Analysis of the scientific research efficiency of hospital department based on stochastic frontier method / 中华医学科研管理杂志

Objective Based on the data of scientific research output in a top three hospital in Beijing from 2015 and 2016,stochastic frontier analysis is conducted to estimate the efficiency of scientific research performance in different departments of this hospital,so as to draw the impetus for the growth of departments.Methods According to the results of the stochastic frontier model,comprehensive analysis and evaluation are conducted for the research performance of various departments.Results The overall average technical efficiency of the hospital is 0.44,and improvement space for the technical efficiency of scientific research performance is still 0.56.There are significant differences in the technical efficiency of each department.Among the four major categories,the D section is higher than the technical efficiency of class A,B and C departments.Conclusions The overall technical efficiency of the hospital is not high,the level of scientific research output of the four types of departments is not balanced,which should be emphasized in the improvement of scientific research performance level.

The evaluation of hospital scientific research output efficiency based on data envelopment analysis / 中华医学科研管理杂志

Objective Evaluate the efficiency of scientific research output of the 54 departments in a hospital,to put forward improvement suggestions based on the evaluation results.Methods Select appropriate indicators of scientific input and output,use the Data Envelopment Analysis method to evaluate and analyze the efficiency.Results According to the analysis of DEA,calculate the values of overall efficiency,technical efficiency,scale efficiency and scale income.Then compare and analyze the relative efficiency of different units scientific output,to identify the relatively superior department a mong the various categories.Conclusions According to the evaluation results,to find out the input surplus and insufficient output of each decision units.Then we will put forward suggestions on hospital resource allocation to optimize the scientific input and output,to improve the competitiveness of the hospital,and to activate the potential of each department's scientific research.

Padrão dos atendimentos em uma emergência psiquiátrica de referência para a Região Central do Rio Grande do Sul / Patterns of consultations in a reference psychiatric emergency service in the central region of Rio Grande do Sul

Introdução: Os Serviços de Emergência Psiquiátrica (SEPs) constituem um elemento fundamental na rede de atendimento em saúde mental, intervindo principalmente em situações de crise. Procurando levantar dados sobre a demanda pelo serviço de emergência, este artigo objetiva descrever as características dos atendimentos realizados em um SEP de referência para a região central do Rio Grande do Sul. Métodos: Foi realizado um estudo transversal retrospectivo, com dados dos atendimentos do SEP do Hospital Universitário de Santa Maria (SEP/HUSM), de 2010 e 2011, utilizando o formulário de registro das consultas e dados do sistema de informática do hospital. Foram construídas tabelas de frequência e foi utilizado o Teste Qui-quadrado para comparações entre variáveis. Resultados: A amostra foi composta por 7853 atendimentos, sendo a maioria do sexo masculino (52%), na faixa etária de 25-44 anos (49,7%). Os diagnósticos mais comuns foram os transtornos de humor (39,6%), de uso de substâncias (28,8%) e de personalidade (26,1%). Homens consultam mais por transtornos de uso de substâncias (49,1%), transtornos de humor (27,4%) e de personalidade (14,2%), e mulheres, por transtornos de humor (52,8%), de personalidade (39,0%) ou transtornos neuróticos (14,4%). Os pacientes foram admitidos à sala de observação ou internados em 40,4% dos casos e encaminhados para CAPS ou UBS em 39,9% dos casos. Conclusão: Os pacientes que consultam no SEP/HUSM são adultos com diagnósticos de transtorno de humor, de uso de substâncias e de personalidade, na maioria dos atendimentos. Casos graves que necessitam de tratamento intensivo são atendidos em aproximadamente metade dos casos(AU)

