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1.
Braz. J. Pharm. Sci. (Online) ; 60: e23366, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1533980

ABSTRACT

Abstract Prostate cancer (PCa) is a highly prevalent condition among men worldwide, resulting in reduced quality of life and increased costs to health systems due to hospitalization and death. This study aimed to explore and understand the evolution of PCa in Brazil from 2008 to 2018. Data were obtained from the National Health System Department of Informatics (DATASUS) using code C61 for malignant prostatic neoplasms. We presented the hospitalization and mortality rates in a temporal-, regional- and age-dependent manner. From 2008 to 2018, a year-dependent increase in hospital admissions due to PCa was reported in Brazil, in which the Southeast region showed the highest prevalence. Men aged ≥80 and those 70-79 years old had similar hospitalization rates, followed by men aged 60-69, 50-59, 40-49 and 30-39 years old. Similarly, an increase in deaths due to PCa was reported during this period, with the highest rates seen in the Southeast. Men aged ≥80 years had higher mortality rates, followed by those aged 70-79, 60-69, 50-59, 40-49 and 30-39 years old. The results obtained indicate an age- and region-dependent increase in PCa morbidity and mortality in Brazil overtime and may contribute to the ongoing discussion on the role and future perspective of the health care system in Brazil.

2.
São Paulo med. j ; 141(2): 120-124, Mar.-Apr. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1424670

ABSTRACT

ABSTRACT BACKGROUND: Since the impact of the coronavirus disease 2019 (COVID-19) pandemic in March 2020, several studies have shown a strong relationship between obesity and severe cases of COVID-19. It is imperative to assess whether bariatric surgery exerts a protective effect in such cases. OBJECTIVE: This study aimed to assess the impact of bariatric surgery on the morbidity and mortality in obese patients during the COVID-19 pandemic. A comprehensive search was performed using the PubMed and Cochrane Library databases. DESIGN AND SETTING: Retrospective cohort studies conducted in the Faculdade de Medicina da Universidade Cidade de São Paulo, São Paulo (SP), Brazil. METHODS: The search comprised the following descriptors: "bariatric, surgery, COVID-19". Current retrospective cohort studies that examined the influence of bariatric surgery on the morbidity and mortality of obese patients during the COVID-19 pandemic were considered eligible. RESULTS: After removing duplicates, 184 studies were obtained from the databases. Of these, 181 were excluded from the analysis as they did not meet the eligibility criteria. Patients undergoing postoperative follow-up of bariatric surgery had a similar probability of SARS-CoV-2 infection compared to the general population, and persistent comorbidities were associated with an increased risk and severity of infection. CONCLUSION: Bariatric surgery has a protective effect against severe COVID-19 in the obese population, bringing the prevalence of severe disease cases to levels equivalent to those of the nonobese general population, with a positive impact on morbidity and mortality.

3.
Chinese Journal of Industrial Hygiene and Occupational Diseases ; (12): 656-659, 2019.
Article in Chinese | WPRIM | ID: wpr-797428

ABSTRACT

Objective@#To study the main factors that influencing Pneumoconiosis patients' healthcare seeking behaviors.@*Methods@#Conducting a descriptive analysis to analyze the relationship between the annual hospitalization rate and social security status (medical insurance, location of medical insurance, proportion of insurance used for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, whether to apply for compensation after diagnosing pneumoconiosis, whether they receive social assistance and a minimum allowance) , social relationship status of patients (whether there is pneumoconiosis in the family or relatives, whether there is a pneumoconiosis in a friend or a colleague, and whether or not he/she has received financial assistance) , life quality of patients (subjective feelings) and living standard of patients (dietary level) based on data acquired from 120 pneumoconiosis patients.@*Results@#The results of single factor analysis reveal that the location of medical insurance, the proportion of insurance for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, whether to apply for compensation after diagnosing pneumoconiosis are statistically significant in pneumoconiosis patients' hospital utilization ratio (P<0.05) . The place where medical insurance is located is the current place of residence, the reimbursement ratio of medical insurance for pneumoconiosis is listed as 50%-70%, the work unit has medical insurance, those who have not applied for compensation for pneumoconiosis have a higher utilization rate of hospitalization services. The annual hospitalization rate was 73.3%, 80.0%, 60.6%, 63.0%, respectively.@*Conclusion@#The location of patient medical insurance, the proportion of insurance used for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, and whether to apply for compensation after pneumoconiosis are the influencing factors of the patients' annual hospitalization rate.

