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Objective:To investigate the status and willingness of information disclosure based on social supervision in tertiary and secondary public hospitals, so as to provide reference for expanding information disclosure content.Methods:By using stratified cluster random sampling method, 66 tertiary public hospitals and 126 secondary public hospitals in 6 provinces were selected for questionnaire survey in April 2021. Thirty-one indicators in 3 categories and 5 groups were selected to obtain the information disclosure status and willingness. Chi-square test, variance analysis and paired t-test were used to conduct difference analysis. Results:The indicators with higher disclosure rates in public hospitals were drug prices and medical service price adjustments (93.9% in tertiary hospitals and 92.1% in secondary hospitals) and medical insurance reimbursement policies and compensation processes (90.9% in tertiary hospitals and 86.5% in secondary hospitals), while the indicators with lower disclosure rates were case fatality rates in low-risk groups (24.2% in tertiary hospitals and 26.2% in secondary hospitals), proportion of special needs medical services (27.3% in tertiary hospitals), and average daily outpatient visits per practitioner (27.3% in tertiary hospitals and 26.2% in secondary hospitals). The indicators that public hospitals thought could be disclosed at a higher rate were drug and medical service price adjustments, medical insurance reimbursement policies and compensation processes, and prices and medical insurance reimbursement of commonly used drugs and major medical consumables, while the indicators that were thought to be disclosed at a lower rate were some medical service safety indicators and hospital financial indicators.For all indicators, the percentage that the hospitals thought could be disclosed was higher than the percentage that had been disclosed.Conclusions:At present, China′s secondary and tertiary public hospitals have a low rate of disclosure about medical service efficiency, medical service safety, statistical summary cost and financial indicators. However, except for some medical service indicators and financial related indicators, the hospitals′ information disclosure willingness is relatively high, and the scope of information disclosure can be expanded in an orderly manner in steps.
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Objective:To evaluate percutaneous mechanical thrombectomy (PMT) using Aspirex device for treating acute iliofemoral deep vein thrombosis (IFDVT).Methods:The clinical and follow-up data of 68 patients with IFDVT at our institution from Jan 2019 to Jun 2021 was retrospectively analyzed.Results:Twenty-six patients who had received PMT combined with auxiliary catheter directed thrombolysis (CDT) were included into group A, and 42 patients received CDT alone were into group B.The final thrombus clearance rates were more than 50%, and the clinical efficacy of thrombolysis was achieved. Group A associated a significant reduction in lysis duration and UK dosage and hospital days and degree of detumescence after 24 h compared with group B,and all aforementioned differences were statistically significant. Hospitalization costs in group A were more than group B. At one year follow-up, there were no significant differences between the two groups in the cumulative prevalence post-thrombotic syndrome (PTS) and the Villalta score and primary patency (92.0% vs. 90.0% , χ2=0.059, P=0.807). Conclusions:The application of PMT using the Aspirex device for acute IFDVT was safe and effective, which could accelerate the clearance of thrombus, and reduce UK dosage, lysis duration, hospital days. However, it increased the hospitalization costs.
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Objective:To investigate the development trend of physical examination volume and revenue in health-checkup institutions in China from 2010 to 2019.Methods:In this longitudinal study, the annual income, annual physical examination volume and other indicators reflecting institutional size were collected with questionnaire from 374 health-checkup institutions in the year of 2010, 2015 and 2019. The geometric mean method is used to calculate the compound annual growth rate (CAGR) of the annual physical examination volume, annual income, mean per capita cost from 2010 to 2015 and 2015 to 2019.Results:The annual physical examination volume of health-checkup institutions increased from 1.81 (1.00, 3.20) ×10 4 person times in 2010 to 5.08(3.50, 7.28)×10 4 person times in 2019; the CAGR of the physical examination volume from 2010 to 2015 was 14.04%(8.14%, 23.78%), and it was 9.49%(3.39%, 19.07%) from 2015 to 2019. The annual revenue increased from 768.73 (350.00, 1 623.75) ×10 4 yuan in 2010 to 3 500.00 (1 997.73, 6 818.54) ×10 4 yuan in 2019; the CAGR of annual revenue from 2010 to 2015 was 25.75% (15.17%, 35.09%), and it was 15.67% (8.78%, 26.11%) from 2015 to 2019. The mean per capita cost increased from 434.26 (278.82, 666.66) yuan in 2010 to 755.80 (506.90, 1 005.42) yuan in 2019; the CAGR of the mean per capita cost was 9.82% (1.71%, 17.10%) from 2010 to 2015, and it was 5.37% (0.95%, 10.46%) from 2015 to 2019. Conclusion:From 2010 to 2019, health-checkup institutions in China developed rapidly, and the CAGR of the annual physical examination volume, annual revenue, mean per capita cost are high.