Introduction: Psychiatric Emergency Services (PES) are a key element in the mental health care network, intervening mainly in crisis situations. Searching for data on the demand for emergency services, this article aims to describe the characteristics of mental care provided in a reference PES in the central region of Rio Grande do Sul. Methods: A retrospective cross-sectional study was conducted with PES consultations data at the School Hospital of Santa Maria (SEP/HUSM) from 2010 and 2011, using the consultation record forms and hospital information system data. Frequency tables were constructed and the chi-square test was used for comparisons between variables. Results: The sample consisted of 7,853 visits, mostly by male patients (52%) aged 25-44 years (49.7%). The most common diagnoses were mood disorders (39.6%), substance use disorder (28.8%) and personality disorder (26.1%). Men consulted more for substance use disorder (49.1%), mood disorders (27.4%) and personality disorders (14.2%), and women for mood disorders (52.8%), personality disorders (39.0%), or neurotic disorders (14.4%). Patients were admitted to the observation room or hospitalized in 40.4% of cases and forwarded to Psychosocial Attention Centers (CAPS) or Basic Health Units (UBS) in 39.9% of cases. Conclusion: The patients who consult the PES/HUSM are adults with diagnoses of mood, substance use, and personality disorders in most visits. Severe cases requiring intensive care are treated in about half the cases(AU)

Preliminary results of Lean method implementation in a pathology lab from Northeastern Brazil / Resultados preliminares da implantação da filosofia Lean em um laboratório de patologia

Oncologic care shows a growing and unmet demand, and requires the search for alternatives that allow the efficient use of limited resources, the building of autonomy, and the endeavour for continuous improvement of processes. In the present work, we present the implementation of Lean philosophy at a pathology laboratory of an oncology hospital. Among the preliminary results, we highlight the redefinition of the dynamics of the staff, and the physical reorganization of the area. Such important changes culminated in an expressive reduction of lead time, even with a significant increase in the monthly load of exams.

A assistência em oncologia possui uma demanda crescente e reprimida e requer a busca por alternativas que viabilizem o uso eficiente de recursos limitados, a construção de uma cultura laboral de autonomia dos colaboradores e a melhoria contínua dos processos. No presente trabalho, apresentamos a experiência de implantação da filosofia Lean em um laboratório de patologia especializado em oncologia. Entre os resultados preliminares, destacamos a redefinição da dinâmica de trabalho do corpo técnico e a reorganização física do laboratório. Tais alterações culminaram em uma expressiva redução do tempo total de execução, mesmo com o aumento significativo da carga mensal de exames.

<b>Research on Kampo Prescription Status by non-Kampo </b><b>Specialists at Iizuka Hospital </b> / 日本東洋医学雑誌

We studied the status of Kampo preparations at Iizuka Hospital by analyzing the content of doctors' prescriptions outside the department of Japanese Traditional (Kampo) Medicine.<br>Our method of analysis was to convert the prescription volume (or quantity) of into a number of Kampo packets for every half-year starting from 2003. As a result of this research, we saw that Kampo preparation volume gradually increased from 2003. Furthermore, we reviewed the content and volume of Kampo preparations prescribed by each doctor and department in the second half of 2009. Accordingly, the most prescribed Kampo preparation was daikenchuto, followed by daiokanzoto and goshajinkigan.<br>Moreover, Kampo preparations were prescribed by 87% of all doctors and departments. The Department of Surgery prescribed more than any other. And similarly characteristic usage patterns were seen for the Departments of Obstetrics & Gynecology, and Urology.<br>Thus we suggest that Kampo preparations are useful for medical treatment in the Hospital.

Dieta enteral por sistema aberto em unidade de terapia intensiva cardiológica: qual o custo do desperdício? / Dieta enteral por sistema abierto en la unidad de cuidados intensivos cardíacos: ¿cuál es el costo de los desechos? / Enteral open system in cardiac intensive care unit: what is the cost of waste?

A nutrição enteral (NE) tem sido frequentemente indicada por estar associada à evolução favorável dos indicadores nutricionais e bioquímicos. Porém, alguns fatores podem limitar sua oferta, gerando, assim, custos relacionados ao desperdício. O objetivo do estudo foi identificar o custo da produção das NE não-administradas em unidades de tratamento intensivo cardiológicas e as causas da não-oferta. Foram estudados, prospectivamente, durante 30 dias, os volumes das NE não-administradas. Para identificação dos fatores limitantes da oferta, foram observadas as anotações de assistência de enfermagem no prontuário médico. A estimativa do custo foi realizada por meio da adaptação do modelo de cálculo sugerido pela "Nestlé Nutrition Services". O volume total de dieta produzida foi de 295 litros, sendo que 28% foram desprezados. Como fatores limitantes da administração das NE, observou-se que 45% foram em decorrência de jejum e 23% pela ocorrência de débito gástrico elevado. Entretanto, em 53% das consultas aos prontuários médicos não foi possível identificar a justificativa da não-oferta, devido à indisponibilidade de registros. Quanto ao desperdício, verificou-se que o mesmo gerou um custo adicional de R$ 2.380,00, correspondendo a 31% do custo total das NE foi alto. Portanto, seu controle e a redução da ocorrência dos fatores que elevam os gastos financeiros são medidas emergenciais e necessárias, que podem ser alcançadas havendo a participação efetiva dos membros da equipe multiprofissional.

