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Objective:To discuss the comprehensive evaluation of the effectiveness of iodine deficiency disorders prevention and control in Xinjiang Production and Construction Corps (Corps for short) using technique for order preference by similarity to an ideal solution (TOPSIS) and rank-sum ratio (RSR) methods, and identify weaknesses in the prevention and control of iodine deficiency disorders in the Corps at present.Methods:The monitoring data on iodine deficiency disorders in the Corps from 2014 to 2020 were collected from the Disease Control and Prevention Center of the Corps. Six indexes were selected, including the consumption rate of qualified iodized salt, the coverage rate of iodized salt, the qualified rate of iodized salt, the appropriate percentage of urinary iodine in children, the goiter rate of children and the appropriate percentage of urinary iodine in pregnant women. The TOPSIS method and RSR method were combined to comprehensively evaluate the prevention and control effect of iodine deficiency disorders in the Corps.Results:The results of TOPSIS method showed that the control effect was from superior to inferior in the order of 2020, 2018, 2016, 2019, 2015, 2017 and 2014. Based on the RSR method, the control effect was divided into three levels: 2018 and 2020 (with an estimated RSR value of ≥0.525) in the first level (good), 2014 (estimated RSR value < 0.007) in the third level (poor), and other years (0.007≤estimated RSR value < 0.525) in the second level (medium). Referring to the monitoring data, the appropriate percentage of urinary iodine in children and pregnant women in the middle years was the weak point. Conclusions:TOPSIS method combined with RSR method can accurately and reasonably evaluate the effectiveness of prevention and control of iodine deficiency disorders in the Corps, the evaluation results are consistent with the actual situation. It is found that the appropriate iodine nutrition levels of children and pregnant women are the weak points in the prevention and control of iodine deficiency disorders in the Corps.
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Objective:To evaluate the barrier-free level of village clinics of a city in the aging era, for references in improving the barrier-free medical environment for the elderlies.Methods:The village dectors of 156 village clinics in 12 counties of a city were selected as the objects of a questionnaire survey from Dec.2020 to Jan.2021, with 6 evaluation indexes established, each set with 1-10 points. This questionnaires was used to survey the barrier-free construction levels of village clinics. The data were statistically analyzed by rank sum ratio and quadrant graph model.Results:The barrier-free buildings of such clinics scored 32.86 points in average. Among the six indexes, the barrier-free access and doors(7.21 points) scored the highest, and the barrier-free parking space(4.71points) and toilets(3.28 points) scored the lowest. All the counties of the city fell into four categories, including 2 counties with high degree of aging-high level of accessibility, 4 counties with low degree of aging-high level of accessibility, 4 counties with low degree of aging-low level of accessibility, and 2 counties with high degree of aging-low level of accessibility, according to the quadrant graph model built based on the aging degrees and the barrier-free levels of village clinics.Conclusions:The barrier-free level of the village clinics in a city needs to be further improved, and the barrier-free transformation of parking space and toilets should also be strengthened in the future. The government should take different measures in view of conditions of each county to improve the accessibility of village clinics and facilitate the health care-seeking of elderlies.
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Objective:To evaluate medical service performance of the DRG pilot public hospitals in a city was carried out by using the entropy weight TOPSIS and the rank sum ratio method, so as to provid the decision-making basis for the DRG pilot reform and the high-quality development of public hospitals.Methods:The case-mix index(CMI) value, the number of DRG groups, the time consumption index, the cost consumption index, and the low-risk mortality rate were obtained from the first page of medical records of 21 DRG pilot hospitals in a city from January 2019 to December 2020.The entropy weight TOPSIS method and the rank sum ratio method were used to evaluate the medical services performance of 21 DRG pilot hospitals.Results:The CMI value and the number of DRG groups in 21 DRG pilot hospitals increased from 0.81 and 353 in 2019 to 0.86 and 369 in 2020 respectively, and the time consumption index decreased from 0.98 to 0.92. The entropy weight TOPSIS method and the rank sum ratio method had good consistency and correlation with the hospital performance evaluation results from 2019 to 2020 ( P<0.05). The overall ranking of the performance evaluation of pilot hospitals in 2020 was higher than that in 2019, the tertiary hospitals were higher than secondary hospitals, and hospitals were higher than maternal and child health care hospitals. Conclusions:The DRG payment reform had promoted the quality and efficiency of medical services in the city.
