The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatme...The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.展开更多
Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within...Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.展开更多
The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,central...The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.展开更多
Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall per...Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.展开更多
With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements ...With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements imposed by the new medical reform on human resource allocation in public hospitals,examines existing issues such as an unbalanced personnel structure,unscientific job design,and an inadequate talent mobility mechanism,and proposes corresponding optimization strategies.These strategies include improving the recruitment and selection process,scientifically planning job structures,and establishing a flexible talent mobility mechanism.The goal is to enhance the quality of medical services,improve hospital operational efficiency,and promote the sustainable development of public hospitals.展开更多
With the rapid development of the medical industry,ensuring patient safety and improving medical quality have led to the development of a very important aspect:hospital infection control.This paper intends to evaluate...With the rapid development of the medical industry,ensuring patient safety and improving medical quality have led to the development of a very important aspect:hospital infection control.This paper intends to evaluate the job competencies of infection prevention and control personnel in Chinese medicine hospitals through an analysis of the necessity of such competencies,the establishment of criteria for evaluation,and the exploration of methods for implementation.This paper proposes an effective evaluation system on the basis of recent research findings and some recommendations for how to improve infection management in these hospitals.This study provides suggestions for the training and management of staff in infection prevention and control through a review of the relevant literature within the context of Chinese medicine hospitals.展开更多
Fangcang shelter hospitals are modular,rapidly deployable facilities that play a vital role in pandemic response by providing centralized isolation and basic medical care for large patient populations.Artificial intel...Fangcang shelter hospitals are modular,rapidly deployable facilities that play a vital role in pandemic response by providing centralized isolation and basic medical care for large patient populations.Artificial intelligence(AI)has the potential to transform Fangcang shelter hospitals into intelligent,responsive systems that are capable of significantly improving emergency preparedness,operational efficiency,and patient outcomes.Key application areas include site selection and design optimization,clinical decision support,AI-assisted clinical documentation and patient engagement,intelligent robotics,and operational management.However,realizing AI's full potential requires overcoming several challenges,including limited data accessibility,privacy and governance concerns,inadequate algorithmic adaptability in dynamic emergency settings,insufficient transparency and accountability in AI-driven decisions,fragmented system architectures due to proprietary formats,high costs disproportionate to the temporary nature of Fangcang shelter hospitals,and hardware reliability in austere environments.Addressing these challenges demands standardized data-sharing frameworks,development of explainable and robust AI algorithms,clear ethical and legal oversight,interoperable modular system designs,and active collaboration among multidisciplinary stakeholders.展开更多
Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clin...Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clinical data from patients who received treatment in the Department of Orthopedics and the Department of Acupuncture and Moxibustion at our hospital from January 1,2023,to December 31,2023.The study compared the costs of medications,examinations,treatments,laboratory tests,nursing and other expenses,and total treatment costs between the two departments.It analyzed the cost structure of the two departments and proposed further improvement suggestions.Results:The study results indicated that the total costs in the Department of Acupuncture and Moxibustion were significantly higher than those in the Department of Orthopedics.Among medication costs,the total medication costs in the Department of Orthopedics were higher than those in the Department of Acupuncture and Moxibustion,with costs for Western medicine,proprietary Chinese medicine,and herbal medicine all being higher(p<0.05).Regarding examination costs,consultation fees in the Department of Orthopedics were lower than those in the Department of Acupuncture and Moxibustion,while examination costs were higher(p<0.05).In terms of treatment costs,orthopedic treatment and surgical fees were higher than those in the Department of Acupuncture and Moxibustion(p<0.05).For laboratory test costs,orthopedic laboratory fees were significantly higher than those in the Department of Acupuncture and Moxibustion(p<0.05).Among nursing and other expenses,orthopedic blood transfusion,bed fees,and other expenses were higher than those in the Department of Acupuncture and Moxibustion,while nursing fees were lower(p<0.05).Conclusion:Treatment fees in the Department of Acupuncture and Moxibustion are the core and account for a relatively high proportion of the total costs.The benefits generated by the Department of Orthopedics are primarily derived from medication,examination,and laboratory fees,aligning with the characteristics of combining diagnosis,medication,and surgical intervention in orthopedic treatment.Consultation fees,nursing fees,and bed fees in the Department of Acupuncture and Moxibustion are higher than those in the Department of Orthopedics,indicating a longer treatment cycle in acupuncture,which warrants clinical attention.展开更多
BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outc...BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at ICU departments of 37 cancer specialized hospitals in China.Patients aged≥14 years with ICU duration≥24 hours were included.Clinical records of patients with primary esophageal cancer diagnosis were reviewed.Patients were separated into groups according to the 90 days survival.Characteristics between groups were compared.Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS Total 180 esophageal cancer patients were included.The 90 days mortality was 22.2%.Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward.The current evaluation tools,including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death.ICU admitted esophageal cancer patients have poor prognosis,especially those with acute illness.CONCLUSION The prognostic tools for these patients need to be further optimized.展开更多
Alcohol use has contributed to large disease burdens,and alcohol-related problems are prevalent among patients in general hospitals and primary care settings.This review aims to deepen the understanding of screening,i...Alcohol use has contributed to large disease burdens,and alcohol-related problems are prevalent among patients in general hospitals and primary care settings.This review aims to deepen the understanding of screening,intervention,and treatment referral for alcohol-related problems in these settings.We searched the literature published in English from PubMed,ScienceDirect,and the World Health Organization website.We found that while a series of screening tools can be used,screening rates were low.The awareness of screening should be strengthened.Brief interventions and pharmacotherapy are the two main methods used in general hospitals and primary care settings,with complementary and alternative medicine considered under the framework of integrative medicine.Individuals with severe alcohol-related problems or alcohol use disorders should be referred to specialty treatment for alcohol abuse,but referral is sometimes ignored.A gap exists between general hospitals/primary care facilities and specialized alcohol-related treatment providers.In conclusion,screening,intervention,and referral to treatment comprise a continuum for patients with alcohol-related problems.Opportunities to prevent and manage these problems in general hospitals and primary care settings are abundant,and taking action will promote the addressing of this public health issue.展开更多
Objective:To explore the target management model for clinical pharmacists in primary hospitals facing current shortages of clinical pharmacists,in order to improve the work efficiency and service quality of clinical p...Objective:To explore the target management model for clinical pharmacists in primary hospitals facing current shortages of clinical pharmacists,in order to improve the work efficiency and service quality of clinical pharmacy,and promote the high-quality development of clinical pharmacy in primary hospitals.Methods:Developing a target management model,adopting a wide coverage work model of“1+1+N”(that is,1 clinical pharmacist,1 resident clinical department,and N contracted clinical departments).According to the SMART principle,various work assessment indicators were quantified.This involved setting clear work goals,diversifying work methods,personalizing work methods,standardizing workflows,and using numerical assessment indicators.Regular supervision,inspection,feedback,and improvement mechanisms were implemented.Results:The implementation of the target management model has made the work effectiveness of clinical pharmacists visualized.There were more than 200 annual consultations and multidisciplinary team(MDT)cases,with an opinion adoption rate of 90.2%and a patient improvement rate of 80.6%.More than 1500 rational drug use interventions were conducted,with a suggestion adoption rate of 83.5%.In terms of pharmaceutical indicators control.The intensity of antibacterial drug use in 2024(without CMI adjustment)was 30.07 DDDs,significantly lower than the 2023 value of 33.54 DDDs,and also significantly lower than the provincial average(32.87 DDDs)and the average for hospitals of the same level(32.49 DDDs).The daily usage of intravenous infusion per bed for hospitalized patients was 2.09,a decrease from 2.15 in 2023,significantly lower than the provincial average of 2.71 and the average of 2.56 in hospitals of the same level.The amount of the second batch of national key monitoring drugs accounts for the value was 6.48%,significantly lower than the provincial average of 8.27%and the same level hospital average of 8.82%.In terms of chronic disease pharmaceutical management,taking the pharmaceutical management of patients with chronic heart failure as an example,the usage rates of renin-aldosterone-angiotensin-system inhibitors(RAAS inhibitors)and beta-blockers for heart failure in the management group were 87.88%and 80.81%,respectively,significantly higher-1 than those in the control group(62.22%and 65.56%).Heart rate in the management group(69.54±10.68 times·min-1)was significantly lower than in the control group(80.04±17.68 times·min)(P<0.001).The low-density lipoprotein cholesterol(1.69±0.57 mmol·L-1)was significantly lower than the control group(1.95±0.77 mmol·L-1)(P<0.001),and the 1-year readmission rate was 47.47%,significantly lower than the control group 56.67%.The Minnesota Living with Heart Failure Questionnaire(MLHFQ)Score was(44.20±10.78),significantly lower than the control group(55.89±11.48)(P<0.001),indicating a significant improvement in the patient’s quality of life.Conclusions:The targeted management model for clinical pharmacists can effectively enhance communication and collaboration between clinical pharmacists and clinicians,improve the work efficiency and service quality of clinical pharmacists in primary hospitals,promote the work of clinical pharmacy towards standardization and scientificization,boost the high-quality development of pharmacy in primary hospitals,and also provide new ideas and methods for the management of clinical pharmacists in other primary hospitals.展开更多