The enteral nutrition (EN) has often been shown to be associated with favorable nutritional and biochemical indicators. However, some factors may limit their supply, thus generating costs related to waste. The objective was to identify the cost of production of non-administered NE in cardiac intensive care units and the causes of non-offer. Were prospectively studied during 30 days, the volumes of non-administered NE. To identify factors limiting the supply, there were notes of nursing care in the medical record. The cost estimate was performed by adapting the calculation model suggested by the "Nestle Nutrition Services." The total volume of diet produced was 295 liters, of which 28% were discarded. As factors affecting the administration of NE, we observed that 45% were due to fasting and 23% by the occurrence of gastric high speed. However, in 53% of medical charts was not possible to identify the rationale for with holding due to the unavailability of records. As for waste, it was found that it generated an additional cost of R$ 2.380,00, representing 31% of the total cost of NE was high. Therefore, its control and reducing the occurrence of factors that increase the cost financially and emergency measures are necessary, which may be achieved there is effective participation of members of the multidisciplinary team.

La nutrición enteral (NE) a menudo se ha mostrado estar asociado con favorables indicadores nutricionales y bioquímicos. Sin embargo, algunos factores pueden limitar su oferta, generando así los costes relacionados con los residuos. El objetivo fue identificar el costo de producción de no-NE administrada en unidades de cuidados intensivos cardiacos y las causas de la no-oferta. Se estudiaron de forma prospectiva durante 30 días, los volúmenes de los no administrados NE. Para identificar los factores que limitan la oferta, se toma nota de los cuidados de enfermería en la historia clínica. La estimación de gastos se llevó a cabo mediante la adaptación del modelo de cálculo propuesto por los "Servicios de Nutrición Nestlé". El volumen total de la dieta producidos fue de 295 litros, de los cuales se descartaron 28%. Como factores que afectan la administración de NE, se observó que el 45% se debió al ayuno y el 23% por la ocurrencia de alta velocidad gástrico. Sin embargo, en el 53% de los registros médicos no fue posible identificar la razón de la retención debido a la falta de disponibilidad de registros. En cuanto a los residuos, se constató que genera un costo adicional de R$ 2.380,00, lo que representa el 31% del coste total de NE fue alta. Por lo tanto, su control y reducir la incidencia de los factores que aumentan el costo financiero y las medidas de emergencia son necesarias, que se puede lograr es la participación efectiva de los miembros del equipo multidisciplinario.

Correlation of Mental Status and Personality of Inpatients in Department of Neurology of General Hospital / 中国康复理论与实践

@# Objective To explore the relationship between personality and mental status of inpatients in the department of neurology of general hospital.Methods 150 inpatients in the department of neurology had been surveyed by Eysenck Personality Questionnaire(EPQ) and Symptom Checklist-90(SCL-90) with the domestic norm as control.Results The examining results of the inpatients in the department of neurology were as following.The scores of neurotisim(N) of EPQ were higher than that of the domestic norm(P<0.05);the scores of extra-introversion(E) and psychoticism(P) of EPQ were lower than that of the domestic norm(P<0.05).The scores of 7 factors including total scores,somatisation,depression,anxiety,hostility,panic and psychosis in SCL-90 were higher than that of the domestic norm( P<0.05).The N scores of EPQ was positively correlated with all factors of SCL-90,the E scoers of EPQ was positively correlated with hostility and paranoia factor of SCL-90,the P scores of EPQ was positively correlated with paranoia factor of SCL-90.Conclusion The mental characteristics of inpatient in the department of neurology of general hospital in acute period are that the incidence of somatisation,depression,anxiety,panic and psychosis are higher than normal people,compulsion and paranoia are as well as normal people.The character of neurotisim and introversion may be the personality background of it.