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Objective:To investigate the quality of rehabilitation medical service in tertiary general hospitals in Gansu Province. Methods:Stratified sampling was used to sample tertiary general hospitals in Gansu Province for on-site surveys in 2017. A quality evaluation index system was established in the view of medical service providers, including 17 indicators, based on Donabedian model and experts' opinions. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Rank-sum Ratio were applied to make a comprehensive evaluation on the overall service quality of the hospital rehabilitation medical service. Results:A total of 27 tertiary general hospitals were sampled, in 13 cities/prefectures of Gansu Province. For the structure quality, the compliance rate of the business operation area and the number of beds in the rehabilitation medicine department were 77.78% and 51.85% respectively; while the compliance rates of the physicians, therapists and nurses were all less than 50%. For the process and results quality, the compliance rates were all more than 85%. For the overall quality of rehabilitation medical service, five hospitals were classified as Good, located in Lanzhou, Tianshui and Jiayuguan; 18 hospitals were classified as Medium, located in Longnan, Longdong, Lanzhou and surround, Linxia and Hexi regions; four hospitals classified as Poor, located in Lanzhou and Tianshui. Conclusion:The overall quality of rehabilitation services in the tertiary general hospitals of Gansu Province needs to be improved, and the development of rehabilitation services is uneven in various regions. Comprehensive evaluation provides an important reference to promote the rational distribution of rehabilitation medical resources and improve the quality of rehabilitation medical services.
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Objective To comprehensively evaluate the health education effects of iodine deficiency disorders in different areas of Tianjin, and to provide a reference for improving the quality of iodine deficiency disorders health education. Methods The rank sum ratio method (RSR), TOPSIS and fuzzy combination were used to comprehensively evaluate the effect of health education intervention on iodine deficiency disorders in 16 areas of Tianjin. Results The evaluation results of RSR, TOPSIS and fuzzy combination method ranked N, D, and E areas in the last three places, while G, F, and P areas ranked first, second, and third. Combined with the RSR method, it was shown that in the evaluation of the effects of iodine deficiency health education interventions in 16 areas, the health education effect in G, F and P areas was classified as superior, the health education effect in D ,E and N areas was classified as inferior, and other areas were moderate. Conclusion The fuzzy combined RSR-TOPSIS method avoided the limitation of using either RSR or TOPSIS alone and made the conclusion more objective and accurate, and provided comprehensive quantitative results for the health education of iodine deficiency diseases in different areas of Tianjin. This fuzzy combination method objectively evaluated the intervention effect of health education in different areas, which provides a reference for improving the quality of health education for iodine deficiency disorders.
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Objective@#To understand the current equalization in essential public health services in China, and to provide recommendations for health resource allocation and public health policy making.@*Methods@#WHO′s comprehensive evaluation model, and the Rank Sum Ratio (RSR) method were used to analyze, rank and categorize essential public health services.@*Results@#Thirty-one provinces (cities, autonomous regions) in China were grouped into five categories, namely, relatively balanced area, low input area, resource shortage area, over utilization area and resource waste area.@*Conclusions@#The equalization of essential public health services in China is gradually being realized, but there are still setbacks such as mismatch between health needs and resource input, waste and over-utilization of resources. To correct these problems, relevant recommendations on health policy making for different areas were given.
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Objective To explore the scientificity and feasibility of using weighted rank-sum ratio (RSR) method based on diagnosis-related groups ( DRGs) indicators in nursing performance evaluation. Methods Homepage data of medical records were extracted from inpatients discharged in 2017, and " CN-DRGs" burster was used to obtain the DRGs data. Data of medical safety were obtained from the nursing adverse event management system, while data of nursing grading information and medical expenses were obtained from the hospital information system, and the patient satisfaction was obtained in a questionnaire survey. Based on the indicators available, the weighted RSR was applied to evaluate the nursing performance from the 11 dimensions, namely workload, nursing competence, nursing quality, nursing personnel allocation, patient satisfaction, etc. Results The results of the weighted RSR showed that 43, 39, and 6 wards of total 88 wards of the hospital were rated as excellent, medium and poor grades respectively. The results of ANOVA showed that the difference of the 3 grades was significant (F=170. 391, P<0.001). The nursing performance evaluation results were consistent with the actual situation. Conclusions The evaluation of nursing performance with weighted RSR method based on DRGs indicators prove its practical application value, as this method can not only provide data support for nursing personnel allocation, but also provide reference for nursing quality evaluation and supervision.
