspection and triage staff has been relaxed and the protection has not reached the standard. The relevant staff were criticized and educated, and it was required to continue to strictly implement the workflow of pre-inspection and triage.

Four, negative pressure ward inspection

With the completion of the transformation of the negative pressure isolation ward, the construction area of the transformed negative pressure ward is140m2, and it is equipped with a single isolation ward and a three-person isolation ward, which can treat four patients with infectious diseases at the same time. Reasonable division of potential pollution areas, buffer areas and pollution areas. Ask the person in charge of infection department to organize the personnel of this department to carry out process training.

Verb (short for verb) Radiological examination

In the early days of radiology, the division was unreasonable, and the medical staff did not strictly implement the standard protection principle. Now the radiology department has optimized the whole process according to the clean area, semi-polluted area and polluted area, set up the patient channel and medical channel, and trained the department staff. Radiology department is required to wear masks according to the standard protection requirements in daily work, and at the same time strengthen the management of medical waste. At the same time, the Registration Form for Air and Surface Disinfection in Radiology Department and COVID-19 Medical Waste Disposal Record will be issued. Please execute and record as required.

Six, medical waste disposal

Post signs on the vehicles of patients transferred to hospitals in novel coronavirus, and train relevant personnel on occupational protection and vehicle disinfection. The registration of air and surface disinfection of transfer vehicles in COVID-19 and medical waste disposal records in COVID-19 were issued, and the terminal disinfection requirements of each transfer patient were implemented and recorded as required. At the same time, our hospital purchased a negative pressure ambulance stretcher, and also sent relevant surgical videos to the person in charge of outpatient and emergency departments through WeChat, requesting to organize staff for training.

We have done a good job in the medical waste disposal of all departments, distributed the Emergency Plan for the Medical Waste Disposal of New Coronary Heart Disease and Pneumonia in County People's Hospital and the COVID-19 Related Medical Waste Disposal Register to all departments, and made a red "COVID-19" medical waste label. All departments are required to strictly implement and train personnel (staff and cleaning staff). In the process of hidden danger investigation, it was still found that some departments did not give enough health education to patients and cleaning staff, and patients had the behavior of disposing of medical waste by themselves, which was reported to relevant departments for criticism and education.

With the gradual improvement of the epidemic situation, the standard protection consciousness of medical staff began to relax. When asking the staff of relevant departments, it was found that the process of treating patients with fever and suspected patients began to be forgotten. The novel coronavirus Leading Group of the Hospital will organize the staff of the whole hospital to carry out process training and isolation gown training in batches again this week. And plans to organize novel coronavirus emergency drill again on Friday.

After receiving the rectification opinions issued, the heads of all departments attached great importance to it and immediately carried out rectification, requiring all departments to seriously implement the procedures in the next step. At the same time, it is required to conduct full coverage and special training for all staff in the department this week, and master the relevant technical specifications for diagnosis, treatment and prevention and control in COVID-19 as soon as possible, so that all medical staff can enhance their ability of discovery and identification, and take technical measures such as isolation, reporting, hospital infection control and personal protection to ensure that no one is missed and infection is not spread.

Hospital management self-inspection report 2 The county has gradually implemented standardized management of township hospitals. Through convening a mobilization meeting, issuing implementation plans, defining work objectives and tasks, and formulating work measures, pilot projects were carried out in some township hospitals and gradually pushed out throughout the county. So far, this work has been fully implemented in the county 13 township hospitals. According to the requirements of the superior, the progress of the pilot work of standardized management of township hospitals in our county is reported as follows:

First, performance.

1. Through the standardized construction of clinical departments and vaccination clinics in traditional Chinese medicine hospitals for public health and environmental construction, the infrastructure construction of department configuration, medical equipment configuration and use, and post appointment of professional and technical personnel in township hospitals has been further improved.

