RESUMO
Objective:To clarify the immediate administration issues faced by hospitals in China in their implementing the diagnosis-related groups(DRG) payment as a reference for the reform.Methods:By using " DRG" , " hospital" , and " administration" as search terms, the authors systematically retrieved literature data from CNKI, Wanfang Data, PubMed, Embase and Web of Science from the establishment of the database to April 30, 2022. Based on such data, administration issues pertaining to the reform process were extracted and built into a co-word matrix. The social network analysis was used to measure the network density and network centrality of these administration issues. The entropy weight-technique for order preference by similarity to ideal solution(TOPSIS) method was used to comprehensively evaluate the indicator results of network centrality indicators.Results:Of the 32 literatures included, 25 issues in hospital administration during the reform of DRG payment method were extracted. As shown in the social network analysis, the network density was 0.717, while the top issues ranking by degree centrality, betweenness centrality and closeness centrality, were inappropriate main diagnosis selection(68, 8.842, 25), imperfect DRG grouping device setting(54, 8.361, 26), imprecise recording of other disease diagnosis and surgical operations(60, 6.885, 26), and poor professional knowledge of medical record managers(54, 6.991, 25). The top four issues as shown in the entropy weight-TOPSIS analysis were inappropriate main diagnosis selection(1.000), imperfect DRG grouping device setting(0.871), imprecise recording of other disease diagnosis and surgical operations(0.803), and poor professional knowledge of medical record managers(0.787).Conclusions:Fill-out errors of medical record homepage, imperfect formulation of DRG grouping plans and poor professional knowledge of medical record manage team, rank the tope administration issues of high priority in implementing the reform of DRG payment methods. It is imperative to strengthen quality control of the medical record homepages, to scientifically formulate the DRG grouping plans, and to improve the construction of medical records professional team, in an effort to the further smooth and orderly implementation of the reform.
RESUMO
Objective To discuss a method to show the structure of small mammary gland well by computed radiography(CR).Methods By analyzing 150 radiographs of mammary glands,the results showed that the mammary structure showed well whether or not was depended on the size of mammary gland.Using 24 steps aluminum ladder mimiced the small mammary gland and radiography was taken with various parameters and different imaging plate(IP) shading ways,then processed and printed,after that it was measured by density instrument.Results The display of grey scale of 24 steps aluminum ladder was improved if shading 10~15 mm margin of the IP by collimator or shading the central by a square cuprum plate with 22 mm length and 0.2 mm thickness.Radiography of small mammary gland by the same way was performed and the mammary structure was also showed well.Conclusion Shading the exposing areas properly by collimator or cuprum plate during CR can apparently improve the display of small mammary structure.