Research on the construction of drug knowledge base based on machine learning / 中华医院管理杂志

Objective:To construct a drug knowledge base based on drug instructions.Methods:Six hundred randomly selected drug instructions were labeled manually and divided into training set and test set. The training was based on bidirectional long short-term memory(Bi-LSTM) and conditional random fields(CRF) model to complete the recognition of medical entities. The extracted entities were standardized by the hybrid model of " similarity calculation and rule mapping table" , and then the drug information was imported into the Access database.Results:In the task of named entity recognition based on Bi-LSTM and CRF model, except for the crowd entities, the other entities had achieved good results with an F-value higher than 85%. Based on the hybrid model of " similarity calculation and rule mapping table" , the accuracy of entity standardization was 88.23%.Conclusions:The effect of the machine learning model in this study is similar to that of other named entity recognition and entity standardization studies, which can complete the task of drug knowledge base construction satisfactorily.

Study on bundled payment for breast cancer based on the medical record homepage data of 31 792 inpatient cases / 中华医院管理杂志

Objective:To explore influencing factors of hospitalization cost for breast cancer inpatients, develop an applicable standard using bundled payment approach, so as to provide reference for health insurance organizations to formulate reasonable imbursement method.Methods:31 792 inpatients′ medical records from 16 tertiary hospitals in Beijing, 2015 were included in the present study. Non-parametric tests and logistic regression model for ordinal categorical variable were applied to explore potential influencing factors. Decision tree model was performed to yield case-mix related groups.Results:The breast cancer inpatients were classified into 17 groups based on the following factors: surgical treatment/non-surgical treatment, surgical modality, radiology treatment, lymphadenectomy, comorbidity. RIV(reduction in variance)was 0.26. CV(coefficient of variation)was 0.24~0.97.Conclusions:It was feasible to apply the case-mix bundled payment method as a reimbursement method for breast cancer inpatients. The present study served as reference for formulating related policies.

Predictive study on the pooling fund income and expenditure of the basic medical insurance for urban employees in Beijing / 中华医院管理杂志

Objective To predict the age structure of basic medical insurance participants in Beijing from 2017 to 2030, and the pooling fund income and expenditure of basic medical insurance for urban employees in Beijing for the same period, for reference of the establishment of a scientific and reasonable medical insurance policy. Methods Based on the data of basic medical insurance participants in Beijing from 2010 to 2016, the age structure of insured population from 2017 to 2030 was calculated by"Feedback" calculating method. Combined with the growth rate of pooling fund income and expenditure of basic medical insurance for urban employees, the pooling fund income and expenditure was predicted from 2017 to 2030. Results The age structure of basic medical insurance participants in Beijing stays at a"young" stage at present in general, and the fund is faced with less fund-raising pressure relatively. The proportion of retirees and those insured aged 65 years old and above will be up to 23. 28％ and 15. 06％, respectively. The pressure of fund operation is increasing. Conclusions Under the existing policies, the pressure on fund operation is increasing, and the fund may fail to make ends meet in the future, which calls for measures to cope with.

Data dimensionality reduction for hospital efficiency measurement / 中华医院管理杂志

A comparison was made for the correlation and application scope of the statistical methods commonly used by hospitals for their efficiency measurement.Hospital data processed with PCA (principal component analysis)for dimension reduction were used in a correlation analysis for the results of ratio analysis (RA),stochastic frontier analysis(SFA)and data envelopment analysis(DEA).The authors hold that the RA can expediently display the order of hospital efficiency,the SFA demands a stricter premise yet presents more stable results,while the DEA boasts greater relative advantages and thus suitable for processing hospital efficiency measurement tasks of multi-input and multi-output indexes.

Utilization of antibacterial agents for emergency patients with acute upper respiratory infections in tertiary hospitals in Beijing / 北京大学学报(医学版)

Objective:To investigate the use of antibacterial agents for emergency patients with acute upper respiratory infections in tertiary hospitals in Beijing .Methods:We used the medical claim data for urban workers in 10 tertiary hospitals in Beijing from Oct .2010 to Sep.2012.Medical records of emer-gency patients with acute upper respiratory tract infections had been selected as the study sample .The proportions of antibacterial prescriptions and categories of antibacterial drugs were described and ana -lyzed.Results:This study included 135 979 visitors (male:42.7%;mean age:43.6 ±16.2 years).The average antibacterial prescription rate was 71.2% (95%CI 71.0%-71.5%), of which the single kind use was 80.0%(95%CI 79.7%-80.2%).Among acute upper respiratory tract infections , the antibacte-rial prescription rate for acute tonsillitis visits was highest (85.1%, 95%CI 84.5%-85.6%), followed by acute laryngitis and bronchitis (81.69%, 95%CI 80.4%-82.8%), acute pharyngitis (81.4%, 95%CI 77.7% -85.0%), acute sinusitis (77.0%, 95%CI 74.6% -79.4%), acute nasopharyngitis (74.3%, 95%CI 73.7%-75.0%), and common cold (67.6%, 95%CI 67.3%-67.9%).Compared with the female group, the antibacterial prescription rate for the male was higher (73.2%, 95%CI 72.8%-73.6%vs.69.7%, 95%CI 69.4%-70.0%).Compared with the <60 years age cases, the anti-bacterial prescription rate for the ≥60 years cases was higher (72.1%, 95%CI 71.8%-72.3% vs. 66 .8%, 95%CI 66 .2%-67 .5%) .In the visitors who used antibacterial drugs , the average percentage of injection use was 50.6%(95%CI 50.3%-50.9%).The top antibacterial drugs in the list of varie-ties were the second generation cephalosporins (28.4%) , followed by the third generation cephalosporins (21.7%), fluoroquinolones (21.0%) and macrolides (17.6%).Conclusion: The antibacterial pre-scription rate for acute upper respiratory tract infections in the general hospitals in Beijing is high , and the second generation cephalosporins , third generation cephalosporins , fluoroquinolones and macrolides take the lead in the total antibacterial drugs .