4.
Chinese Journal of Preventive Medicine ; (12): 503-507, 2019.
Article in Chinese | WPRIM | ID: wpr-805267

ABSTRACT

Objective@#Using data of health information system (HIS) of medical institutions to study the incidence and hospitalization of herpes zoster in three districts of Beijing.@*Methods@#According to the different level of economic development and geographical features in Beijing, 3 districts of Xicheng, Changping and Miyun were chosen and all 110 medical institutions of the first level and above in the 3 districts are included in the survey. All the outpatient and inpatient herpes zoster cases in 2015 were retrospectively reviewed by HIS system. After distinguishing the reduplicated cases, Using the first outpatient case as a molecule and the resident population as denominator to estimate the annual incidence rate, as well as the annual hospitalization rate was estimated based on primary diagnostic hospitalized cases as molecule and the resident population as denominator.@*Results@#A total of 32 313 primary visit outpatient cases were investigated, of which 18 360 cases (56.8%) were women and 20 923 cases (64.8%) were ≥50 years old. The overall estimated incidence of the 3 districts was 8.8‰ with an increase trends with age and reached to the highest in ≥80 years old (30.5/1 000). The incidence of Xicheng, Changping and Miyun districts are respectively 16.2‰, 4.0‰ and 5.7‰. A total of 701 primary visit inpatient cases were identified, of which 366 cases (52.2%) were women and 651 cases (92.9%) were ≥50 years old. The estimated annual hospitalization rate was 19.4/100 000, with the primary and secondary diagnostic hospitalization rate are respectively 5.9/100 000 (212 cases) and 13.5/100 000 (489 cases). The disease types of secondary diagnostic inpatient herpes zoster cases were as follows: cardiovascular disease (19.0%, 93 cases), stroke (14.5%, 71 cases), pneumonia/chronic obstructive pulmonary disease (14.1%, 69 cases), tumor (12.5%, 61 cases) and diabetes (5.7%, 28 cases).@*Conclusion@#Most of the herpes zoster cases in Beijing are over 50 years old, and the incidence of female is slightly higher than male. This disease should become a public health issue of great concern.

5.
Chinese Journal of Preventive Medicine ; (12): 1097-1101, 2017.
Article in Chinese | WPRIM | ID: wpr-809724

ABSTRACT

Objective@#To estimate the influenza infection rate among severe acute respiratory infection(SARI) cases and the hospitalization rates of SARI attributable to influenza, based on two sentinel hospital surveillance databases in Beijing, 2015.@*Methods@#Surveillance was conducted at two sentinel hospitals in Beijing in 2015. A total of 1 842 patients who admitted to the sentinel hospitals and met the definition of SARI were enrolled in the study. The respiratory tract specimens of SARI cases were collected, and sent to laboratories within 48 hours for influenza RNA detection. The catchment area of sentinel hospitals was defined by reviewing the home address of inpatients; A total of 1 491 patients were sampled and tested for influenza. The population size of catchment areas was obtained from demographic year book. We investigated the number of pneumonia patients admitted to the sentinel hospitals and other hospitals in catchment areas in 2015, and calculated the proportions of pneumonia patients that were admitted to sentinel hospitals in catchment areas. The catchment population size was calculated using the number of total population of catchment areas multiply by the proportions of pneumonia patients that were admitted at sentinel hospitals.@*Results@#Among 1 491 patients, 13.7% (205 cases) was test positive for influenza viruses, 2 (0.9%) cases positive for influenza A (H1N1), 91 (44.6%) cases influenza A (H3N2), 1 (0.5%) case influenza B/Victoria, 111 (54.0%) cases influenza B/Yamagata. Influenza was associated with an estimated 30 (95%CI:9-51) SARI hospitalizations per 100 000 during 2015. The hospitalization rate was 243 (95%CI: 232-255), 86 (95%CI: 59-112),1(95%CI: 0-5), 8 (95%CI: 0-23) and 92 (95%CI: 16-168) SARI hospitalizations per 100 000 population for<5 years children, 5-14 years children, 15-24 years adult, 25-59 years adult and ≥60 years population, respectively. The hospitalization rate of SARI attributed to influenza A and B was 14 (95%CI:4-17) and 16 (95%CI:0-23) per 100 000 population, respectively.@*Conclusion@#The influenza positive rate among SARI cases was relatively high. The hospitalization burden of SARI attributed to influenza was the greatest in children under 5 year-old.

