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Objective:To explore the establishment of a surgical complication monitoring mode based on data on the medical record homepage, and analyze its impact on the trend of changes in surgical complication incidence.Methods:A monitoring mode of surgical complication was developed based on the " structure-process-results" framework by using surgical complication rates derived from performance appraisal for a tertiary general hospital in Guangzhou. The number of surgical complications and the number of discharged surgical patients was collected from the hospital from January 2019 to June 2022 through the home page collection system for performance appraisal of national tertiary public hospitals. Descriptive analysis was used to analyze the incidence of surgical complications, and Joinpoint regression was used to analyze the trend of changes in the incidence of surgical complications. Monthly percentage change ( MPC) and average monthly percentage change ( AMPC) were calculated. Results:Since the hospital began implementing the surgical complication monitoring mode in May 2021, the incidence of surgical complications had decreased from 2.55% in June 2021 to 0.82% in June 2022, with an MPC of -5.58% ( P=0.024), which was better than the changes from January 2019 to May 2021 ( MPC=0.18%, P=0.755). Conclusions:The surgical complication monitoring mode constructed by the hospital can effectively reduce the incidence of surgical complications, providing reference for optimizing hospital′s medical quality management process and decision-making mode.
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Objective:To analyze the hospitalization expenses of elderly patients with hypertension and its influencing factors, so as to provide reference for optimizing the medical service management of elderly patients with hypertension.Methods:Medical record home page data of all hypertension inpatients of elderly patients at two tertiary general hospitals in Jiangsu province from 2017 to 2020 were retrieved. These data were used to analyze the basic information, hospitalization expenses and their influencing factors. Descriptive analysis was used for all data, variance analysis was used for one-way analysis, and multiple linear regression was used for multivariate analysis.Results:A total of 20 596 elderly inpatients with hypertension were included in this study. The number of patients was increased from 1 476 in 2017 to 10 771 in 2020. Among them, the number of inpatients with≥2 diseases increased from 1 105(74.86%) to 10 564(98.08%); From 2017 to 2020, the average hospitalization expenses of elderly inpatients with hypertension were 11 500 yuan, 13 600 yuan, 13 800 yuan and 14 100 yuan respectively, increasing year by year; Gender, age, number of hospitalizations, hospitalization days and number of diseases were the influencing factors of hospitalization expenses( P<0.05), and the hospitalization expenses increased with the increase of hospitalization days, number of diseases and age. Conclusions:The number of elderly patients with hypertension, the incidence of comorbidity, and the average hospitalization cost in tertiary hospitals in Jiangsu province were increasing year by year. There were many factors affecting the hospitalization cost. The author suggested that the treatment of elderly patients with hypertension should be shifted to prevention, so as to reduce the economic burden of disease and improve their quality of life.
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Objective: To research lung infection related factors in proximal femoral fractures inpatient according to thehome page of its medical cases. Methods: The medical home pages of entire proximal femoral fracture cases from January1, 2003 to December 31 was extracted from the database of Chinese Academy of Traditional Chinese Medicine WangjingHospital. s medical information system. The information is verified and cleaned to build an Excel database with allavailable information. Logistic multivariate binary analysis was used to identify the related risk factors of pulmonaryinfection. The age of patients, the admission duration, chronic respiratory disease and using of traditional Chinese herbsare all closely related to pulmonary infection. Results: Logistic multivariate binary review found that the factors affectinglung infection were age, length of hospitalization days, chronic respiratory diseases, and whether to use of Chinese herbalmedicine. Conclusion: Under the premise conditions, patients with proximal femoral fractures should be allow to shortenthe length of time or early surgery. For elderly patients, and patients with chronic respiratory diseases, measures shouldbe taken as early as possible to prevent the onset of lung infection. The use of Chinese herbal medicine for prevention andtreatment of pulmonary infection is recommended, namely the combination of Traditional Chinese Medicine and westernmedicine in prevention and treatment of pulmonary infection.
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Objective To study the characteristics of the diseases spectrum in hospitalized children.Methods The items of main diagnosis,gender,age,etc.in the inpatients medical records home page data aged 0? 12 years old in second-level and above hospitals of Chongqing City during 2015 were performed the disease spectrum sequence and constituent ratio analysis for deeply digging the relation between the disease change trend with the age and sex.Results The top 5 main system diseases affecting children's health were respiratory system diseases (male 43.84％,female 45.74％),some conditions originated from prenatal period (male 12.01 ％,female 13.87 ％),infectious diseases and parasites diseases (male 9.48 ％,female 9.88 ％),digestive system diseases (male 9.09 ％,female 6.95 ％),injury,poisoning and some other consequences of external causes(male 6.86 ％,female 5.27 ％).Respiratory system diseases always ranked the first place,the sexual difference among various system disease was unobvious,the sequence of injury,poisoning and some other consequence of external causes was increased with the age increasing;in the ranking of respiratory system diseases,pneumonia(38.73 ％),acute bronchitis(17.29 ％) and acute tonsillitis(13.83％) were the top 3 diseases affecting children's health.Conclusion Respiratory system diseases are the concerned key point for children health promotion.The health and epidemic prevention departments should provide effective methods and measures for preventing respiratory system diseases in children.Furthermore,the targeted prevention and treatment measures should be proposed aiming at the difference of disease sequence in different age groups.
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Objective Analyze the causes of ambiguous medical records to provide evidence for the DRGs.Methods 268 Ambiguous medical records were selected from 17 751 surgery medical records between 2010 and 2014 based on major diagnosis and major surgery.The single factor Chi-square test was used to study the influence of various inpatient characteristics on the occurrence of ambiguous medical records, and those significant variables were given assignment to find influencing factors of ambiguous medical records by using logistic regression analysis.Results Ambiguous medical records account for 1.51％ of all surgical medical records.Logistic regression analysis results show that such risk factors as discharging from internal medicine, death of patient, transfer between departments, elderly, long time of hospitalization, and tumor patients, as contributing to ambiguous medical records.All the results are statistically significant (P＜0.05), including discharging from which departments (OR=6.595, 95％CI..5.043 ～ 8.625), death of patient (OR=3.787, 95％ CI: 2.611 ～ 5.492) and transfer between departments (OR =2.746, 95％ CI: 2.061 ～ 3.659), which rank important risk factors for ambiguous medical records.Conclusion Analysis of the causes of ambiguous medical records provides important evidences for the hospital to improve its medical record quality management.
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Collection and quality control of inpatient medical record home page information are key to the study and use of DRGs.The paper covered the sampling methods, inspection items, inspection methods, data assembly methods, and data reporting quality scoring methods of Beijing authorities on the hospitals in the city.Also introduced were the inspection results of the city in 2014, which prove a satisfactory outcome in the end.
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This article discussed the development, challenge and solution for the front page of inpatient medical record based on DRGs (diagnosis related groups).It will facilitate the stakeholders' understanding, unifying the standard of data, building quality control system, improving the quality of the front page of medical record.Thus, the information in the front page will contribute to the scientific evaluation of health service ability and quality for hospital.
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In this article, we describe the use of the home page of “Digestion” for self-learning and review by third-year students of our medical school. A home page should provide an overview of the site for easy navigation and present a briefexplanation of important or difficult terms. The page should minimize previously unseen information but should use multiple colors and animation to keep the student's attention. We propose that a nationwide collection of educational materials be established to avoid copyright problems.