A total of 626 questionnaires were collected and analyzed to study the current status of Clinical Pharmacist Pilot Training（CPPT）in Chinese hospitals.The training satisfaction of the training hospitals,trainees,and ...A total of 626 questionnaires were collected and analyzed to study the current status of Clinical Pharmacist Pilot Training（CPPT）in Chinese hospitals.The training satisfaction of the training hospitals,trainees,and the trainee providing hospitals are all very high,among which the satisfaction of the training hospital is the highest.According to the results of the questionnaire, the most important training mode in the training hospitals＇ opinion is different from that in the trainees＇ opinion.Trainees prefer more initiative,practical,and participatory training and hope to learn from the wards round process,while the training hospitals are more inclined to group discussion and teaching.It＇s necessary to increase the number of eligible training hospitals, to implement one on one mentoring strategy in hospital pharmacist training,and to increase active learning in the training program. The result of this research would help to build more effective and efficient pharmacist training programs in Chinese hospitals.展开更多
This study aimed to investigate the salary status of medical doctors who work in county-level hospitals, and analyze the existing problems. We collected the data from questionnaires and applied both EXCEL and SPSS to ...This study aimed to investigate the salary status of medical doctors who work in county-level hospitals, and analyze the existing problems. We collected the data from questionnaires and applied both EXCEL and SPSS to conduct analysis. Doctors working in county level-hospitals received relatively lower salaries, with 78.5% of the doctors making lower than 5000 RMB per month. Influencing factors for the salary levels included personal factors, attributes of the hospitals, workload and performance appraisal. Reasonable adjustment for the salary levels is needed to refine important elements of salary distribution, and to construct a rational performance appraisal system.展开更多
Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving p...Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P <han visitors to in-patient f 0.05). Patients of 60 years of age and above reported mor< 0.001) and reliability e positive perception th<an those between 40 and 49 on reliability(F = 3.311, P = 0.010), assurances(F = 2.751, P 0.05) and empathy(F = 4.009, P = 0.003). For the i ve dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.展开更多
In South Africa,nurses and doctors are emigrating in significant numbers. Job satisfaction,safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). ...In South Africa,nurses and doctors are emigrating in significant numbers. Job satisfaction,safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression,creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India,which has a population of more than 1 billion people,is struggling with similar problems. For the past 10-15 years,private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss,based on the current status and projected specialist and subspecialist personnel requirements,thefuture structure and logistics of training needs. This is required in all subspecialities including gastroenterology,as has been done in India. It is hoped that as a consequence well-trained doctors,similar to those in India,might move to provincial hospitals in rural areas,upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa,as India already is for South-East Asia.展开更多
Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on ...Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.展开更多
Summary： With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics a...Summary： With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program （ASP） at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children＇s, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses （DDDs） per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient eases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days （P〈0.001）. The percentage of antibiotic use in outpatient prescriptions （range： 24.12%-18.71%, P=0.109） and inpatient cases （64.85%-60.10%, P=-0.006） also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.展开更多
Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the propor...Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the proportion of cases at each site and the related features.In this study,we explored the location,distribution and other features of colorectal cancers at each anatomic site in Chinese patients.Methods:We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018;the reports covered a total of 2,097,347 hospitalizations.Incident cases were chosen as the study population,and their epidemiological features were further analyzed.Results:A total of 20,739 colorectal cancer patients were identified.Rectum was the most common location(48.3%)of the cancer,whereas the proportions of patients with distal and proximal colon cancer were 24.5%and18.6%,respectively.Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites(each P<0.001).The highest proportion of emergency admissions,the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer(each P<0.001).The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy,cholecystolithiasis and/or gallbladder polyps and appendectomy(P=0.009,P<0.001 and P<0.001,respectively).The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension(P<0.001,respectively).Conclusions:The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer.Different epidemiological features were also found based on anatomic sites.Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.展开更多