6.
Rev. chil. pediatr ; 88(5): 602-607, 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-900023

ABSTRACT

El asma bronquial es la enfermedad crónica más frecuente en la infancia. Todos los años un número importante de pacientes pediátricos se hospitaliza por esta causa. No existe en Chile un conocimiento sobre su magnitud. Objetivo: Conocer la tasa de hospitalización por asma en niños de 5 a 15 años y evaluar su evolución en el tiempo. Pacientes y Método: Se calculó la tasa de hospitalización por asma en base al número de egresos hospitalarios del registro de egresos del Departamento de Estadística e Información de Salud del Ministerio de Salud de Chile (DEIS) y de las poblaciones expuestas al riesgo de hospitalización obtenidas de las proyecciones de población, proporcionadas por el Instituto Nacional de Estadística. Se evaluó la evolución de estas tasas desde el año 2001 al 2014. Resultados: Durante el lapso estudiado se observó un aumento significativo de la tasa de hospitalización por asma en niños, desde 3,8 por 10.000 habitantes el 2001 a 7,8 por 10.000 habitantes el 2014. El promedio de edad fue de 8,5 ± 2,7 años, siendo de sexo masculino el 57,58% de los pacientes con una mediana de estadía hospitalaria de 3 días (rango 1-12). Conclusiones: La tasa actual de hospitalizaciones por asma en Chile en niños de 5 a 15 años es de 7,8 por 10.000 habitantes, observándose una duplicación de ésta en los 14 años estudiados.


Bronchial asthma is the most prevalent chronic disease in children. Every year an important number of asthmatic children is hospitalized for asthma crisis. The magnitude of this problem in Chile is unknown. Objective: To evaluated the asthma hospitalization rate in 5-15 year-old children and evaluate their evolution. Patients and Method: We calculate the asthma hospitalization rate in children based on data from the National Hospitalization Discharge Registry from the Statistics and Health Information Department of the Ministry of Health (DEIS) and the National Institute of Statistics (INE). We evaluate the evolution of these rates from 2001 to 2014. Results: We observed a significant increase in the asthma hospitalization rates in children from 3,8 for 10.000 inhabitants in 2001 to 7,8 for 10.000 inhabitants in 2014. The average age was 8,5 years ± 2,7. Male gender was predominant (57,58%) with a mean length of stay of 3 days (range 1-12). Conclusions: The actual asthma hospitalization rate in Chile is 7,8 for 10.000 inhabitants for children 5 to 15 years old, with a double increase in this rate during the 14 year period analyzed.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Asthma/epidemiology , Hospitalization/trends , Asthma/therapy , Chile/epidemiology , Registries , Hospitalization/statistics & numerical data
7.
China Pharmacy ; (12): 2813-2816, 2017.
Article in Chinese | WPRIM | ID: wpr-616267

ABSTRACT

OBJECTIVE:To investigate the effects of tiotropium bromide assisted with bronchoalveolar lavage (BAL) on short-term efficacy,quality of life and re-hospitalization rate of patients with bronchiectasis complicated with lung infection. METH-ODS:A total of 140 patients with bronchiectasis complicated with lung infection selected from our hospital during Oct. 2013-Dec. 2015 were divided into control group and observation group by lottery,with 70 cases in each group. Based on intervention therapy, control group received BAL. Observation group was additionally given Tiotropium bromide powder inhalation 18 μg ,once a day before going to bed,on the basis of control group. Both groups were treated for 4 weeks. Clinical efficacy was compared between 2 group;pulmonary ventilation function indexes,blood gas analysis indexes,BODE index scores and QLI scores before and after treatment,re-hospitalization rate and the occurrence of ADR were also compared between 2 groups. RESULTS:The total response rate of observation group was 91.43%,which was significantly higher than that of control group(78.57%),with statistical signif-icance (P0.05). After treatment,FVC,FEV1,FEV1%,p(O2) and QLI score of 2 groups were increased significantly,while p(CO2)and BODE index scores were decreased significantly,com-pared to before treatment;all indexes of the observation group was significantly better than the control group,with statistical sig-nificance (P<0.05). The re-hospitalization rate of observation group 3,6 months after treatment was significantly lower thanthat of control group,with statistical significance(P<0.05). No ADR was found in 2 groups. CONCLUSIONS:For patients with bronchiectasis complicated with lung infection,tiotropium bromide assisted with BAL can effectively relieve the clinical symp-toms and signs,improve lung ventilation function and the quality of daily life and can be helpful to reduce the risk of re-hospital-ization with good safety.

