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Objective:To analyze the implementation effect of single disease payment policy for day surgery (hereinafter referred to as the policy), for references for the reform of medical insurance payment.Methods:By collecting the information of inpatients from 2017 to 2019 in a tertiary hospital, the research group took patients with colorectal benign tumor and nodular goitre as the policy implementation group and the control group respectively. 2017-2018 was the pre implementation stage of the policy, and 2019 was the post implementation stage of the policy. The difference-in-differences (DID) model was used to analyze the changes in indicators such as length of stay and hospitalization expenses after policy implementation, under whether the policy is implemented or not, as well as before or after policy implementation.Results:A total of 2 419 patients were included, including 927 patients with nodular goiter in the control group and 1 492 patients with colorectal benign tumors in the policy implementation group (688 patients before the policy implementation and 804 patients after the policy implementation). The results of DID showed that the hospital days for patients with colorectal benign tumor decreased by 56.53%, the hospitalization expenses decreased by 26.51%, the out-of-pocket expenses decreased by 26.66%, the treatment expenses increased by 11.96%, the drug expenses decreased by 50.29% and the consumables expenses decreased by 20.23% after the implementation of the policy.Conclusions:The implementation of the policy could reduce length of stay, hospitalization expenses and out-of-pocket expenses, optimize the structure of hospitalization expenses, improve the efficiency of hospital diagnosis and treatment, and help the hospital realize its transformation from a size expansion to a quality and benefit expansion.
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Objective To investigate the residents' acceptance and the influencing factors of the hierarchical medical system in Xuzhou, and to suggest on effective system implementation. Methods Xuzhou residents free of cognitive impairment and over 18 years old were sampled for questionnaire survey in July-August 2016, to study their acceptance of their basics and acceptance of the system. 1 550 questionnaires were distributed, and 1 473 valid ones were recovered. The count data were expressed as constituent ratio, and χ2test was used for single-factor analysis, with binary logistic regression analysis for multi-factor analysis. Results 71. 0% of the residents embraced this system. Their acceptance varies significantly with their age, place of residence, education, annual average monthly income, self-rated health status, physical examination experience, conditions of chronic diseases, medical visit experience at primary healthcare institutions, and their awareness of the system (P<0.05). Conclusions The acceptance of the system by Xuzhou residents needs to be elevated, by means of greater promotional efforts, capacity building for primary institutions, so as to fully leverage the system to serve the residents.
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Objective To investigate the protective effect of pitavastatin on the patients with earlystage diabetic nephropathy and its mechanism.Methods Seventy cases of early-stage type 2 diabetic nephropathy were divided into pitavastatin group and regular treatment group by random digits table method with 35 cases each.Meanwhile,35 healthy adults with physical examination were recruited as control group.Before and after treatment in pitavastatin group and regular treatment group and on the day of physical examination in control group,the blood glucose,blood lipid,renal function,urinary albumin excretion rate (UAER),high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-18 were determined and compared.Results Before treatment,the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglycerides (TG),fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18,HDL-C were (5.74 ± 1.35) mmol/L,(3.73 ± 0.75) mmol/L,(3.46 ± 1.87) mmol/L,(10.25 ± 2.36) mmol/L,(15.59 ± 3.64) mmol/L,(8.67 ± 2.28)％,(124.2 ± 52.5) μg/min,(3.64 ± 1.48) mg/L,(43.74 ± 8.35) μ g/L,(113.43 ± 32.75) ng/L,(1.15 ± 0.36) mmol/L in regular treatment group and (5.93 ± 1.41) mmol/L,(3.68 ± 0.71) mmol/L,(3.29 ± 1.92) mmol/L,(10.48 ± 2.69) mmol/L,(16.04 ± 3.16) mmol/L,(9.48 ± 2.46)％,(116.2 ± 50.4) μ g/min,(3.48 ± 1.46) mg/L,(45.93 ± 9.41) μg/L,(120.68 ±35.20) ng/L,(1.18 ±0.35) mmol/L in pitavastatin group,and (4.57 ±0.83) mmol/L,(2.87 ± 