Medical disputes analysis based on DRGs mortality risk ranking / 中华医院管理杂志

Objective@#To analyze cases in different groups of DRGs mortality risk ranking regarding overall medical dispute cases of the hospital from 2012 to 2017, and to study various groups of such ranking for these disputes as faced by different clinical departments, for the purpose of targeted intervention into medical risk exposures.@*Methods@#Inpatient medical dispute cases in 2012-2017 period were selected, and classified into the various mortality groups by the standards and definition of BJ-DRGs. These data were used to calculate medical dispute incidence in each group, and analyze the difference between internal medicine and surgery departments.@*Results@#Medical disputes of the hospital were mostly found in case groups of mortality free and those of low mortality risks, accounting for 66% of the total cases. This figure was the highest in surgical departments, having a percentage as high as 72%, and the CMI values of these cases were low as well (0.765 and 1.416 respectively).@*Conclusions@#As case groups of mortality free and low risks tend to attract disputes, the hospital is recommended to enhance the risk awareness and training of its medical staff and key medical regulations.

Clinical pathway management and information systems combination strategy / 中华医院管理杂志

Peking University Third Hospital is one of the first hospitals for experiments in clinical pathway selected by the Ministry of Health,which keeps optimizing the clinical pathway management mechanism and function of information system in its 4-year practice.This article described the combination strategy of clinical pathway management and information system applications,in terms of reasonable design of the management plan,standardized clinical pathway,strengthened execution control and improvement of the quality control.The purpose is to balance the relationship between clinical pathway management norms and user-friendliness of the system,enhance rationality and feasibility,improve efficiency and provide high-quality service to ensure medical safety.

An Ethical Discussion on the Case of Intra-vital Organ Donations between Relatives / 中国医学伦理学

This study based on an ethical review of the kidney donation from a young man to his elder relative.We discuss the problems existing in present field of intra-vital organ transplantations,as well as its risk and the ethics review mode.It is recommended that ethics review is performed as a complete procedure,which should not only present in certain format,but also emphasize weighing the advantages and disadvantages of both patients and donors;intra-vital organ transplantations between relatives should also follow the principle of "no compensation and non-commercialization";hospitals should give out the judgment under sufficient considerations of both patients' and donors' benefits within the scope of laws,as well as taking into account of other factors such as prospective outcome of the operations,rather than barely basing on the risk probabilities.