Analysis on hospitalization expenses of elderly inpatients covered by medical insurance in Beijing and the influential factors / 中华医院管理杂志

Objective To analyze hospitalization expenses and influential factors of elderly inpatients with medical insurance,and to provide scientific evidences for curbing hospitalization expenses and adjusting medical insurance policy.Methods Based on hospitalization data derived from Beijing town during 2007-2011 from 65082 elderly urban inpatients under medical insurance,descriptive analysis and multiple stepwise linear regression methods were used to analyze the hospitalization expense and its influential factors.Results The last 5 year witnessed rising hospitalization expense and average hospitalization expense per admission of elderly patients with medical insurance; among the components of hospitalization expense,cardiovascular/cerebrovascular/tumor/respiratory system diseases cause the heaviest medical burden; days of stay,hospital level,out-of-pocket proportion are the most important influential factors on their hospitalization expense per time.Conclusion The hospitalization expense of elderly patients with medical insurance keeps growing.Therefore,shorter days of stay,rational referral of patients to appropriate hospitals,adjusting out-of-pocket proportion would be effective measures of curbing hospitalization expense.

Analysis of the hospitalization expenditure of cervical cancer patients and influencing factors / 中华医院管理杂志

Objective To analyze the variations and influencing factors of hospitalization expenditure of cervical cancer patients among urban employees in Beijing from 2006 to 2010,and to provide evidences for developing reasonable measures of medical expenses control.Methods Based on the hospitalization expenditure data of 1146 cervical cancer cases,the paper probed into the changes of hospitalization age and hospitalization expenditure,and the influencing factors of hospitalization expenditure by means of descriptive analysis and multiple stepwise regression.Results The last 5 years witnessed no significant change in the first hospitalization age of cervical cancer patients,rise of hospitalization age,gradual rise of the hospitalization expenditure per time along with their age groups,as well as a rising trend of the average hospitalization expenses,average drug cost and proportion of average drug cost year by year.Results of the multiple stepwise linear regression showed that days of stay,proportion of drug cost and surgery or not as important influencing factors for hospitalization expenditure.Conclusion Hospitalization expenditure of cervical cancer keeps growing.Against this background,reasonable shortening of the days of stay,reasonable setup of an appropriate proportion of out-of-pocket payment,and reduction of the proportion of drug costs become effective means to reduce hospitalization expenditure.

The effectiveness of the implementations and recommendations for community health services in Beijing / 中华医院管理杂志

It's a new financial management system that our country implemented the management of separating the income and expenditure in the community health services.Beijing is one of the former pilot cities which carried on the management of separating the income and expenditure.To know the effectiveness of the implementations and its influence to the health services,this article analyses the status of community health services,the financial investment and the performance results in Beijing.Considering the above,this paper also provides policy recommendations on the development of health services in Beijing to improve the new urban medical service system which based on the community health services.

Research on the assessment indexing of diagnosis and treatment in clinical specialties / 中华医院管理杂志

Objective Probing into a way to reform the assessment indexing of diagnosis and treatment in clinical specialties, to help with objective assessment and ranking among hospitals in terms of the performances of their respective specialties. Methods Treatment outcomes of the diseases pinpointed by heart physicians and urology surgeons of three hospitals in 2005 as the criteria to calculate the adjusted value for fatality rate and cure rate. Results The adjusted value of fatality rate for the heart physicians is CFR≥1, and that of cure rate for the urology surgeons is CFR≤1. A trial assessment is made based on these figures, and a ranking is achieved on the diagnosis and treatment outcomes of the clinical medicine specialties in these three hospitals as a result. Conclusions Diseases as the assessment levels for medical quality of clinical medicine specialties and relative risks as the core computation adjusted factor, may help yield the indexes and methodology for clinical medicine specialties in line with China's specifics.

Discussion of reform in ttae management system of state-owned hospitals / 中华医院管理杂志

Under the socialist market-oriented economic system, state-owned hospitals need to overcome many problems in their traditional management system. The authors discuss a series of issues, including the property right involved in the reform of the management system of state-owned hospitals; the relationships between nonprofit hospitals run by the government and ways of handling them; the conditions of using the corporation management structure in hospitals; the responsibilities of the government in the framework of medical services and the form in which the government supervises state-owned hospitals. Lastly, the authors put forward suggestions from the perspective of policy-making on the reform of the management system of state-owned hospitals.