Preliminary study on the block-based charging model for neonatal medication in pharmacy intravenous admixture service / 中华医院管理杂志

Objective:To explore the block-based charging method for centralized dispensing of neonatal drugs in pharmacy intravenous admixture service (PIVAS), analyze its effect on drug savings and inpatient drug cost, so as to provide the reference for the appropriate charging method of neonatal drugs.Methods:According to the balance quantity and amount of neonatal intravenous drugs that were centrally allocated by the PIVAS of our hospital, refer to the doctor′s orders, the dosage per dose as well as the number of patients per dose were analyzed, then the drug types and plans for block-based charging were formulated. Before and after the implementation of the plan, the monthly average drug balance quantity and amount, the average number of drug charges for the neonates, the average daily drug cost, and the adverse events of related drugs were used as the indicators to be investigated to clarify the implementation effect of the block-based charging mothod.Results:Fourteen medicines were charged by block-based, including 4 antibiotics, 2 ordinary infusion preparations, and 8 parenteral nutrition solution preparations. The monthly average drug balance quantity was reduced from 5 047±541 to 1 856±225, and the monthly average balance amount was reduced from 65 811±10 265 yuan to 20 659±6 002 yuan. The average drug dosage for children in the trial drug was significantly reduced with a decrease range of 39.2% to 90.1%. Both the inpatient daily drug cost of neonatus and the daily average antibacterial drug cost was decreased. During the centralized dispensing of neonatal drugs, no related adverse drug events occurred.Conclusions:The block-based charging method of centralized drug distribution can improve the utilization rate of drugs, reduce drug waste, reduce the cost of inpatient medicines the financial burden on children′s families, which is worthy of further promotion and implementation.

Practice of refined cost management of medical service charging items based on hospital intelligent agent / 中华医院管理杂志

In recent years, public hospitals have been facing pressure from the reform of medical insurance payment methods. It is urgent to strengthen the operation and management of public hospitals. In June 2022, a tertiary public hospital utilized hospital intelligent agents to carry out refined cost management practices for medical service charging projects, sorted out medical service charging projects, designed management paths, and calculated project costs. The hospital conducted refined management on the cost of medical service charging items from three control dimensions of project unit cost with manpower, equipment and consumables, and two comparative directions with horizontal and vertical. The refined cost management practice not only pointted out the direction for global refinement cost control within the hospital, but also reduced the proportion of hospital consumption, which provided reference for improving the level of refined operation and management of public hospital hospitals.

Impact on the Distribution Grid Due to the Introduction of Electric Vehicles on Fernando de Noronha Island (Brazil)

Abstract Increasing global temperatures over the past years have become a worry. To mitigate this, countries have set out to decrease their greenhouse gas emissions soon. A major contributor to these emissions has been the transport sector. Electric mobility has appeared as an opportunity to decarbonize this sector. With this in mind, Fernando de Noronha Island, a UNESCO World Heritage Site, has determined to ban all fossil fuel vehicles by 2030. Understanding the impact electric vehicles can have on the island's distribution grid is fundamental to achieving this goal. To determine these impacts, electrical vehicle chargers were added to the model of the island's power system in GridLad-D. Apart from these chargers, the impact of adding an extra carport charger fitted with solar panels was also determined. In total, six different charging scenarios were simulated, with each varying the period in which vehicle charging was allowed to take place. The impacts were determined for the day, afternoon, and night charging, with and without the presence of a carport. The parameters measured include system power demand, voltage, and total losses. From the results, it was possible to determine the charging strategy that causes the least and most impact on the system's distribution grid.

Establishment and Application of Dispensing ，Charging and Reimbursement Mode by Dose of Trastuzumab for Injection / 中国药房

OBJECTIVE：To standardize and optim ize the clinical use of Trastuzumab for injection ，and to provide reference for rational use of drugs in the patients. METHODS ：The pharmacy intravenous admixture service （PIVAS）in our hospital took the lead in communication and coordination with financial ，information，medical insurance departments as well as clinicians and nurses，to set up dispensing ，charging and reimbursement mode by dose of trastuzumab. Under that ，doctors could give orders according to the clinical dosage of patients ；PIVAS dispenses drugs according to the actual dose ；the drugs were shared among patients；the charge and reimbursement of drugs are carried out according to the actual dose of patients. At the same time ，the questionnaire survey was conducted among 60 patients about the medical experience and cost savings before and after the implementation of the mode . RESULTS ：The questionnaire survey showed that in terms of solving the potential safety problems of trastuzumab and the inconvenience of patients ’medical treatment ，the solution rate of the mode was 100％；in terms of improving patients’feeling of seeking medical treatment and helping treatment ，the improvement rate was 100％；in terms of saving patients ’ treatment costs ，most（80％）of the patients thought that it could save less than 500 yuan each time ，and rest of the patients thought that it could save more than 500 yuan each time. CONCLUSIONS ：The mode of dispensing ，charging and reimbursement of Trastuzumab for injection in our hospital has solved the problems of drug waste ，occupational injury and inconvenient preservation in clinical use ，and has played a good role in drug safety ，cost saving and patient convenience.

