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Objective:To develop a new kind of efficiency-based hospital ranking based on existing major hospital rankings with reference to hospital input data.Methods:DEA method was called into play and built five models for hospital ranking according to the efficiency value so calculated. The hospital beds available and the number of employees of 59 general hospitals in 2018 were used as the input indicators, and China′s Best Hospitals ranking by Fudan University′s Hospital Management Institute(Fudan ranking)and the total scoring and individual items evaluation from China Hospital STEM ranking by the Medical Information Institute of the Chinese Academy of Medical Sciences were used as the output indicators.Results:The correlation coefficients between hospital beds and the scores from Fudan-rankings and STEM-ranking were 0.08 and 0.09 respectively( P>0.05), and the correlation coefficients between personnel and scores from the two rankings were 0.34 and 0.39 respectively( P<0.01). The correlation coefficients of the efficiency values of the five super-efficiency DEA models and the beds were 0.37, -0.61, -0.71, -0.61 and-0.61 respectively( P<0.01), and the correlation coefficients of personnel were-0.17, -0.37, -0.60, -0.39 and -0.39( P<0.01)respectively. Compared with the original ranking, the ranking of the efficiency value of the super-efficiency DEA model found the average ranking of hospitals in Beijing and Shanghai rose by 6.38 places, and the ranking of hospitals in non-Beijing and Shanghai areas dropped by 4.37 places on average. The difference was statistically significant( P=0.02), and other differences in the ranking of different types hospitals were not statistically significant. Conclusions:Thanks to the super-efficiency DEA efficiency value which is added with such input indicators as hospital beds and personnel, the ranking becomes more scientific and comprehensive. The research results can provide references for more rational patient flow and encourage hospitals onto a more healthy development pathway.
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Objective@#To explore the establishment of an evaluation indicator system for disease prevention and control workload at public hospitals, based on the current situation of disease prevention and control work undertaken by public hospitals of and above secondary level in Beijing, and to provide evaluation assistance for them to do better in this regard.@*Methods@#This research was based on our pervious study of the current situation description of disease prevention and control work undertaken by public hospitals in Beijing, by which the contents of routine disease prevention and control work at hospitals have been initially established. The unit strength of each work was consulted, and the disease prevention and control work was classified according to the results. Meanwhile the consistency test of the work intensity within the category was carried out. After integration, the classification and evaluation indicator of disease prevention and control work in public hospitals of and above secondary level in Beijing was finally established.@*Results@#The workload evaluation indicator system was divided into eight parts: report work, report quality control work, monitoring work, training work, work of public health related clinical diagnosis and treatment, work of clinical examination and vaccination, work of sampling and testing and public health related consultation work. The work intensity of each category ranged from 4.78 to 7.34.@*Conclusions@#The evaluation indicator system of workload is suitable for the evaluation of basic works. The unified transformation of workload by using the value of work intensity is conducive to management evaluation, but the limitation of the indicators exists in time and region, making it necessary to adjust by the local specific situation at the promotion and application level.
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Objective@#To investigate the implementation of disease prevention and control services at tertiary public general hospitals in Beijing for providing evidences to explore and build a scientific evaluation model of disease control service in medical institutions.@*Methods@#June to September 2018, through a questionnaire survey of 50 tertiary public general hospitals in Beijing, a descriptive analysis was made on the department setting, personnel allocation and service provision status of disease prevention and control at tertiary public general hospitals in Beijing.@*Results@#Among the 44 investigated public tertiary general hospitals, 26(59.1%) medical institutions have set up departments of disease prevention and control. The average staffing of 44 hospitals was 5.8 persons for the department. Professional composition of the staff was mostly nursing and clinical disciplines, and the academic and professional titles were mostly undergraduate and intermediate degrees respectively. Overall performance of disease prevention and control services in public tertiary general hospitals was satisfactory. The work was well carried out in communicable disease control and death-surveillance management, namely in immunoprophylaxis, chronic noncommunicable diseases and injury monitoring, which varies widely in mental health services, occupational health management, environmental and health monitoring and other functions.@*Conclusions@#Professional ability and management level of personnel still need to be improved. We should further clarify the joint prevention and control mechanism of the " Three-in-one" nature of disease control institutions, medical institutions and communities, promote the combination of medical treatment and prevention, and explore the classification and grading evaluation of disease control work based on the types and quantity requirements of disease prevention and control services undertaken by hospitals, so as to effectively improve the level of disease control services in hospitals.