Objective: This study aimed to evaluate Chinese tertiary hospital nurses' research output,research ability,and their related training needs regarding scientific research methodology and analyze the relations among...Objective: This study aimed to evaluate Chinese tertiary hospital nurses' research output,research ability,and their related training needs regarding scientific research methodology and analyze the relations among them.Methods: A nationwide survey was conducted in China on a large sample of tertiary hospital nurses (n =27,335) recruited from 22 provinces,autonomous regions,and municipalities.A validated,self-designed questionnaire,consisted of a common questionnaire,the Science Research Skills Self-Rating Questionnaire (SRSQ) and the Scientific Research Training Needs Questionnaire (SRTNQ) were used to assess nurses' research output,self-rated research skills and research-training needs.Results: The nurses' scientific research participation rates (with 4.13%,7.85%,5.35%,and 2.04% in research projects,research attendance,papers published,and patent,respectively) and their self-rated research skills 25.00 (12.50,37.50) were very low.However,the research training needs were relatively high 53.12(37.50,75.00).Significant differences in research participation rates (research projects,research attendance,papers published,and patent),scientific research skills,and research-training needs were determined by age,highest education level,nursing experience,employment,technical title,administrative post,and clinical tutoring experience (P< 0.05).Female and male nurses had different research participation rates (only research projects and studies published) and scientific research skills (P < 0.05).Positive correlations were observed among research output,scientific research skills,and researchtraining needs (P < 0.01).Conclusions: Nurses' scientific research participation and self-rated research ability were below the optimal despite that they had relatively high research-training needs.Nurses should be provided further research training with tailored content to their characteristics and capacity.展开更多
China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Easter...China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals（39, 45, and 43 in Eastern, Central, and Western China, respectively） were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency（PTE）, and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.展开更多
文摘The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.
文摘Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.
文摘The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.
文摘Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.
文摘With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements imposed by the new medical reform on human resource allocation in public hospitals,examines existing issues such as an unbalanced personnel structure,unscientific job design,and an inadequate talent mobility mechanism,and proposes corresponding optimization strategies.These strategies include improving the recruitment and selection process,scientifically planning job structures,and establishing a flexible talent mobility mechanism.The goal is to enhance the quality of medical services,improve hospital operational efficiency,and promote the sustainable development of public hospitals.
基金supported by Weifang Science and Technology Development Plan Project(Soft Science,2022RKX054)Shenzhen Elite Talent Project(JY2024-2).
文摘With the rapid development of the medical industry,ensuring patient safety and improving medical quality have led to the development of a very important aspect:hospital infection control.This paper intends to evaluate the job competencies of infection prevention and control personnel in Chinese medicine hospitals through an analysis of the necessity of such competencies,the establishment of criteria for evaluation,and the exploration of methods for implementation.This paper proposes an effective evaluation system on the basis of recent research findings and some recommendations for how to improve infection management in these hospitals.This study provides suggestions for the training and management of staff in infection prevention and control through a review of the relevant literature within the context of Chinese medicine hospitals.
文摘Fangcang shelter hospitals are modular,rapidly deployable facilities that play a vital role in pandemic response by providing centralized isolation and basic medical care for large patient populations.Artificial intelligence(AI)has the potential to transform Fangcang shelter hospitals into intelligent,responsive systems that are capable of significantly improving emergency preparedness,operational efficiency,and patient outcomes.Key application areas include site selection and design optimization,clinical decision support,AI-assisted clinical documentation and patient engagement,intelligent robotics,and operational management.However,realizing AI's full potential requires overcoming several challenges,including limited data accessibility,privacy and governance concerns,inadequate algorithmic adaptability in dynamic emergency settings,insufficient transparency and accountability in AI-driven decisions,fragmented system architectures due to proprietary formats,high costs disproportionate to the temporary nature of Fangcang shelter hospitals,and hardware reliability in austere environments.Addressing these challenges demands standardized data-sharing frameworks,development of explainable and robust AI algorithms,clear ethical and legal oversight,interoperable modular system designs,and active collaboration among multidisciplinary stakeholders.