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Objective To evaluate the professional competency of the clinicians with DRGs indexes. Methods The homepages of medical records of the hospital from January to June in 2018 were extracted, and the conventional evaluation indexes ( i. e. percentage of drug expenditure, percentage of medical consumables expenditure, and percentage of antimicrobials application ) of each clinician were obtained. " CN-DRGs" burster was used to calculate the DRGs indexes. The weighted RSR was applied to evaluate the professional competency of the resident physicians. Results A comprehensive evaluation of the professional competency of 438 resident clinicians was conducted. 218, 190, and 30 clinicians fell into excellent, medium and poor categories respectively. The results of ANOVA showed that the differences of the 3 categories were significant ( F =664. 863, P <0. 001 ). Conclusions The evaluation of clinicians′professional competency based on DRGs was reasonable, objective and feasible, proving its importance for the establishment of a scientific and standardized clinicians evaluation system.
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Objective To analyze 20 indicators for the evaluation of medical radiation protection monitoring in 31 provinces,municipalities or autonomous regions in 2017 and provide technical support and reference for further optimization of medical radiation protection monitoring projects.Methods According to " medical radiation protection monitoring assessment score sheet for medical and health institutions",a full range of analysis and evaluation was carried out of medical radiation protection monitoring and implementation at nationwide medical and health institutions by using fuzzy combined method of TOPSIS and rank sum ratio.Results TOPSIS method and rank sum ratio weighted fuzzy joint analysis showed that the top three indicators,in descending order,were management of provincial implementation plans,management of project leaders in various cities and management of funds whereas the lowest three indicators were completion of radiotherapy equipment commissioning,innovation and highlights and tcoverage of radiotherapy equipment.Conclusions The fuzzy combined application of TOPSIS method and rank sum ratio method can provide the comprehensive quantitative result for the implementation of medical radiation protection monitoring in 2017,objectively evaluate the implementation of various indicators,summarize the highlights and bottlenecks of work in 2017,and provide technical support and reference for further optimization of medical radiation protection monitoring.
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Objective To analyze the 14 indicators of on-site evaluation at 18 hospitals under Beijing hospital authority in 2016 , and to provide technical support and reference for further optimization of medical quality and service .Methods According to the "Beijing Municipal Administration of Hospital 2016 On-site Evaluation Indicators", the results were analyzed using the fuzzy combined method of TOPSIS and rank sum ratio , and the ranking of the indicators was sorted .Results TOPSIS method and rank sum ratio weighted fuzzy joint analysis showed that the top three indicators from high to low were medical technology management , patient identification and verification system , clinical care service management;and the last three indicators were hospital-acquired infection monitoring , medical malpractice reporting and management , critical value report and disposal .Conclusions Hospitals are recommended to strengthen their exchange , popularize the concept of continuous improvement , the use of management tools to solve practical problems , and further improve the hospital medical quality and service quality .
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Objective To study the performance indicators after reorganization for 10 Years in enterprise hospital.Methods The performance indices from 2005 to 2014 of a Class One Grade A hospital was evaluated by rank sum ratio.Results The reform was in the doldrums in 2005, improved slightly in 2006 and 2007, increased significantly and steadily in 2008, reached the best in 2014.Conclusion Evaluating the performance of hospital management with rank sum ratio is scientific and clear, which has certain practical value.
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Objective To ascertain and evaluate the quality of radiological protection in rural and urban primary health care institutions . Methods Questionnaires were designed to investigate the protection levels in diagnostic radiology in primary health care institutions in six cities in 2013 and to evaluate the results by using the technique for order preference by similarity to an ideal solution ( TOPSIS) combined with the rank sum ratio ( RSR) method.Results The six cities and an integrated case ( all the data of the six prefecture-level citys were merged as one for comprasion ) were ranked based on the comprehensive assessment.The order from good to bad was Suzhou , Dalian, Yichang, integrated case, Shaoxing, Quzhou and Heihe.The results were divided into three grades , with Suzhou, Dalian at best grade, Yichang, integrated case, Shaoxing, Quzhou at middle grade, and Heihe at poor grade. Conclusions The quality of protection in radiation diagnosis varied considerably .Suzhou ranked the first and Heihe ranked the last .The study suggests that efforts should be focused on the management of key cities and indicators to upgrade whole protection level in radiation diagnosis .