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Objective To explore the establishment of an evaluation indicator system for disease prevention and control workload at public hospitals, based on the current situation of disease prevention and control work undertaken by public hospitals of and above secondary level in Beijing, and to provide evaluation assistance for them to do better in this regard.Methods This research was based on our pervious study of the current situation description of disease prevention and control work undertaken by public hospitals in Beijing, by which the contents of routine disease prevention and control work at hospitals have been initially established. The unit strength of each work was consulted, and the disease prevention and control work was classified according to the results. Meanwhile the consistency test of the work intensity within the category was carried out. After integration, the classification and evaluation indicator of disease prevention and control work in public hospitals of and above secondary level in Beijing was finally established. Results The workload evaluation indicator system was divided into eight parts:report work, report quality control work, monitoring work, training work, work of public health related clinical diagnosis and treatment, work of clinical examination and vaccination, work of sampling and testing and public health related consultation work. The work intensity of each category ranged from 4.78 to 7.34. Conclusions The evaluation indicator system of workload is suitable for the evaluation of basic works. The unified transformation of workload by using the value of work intensity is conducive to management evaluation, but the limitation of the indicators exists in time and region, making it necessary to adjust by the local specific situation at the promotion and application level.
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Objective To investigate the implementation of disease prevention and control services at tertiary public general hospitals in Beijing for providing evidences to explore and build a scientific evaluation model of disease control service in medical institutions. Methods June to September 2018, through a questionnaire survey of 50 tertiary public general hospitals in Beijing, a descriptive analysis was made on the department setting, personnel allocation and service provision status of disease prevention and control at tertiary public general hospitals in Beijing. Results Among the 44 investigated public tertiary general hospitals, 26 ( 59.1% ) medical institutions have set up departments of disease prevention and control. The average staffing of 44 hospitals was 5.8 persons for the department. Professional composition of the staff was mostly nursing and clinical disciplines, and the academic and professional titles were mostly undergraduate and intermediate degrees respectively. Overall performance of disease prevention and control services in public tertiary general hospitals was satisfactory. The work was well carried out in communicable disease control and death-surveillance management, namely in immunoprophylaxis, chronic noncommunicable diseases and injury monitoring, which varies widely in mental health services, occupational health management, environmental and health monitoring and other functions. Conclusions Professional ability and management level of personnel still need to be improved. We should further clarify the joint prevention and control mechanism of the " Three-in-one" nature of disease control institutions, medical institutions and communities, promote the combination of medical treatment and prevention, and explore the classification and grading evaluation of disease control work based on the types and quantity requirements of disease prevention and control services undertaken by hospitals, so as to effectively improve the level of disease control services in hospitals.
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Objective To assess the effectiveness of China Healthcare Improvement Initiative from 2015 to 2017.Methods The 3rd round evaluation was conducted from December 2017 to January 2018 at 136 tertiary public hospitals, and the results were compared with the previous two surveys. Hospital Questionnaire, Patient Questionnaire and Doctor-Nurse Questionnaire were designed and administered by experts, onsite investigators and self-administered cellphones respectively. Data were analyzed by SPSS software.Results In 2017, the hospital performance scoring of these hospitals was 91.77% , which rose steadily from 2015 and 2016.Significant dimensions scoring the highest included the appointment system, rational allocation of medical resources and IT use.Overall patient satisfaction remained over 90% with both outpatients and inpatients. Defects however remained in such areas as long waiting time, insufficient communication between doctors and patients.Heavy workload was common among medical staff, in addition to poor staff welfare and poor health, resulting in declining job satisfaction.Conclusions The Initiative has made significant progress in the past 3 years, while there still remain some important challenges.Substantial improvement of the welfare and job satisfaction of medical profession deserves a top priority in healthcare reform in the future.
