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<p><b>OBJECTIVE</b>To observe the changes of hospitalization rates and in-hospital mortality for coronary heart disease (CHD) in Beijing from 2007-2012.</p><p><b>METHODS</b>Patients hospitalized for CHD in Beijing from 1 January 2007 to 31 December 2012 were identified from"The Cardiovascular Disease Surveillance System in Beijing". In total, 421 929 patients aged ≥25 years of permanent Beijing residents were admitted for CHD in Beijing during the 6 years. After excluding duplicate records and validation for the completeness and accuracy of the records, the hospitalization rates for CHD and in-hospital CHD mortality were analyzed. Trends in hospitalization rates and the in-hospital mortality for CHD were analyzed with Poisson regression models.</p><p><b>RESULTS</b>The age-standardized average hospitalization rate of CHD was 515.3 per 100 000 population in patients aged ≥25 years in Beijing. During the six years, an increasing trend was observed in the hospitalization rates for CHD after adjusting the age and gender (P<0.001). The age-standardized hospitalization rates of CHD increased by 43.0% in the past six years. The greatest increases of hospitalization rates were noted in both men and women between 45 to 54 years. The age-standardized in-hospital mortality decreased from 3.3% to 2.2% over the time (P<0.001), with a in-hospital mortality reduction for acute myocardial infarction from 11.3% to 8.5%.</p><p><b>CONCLUSIONS</b>An increasing trend in hospitalization rate was observed during 2007-2012 for Beijing residents aged ≥25 years, indicating an urgent need in CHD prevention in Beijing. The in-hospital mortality reduction during this period might reflect the improvement in the in-hospital treatment modalities of CHD.</p>
Subject(s)
Humans , Anterior Wall Myocardial Infarction , Coronary Artery Disease , Coronary Disease , Hospital Mortality , Hospitalization , HospitalsABSTRACT
Objective To analyze the inpatient specialist capacity of a hospital during 2013-2014 in Beijing for its specialists development, based on relevant local specialist development.Methods Analyzing the inpatient specialist capacity using case mix index (CMI) and DRG numbers according to BJ-DRG grouping method.Each MDC of the hospital is divided into four types according to the status and development of inpatient specialist capacity.Results Of the 19 MDCs, 2 (such as nervous system disease) fall into type 1, 6 MDCs (such as neck, ears, nose, mouth, pharynx disease and dysfunction) into type 2, while 5 MDCs (such as female reproductive system diseases and dysfunction) into type 3, and 6 MDCs (such as pregnancy, childbirth and postpartum) into type 4.Condusion Most of the MDC inpatient specialist capacities of the hospital in question are at ranking high in Beijing, and such capacities for various MDC can be improved by all means.
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Objective To analyze the applicability of case mix index (CMI) in medical performance evaluation of different type of hospitals and its calculation method.Methods Standardized adjustment to the CMI value of hospitals according to the CMI of the main disease categories (MDC) of short-term inpatient cases of the city, to align the CMI values of various hospitals with their levels of medical and technical services.Results The said adjustment ensures the CMI value to better represent the levels of such hospitals.Conclusion The adjusted CMI calculation method can provide accurate data support for various hospitals' performance evaluation.
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Collection and quality control of inpatient medical record home page information are key to the study and use of DRGs.The paper covered the sampling methods, inspection items, inspection methods, data assembly methods, and data reporting quality scoring methods of Beijing authorities on the hospitals in the city.Also introduced were the inspection results of the city in 2014, which prove a satisfactory outcome in the end.
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Objective Taking the respiratory department of internal medicine as an example, to compare the coverage of clinical treatment of the MDC covered by DRGs of Beijing version with the professional services offered as secondary clinical treatment subjects in China.Methods Using the data from medical record home page from hospitals in Beijing above secondary level from 2012 to 2014 and both the DRGs defined in Pareto diagram statistical method and the DRGs proved by experts, for analysis and definition of the DRGs coverage involved by respiratory discipline of internal medicine.Results Respiratory discipline of internal medicine involved DRGs of 42 groups as found by the two methods.Conclusion The DRGs scope of secondary clinical departments in hospitals should be made based on both expert consultation and clinical data statistics method.
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Objective To use diagnosis related group (DRGs ) for the first time in overall evaluation of inpatient service performance evaluation of major diagnostic category (MDC)for all the Beijing municipal hospitals,and recommend how to strengthen Beijing municipal hospitals system in diagnosis and treatment ability of main diseases and improve inpateint service performance.Methods BJ-DRGs burster software was used to analyze the first page information of the medical records of cases discharged from all the Beijing municipal hospitals between 2012 and 2014 to determine the weight of each DRG,and based on such weight the related indicators of such hospitals and central hospitals in 2012, 2013,2014 were compared and analyzed.Results Improvements were found in such indices as diagnosis and treatment difficulty of 50% MDC,time efficiency of 81.8% MDC,cost efficiency of 77.3% MDC, and general capacity of 54.5% MDC for all Beijing municipal hospitals.In addition,the municipal hospitals were found superior to the central hospitals in such indices as cost efficiency of 68.2% MDC, and time efficiency of 59.1% MDC.On the other hand however,they were found inferior to the central hospitals in such indices as diagnosis and treatment difficulty of 72.7% MDC,and the comprehensive ability index of the two systems were found equivalent.Another finding was that there was no obvious improvement of the coverage of disease types at major tertiary hospitals in Beijing for the past three years.Municipal hospitals of greater contribution of MDC weight were highly consistent with the hospitals assigned with national key projects of disciplinary developments. Conclusion The comprehensive evaluation results of inpatient service performance of main diseases at Beijing’s municipal hospitals based on DRGs system,showed that the Beijing’s hospital authority had played an important role in improving inpatient service performance especially in reducing the burden of patients,improving the service efficiency through increasing government investment,optimizing service organization and implementation of performance management.But it also suggested that measures such as collectivize construction and management should be taken to improve municipal hospitals’linical specialty ability, improve the MDC diagnosis and treatment difficulty,and resume their functions of tertiary hospitals.