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Objective To analyze the inputs and outputs of Health Human Resource for County -level Hos-pitals in Western China , discuss the reasons for low efficiency and quality , and provide references for improving the efficiency and quality of health human resources .Methods Using rank-sum ratio to evaluate the health human re-sources of 33 county -level hospitals of 11 provinces in western China , and to compare the evaluation results . Results In the comprehensive analysis of human input and output of health human resources between 11 provinces , according to the health human resources efficiency level of 11 provinces into third gear:a hard stop ( high-grade):Sichuan, Guangxi;second gear (mid-range): Gansu, Guizhou, Yunnan, Shaanxi, Ningxia, Inner Mongolia, Ti-bet, Xinjiang;third gear (low-grade):Qinghai.Conclusion In the nationwide perspective , the efficiency of the western provinces of health human resources is lower , and we need to take measures to improve the efficiency of health human resources .
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Objective Different methods were used for the analysis of different medical and health institutions in Henan Province in 2012 of hospital bed utilization,to find bed utilization problems,and provide reference for the rational allocation of resources.Methods Static beds utilization model method (SBMA)and the method of rank sum ratio(RSR)were used for planning of data in“2012 health statistics yearbook of Henan province”,for comprehensive analysis of bed utilization efficiency.Results Among the medical and health institutions in Henan province in 2012,general hospitals,maternal and children hospitals(centers)are found with higher utilization of hospital beds,while other institutions (nursing homes),community health service centers(stations)are found lower.Conclusion Henan Province in 2012 was found on the whole with efficient utilization of hospital beds,yet with rooms of improvement for different medical institutions,especially those at the primary level.
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Objective To explore osculating value method combined with rank sum ratio method in evaluation of nursing quality in the hospital nursing management application, to provide a scientific basis for decision making. Methods By reference, from the working efficiency, the quality of nursing, 3 dimensions of nursing skill training, the choice of 11 commonly used in the evaluation of nursing quality indicators, the raw data of each index was normalized, the school of nursing quality with 2004-2013 years of osculating value method analysis was assessed, the development of nursing quality combined with rank and file classified score method. Results The nursing quality of the overall upward trend, according to the grading each year osculating value and ranking in 2011, nursing quality best, osculating value was 0.000, the worst quality of nursing in 2004, osculating value was 3.248;the annual nursing quality grading was reasonable, 2011, 2012 and 2013 were in good quality grade, 2004, 2005 and 2006 were of poor quality grades, the rest of the year at a medium level, with statistically significant difference of the file, P<0.05. Conclusion Osculating value method combined with rank sum ratio method in comprehensive evaluation of nursing quality in the hospital has the objectivity and practicability.
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Objective To explore scientific and effective evaluation methods of hospital nursing performance.Methods Using balanced score card (BSC),Delphi method and key performance indicator (KPI) to build a system of nursing performance indicators; using entropy weight method to determine the weight coefficients of nursing performance indicators; using RSR method to compare the nursing effects of wards before and after the nursing performance management.Results 4 first-level nursing performance indicators,9 secondary-level ones and 27 tertiary-level ones were obtained,and the weight coefficient of every index was computed; According to terrible,poor,moderate,good,excellent levels,25 wards were ranked after implementing nursing performance management.There was significant difference of the overall performance management effects of 25 wards after implementing performance evaluation,comparing with the case before.Conclusions To combine entropy weight method and Rank-sum ratio (RSR) method is pertinent,scientific and reasonable,and the results can be taken as the evidence for nursing performance evaluation.
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Objective:To effectively manage the hospitalized patients' medical charges and rationally improve the hospital economic benefits.Methods:The research has been done through the rank sum ratio way for exploring the charges of hospitalized patients with breast cancer in Chongqing.Results:It was found that the medical charges exist a continually rising trend with graded by RSR.Conclusion:This paper concludes that both the medical charges and the hospital benefits are increasing at the same time.