文摘Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clinical data from patients who received treatment in the Department of Orthopedics and the Department of Acupuncture and Moxibustion at our hospital from January 1,2023,to December 31,2023.The study compared the costs of medications,examinations,treatments,laboratory tests,nursing and other expenses,and total treatment costs between the two departments.It analyzed the cost structure of the two departments and proposed further improvement suggestions.Results:The study results indicated that the total costs in the Department of Acupuncture and Moxibustion were significantly higher than those in the Department of Orthopedics.Among medication costs,the total medication costs in the Department of Orthopedics were higher than those in the Department of Acupuncture and Moxibustion,with costs for Western medicine,proprietary Chinese medicine,and herbal medicine all being higher(p<0.05).Regarding examination costs,consultation fees in the Department of Orthopedics were lower than those in the Department of Acupuncture and Moxibustion,while examination costs were higher(p<0.05).In terms of treatment costs,orthopedic treatment and surgical fees were higher than those in the Department of Acupuncture and Moxibustion(p<0.05).For laboratory test costs,orthopedic laboratory fees were significantly higher than those in the Department of Acupuncture and Moxibustion(p<0.05).Among nursing and other expenses,orthopedic blood transfusion,bed fees,and other expenses were higher than those in the Department of Acupuncture and Moxibustion,while nursing fees were lower(p<0.05).Conclusion:Treatment fees in the Department of Acupuncture and Moxibustion are the core and account for a relatively high proportion of the total costs.The benefits generated by the Department of Orthopedics are primarily derived from medication,examination,and laboratory fees,aligning with the characteristics of combining diagnosis,medication,and surgical intervention in orthopedic treatment.Consultation fees,nursing fees,and bed fees in the Department of Acupuncture and Moxibustion are higher than those in the Department of Orthopedics,indicating a longer treatment cycle in acupuncture,which warrants clinical attention.
文摘BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at ICU departments of 37 cancer specialized hospitals in China.Patients aged≥14 years with ICU duration≥24 hours were included.Clinical records of patients with primary esophageal cancer diagnosis were reviewed.Patients were separated into groups according to the 90 days survival.Characteristics between groups were compared.Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS Total 180 esophageal cancer patients were included.The 90 days mortality was 22.2%.Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward.The current evaluation tools,including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death.ICU admitted esophageal cancer patients have poor prognosis,especially those with acute illness.CONCLUSION The prognostic tools for these patients need to be further optimized.
基金Supported by Shandong Province Medical and Health Technology Development Plan Project,No.202203090753.
文摘Alcohol use has contributed to large disease burdens,and alcohol-related problems are prevalent among patients in general hospitals and primary care settings.This review aims to deepen the understanding of screening,intervention,and treatment referral for alcohol-related problems in these settings.We searched the literature published in English from PubMed,ScienceDirect,and the World Health Organization website.We found that while a series of screening tools can be used,screening rates were low.The awareness of screening should be strengthened.Brief interventions and pharmacotherapy are the two main methods used in general hospitals and primary care settings,with complementary and alternative medicine considered under the framework of integrative medicine.Individuals with severe alcohol-related problems or alcohol use disorders should be referred to specialty treatment for alcohol abuse,but referral is sometimes ignored.A gap exists between general hospitals/primary care facilities and specialized alcohol-related treatment providers.In conclusion,screening,intervention,and referral to treatment comprise a continuum for patients with alcohol-related problems.Opportunities to prevent and manage these problems in general hospitals and primary care settings are abundant,and taking action will promote the addressing of this public health issue.
