Evaluation of the outpatients risk pooling of capitation payment under basic medical insurance in China / 中华医院管理杂志

An analysis is made according to policy documents of localities on capitation payment, and by means of literature review and the analysis framework of the World Bank,this paper reviewed studied the following:definition of service package,per capita rate,designated institutions,design of financial regulations,and service supervision.Given the attempts made at localities,most of the schemes are incomplete in design,and defective in capitation measurement methods and dynamic adjustment mechanisms.The authors recommend a systematic design of the capitation payment scheme for better outcomes.

Analysis on the premium standard for minors of urban residents with basic medical insurance in Tangshan city / 中华医院管理杂志

Objective To analyze the factors for willingness to pay(WTP)in different quantiles and to provide evidence for formulating premium of minors covered by Urban Residents'Basic Medical Insurance.Methods In a field survey,the study adopted the contingent valuation method and quantile regression to measure and analyze the WTP.Results The influencing factors and degree of influence varied in different quantiles.Annual household income was significant in 10 of 11 quantiles with the maximum marginal effect of 350 yuan.Whether the insured comes from a village in a city affects 8 of the 11 quantiles whereas gender,age and health conditions of minors have minor effect on willingness to pay.Conclusion The premium standard should be raised from 40 yuan per person per year to 100 yuan.Minors can be categorized into subgroups and be set with distinct premiums in terms of the significant influencing factors and its influence degree.

Imaging Study of Acromioclavicular Joint Injury / 实用放射学杂志

Objective To study the imaging findings of the normal acromioclavicular joint and acromioclavicular dislocation.Methods CR films of normal shoulder in 68 cases and normal chest in 400 cases were collected.The distances of the acromioclavicular joint were measured,and the inferior cortex line of the acromioclavicular joint was observed on CR.MRI in 30 cases with normal shoulder,24 cases with acromioclavicular dislocation and 7 cases with shoulder impingement syndrome were also presented.Results The normal distance of the acromioclavicular joint was (3.36±0.44) mm.There was an arch line on the inferior cortex of the acromioclavicular joint for normal subjects.According to the Rockwood classification,acromioclavicular dislocation included type Ⅰ in 7/24 cases,type Ⅱ in 5/24 cases and type Ⅲ in 12 cases.The distances of the acromioclavicular joint were increased(＞4.3 mm) in type Ⅱ and type Ⅲ,and the inferior cortex lines of the acromioclavicular joint were not continual in type Ⅲ.MR imaging showed that the intra-articular fibrocartilaginous disk,the capsular and acromioclavicular ligament structure were ruptured in type Ⅱ,and coracoclavicular ligament torn in type Ⅲ.Conclusion The distance and the inferior cortex line of the acromioclavicular joint are of important value in diagnosis and classification of acromioclavicular dislocation.MRI is the most significant method in diagnosis of acromioclavicular dislocation.

Imaging Analysis of Coracoclavicular Ligament / 实用放射学杂志

Objective To study the imaging finding of the coracoclavicular ligament.Methods 400 cases of normal chest films 200 men and 200 women were collected.The presented rates of pseudoarthrosis of the coracoclavicular joints and the clavicular tuberosities which are the coracoclavicular ligament attachment were evaluated and the distances between the clavicle and coracoid process interval were measured.There were 30 cases of normal shoulder MRI,the displaying rate of coracoclavicular ligament, the length and width of the coracoclavicular ligament were measured at MR imaging.8 case with type Ⅱ(n=5) and type Ⅲ(n=3)of acromioclavicular injury were also included in this study.Results Among 400 cases(800 sides),one pseudoarthrosis(0.25%)and 198 clavicular tuberosities(24.8%)were found.The normal distance between the clavicle and coracoid process interval was (6.92±3.16)mm.On MRI study,30 cases of coracoclavicular ligament were all showed on oblique coronal slices. The acromioclavicular ligament and coracoclavicular ligament tear were found in type Ⅱ and type Ⅲ,of acromioclavicular injury respectively on MRI.The length and width of conoid ligament were(11.48±1.43) mm and (4.82±1.21) mm respectively,and the length and width of trapezoid ligament were(9.09±0.84) mm and (5.10±0.87) mm respectively.Conclusion The normal anatomic measurement standards of the coracoclavicular ligament are established on X-ray and MRI,which is important for diagnosis of coracoclavicular ligament lesions.The coracoclavicular ligament torn is showed in typeⅢ of acromioclavicular dislocation.