2. Through the unified management of people, talents and materials in township hospitals, the hospital has straightened out the management system of township hospitals in terms of technical personnel deployment, qualification access, fund investment, asset management, business guidance and work coordination, public health and medical market supervision.

3. The reform of personnel distribution system in township hospitals has been completed. On the basis of implementing the target responsibility system of the president's term of office and perfecting various management systems, the department setting of township hospitals is divided into public health and medical treatment, and it is clear that all township hospitals should focus on public health services. On this premise, the central hospital should further improve the level of medical technology and guide the business work of the surrounding general hospitals. A strict performance appraisal system has been established, and the salary distribution of personnel is linked to the services provided and labor contributions, which improves the internal vitality of township hospitals and stimulates the enthusiasm of cadres and workers.

4. The hospital's administration and business have been institutionalized. Formulate the class objectives and tasks of hospital leaders and department heads. The post responsibility system combining responsibility, right and benefit shall be implemented, and various medical and nursing work systems such as handover of clinical departments, standardized writing of medical documents, registration of errors and accidents, disinfection and isolation shall be established and improved to prevent medical disputes and put an end to medical liability accidents.

5. Actively carry out counterpart support to rural health institutions, arrange five county-level medical and health institutions to provide counterpart support to 13 township health centers, and take charge of the responsibility system for 248 village clinics in the county according to the regional arrangement 13 township health centers, effectively establish and improve the rural three-level medical and health network infrastructure, and give full play to its due role. By signing the counterpart support agreement, the work objectives, tasks, working methods, time, responsibilities and rights of both parties were clarified, the management and service capabilities of grassroots medical and health institutions at all levels were improved, and the environmental construction and connotation construction of recipient township hospitals and village clinics were significantly changed and rectified.

6. Strengthen the management of accounting, health care and prevention professionals, women and children professionals, combined therapy professionals and other full-time personnel in township hospitals, and formulate measures for the employment and assessment of all professionals. All professionals must be declared by the hospital and approved by the Health Bureau before they can take up their posts. Without the permission of the superior, the hospital is not allowed to change at will, which ensures the stability of the full-time staff of the hospital and effectively promotes the smooth progress of financial and health work.

7. Formulated and issued the "Ten Provisions for the Dean of Township Health Centers in Huaxian County", which strengthened the management of the directors of health centers. It is clearly required that hospital directors should carry out all work in accordance with relevant national laws and regulations, obey the management of the Health Bureau, ensure the smooth implementation of government decrees, and strictly demand themselves in accordance with the Ten Provisions for the Directors of Township Hospitals in hua county to complete all tasks on schedule.

Second, the existing problems

1. Due to historical reasons, some township hospitals are short of technical personnel and small in scale, and the existing medical equipment cannot play its due role. Solution: The hospital is solving the problem through temporary secondment and entrusted training.

2. The distribution of medical equipment resources is uneven. Solution: Through investigation and statistics, the Health Bureau uniformly registered, repaired, maintained and debugged all the damaged and idle medical equipment in township hospitals throughout the county, and then re-deployed them. In order to improve the utilization rate of equipment and facilitate the people to seek medical treatment.

3. Effectively combine the internal similarities and differences of standardized construction of village clinics, standardized management of township hospitals and integrated management of rural health services, and make scientific and reasonable arrangements, which greatly improves work efficiency.

In order to steadily implement the national basic drug system, effectively solve the problem of "difficult and expensive medical treatment" for the masses, and implement the policy of benefiting the people of the party and the state, we have strengthened measures, paid close attention to implementation, and solidly promoted the "three unifications of drugs." The self-inspection of the "three unifications" of drugs in my jurisdiction is reported as follows:

First, our hospital has set up a leading group for the work of "three unifications", headed by the president. The principles and objectives of pharmaceutical quality management have been formulated, the quality management program documents and operating rules have been compiled, and the combination of regular inspection and routine inspection has been implemented, so that the pharmaceutical quality management in our hospital can be based on evidence and rules.

