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Objective:To study the influence of the choice of main diagnosis on diagnosis-related groups(DRG) grouping and weight change, by taking cerebral infarction as the entry point.Methods:From January 1, 2019 to March 31, 2019, 331 patients in three DRG groups(BR25, BR23, BR21) with cerebral infarction were selected. The original group was used as the control group; the main diagnosis was exchanged with the first other diagnosis, then DRG group was used as the experimental group. The difference of the number of cases and weight between the two groups was analyzed.Results:41.4%(137/331) of the patients in the experimental group were enrolled in BZ11 with other neurological disorders associated with important comorbidities and comorbidities, and 82.5%(273/331) patients′ weight increased after diagnostic conversion.Conclusions:Choosing other diagnosis as the main diagnosis may change the weight of the disease and affect the corresponding disease benefit. In order to prevent downcoding, DRG grouping should be detailed, and DRG payment should consider how to reflect the value of difficult cases; for upcoding behavior, medical insurance center and relevant medical institutions should check the correctness of coding, and monitor in place.
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Objective: The main objective of this research paper is to analyze the research focus and trend in the health policy and services between 2010 and 2016, with a view to providing a reference for the research on health policy and service in China to tackle a number of challenges and opportunities for future studies.Methods: This article retrieved English literature about the Health Policy & Services from the Web of Science (2010-2016), and analyzed the records with Citespace by general analysis, word frequency and centrality.Results: A total of 22,716 articles were obtained.The three keywords with the highest frequency of word frequency were: care, quality of life and healthcare, and Quality of life had the highest centrality.Keywords could be divided into five clusters: health measurement;health factor;health intervention;medical insurance;health intervention evaluation.Conclusions: Foreign health policy research focused on health and health care;focusing on measuring the impact of health outcomes;and committed to improving the health and quality of life of the population.
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Objective:Based on the framework of reference point contract theory,the experimental economics methodwas used to explore the medical institution managers' motivation and reflection of the profit allocation in vertical integrated?medical service system.Methods:Z-tree software was applied to design the experimental program.40 undergraduate students majoring in health management were recruited as the subjects.Sharing rates and effort levels were collected and calculated by Excel 2007 and SPSS 17.0.Results:The median of sharing rate hospital managers allocated to community health centers?was 35.00％.The median of effort level that community health center directors chose was 8.00.The proportion of sharing rates equal to or less than 50.00％ accounted for 98％.The proportion of the highest effort level was 23.50％.The correlation between sharing rate and effort level was significant(P＜0.05).Conclusion:In the process of establishing vertical integration of medical service system,sharing rates and effort levels were closely related while the community health centers' effort was shading.
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Objective To analyze the effects of the " Clinic-pharmacy separation" reform in Beijing. Methods Following the chronological order, 60-month operational data of a pilot hospital from 2012 to 2016 were analyzed. These data included medical statistics reports, financial information, HIS information,authority information,and patients′satisfaction on site. Results Pilot hospital showed that its medical work efficiency continued to grow. During 2013 -2016, its outpatients volume growth rate ranged 3.53% ~15.20%, and its number of discharged patients growth rate ranged 3. 12% -8. 48%. The hospital harvested 12.21 million yuan of converted income from September 2012 (when the reform was in place to cancel the drug markup and collect medical service fees) to August 2013,scoring a smooth shift of revenue sources. Medical insurance fund expenditure did not increase as a result. The percentage of drug expense was significantly decreased,dropping over 15% in 5 years. Outpatient drug fees and inpatient drug fees continued to decline year by year. Patients expressed higher satisfaction over medical services due to longer time of consultation with physicians. Conclusions " Clinic-pharmacy separation" reform has achieved the following objectives. The revenue is maintained stable; Patients flow is diverted under guidance, with less financial burden; and medical insurance expenditure is under control. We propose to improve the performance incentive and constraint mechanism for drug prescriptions by physicians.
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We conducted complete competition market experiment in the classroom,meanwhile simulated market transactions,and at the end of the experiment taught the experiment theory and economics theory.After the class we carried out a survey to investigate the necessity of teaching methods and the help of theoretical understanding.It was found that the experimental results of the classroom experiment were quite robust compared with the theoretical predictions of the fully competitive market,and the market operating efficiency was also higher.Students affirmed the necessity of experiment teaching and thought that experiment was helpful to understanding the learning theory.
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<p><b>OBJECTIVE</b>To evaluate the cost-effectiveness of two-stage and three-stage hearing screenings for newborns.</p><p><b>METHODS</b>Hearing screening was performed for the normal newborns born in 7 hospitals in Beijing from October 2010 to December 2012 by using two stage and three stage strategies as well as hearing diagnostic test, and the cost effectiveness evaluation of two strategies was conducted. The data about the cost of screening and diagnostic test were from the hospitals. The data about car fare and charge for loss of working time of parents were collected through questionnaire survey. The sensitivity was analyzed according to the compliance rate.</p><p><b>RESULTS</b>A total of 62,695 newborns received initial hearing screening, 5,809 newborns failed, the positive rate was 9.30%. A total of 4,933 newborns received rescreening, 972 newborns failed, the positive rate was 19.70%. Among the newborns failed in rescreening, 412 were provided with hearing diagnostic test and 360 received diagnostic test. The diagnostic test indicated that the hearing of 217 newborns were abnormal (60.28%). A total of 276 newborns received the third screening, 163 newborns failed, in which 125 received diagnostic test and 112 had abnormal hearing (45 had moderate and above hearing impairment), the abnormal rate was 89.60%. The average cost for three-stage screening (37,242 yuan RMB per case) was higher than that for two-stage screening (19,985 yuan RMB per case). With the increase of compliance, the cost-effectiveness of three-stage screening increased.</p><p><b>CONCLUSION</b>The cost-effectiveness of three-stage screening was influenced by screening compliance. It is recommended that three-stage screening strategy might be taken in area where the screening compliance rate is >90%.</p>
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Humans , Infant, Newborn , Cost-Benefit Analysis , Hearing Loss , Diagnosis , Hearing Tests , Economics , Methods , Neonatal Screening , Economics , MethodsABSTRACT
Objective To study teaching cases of health economics in the context of health reform and development in China.Method Preparing for lessons in groups,information collection,experiences summary,and field research.Result Three productions:a teaching plan,a case collection,and a guideline of case teaching.Discuss It is useful to improving students’ ability to contact theory with practices and enhance teacher’s teaching and researching ability,but it also needs further improvement.