8.
China Pharmacy ; (12): 5021-5023,5024, 2016.
Article in Chinese | WPRIM | ID: wpr-605872

ABSTRACT

OBJECTIVE:To evaluate the effects of clinical pharmacists participating in disease management of chronic heart failure(CHF). METHODS:A total of 180 CHF inpatients selected from cardiovascular medicine department of our hospital during Jan. 2013 to Dec. 2014 were divided into control group and pharmacist management group according to random number table,with 90 cases in each group. The control group was given routine treatment. The pharmacist management group additionally received indi-vidualized pharmaceutical care,such as pharmaceutical monitoring,psychological counseling,medication education and 6-month follow-up. The comprehensive self-care ability of the 2 groups were compared on admission and on discharge;re-hospitalization and mortality were compared between 2 groups within 6 months after discharged;the patients’NYHA classification,LVEF,plas-ma level of NT-proBNP and quality of life were compared between 2 groups on admission and 6 months after discharge. RE-SULTS:There was no statistical significance in the cognition of patients to disease,self-care ability,medication compliance score and total comprehensive self-care ability score between 2 groups on admission (P>0.05). Each score and total score of 2 groups were better on discharge than on admission,and the pharmacist management group was better than control group,with statistical significance(P0.05). There was no statistical significance in NYHA classification,LVEF,plasma level of NT-proBNP be-tween 2 groups on admission(P>0.05). 6 months after discharge,the above 3 indexes of pharmacist management group as well as NYHA classification and plasma level of NT-proBNP of control group were improved significantly compared to on admission;NYHA classification,LVEF and plasma level of NT-proBNP of pharmacist management group were better than those of control group at corresponding period,with statistical significance (P0.05). 6 months after discharge,each score and total score of 2 groups were all better than on admission,and the pharmacist management group was better than control group, with statistical significance (P<0.05). CONCLUSIONS:The participation of clinical pharmacists in the disease management of CHF can significantly improve comprehensive self-care ability,decrease re-hospitalization rate,ameliorate cardiac function and en-hance the quality of life.