2. Our hospital began to be distributed by the "three unified" enterprises on June 20xx 10, and the utilization rate of essential drugs was 100%.

Three. There are 15 standardized village clinics in our jurisdiction, all of which have signed contracts with the "three unifications", and medicines are purchased by the "three unifications".

4. We have trained all the staff in the hospital on clinical guidelines for essential drugs. At present, clinicians can use essential drugs reasonably and safely. The main problems existing in the process of "three unifications" distribution are as follows:

1. The drug varieties of distribution enterprises are not comprehensive, and some basic drugs cannot meet the clinical use of drugs in hospitals and village clinics. Such as emergency medicine.

2. The delivery is not timely in the process of drug delivery.

3. Some drugs are very expensive.

In the future work, we are determined to implement the reform of the national essential drug system, strengthen publicity and supervision, improve the long-term supervision mechanism of drug "three unifications", and ensure the smooth progress of drug "three unifications".

Self-inspection report on hospital management 3 In order to fully understand the activities of the first hospital management year in the county, urge, guide and help all units to carry out the activities of the hospital management year in a solid and effective manner, and discover, establish and popularize good practices, advanced models and successful experiences, according to the spirit of the document of the Health Department of the autonomous region and the requirements of the Implementation Plan of the Hospital Management Year with the theme of patient-centered and improving medical service quality of xx County Health Bureau, the County Health Bureau requires all medical units to take the form of self-inspection at the end of xx.

X medical institutions in the county have conducted self-examination and summarized and reported. The self-inspection is now reported as follows:

I. Main achievements

On the whole, hospitals have creatively carried out the work of hospital management year in combination with their own reality, with their own characteristics and remarkable results.

(a) the leadership attaches great importance to the sound institutions. All hospitals and health centers have set up leading groups for hospital management year activities, with the top leader as the first responsible person. The members of the county people's hospital team played an exemplary role in the hospital management year activities, taking the hospital management year activities as the' top priority' of hospital work and taking the hospital management year activities as an opportunity and breakthrough to comprehensively strengthen the hospital connotation construction; County People's Hospital, County Second People's Hospital, County Traditional Chinese Medicine Hospital and County Maternal and Child Health Hospital all specially appointed an office director to take charge of the hospital management year, which provided sufficient organizational guarantee for the effective implementation of the hospital management year activities.

(2) Full mobilization and careful deployment. Most hospitals attach great importance to the annual activities of hospital management. According to the requirements of the Ministry of Health and the Health Department, the health bureaus of cities and counties mobilized and deployed at different levels, and combined with the actual situation, formulated the implementation plan for the annual activities of hospital and department management, with clear objectives and specific tasks.

(3) Vigorously publicize and strengthen education. All hospitals have carried out in-hospital and social publicity to varying degrees, using fixed banners, slogans, publicity windows and so on. Moreover, most hospitals have set up briefings on hospital management year activities to convey the spirit of higher health administrative departments in time and report the development of their own management year activities. Some hospitals also use the advanced figures and typical deeds around them to strengthen the professional ethics education for medical staff and carry out discussions on topics such as "If I were a patient". Through these activities, medical staff are urged to change their perspectives and service concepts, and their patient-centered initiative and consciousness are enhanced.

(4) Improve services and reduce costs. Some hospitals put the work of improving medical services and reducing medical expenses into the first stage of hospital management year, which started early and acted quickly, and achieved initial results and won favorable comments from the society. The county people's hospital opened a green channel, giving priority to the disabled and the elderly over 70 years old, and providing wheelchairs and trolleys for patients. Free of charge, and implement flexible management of commuting time in medical technology departments, pharmacies and toll rooms, optimize service processes, dredge service links and other measures to provide convenient services for patients; In order to make medical services closer to patients and the masses, and realize patient-centered quality service, the Second People's Hospital of the county compiled the notice of hospitalization procedures and the flow chart of hospital convenience service on the bulletin board of psychiatric inpatient department, which greatly facilitated patients.

