A prospective cohort study on injuries among school-age children with and without behavior problems / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the annual incidence of injuries and the relationship between behavior problems and injuries among school-age children.</p><p><b>METHODS</b>A prospective cohort study on injuries for 1-year follow-up period was conducted among 2 005 school-age children selected by cluster sampling from three primary schools in Maanshan city. They subjects were divided into two groups with or without exposure according to behavior problems rated by the Rutter Child Behavior Questionnaire at the beginning of the study. Nonparametric test was performed to analyze the differences in injuries between the two groups of children, and the influential factors for injuries were analyzed with multi-classification ordinal response variable logistic regression model.</p><p><b>RESULTS</b>The overall incidence rate for injuries in school-age children was 42.51%, while among children with and without behavior problems were 64.87% and 38.85%, respectively. There were significant differences between the two groups (u = -6.054, P = 0.000). However, the incidence rates of injuries in school-age children with antisocial (A) behavior, neurotic (N) behavior and mixed (M) behavior were 66.99%, 67.41% and 61.40%, respectively. No significant differences were found among them (u(A,N) = -0.052, P = 0.958; u(A,M) = -0.400, P = 0.689; u(N,M) = -0.364, P = 0.716). Multivariate analysis indicated that injuries in school-age children were associated with children behavior problems, maternal age at childbirth, bad conditions during mother pregnancy, education background of mother, prevention measures for safety at home and the child accompanied to travel between school and home by adults. Behavior problems of children seemed to be the major risk factors for injuries.</p><p><b>CONCLUSION</b>Children with behavior problems represented a significant risk group for injuries among school-age children. When planning intervention strategies on injuries, behavior problems should be emphasized to ensure optimal effectiveness of intervention.</p>

Measuring the efficiency of the outpatient process with queuing theory model / 中华医院管理杂志

Objective The paper analyzes the operating patterns of the outpatient process and identifies the links needing reengineering so as to provide scientific basis for the optimal allocation of outpatient resources and process reengineering and prove the rationality and feasibility of using the queuing theory. Methods Using the methods of the queuing theory, the service time and the patients' arrival time at such service links as registration, billing and accounting, internal medicine, and gynecology in the outpatient department of a certain hospital were measured and the operational indexes at various links such as service intensity, average queuing length, average queuing time, average stay, probability of the service desks being idle, and the probability of the patients having to wait were calculated so as to estimate the rational number of service desks and the optimal value of the sum of the cost of waiting and the cost of service. Results Registration, billing and accounting , service intensity in internal medicine, personnel allocation, and queuing time were basically rational in the outpatient department of the hospital surveyed. One more physician should be added to the gynecology department so as to improve efficiency and reduce patients' waiting time and queuing length. There was currently a shortage of medical staff in the hospital. The cost of hospital input was moderate while the cost of waiting was on the high side. Conclusion It is rational and feasible to evaluate the efficiency of the outpatient process with the methods of the queuing theory. The method deserves to be spread.