9.
Chinese Journal of Endemiology ; (12): 208-212, 2015.
Article in Chinese | WPRIM | ID: wpr-470384

ABSTRACT

Objective To analyze the changes in the composition of hospitalization of thyroid disease in Lianyungang City from 2002 to 2010,to learn the impact of iodine intake on thyroid disease in Lianyungang City after implementing universal salt iodization (USI),and to get epidemiologic evidence for prevention and control of iodine deficiency disorders scientifically.Methods Medical reports of the patients with thyroid disease were collected from hospitals at county level and above institutions in Lianyungang City from 2002 to 2010.Monitoring results of household iodized salt were also collected from five counties (districts) in Lianyungang City.The changes in the composition of hospitalization of thyroid disease were analyzed,and the relationship between thyroid disease and iodized salt was studied.Results ① A total of 3 559 patients with thyroid disease were enrolled in the study,the ratio between male and female was 1 ∶ 3.36.Mean age was (46.81 ± 14.94) years old and the peak age was from 40 to 60 years old.② Among the hospitalized patients with thyroid disease,the proportion of goiter patients,hyperthyroidism patients,thyroiditis patients,hypothyroidism and other thyroid disorders was 41.64% (1 482/3 559),40.07% (1 426/3 559),6.83% (243/3 559),6.21% (221/3 559) and 5.25% (187/3 559),respectively.③In 2002-2010,the hospitalization rate of thyroid disease showed an upward trend (x2 =460.12,P< 0.01),and the hospitalization rates of hypothyroidism,goiter,hyperthyroidism,thyroiditis and other thyroid disorders were all increased year by year (x2 =50.54,281.91,85.15,19.51 and 65.01,all P < 0.01).④From 2002 to 2006,among the patients with thyroid disease,the proportion of hyperthyroidism was the highest,and the range of values was from 42.03% (124/295) to 53.02% (114/215).Followed by goiter,and the range of values was from 34.55% (142/411) to 39.25% (73/186).From 2007 to 2010,the proportion of goiter became the highest,and the range of values was from 42.11% (232/551) to 49.57% (291/587).Followed by hyperthyroidism,and the range of values was from 33.05% (194/587) to 40.47% (223/551).⑤From 2002 to 2010,the coverage of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,all P < 0.01).⑥There were positive correlations between the hospitalization rates of thyroid disease,hypothyroidism,goiter,other thyroid disorders and the coverage of iodized salt,and the consumption rate of qualified iodized salt (rs =0.83,0.93,0.82,0.87,0.83,0.93,0.74 and 0.91,all P < 0.05).⑦There was a positive correlation between the hospitalization rate of hyperthyroidism and the consumption rate of qualified iodized salt (rs =0.72,P < 0.05).Conclusions There are some changes in the composition of hospitalization of thyroid disease in Lianyungang city from 2002 to 2010.Iodine intake may affect the hospitalization rate of thyroid disease.

10.
Korean Journal of Psychopharmacology ; : 141-148, 2014.
Article in Korean | WPRIM | ID: wpr-18401

ABSTRACT

OBJECTIVE: This study was designed to investigate the clinical characteristics of patients with major depressive disorder who were rehospitalized within a year in a naturalistic setting at a university hospital. METHODS: Inpatients with major depressive disorder patients were retrospectively investigated. Data on patients' demographic factors, clinical variables-age, sex, education year, socioeconomic state, marital state, illness duration, length of stay, severity of illness, presence of psychotic features, number of past depressive episodes and hospitalization, family history, comorbidity-were collected. Use of antidepressants, antipsychotics, mood stabilizers and hypnotics were investigated. RESULTS: A total of 238 patients participated in the study. No significant differences were observed between one-year rehospitalized group and the non-rehospitalized group in demographic factors and clinical variables except for the number of previous psychiatric hospitalizations. The mean number of previous psychiatric hospitalization was significantly higher in the one-year rehospitalized group than the non-rehospitalized group (0.41+/-0.83 times vs. 0.23+/-0.83 times) (p=0.048). No significant differences in rehospitalized rates were observed among the disparate treatment types. One-year rehospitalization rate was significantly higher in patients who discontinued antidepressants than the patients who continued the antidepressants (15.9% vs. 0%) (p=0.002). CONCLUSION: The present data suggest that the number of previous psychiatric hospitalizations is higher in patients who were rehospitalized within a year and the discontinuation of antidepressant might be an influencing factor. Further controlled studies are recommended to confirm our findings.


Subject(s)
Humans , Antidepressive Agents , Antipsychotic Agents , Demography , Depressive Disorder, Major , Education , Hospitalization , Hypnotics and Sedatives , Inpatients , Length of Stay , Retrospective Studies
11.
Chinese Journal of Endemiology ; (6): 419-423, 2013.
Article in Chinese | WPRIM | ID: wpr-642786