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DRG-based prospective payment system ( DRG-PPS ) is one type of mature inpatient care payment mechanisms in most countries and pilot projects would be introduced to China in 2017. This article provides an overview of the previous typical DRG-PPS reform initiatives on provincial, municipal and county level respectively. It also summa-rizes the characteristics of the reform programs, describes the diversities of policy implementation, and discusses the suc-cessful experience and implications of the initiatives. The paper puts forward some suggestions on the upcoming DRG-PPS pilot projects based on the progress and problems of the initiatives, to promote the DRG-PPS reform in China.
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<p><b>OBJECTIVE</b>To conduct with a cost analysis of the colorectal neoplasm screening program in Beijing, and provide data evidence for decision making.</p><p><b>METHODS</b>Based on stratified cluster sampling method, we carried out a 2-stage colorectal neoplasm screening program within 6 districts, Dongcheng, Xicheng, Chaoyang, Haidian, Fengtai and Shijingshan, of Beijing city between October, 2012 to May. 2013. The first stage of the program was to conducting a cancer risk level evaluation for community residents who were forty years older and the second stage's task was to providing clinical exam for those high risk people who were selected from the first stage. There were about 12 953 residents were involved in this program. We calculated the main cost of the colorectal neoplasm screen program in Beijing. Then estimate the cost of detecting one Colorectal Neoplasm patient of this program and compare it with the total treatment cost for a patient.</p><p><b>RESULT</b>2 487 high risk residents were selected by the first stage and 1 055 of them made appointment for the colonoscopy exam but only 375 accepted the exam, participate rate was 35.5%. 9 neoplasm cancer patients and 71 pre-cancer patient were found at the second stage, the detection rate were 69.2/100 000 and 546/100 000, respectively. The direct input for this neoplasm screening program was 227 100 CNY and the transport expense was 4 200 CNY in the calculations. The cost for detecting one cancer patient was about 19 900 CNY. Comparing with the total medical care cost of a cancer patient (1 282 800 CNY), especially for those have been diagnosed as middle to end stage cancer, the screening program (cost 842 800 CNY) might help to reduce the total health expenditure about 128 700 CNY, based on 12 953 local residents age above 40 years old.</p><p><b>CONCLUSION</b>An colonoscopy based colorectal neoplasm screening program showed its function on medical expenditure saving and might have advantage on health social labor creating.</p>
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Adult , Aged , Humans , Middle Aged , China , Colonoscopy , Colorectal Neoplasms , Cost-Benefit Analysis , Costs and Cost Analysis , Early Detection of Cancer , Health Care Costs , Mass Screening , Risk AssessmentABSTRACT
Objective To study the effect of PcG member NSPc1 on proliferation of HeLa cells.Methods Using bioinfomatic analysis to design the siRNA sequence to knockdown NSPc1.Detecting the expression level of NSPc1 in HeLa cell line using semi-quantitative RT-PCR,Real-time PCR and Western blot after transfection of the designed siRNA.Transient transfecting pSUPER-NSPc1 into Hela cells and performing BrdU incorporation assay.Establishing NSPc1 stably knockdown cell line,comparing proliferation abilities with the control cells.Results(1)The designed siRNA did efficiently knockdown the expression of NSPc1;(2)Transient knockdown of NSPc1 could repress BrdU incorporation;(3) The established NSPc1-knockdown cell lines had a significantly lower proliferation rate than that of control cells.Conclusion The expression of NSPc1 is necessary for the normal proliferation of HeLa cells.The NSPc1 stably knockdown cell pool is a useful model for further study of pathway related to NSPc1.
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By analyzing the questionnaire survey of consciousness of rights protection and status quo of rights and interests among medical staff in three 3rd degree and A grade hospitals located in northwest Hubei province,this paper concludes that medical staff there have a generally strong consciousness of rights,while their rights and interests are not well protected by society and hospitals,especially certain aspects including personal security,occupational health,working hours,legal vacation,and the rights to be involved in hospital management.It is suggested that legal rights and interests of medical staff should be improved through legislation,social support,and the direction function of public opinions.