文摘Objective:To explore the target management model for clinical pharmacists in primary hospitals facing current shortages of clinical pharmacists,in order to improve the work efficiency and service quality of clinical pharmacy,and promote the high-quality development of clinical pharmacy in primary hospitals.Methods:Developing a target management model,adopting a wide coverage work model of“1+1+N”(that is,1 clinical pharmacist,1 resident clinical department,and N contracted clinical departments).According to the SMART principle,various work assessment indicators were quantified.This involved setting clear work goals,diversifying work methods,personalizing work methods,standardizing workflows,and using numerical assessment indicators.Regular supervision,inspection,feedback,and improvement mechanisms were implemented.Results:The implementation of the target management model has made the work effectiveness of clinical pharmacists visualized.There were more than 200 annual consultations and multidisciplinary team(MDT)cases,with an opinion adoption rate of 90.2%and a patient improvement rate of 80.6%.More than 1500 rational drug use interventions were conducted,with a suggestion adoption rate of 83.5%.In terms of pharmaceutical indicators control.The intensity of antibacterial drug use in 2024(without CMI adjustment)was 30.07 DDDs,significantly lower than the 2023 value of 33.54 DDDs,and also significantly lower than the provincial average(32.87 DDDs)and the average for hospitals of the same level(32.49 DDDs).The daily usage of intravenous infusion per bed for hospitalized patients was 2.09,a decrease from 2.15 in 2023,significantly lower than the provincial average of 2.71 and the average of 2.56 in hospitals of the same level.The amount of the second batch of national key monitoring drugs accounts for the value was 6.48%,significantly lower than the provincial average of 8.27%and the same level hospital average of 8.82%.In terms of chronic disease pharmaceutical management,taking the pharmaceutical management of patients with chronic heart failure as an example,the usage rates of renin-aldosterone-angiotensin-system inhibitors(RAAS inhibitors)and beta-blockers for heart failure in the management group were 87.88%and 80.81%,respectively,significantly higher-1 than those in the control group(62.22%and 65.56%).Heart rate in the management group(69.54±10.68 times·min-1)was significantly lower than in the control group(80.04±17.68 times·min)(P<0.001).The low-density lipoprotein cholesterol(1.69±0.57 mmol·L-1)was significantly lower than the control group(1.95±0.77 mmol·L-1)(P<0.001),and the 1-year readmission rate was 47.47%,significantly lower than the control group 56.67%.The Minnesota Living with Heart Failure Questionnaire(MLHFQ)Score was(44.20±10.78),significantly lower than the control group(55.89±11.48)(P<0.001),indicating a significant improvement in the patient’s quality of life.Conclusions:The targeted management model for clinical pharmacists can effectively enhance communication and collaboration between clinical pharmacists and clinicians,improve the work efficiency and service quality of clinical pharmacists in primary hospitals,promote the work of clinical pharmacy towards standardization and scientificization,boost the high-quality development of pharmacy in primary hospitals,and also provide new ideas and methods for the management of clinical pharmacists in other primary hospitals.
文摘A total of 626 questionnaires were collected and analyzed to study the current status of Clinical Pharmacist Pilot Training（CPPT）in Chinese hospitals.The training satisfaction of the training hospitals,trainees,and the trainee providing hospitals are all very high,among which the satisfaction of the training hospital is the highest.According to the results of the questionnaire, the most important training mode in the training hospitals＇ opinion is different from that in the trainees＇ opinion.Trainees prefer more initiative,practical,and participatory training and hope to learn from the wards round process,while the training hospitals are more inclined to group discussion and teaching.It＇s necessary to increase the number of eligible training hospitals, to implement one on one mentoring strategy in hospital pharmacist training,and to increase active learning in the training program. The result of this research would help to build more effective and efficient pharmacist training programs in Chinese hospitals.
文摘This study aimed to investigate the salary status of medical doctors who work in county-level hospitals, and analyze the existing problems. We collected the data from questionnaires and applied both EXCEL and SPSS to conduct analysis. Doctors working in county level-hospitals received relatively lower salaries, with 78.5% of the doctors making lower than 5000 RMB per month. Influencing factors for the salary levels included personal factors, attributes of the hospitals, workload and performance appraisal. Reasonable adjustment for the salary levels is needed to refine important elements of salary distribution, and to construct a rational performance appraisal system.
基金Supported by the 12th Five-Year Infectious Disease Research Project:the Use and Optimization of the Standard Regimen for Diagnosis and Treatment of Tuberculosis in HIV/AIDS Patients in China(No.2012ZX10001-003)the 12th Five-Year Major Science and Technology Project on Discovery of Major New Drugs:Construction of a Technology Platform for Clinical Evaluation of AntiHIV Drugs(No.2012ZX09303013)+2 种基金the National 863 Project"Study the Key Technology of Personnel Protection and Lab Tracking of pathogenic microorganism"(2014AA021403)the year 2014 Key research project of the party of the education and health of Shanghai(201420)Scientific research in hospital construction project of Chinese Medical Doctor Assoclation
文摘Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P <han visitors to in-patient f 0.05). Patients of 60 years of age and above reported mor< 0.001) and reliability e positive perception th<an those between 40 and 49 on reliability(F = 3.311, P = 0.010), assurances(F = 2.751, P 0.05) and empathy(F = 4.009, P = 0.003). For the i ve dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.