ABSTRACT

Objective To observe the changes of hospitalization rates of patients with goiter in Lianyungang City in a coastal area with mild iodine deficiency in 2002-2010.Methods Medical reports of patients with goiter from county hospitals were studied at county level with a retrospective method.In accordance with the National Iodized Salt Monitoring Program,nine townships(towns) were taken from each county (district) [total of five counties(districts)]; four villages were selected from each township (town); salt samples were taken from eight households in each village,and salt iodine was determined using direct titration of sodium thiosulfate.Results The hospitalization rate of patient with goiter increased from 1.87/10 million in 2002 to 7.05/10 million in 2009,and then fluctuated to 6.06/10 million in 2010(x2 =281.91,P< 0.01).Among them,female's hospitalization rates were significantly higher than that of male 's(The variation range of x2 values were 35.23-116.04,all P < 0.01),and the hospitalization rates of people over the age of 40 years were significantly higher than that of people less than 40 years of age(The variation range of x2 values were 33.04-263.04,all P < 0.01),and the hospitalization rates of people in urban areas were significantly higher than that of people in rural areas (The variation range of x2 values were 18.35-140.00,all P < 0.01).Average salt iodine was 27.61-30.13 mg/kg in 2002-2010.The coverage rate of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,P < 0.01).There was a positive correlation between hospitalization rate of patient with goiter and coverage rate of iodized salt(spearman correlation coefficient was 0.83,P < 0.05).There was a positive correlation between hospitalization rate of patient with goiter and the consumption rate of qualified iodized salt too (spearman correlation coefficient was 0.93,P < 0.05).Conclusions In Lianyungang City,the hospitalization rate of patient with goiter,the coverage rate of iodized salt and the consumption rate of qualified iodized salt all show upward trend in 2002-2010.The relationship among them is worth further study.

12.
Chinese Journal of Clinical Nutrition ; (6): 72-76, 2010.
Article in Chinese | WPRIM | ID: wpr-386489

ABSTRACT

Objective To analyze the hospitalization rates of diabetic patients in different departments in different years and compare the differences in hospitalization costs, length of stay, and mortality between diabetic and non-diabetic patients. Methods The clinical data of hospitalized patients from 1995 to 2009 in different departments of Peking Union Medical College Hospital were retrospectively analyzed. Patients were divided into three groups by calendar period (every five years) and into four groups by ages. Results A total of 500 523 patients were enrolled in this study. From 1995 to 2009, the hospitalization rates of diabetic patients increased from 2.85% to 7.65% , especially among patients who were treated in the departments of cardiology, ophthalmology,and vascular surgery. In 2009, the hospitalization rates of diabetic patients in the three departments were 29.36% , 24. 51% , and 21.25 % , respectively. The length of hospital stay was significantly longer among diabetic patients than among non-diabetic patients (P < 0. 001). The total hospital costs were also significantly higher among diabetic patients than among non-diabetic patients in all the period and age groups (P < 0.01 or P <0.001)except in 2000-2004 group and 2005 - 2009 group in 0 - 18 years group (P >0. 05). The hospital cost per day in diabetic patients was significantly lower than that in non-diabetic patients in all the period and age groups (P < 0. 05, P < 0. 01 or P < 0. 001)except in 1995-1999 group in over 65 years group (P > 0.05). The mortality rate of diabetic patients in the 1995-2004 in 0-18 years group was zero, and the mortality rates were not significantly different between diabetic patients and non-diabetic patients in 2005 -2009 group in 0-18 years group (P >0.05), and were significantly higher in diabetic patients than in non-diabetic patients in all other period and age groups (P <0.01 or P < 0. 001). Conclusions Diabetic inpatients tend to have a longer hospital stay, higher hospitalization rate, higher hospital costs, and higher mortality rates. A hospital-wide diabetes management mode should be developed to optimize its treatment.

13.
Chinese Journal of Hospital Administration ; (12): 649-652, 2008.
Article in Chinese | WPRIM | ID: wpr-381280

ABSTRACT

Objective of this study is to re-compute the national hospitalization rate in China using the second-hand data and explore the practical use of systematic review in health policy research field.Methods Domestic literatures on hospitalization rate in the last six years were collected and quality assessment was done.Merging analysis was used based upon systematic review approach.Results 25 reported literatures on hospitalization rate of urban and rural residents were included into the study.After merging analysis,the hospitalization rates were 4.70% for the country,5.31% for the urban and 4.26% for the rural.They are higher than the reported hospitalization rate in National Health Services Survey (NHSS)in 2003.After merging with the NHSS data,the hospitalization rate were 4.12%,4.85% and 3.82% respectively.Conclusions Systematic review can be applied in health service and policy research field.Data merging and information processing methods are diversified and could be selected upon research purpose and data attribute.Computation methods in systematic review in health policy research still need to be developed.

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