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Objective@#To carry out the 4th round of third-party evaluation on the implementation and effect of the 1st year of the 2nd Phase National Healthcare Improvement Initiative(abbreviated as Initiative)since 2015.@*Methods@#The 4th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations.@*Results@#The 4th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces(autonomous regions, municipalities directly under the Central Government)and Xinjiang Production and Construction Corps.Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1%, 96.7%for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved.@*Conclusions@#The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction.
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Objective To carry out the 4th round of third-party evaluation on the implementation and effect of the 1st year of the 2nd Phase National Healthcare Improvement Initiative ( abbreviated as Initiative) since 2015. Methods The 4th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations.Results The 4th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces ( autonomous regions, municipalities directly under the Central Government ) and Xinjiang Production and Construction Corps. Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1% , 96.7% for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved. Conclusions The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction.
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Objective: To analyze the trends of development and equity of health institutions in China during the period from 2002 to 2013 , and put forward references to optimize the decision-making on health resources alloca-tion. Methods:Statistical map, Gini coefficient and other methods were used to analyze the distribution and equity of health institutions in China for 12 years, during the period from 2002 to 2013. Results:(1) The overall development of health institutions is on the rise in China, and the distribution density of health resources with the population ad-justment is opposite to the adjustment of both population and geographic area at the same time. (2) In the past 12 years, the number of tertiary hospitals showed an increasing trend, and growth in the eastern region was the most sig-nificant. (3) From 2002 to 2013, the Gini coefficient of the number of health institutions and beds per 1,000 per-sons per square kilometer was maintained at 0. 40, and decreased from 0. 70 to 0. 60 in the eastern region of China, respectively. This same number was maintained at 0. 40 and 0. 20 in the central and western region. Conclusion: In China, the fairness trend of health resources allocation has improved during the period from 2002 to 2013, but the imbalance is more serious in the eastern region than in the central and western regions. It should be paid more atten-tion to optimizing the health resources allocation according to the local conditions of different regions, especially the influence of geographical distribution.
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Based on clinical research and information-sharing system, this article was aimed to study both the syndrome distribution and Chinese medicine composition of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in the COPD base of our hospital using the complex networks. The analysis was made on the common rules of syndrome distribution and features of key Chinese medicine compositions in the diagnosis and treatment of AECOPD. The clinical research and information-sharing system was used on the AECOPD data study (3000 hospital electronic medical records from August 2012 to January 2015). Data was processed by ETL software. The database was constructed. And the complex networks were used in the data mining. The results showed that the distribution of AECOPD common syndromes was heat-phlegm obstructing lung of 41.94%, phlegm-turbid obstructing lung of 22.97%, phlegm-damp obstructing lung of 10.30%,qi-yin deficiency of 6.31%, phlegm-stasis obstructing lung of 5.72%, lung-kidneyqi-deficiency of 4.01%, lung-spleenqi-deficiency of 1.15%, and phlegm obstructing orifices of 1.15%. Chinese medicine compositions were obviously divided into two large groups, which were the core Chinese medicine group and the associated Chinese medicine group. The research results illustrated that the clinical research and information-sharing system had good analysis and classification effects, which not only analyzing the medication laws of senior Chinese medicine experts and single disease treatment by a hospital, but also using in the large data analysis (data collection of single or multiple diseases on Chinese medicine clinical research nationally). It provided a good scientific research platform for Chinese medicine.
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Based on the Clinical Medical Research Information Sharing System ( CMRISS ) , this article took thedisease-syndrome-herb study on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) as a model to explore the establishment of disease-syndrome-herb study method on many types of diseases for the guidance of Chinese medicine clinical practice. The CMRISS of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, which contained 5000 format electronic medical records from August 2011 to March 2013 , was used as the database . Data preprocessing , crystal reports and complex network were used in data mining to receive the frequency relation of AECOPD disease-syndrome-herb in order to analyze medica-tion features of different Chinese medicine clinical syndromes of AECOPD . The results showed that three syn-dromes, which were phlegm-heat obstructing the lungs, phlegm-stasis obstructing the lungs, and qi-yin deficien-cy, have corresponding Chinese herbs of licorice, orange peel and earthworm. The treatment of syndrome of phlegm-heat obstructing the lungs contains herbs to clear heat, remove phlegm and activate blood circulation. The treatment of syndrome of qi-yin deficiency contains herbs to benefitqi , nourish yin as well as to activate blood circulation and remove phlegm. It was concluded that the application of CMRISS is able to process a large amount of clinical data. The data mining results can be used to guide clinical practice. It provided a better plat-form for the scientific research of Chinese medicine clinical practice .
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This study was aimed to analyze correlation between traditional Chinese medicine (TCM) syndromes and symptoms of acute exacerbation chronic obstructive pulmonary disease (AECOPD) based on complex network in order to provide a scientific basis for TCM syndrome amendments of diagnostic criteria, and explore relevant technologies to promote its application. By way of the current Clinical Research Information Sharing System, data and data pro-cessing were carried out (EHR 3000 between August 2011 and January 2013) into the database by ETL software. The MISCR (correlation between common symptoms and common syndromes) from both common symptoms and com-mon syndromes of AECOPD was analyzed with existing diagnosis standards of AECOPD. The comparative analysis on TCM syndromes such as heat phlegm obstructing the lung, lung and kidney qi deficiency, phlegm turbid obstructing the lung and their correspondent existing diagnosis standards of AECOPD showed that the common TCM syndromes in the clinic are the mixture of deficiency and excess syndromes. However, some individual symptom is contradicted to its correspondent syndrome. It was concluded that based on the Clinical Research Information Sharing System, the research on correlation analysis between syndromes and symptoms of AECOPD can provide strong evidence and methodology for the validation and revision of TCM diagnostic criteria.
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This article was aimed to explore the intelligent integration of database as the core-data and application of data mining as the core of knowledge discovery. On the basis of the existed set of information-sharing platform, this article elaborated from aspects of formatting HER intelligent integration, data integration and multi-method combined data mining intelligent integration. With the demonstration study on syndrome distribution and syndrome diagnostic criteria of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), data integration and intelligence optimization of Crystal Reports and complex networks were applied to dig out the correlation between syndromes and symptoms, disease-syndromes-herb association analysis. Analysis mentioned above showed that based on the shared system, and in accordance to research programs, intelligent integration of data and data mining methods, the improvement of the sharing platform application is proved feasible.
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Objectives:To learn about the attitudes toward the "Global Minimum Essential Requirements(GMER) in medical education" between Chinese doctors and graduates from the same medical university and to offer reference for spreading GMER in China.Methods: To investigate the subbjects using a questionnaire describing the related abilities of GMER.Description,rank test,multivariate analysis of variance and factor analysis are applied in data analysis.Results: In general,there are different attitudes toward GMER between doctors and graduates.13 of 23 items have statistical significance in scores between groups.The proportion of person considering every item as important or very important among doctors is higher than that among graduates.There is statistical significance between groups on the transformed score in 7 domains of GMER.The domain of topmost score is "clinical skills",and of the lowermost one is "community health & health system".Conclusions: Doctors and graduates both accept GMER.They both pay attention to occupational skills,but ignore the public health.Doctors think much of basic knowledge,while graduates are short of the cognition on "Information Management".