0.64) mmol/L,(1.37 ± 0.58) mmol/L,(4.57 ± 1.37) mmol/L,(7.38 ± 1.30) mmol/L,(5.84 ± 1.57)％,(14.8 ± 9.4) μ g/min,(0.84 ± 0.52) mg/L,(10.42 ± 2.83) μ g/L,(20.84 ± 8.56) ng/L,(1.54 ± 0.39) mmol/L in control group.Before treatment,the levels of TC,LDL-C,TG,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18 in regular treatment group and pitavastatin group were higher than those in control group,HDL-C was lower than that in control group,and there were significant differences(P ＜ 0.01).The levels of TC,LDL-C,TG were (4.42 ± 1.28),(3.20 ± 0.57),(2.02 ± 0.87) mmol/L after treatment in pitavastatin group,which were lower than those before treatment,and there were significant differences (P ＜ 0.01).The levels of UAER,hs-CRP,TNF-α,IL-18 were (88.3 ± 36.7) μ g/min,(2.54 ± 0.76) mg/L,(35.62 ± 5.28) μg/L,(83.23 ± 21.57) ng/L in regular treatment group and (64.8 ± 34.6)μ g/min,(2.19 ± 0.65) mg/L,(27.70 ± 7.58) μ g/L,(63.20 ± 18.67) ng/L in pitavastatin group after treatment,which were lower than those before treatment,but the decreased degree was obvious in pitavastatin group.Conclusions Pitavastatin can significantly reduce not only UAER,but also the levels of hs-CRP,TNF-α,IL-18,while effectively lower the blood lipid,in early diabetic nephropathy,which indicates that pitavastatin can reduce urine protein and protect renal function by inhibiting the inflammatory process.
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Objective To explore the influential factors of hospital management teaching and to apply new plans to improve quality of teaching. Methods Questionnaire survey was conducted among 94 students majored in health management in Xuzhou Medical College to investigate student' learning behavior as well as contents, applying value, procedures, and teaching effects of the course. Data was put in by Epidata 3.02, described and analyzed by SPSS 18.0. Continous variables were ana-lyzed by t test and classified variables were analyzed by X2 test. Results 25.6%(24/94) students were not interested in this course. 61.7%(58/94) students thought that the course was highly correlated with profession. 56.4%(53/94) students thought that the course was valuable. 35.1%(33/94) students thought that the course was not good in combining theory with practice in teaching. 19.1%(18/94) stu-dents thought that the course was deficient in interactive teaching and teaching methods. 62.8%(59/94) students were satisfied with the teaching effect. Conclusions Main influential factors of hospital man-agement teaching are learning interest, curriculum evaluation and teaching evaluation. To improve quality of hospital management teaching, it is necessary to communicate the importance of the course and to apply new teaching plans to arouse the interests of students.
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The stody explored the stalus and influential factors of Medical Marketing teaching and made some Droposition to teaching.The results showed that some students were dissatisfied with the teaching style,the curriculum,or the teaching effect,whose proportion was 42.6 percent,22.3 percent,14.3percent respectively.Main influential factors of Medical Marketing teaching were age,learning interest,evaluation to the curriculum and evaluation to the teaching.It was the findings through the study that the status of taaching was presented from two aspects,namely the students disliked the learning of curriculum and the teaching style was monotonous.Therefore it was urgent to develop the teaching reform and to arouse students'interest.
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To bring up teaching quality of health service management and students' integrated ability,the author advanced his thoughts and opinions for teaching reform in teaching contents,teaching methods,examination modes and teachers ability based on the characteristics of health service management and combined with teaching practice.
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Objective To know the performance of CT in Xuzhou, and provide references for the allocation optimization of medical resources in effective using of CT in Xuzhou. Methods All hospitals that have large medical equipment in Xuzhou were investigated and the cost, payment and benefit of 42 CT are analyzed. Results The median of cost is 142.6 yuan per person. The median of payment is 277.0 yuan per person. The median of annual net profit is 652 thousand yuan per CT. Conclusion The payment is higher than the cost of CT in Xuzhou. The ratio of profit is 120.8%, but half of CT can't take back of the investment in regular time.