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Objective:To explore the effect of magnetic resonance imaging (MRI) examination in evaluating the severity of liver fibrosis in schistosomiasis.Methods:A prospective study was carried out to select 50 patients with chronic schistosomiasis admitted to the First People's Hospital of Huzhou City from December 2016 to December 2019 as the observation group, and 35 healthy physical examination subjects during the same period as the control group. All subjects underwent 1.5T MRI scan and diffusion-weighted imaging, and the diffusion sensitivity coefficient (b value) was set to 600 s/mm 2. Using liver biopsy as the gold standard, the degree of liver fibrosis stage was determined. The correlation between apparent diffusion coefficient (ADC), exponential apparent diffusion coefficient (eADC) of diffusion-weighted imaging and liver fibrosis stage was analyzed. And receiver operating characteristic curve (ROC curve) was drawn to evaluate the diagnostic value of ADC and eADC in liver fibrosis of schistosomiasis. Results:Among the 50 patients with chronic schistosomiasis, the MRI scan showed that 39 patients presented with liver lobe proportion imbalance, widened liver fissure, atrophy of right lobe of liver, obvious enlargement of the left outer lobe and caudate lobe of liver; hyperfibrosis and hyperplasia around portal vein leaded to thickening of portal vein wall and appearance of fiber cuff sign; both T1WI and T2WI showed low signals but were not sensitive to late calcification; and there was no obvious change of liver lobe contour and proportion imbalance in other 11 patients. Among them, 7 cases were complicated with liver cancer, and 44 cases were complicated with cholecystolithiasis and cholecystitis. The MRI diffusion-weighted imaging showed that there were statistically significant differences in ADC [(1.17 ± 0.08) × 10 -3, (1.38 ± 0.13) × 10 -3 mm 2/s] and eADC value [(0.51 ± 0.07) × 10 -3, (0.40 ± 0.06) × 10 -3 mm 2/s] between the observation group and the control group ( t = 8.497, 7.762, P < 0.05); and the differences in ADC and eADC values of patients in different liver fibrosis stages in the observation group were statistically significant ( F = 21.526, 23.814, P < 0.05). Correlation analysis results showed that chronic schistosomiasis liver fibrosis was negatively correlated with ADC value ( r = - 0.236, P < 0.05), and positively correlated with eADC value ( r = 0.484, P < 0.05). The ADC value for diagnosing of schistosomiasis liver fibrosis with area under ROC curve (AUC) was 0.826, the 95% confidence interval ( CI) was 0.785 - 0.953, the diagnostic specificity was 89.25%, and the sensitivity was 79.58%; eADC value for diagnosing schistosomiasis liver fibrosis with AUC was 0.681, the 95% CI was 0.582 - 0.879, the diagnostic specificity was 81.14%, and the sensitivity was 73.81%. The ADC and eADC values diagnosed liver fibrosis in S2 - S4 stages were significantly higher in AUC than those in S0 and S1 stages ( P < 0.05), but there was no significant difference between S1 and S0 stages ( P > 0.05). Conclusions:In MRI examination of patients with chronic schistosomiasis liver fibrosis, ADC values decreases significantly, and eADC values increases significantly; and there is a correlation between chronic schistosomiasis liver fibrosis and ADC and eADC values. The ADC and eADC values have certain diagnostic value for schistosomiasis liver fibrosis.