ABSTRACT
Objective To explore the relationship between case mix index ( CMI ) and the bed allocation in clinical departments, and to evaluate the performance of bed scale of departments at tertiary hospitals based on CMI. Methods Based on the HIS system of a tertiary hospital, the authors collected the disease treatment information and bed allocation information of each clinical department in 2015. The CMI value was calculated by means of diagnosis-related group( DRG) , while the proportion of cases and average daily beds occupancy corresponding to the quartile of the CMI value of each department was also counted. Then the bed occupancy and distribution of various patients were analyzed. Results The hospital′s overall CMI value, DRG groups, DRG cases at the departments, days of stay, DRGs, CMI values and its quartiles were calculated. It was found that the medical and surgical CMIs had a linear relationship with the critical proportion (r=0. 998, 0. 996, P<0. 001). The main influencing factors of average daily bed occupancy were ranged from high to low as followed: the number of cases that were allocated in the group, employee numbers and CMI (F=87. 656, P<0. 001). Conclusions CMI is an ideal indicator for the difficulty of medical services at different departments and for evaluating the bed scale performance. Hence it can be used as an important reference for bed number adjustment in hospitals.
ABSTRACT
Objective To enhance the test efficiency and management level of medical record quality by designing and using med-ical record quality management system based on new electronic medical record .Methods System design and development were based on JAVA ,consisting of data exchange platform and medical record quality management system .The platform used C/S archi-tecture and the main program used B/S architecture .Achieved the integration with new electronic medical record and clinical infor-mation system through data exchange with business database .Results The supervision model and business workflow of medical re-cord quality were changed ,and the process and terminal medical record quality were promoted .Conclusion Design and application of the system can provides strong support for medical record quality management ,supplys effective supports for supervision of med-ical record quality ,and plays positive role in promoting medical record quality ,clinical work efficiency ,and medical quality .
ABSTRACT
Objective To investigate the infection of Mycoplasma in female urogenital system and the evolution of drug resistance. Methods Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) infections were examined by pathogen culture and fluorescence quantitative PCR in urogenital samples from 530 female patients in 2007, and drug sensitivity tests were performed in vitro. The results were compared with those in 2000. Results In 2000, there were 99 patients with Mycoplasma infections, in which 65 were of UU infections, 15 were of MH infections and 19 were of UU + MH infections. In 2007, there were 344 patients with Mycoplasma infections, in which 236 were of UU infections, 47 were of MH infections and 61 were of UU + MH infections. Patients aged 21～30 had the highest Mycoplasma infection rates both in 2000 (46.2%) and 2007 ( 50.5% ) ; while Mycoplasma infection rate in patients aged under 20 rose from 5.1% in 2000 to 12.8% in 2007 (χ2 = 4.682, P < 0.05). Both in 2000 and 2007, pathogens presented the highest drug resistance rates to tetracycline (TET) and erythromycin ( ERY ) which were all bore 80%. Compared with 2000, drug resistance rates to levofloxacin (LEV), azitromvcin (AZI) and ofloxacin (OFL) rose in 2007, and the differences were of statistical significance (P <0.05), while drug resistance rates to dmoxycycline (DOX), minocyclin (MIN) and josamycin (JOS) were still in the low level. Conclusions UU is the primary pathogen of infection in female urogenital system, and there is a tendency of Mycoplasma infection in younger age women. DOX, MIN and JOS can be the preferred medicines for Mycoplasma infections.
ABSTRACT
Objective To study the relationship between the type of histopathology and prognosis of contained mucous adenocarcinoma(CMAC) of stomach and its clinical significance. Methods Eighty-seven cases of CMAC of stomach were observed by means of pathomorphology, histochemistry, immunohistochemistry and follow up etc. Results The malignant behavior of the cancer was significant difference according to the nature and quantity of the CAMC and the primary pathological type of the cancer.The clinical type in simple mucous carcinoma was mainly Borrmann type I;in tubular papilla mucous adenocarcinoma was mainly Borrmman type II; in signet-ring cell mucous carcinoma was mainly Borrmman type IV,and in mixed cell mucous carcinoma was mainly Borrmman type III. There was significant difference in the lymphatic metastasis and survival rate between the 4 groups. Conclusions Correct differentiation of the pathological type of contained mucous adenocarcinoma of stomach is important for guading the treatment and predicting the prognosis.Cathepsin D expression can help for understanding the biological behavior of CMAC of the stomach.