County Maternal and Child Health Hospital has implemented the policy of benefiting the people, carried out reasonable inspection, carried out high-quality and honest service activities, and implemented services such as acceptance of hospitalization, handling of formalities, accompanying inspection, and delivery after discharge, which improved the service quality and promoted the comprehensive and coordinated development of hospital civilization construction. Around the theme of hospital management year, county traditional Chinese medicine hospital has formulated detailed activity measures, formulated operational quantitative management indicators, implemented convenience measures, set up medical guidance and consultation, and provided humanized services.

(5) Seriously sum up and turn to this section in time. Most hospitals and health centers have annual activity offices in place, with detailed materials and perfect file management. The first phase of work was carefully checked and summarized in accordance with the spirit of the documents of the Health Department of the autonomous region.

Second, problems and deficiencies

Because the form of inspection is self-examination, we certainly don't have a comprehensive and in-depth understanding of the achievements of various hospitals, and there are still many good practices and experiences that have not been discovered.

I hope everyone will strengthen communication and learn from each other through SMS in the future. Judging from the summary report of this self-inspection, the achievements are main, but there are also some problems and deficiencies.

The leaders of a few units have insufficient understanding of the importance of hospital management annual activities and respond negatively. Hospital management year is not regarded as a good opportunity and means to promote hospital internal management and improve hospital service and management level, but as an independent movement; It is not organically combined with the overall work of the hospital, but simply treated as an activity unrelated to hospital work. We just set up the leading group and office of the annual activities of hospital management in form, without full-time staff in charge, and there was a deviation in leadership thinking, which made the annual activities of hospital management a mere formality from the beginning.

The first stage of hospital management year activities is mainly publicity, launch and organization, and the inspection method and content are relatively simple. The purpose of self-examination is to discover, establish and popularize the good practices, advanced models and successful experiences of various hospitals in carrying out hospital management year activities, and to attract all hospital cadres and workers to attach great importance to hospital management year activities, lay a foundation for the next work and comprehensively promote hospital management year activities. According to this spot check, the following requirements are put forward for the next phase of hospital management year activities:

All hospitals and health centers should earnestly strengthen organizational leadership, correct their thinking and define their goals. Hospital management year activities are closely related to the overall work of the hospital, involving all departments, departments and links of the hospital, and its content, requirements and indicators are rich and specific. Doing a good job in hospital management year is a good opportunity to promote hospital internal management and improve hospital service and management level. In the spirit of seeking truth and being pragmatic, hospitals should constantly improve the ideological understanding of the majority of medical staff, and those units that have insufficient publicity and mobilization should make up lessons. It is necessary to make full use of banners, publicity windows, brochures and other media to vigorously publicize the great significance of carrying out the activities of the Year of Hospital Management, publicize typical cases, experiences and achievements, create a good public opinion atmosphere for the activities of the Year of Hospital Management, and form a situation that everyone pays attention to. Each hospital should set up its own expert supervision team, compare the supervision and inspection of its own work with the improvement of its work vertically, run through the hospital management year, seek practical results, and resolutely avoid going through the motions.

All hospitals should actively explore and creatively carry out their work in light of the actual situation of their own units. It is necessary to use effective methods and carriers to enrich the content of activities and strengthen the effect of activities, so that the annual activities of hospital management can fully reflect the characteristics of hospitals and reflect the times and creativity; It is necessary to sum up effective and good ideas and practices, establish a mechanism and form a system, and carry out hospital management year activities to raise the hospital management level and medical service level to a new level.