Clinical Characteristics of Emergency Patients with Asthenia Universalis: Elderly Versus Adult Patients

PURPOSE: Asthenia universalis is a common symptoms complaint found in the emergency department (ED) especially among the elderly. However, emergency physicians often find it difficult to initiate evaluation given lack of research in this field. The aim of this study is to evaluate the clinical characteristics of asthenia universalis in elderly patients and compare them to adult patients presenting to the ED for similar complaints. METHODS: Patients who presented to the ED with asthenia universalis between March 2004 through February 2005 were obtained using data warehouse from electronic medical records. We excluded patients with underlying illness such as neurosis, organic diseases, depression, in addition to patients who refused to participate. Characteristics of the elderly group (> 64 years) were compared with the adult group (15~64 years) based on clinical and laboratory findings. Chi-square test a Fisher's test was used for nominal variables and a Mann-Whitney U test or Students t-test for continuous variables was used. RESULTS: During the study period asthenic patients comprised 0.81% (566/ 69,922) of total ED visits. Of those 566 patients, 82 patients were included in the study of which 25 were male and 56 female. Both genders were equally distributed between the two groups studied (elderly vs. adult). 58.3% of patients had an underlying medical illness (elderly group 81.1%, adult group 46.2%). The clinical impressions included infections or inflammation disorders (30.5%), endocrine disorders (17.1%), and psychiatric illnesses excluding depression (15.9%). Laboratory findings revealed a higher prevalence of hyponatremia (p=0.008), hypokalmia (p=0.033) and hypoalbuminemia (p=0.036) in the elderly group. CONCLUSION: In elderly patients presenting with asthenia universalis to the ED, a higher prevalence of underlying infections and endocrine disorders were present compared to adult patients presenting with asthenia universalis. In addition, the elderly more frequently had associated laboratory abnormalities to include hyponatremia, hypokalemia, hypoalbuminenia when compared to the adult patients.

Analysis of Overcrowding in a Local Emergency Department using National Emergency Department Overcrowding Scale (NEDOCS)

PURPOSE: Emergency Department (ED) overcrowding is a national problem and the quantitative measure of ED overcrowding is required. National Emergency Department Overcrowding Scale (NEDOCS) was designed for objective evaluation and quantification of ED overcrowding based on the standard of emergency providers' opinion. NEDOCS is a simple screening tool that can be used to determine the degree of ED overcrowding easily. The purpose of this study was to analyze the overcrowding in a local emergency department using NEDOCS. METHODS: This was a prospective study that medical record obtained from ED census and Order Communicating System (OCS). Three study periods were 1st study-period (from 14 March 2005 to 3 April 2005), 2nd study-period (from 27 October 2005 to 16 November 2005) and 3rd study-period (from 1 March 2006 to 21 March 2006). Sixparameters, the admission time (Admit time), the patient index (Patindex), the bed ratio (BR), the provider ratio (PR), the acuity ratio (AR), and the demand value (DV), were used to estimate overcrowding. The comparison between weekday and weekend overcrowding was assessed by using t-test. Also, the same statistical method was used to analyze differences between the 1st study-period and the 3rd study-period. The relationship between NEDOCS and six-parameters was tested by using Pearson's correlation analysis and multiple linear regression analysis. RESULTS: The total number of patients was 4,280. Of these, 2,403 (56.1%) were male and 1,877 female (43.9%). This study showed that ED overcrowding in weekend increased significantly. However, there was no significant change of ED overcrowding during 1 year (between the 1st study-period and the 3rd study-period). NEDOCS has a positive correlation with the Patindex (r=0.856, p=0.000), the BR (r=0.734, p=0.000), the PR (r=0.610, p=0.000), and the DV (r=0.559, p=0.000). Multiple linear regression analysis showed that Patindex was the only independent factor of NEDOCS (beta=0.854, p=0.000, adjusted R2=0.724). CONCLUSION: In conclusion, the NEDOCS was well correlated with overcrowding parameters and the only independent factor of NEDOCS was Patindex.