文摘In South Africa,nurses and doctors are emigrating in significant numbers. Job satisfaction,safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression,creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India,which has a population of more than 1 billion people,is struggling with similar problems. For the past 10-15 years,private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss,based on the current status and projected specialist and subspecialist personnel requirements,thefuture structure and logistics of training needs. This is required in all subspecialities including gastroenterology,as has been done in India. It is hoped that as a consequence well-trained doctors,similar to those in India,might move to provincial hospitals in rural areas,upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa,as India already is for South-East Asia.
文摘Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.
基金supported by grants from the General Program of National Natural Science Foundation of China(No.71073062)Major Project in Philosophy and Social Science of Ministry of Education in China(No.10JZD0027)
文摘Summary： With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program （ASP） at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children＇s, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses （DDDs） per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient eases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days （P〈0.001）. The percentage of antibiotic use in outpatient prescriptions （range： 24.12%-18.71%, P=0.109） and inpatient cases （64.85%-60.10%, P=-0.006） also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
基金supported by grants from the National Natural Science Foundation of China(No.81972702 and No.91959110)national multidisciplinary cooperative diagnosis and treatment capacity building project for major diseases:comprehensive diagnosis and treatment of gastrointestinal tumors,National Health and Family Planning Commission Foundation of China(No.2020YB57)“Clinical Medicine+X”Foundation of Peking University(No.PKU2021LCXQ001)。
文摘Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the proportion of cases at each site and the related features.In this study,we explored the location,distribution and other features of colorectal cancers at each anatomic site in Chinese patients.Methods:We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018;the reports covered a total of 2,097,347 hospitalizations.Incident cases were chosen as the study population,and their epidemiological features were further analyzed.Results:A total of 20,739 colorectal cancer patients were identified.Rectum was the most common location(48.3%)of the cancer,whereas the proportions of patients with distal and proximal colon cancer were 24.5%and18.6%,respectively.Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites(each P<0.001).The highest proportion of emergency admissions,the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer(each P<0.001).The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy,cholecystolithiasis and/or gallbladder polyps and appendectomy(P=0.009,P<0.001 and P<0.001,respectively).The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension(P<0.001,respectively).Conclusions:The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer.Different epidemiological features were also found based on anatomic sites.Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.
文摘Objective: This study aimed to evaluate Chinese tertiary hospital nurses' research output,research ability,and their related training needs regarding scientific research methodology and analyze the relations among them.Methods: A nationwide survey was conducted in China on a large sample of tertiary hospital nurses (n =27,335) recruited from 22 provinces,autonomous regions,and municipalities.A validated,self-designed questionnaire,consisted of a common questionnaire,the Science Research Skills Self-Rating Questionnaire (SRSQ) and the Scientific Research Training Needs Questionnaire (SRTNQ) were used to assess nurses' research output,self-rated research skills and research-training needs.Results: The nurses' scientific research participation rates (with 4.13%,7.85%,5.35%,and 2.04% in research projects,research attendance,papers published,and patent,respectively) and their self-rated research skills 25.00 (12.50,37.50) were very low.However,the research training needs were relatively high 53.12(37.50,75.00).Significant differences in research participation rates (research projects,research attendance,papers published,and patent),scientific research skills,and research-training needs were determined by age,highest education level,nursing experience,employment,technical title,administrative post,and clinical tutoring experience (P< 0.05).Female and male nurses had different research participation rates (only research projects and studies published) and scientific research skills (P < 0.05).Positive correlations were observed among research output,scientific research skills,and researchtraining needs (P < 0.01).Conclusions: Nurses' scientific research participation and self-rated research ability were below the optimal despite that they had relatively high research-training needs.Nurses should be provided further research training with tailored content to their characteristics and capacity.
基金supported by the National Natural Science Foundation of China(No.71473099)
文摘China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals（39, 45, and 43 in Eastern, Central, and Western China, respectively） were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency（PTE）, and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.