Hospital Management Self-inspection Report 4 According to the Notice on Printing and Distributing issued by state administration of traditional chinese medicine Office and General Office of National Health and Family Planning Commission, and the Notice on Printing and Distributing the Special Inspection on the Management of Chinese Herbal Pieces in Medical and Health Institutions in Our City, the leading group for quality management of Chinese Herbal Pieces in our hospital recently conducted a comprehensive self-inspection on the procurement, storage, deployment, decoction, prescription management and comments of Chinese Herbal Pieces in our hospital. The self-inspection report is as follows:

First, the management status of Chinese herbal pieces in our hospital

1, and established the management organization. Our hospital has set up a leading group for quality management of Chinese herbal pieces, headed by President Liu Jinghong personally, to strictly manage the procurement, storage, deployment, decoction prescription management and comments of Chinese herbal pieces, so as to ensure the quality of Chinese herbal pieces and the safety and effectiveness of clinical medication.

2. Procurement and acceptance management of Chinese herbal pieces. Can be strictly in accordance with the provisions from the "drug production license" of Chinese herbal pieces production enterprises or "drug business license" of Chinese herbal pieces business enterprises to buy Chinese herbal pieces. When purchasing Chinese herbal pieces, they can be checked and accepted in strict accordance with the national drug standards and the standards and norms formulated by the provincial drug supervision and management departments, including quality, specifications, quantity, packaging, labels, certificates, etc. Each piece of Chinese herbal medicine must be accompanied by the quality inspection report of the drug supervision department, and the person with intermediate title and experience in identifying Chinese herbal medicine pieces is responsible for the acceptance and signature of Chinese herbal medicine pieces before it is qualified. Those who fail to pass the inspection will never be put into storage, and counterfeit and shoddy drugs will be prevented from entering our hospital from the source.

3. Storage, storage and maintenance of Chinese herbal pieces. Our hospital has set up an independent warehouse of Chinese herbal pieces, which has perfect conditions and facilities such as ventilation, temperature regulation, humidity regulation, moisture prevention, insect prevention, rat prevention and theft prevention, and is managed by a special person and checked every day. So as to completely prevent the occurrence of problems such as moldy deterioration, discoloration, moth-eaten, rodent damage and the like of Chinese herbal pieces.

4, Chinese herbal medicine dispensing management. Dispensing personnel in Chinese pharmacy strictly implement the management system for dispensing Chinese herbal pieces, resolutely refuse prescription dispensing that may cause drug safety problems, such as "eighteen evils", "nineteen fears", contraindications to pregnancy, and exceeding the dosage specified in China Pharmacopoeia, and require the prescriber to confirm (double sign) or re-issue the prescription before dispensing. Special decocting methods such as decocting first, decocting later and packaging can be indicated on the medicine bag.

5, Chinese medicine decoction management. The decocting room of our hospital is equipped with two multifunctional automatic decocting machines, which can basically meet the relevant requirements of soaking, frying twice, stirring, frying first and frying later. A relatively perfect operating rules and scientific and reasonable Chinese medicine decoction process have been established, which can operate Chinese medicine decoction pieces with special requirements, such as frying first, then frying, dividing, melting, decocting in water, etc., according to requirements or doctor's advice, and ensure the decoction quality of Chinese medicine decoction pieces.

Second, the existing problems

1. There are few equipments in the decocting room of our hospital, which can only guarantee the basic requirements of patients' decocting decoction pieces. At the same time, due to the lack of staff in Chinese pharmacy, it failed to play a perfect work efficiency.

2. Limited by the professional direction of the staff of the prescription review working group in our hospital, we failed to establish a perfect special review system for prescription of Chinese herbal pieces, and also failed to carry out the related work of prescription review of Chinese herbal pieces smoothly.

Third, the rectification measures

1. Our hospital rationally allocates and adjusts the personnel composition of Chinese pharmacy to ensure the smooth completion of the dispensing and frying of Chinese herbal pieces, ensure the work efficiency, and ensure the timely, safe and rational use of drugs by patients.

2 to strengthen the professional training of the staff of the prescription management review team, establish and improve the special review system of Chinese herbal medicine prescriptions in time, and ensure the smooth development of the relevant work of Chinese herbal medicine prescription review.

