RÉSUMÉ
As suggested by regulatory feedbacks from relevant national regulatory agencies on the use of medical insurance funds, noticeable problems were found in the compliance and rationality of medical service charges among Chinese hospitals. Based on the practice of hospital management, the authors summarized common problems of various medical service charge management as reported by the management authorities at all levels. These problems referred to name-replaceable charges and affiliated charges, splitting charges, repeated charges, and multiple(false) charges. On this basis, the paper analyzed such hospital management risks incurred as regulatory penalties, fee disputes and medical disputes, as well as their internal and external causes. In the end, the paper put forward countermeasures and suggestions for reference by hospitals in their management of medical service charges.
RÉSUMÉ
Objective@#To investigate the relationship among depression, anxiety, stress and addictive substance use behavior in secondary vocational students.@*Methods@#Cluster sampling method and the Adolescent Health-related Behaviors Questionnaire were used to collect demographic characteristics, psychological symptoms, and addictive substance usage among 5 935 students in nine vocational schools in Chongqing, Zhaoqing, Ningbo, and Taiyuan. Multivariate logistic regression analysis was used to analyze the relationship between the addictive substance use behavior and psychological factors.@*Results@#The detection rates of depression, anxiety and stress were 46.5% (n=2 762), 58.7% (n=3 483), and 29.8% (n= 1 770), respectively. The prevalence of addictive substances was 74.8% (n=4 440), traditional drugs was 0.8% (n=50), new drugs was 2.8% (n=166), other addictive drugs was 4.1% (n=241). Multivariate logistic regression analysis showed that compared with the normal psychological states of secondary vocational students, the OR value of mild depression tendency alcohol and tobacco use behavior of secondary vocational students was 1.45; the OR values of mild anxiety, moderate anxiety, severe anxiety and very serious anxiety were 1.46, 1.46, 1.71, and 1.83, respectively; the traditional drugs use behaviors were 5.51, and 2.61, respectively, for the severe anxiety and very serious anxiety. Compared with the normal psychological state of secondary vocational students, the OR values of the severe anxiety and very severe anxiety were 2.56, and 2.66, respectively, for severe anxiety and very serious anxiety. Compared with normal psychological status of secondary vocational students, the OR values of mild, moderate, severe, and very severe anxiety were 2.14, 2.47, 2.39, and 3.45, respectively; all P values <0.05.@*Conclusion@#Anxiety and mild depression were risk factors of tobacco and alcohol use in secondary vocational students; severe and above anxiety were the risk factors of drug use in secondary vocational students; anxiety was the risk factor for other addictive drug use in secondary vocational students.
RÉSUMÉ
Objective:To explore the relation of new-type drug using intention,self-efficacy,and perceived stress in secondary vocational school students.Methods:A total of 2692 secondary vocational school students in Zhaoqing,Guangdong Province were selected.The questionnaire of new-type drugs using intention,General Self-Efficacy Scale (GSES),and Perceived Stress Scale (PSS) were respectively used to assess the secondary vocational school students'new-type drugs using intention,self-efficacy,and perceived stress.Path analysis model was used to analyze the relationship of new-type drugs using intention,self-efficacy,and perceived stress among secondary vocational school students.Results:There were 13.6％ (295/2165) of the secondary vocational school students reported an intention to use new-type drugs.The total scores of GSES and PSS were (2.4 ±0.5) and (18.8 ±5.0),respectively.The results of path analysis showed that,after controlling for age,gender,and residence,the scores of GSES were negatively correlated with the scores of PSS (γ =-0.21,P ＜0.001),and the scores of PSS were positively correlated with the scores of questionnaire of new-type drugs using intention (γ =0.05,P ＜ 0.05).However,the scores of GSES showed no significant direct correlation with the scores of questionnaire of new-type drugs using intention (γ =0.04,P ＞ 0.05).Conclusion:The secondary vocational school students' level of perceived stress are positively correlated with their intention to use new-type drugs.Self-efficacy might moderate the individual's level of perceived stress,thus to show indirect correlation to the secondary vocational school students' intention.