In this self-inspection operation, we found that there are still some problems and deficiencies in the work. Our unit will strictly abide by the requirements of the drug supervision department, actively carry out business study and self-examination to ensure the rational and safe use of drugs by patients.

Hospital Management Self-inspection Report 5 In order to implement the spirit of the document Notice of Wuchang District Health Planning Commission on Printing and Distributing the Implementation Plan of Overmedical Special Remediation Activities of Medical Institutions in Wuchang District, improve the service quality of medical staff in our hospital, enhance the overall service level of the hospital, consolidate and promote the all-round and healthy development of health undertakings, and strengthen the construction of industry style, our hospital actively arranges deployment according to the requirements in the notice of special rectification work, and, in combination with our hospital's situation, formulates practical rectification measures and solidly carries out self-inspection and self-correction activities. The situation report is as follows.

I. Basic information

(1) Strengthen leadership and improve organization. In order to strengthen the smooth progress of the special rectification work, a special rectification work leading group was established, headed by President Zheng Baixiong (in charge of the special rectification work), with Yang Bing as the deputy leader and the directors of relevant departments as members, responsible for organizing, coordinating, supervising, inspecting and rectifying. On April 1 1 day, the staff mobilization meeting of the whole hospital was organized to make the staff of the whole hospital realize the importance of carrying out this work and ensure the implementation of all the work.

(two) to strengthen publicity and education, serious industry discipline. The leading group for special rectification work has a clear division of labor, closely focuses on work priorities, strictly enforces discipline, conducts regular supervision and inspection, and the hospital makes public its service commitment to the society, resolutely putting an end to over-medical treatment, over-inspection and arbitrary charges. Set up 1 special rectification complaint telephone, distribute more than 30 satisfaction survey opinions, and accept social supervision through various ways such as scrolling electronic display screen in outpatient hall. In view of the problems found, the responsibility of relevant departments and directly responsible persons was strictly investigated, which comprehensively promoted the fundamental improvement of medical ethics construction.

Second, check the situation.

20 medical records were filed in 8 departments of the hospital. According to the governance requirements of the Plan, a list of inspection items was designed, and the inspection contents and standards were unified. The medical department and nursing department take the lead, and the branch directors of the organization department check them one by one. The results of spot checks show that no irregularities such as over-examination, repeated examination, use of high-priced drugs, abuse of antibiotics, extension of treatment or hospitalization time have been found. In view of the procurement of drugs, medical equipment, medical materials, laboratory reagents and vaccines. Our hospital conducted a comprehensive clean-up and verification, and found no illegitimate interests such as kickbacks, commissions and red envelopes in various names; Departments and medical staff with medical behavior services did not accept red envelopes, meals or gifts from patients and their families. Problems: incomplete diagnosis, simple course record, weak service consciousness of a few medical staff and blunt attitude towards patients have affected the overall image of our hospital.

Third, the rectification measures

In view of the problems found in the self-inspection, take the following corrective measures:

(1) Strengthen the concept of educational guidance and service. Carry out laws and regulations, disciplinary warning, professional ethics education and training, enhance the consciousness of cadres and workers to consciously resist unhealthy trends, and build a solid ideological and moral and legal defense line.

(2) Strengthen system construction and establish a long-term mechanism. Adhere to the weekly meeting system, conduct regular business training, guide medical staff to make rational diagnosis, treatment and medication, regularly carry out prescription comments, and timely put forward guidance and rectification measures for unqualified prescriptions.

(three) to strengthen supervision and inspection, serious work discipline. If the problems reflected by patients are investigated and verified in time, the relevant responsible persons shall be investigated in strict accordance with the hospital management system and performance appraisal scheme, and linked to the annual assessment, evaluation first, evaluation first and employment. If the circumstances are serious and have a greater impact, they shall be dealt with severely in accordance with relevant regulations.

(four) adhere to the strict national price policy, standardize the charging items and standards, and put an end to the problems of independent items, decomposition of charging items and repeated charging in medical services.

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