Design of Cardiac Pacemaker Based on Low Power MCU / 中国医疗器械杂志

In order to improve the accuracy of the pacemaker's parameter adjustment and to avoid the surgical replacement of the pacemaker when the battery is exhausted, this paper designs a novel single-chamber pacemaker circuit based on low-power single-chip microcomputer. The circuit uses digital control to accurately control the amplitude, pulse width and frequency of the pacing pulse. The circuit is also designed with wireless charging function, and wireless communication with the programmer can wirelessly charge the pacemaker and know the charging information in real time. Wireless charging function can reduce the number of times the patient replaces the pacemaker or even completely avoid it.

Research Progress of External Defibrillation Technique and Its Application / 中国医疗器械杂志

Defibrillator is an important first aid equipment with people attach importance to life and health in today, people pay more attention to the development of defibrillator. This paper reviews the development history of the defibrillator, gives a brief introduction to the structure and working principle of the defibrillator, and then analyzes the key technology of defibrillator, compares the mainstream products on the market and prospects the development trend of defibrillator.

Impact and Thought of the Elimination of Preventive Medical Examination and Other Administrative Fees / 中国卫生经济

It clearly defined 41 administrative fees would be canceled or suspend in China since April 1,2017.Of which,there were 3 projects involved in the center for disease control(CDC).Canceling these three charges brought impact on enterprises,individuals and CDCs.It suggested that the related department should pay attention to it,establish and improve these three measures to eliminate fees,guide and encourage CDCs to provide professional services to outside world,which would promote the healthy development of the real economy and CDCs.

Discussion on Flexible Charging Mechanism for Medical Treatment in Public Hospitals / 中国卫生经济

With the deepening reform of health care system,the value of technical treatment was becoming more and more important.Based on the principle of "optimizing the price" structure,referring to Marxist theory of market value and particularity of medical service,it explored the characteristics of medical service products,considered the differences of medical quality,and put forward the opinions on flexible charging mechanism,which designed to conform to the national spirit of the reform and to improve the medical charging mechanism.It finally proposed suggestions on improving medical insurance policy and establishing scientific evaluation system.

Investigation on monitor equipment utilization rate based on data analysis of charging items / 医疗卫生装备

Objective To analyze statistically the data on the charging items in some hospital to determine monitor equipment utilization rate in the nursing unit,so as to provide data support for proposing monitor equipment allocation scheme in the hospital.Methods Totally 571 pieces of monitor equipment were used as the subjects,and the records on the charging items in HIS database were extracted from January 1st 2016 to June 30th 2017.The monitor equipment utilization rates,that is,the daily hours of operation,in the nursing units were calculated,and then were compared and analyzed.Results The allocation of the monitor equipment proved reasonable although pre-purchase demonstration in some nursing units had no enough data support.Conclusion It's feasible to instruct equipment allocation with the utilization rate based on charging items analysis. [Chinese Medical Equipment Journal,2018,39(5):78-80]

Improving purchasing management of hospital aseptic high-value consumables / 医疗卫生装备

Objective To standardize the purchasing procedure of aseptic high-value consumables to benefit the hospital and patient.Methods The present situation of aseptic high-value consumables management was introduced,the purchasing procedure of them was analyzed,and some countermeasures were put forward aiming at the problems in the purchasing procedure.Results Some suggestions were brought out including normalizing the access qualification management and purchase procedure,executing barcode management to improve its tractability,training administrative staffs to promote refined management and completing aseptic high-value consumables management system.Conclusion The purchasing procedure of aseptic high-value consumables can be improved from the aspects of management system,information management,personnel training and etc.

Improving purchasing management of hospital aseptic high-value consumables / 医疗卫生装备

Objective To standardize the purchasing procedure of aseptic high-value consumables to benefit the hospital and patient.Methods The present situation of aseptic high-value consumables management was introduced,the purchasing procedure of them was analyzed,and some countermeasures were put forward aiming at the problems in the purchasing procedure.Results Some suggestions were brought out including normalizing the access qualification management and purchase procedure,executing barcode management to improve its tractability,training administrative staffs to promote refined management and completing aseptic high-value consumables management system.Conclusion The purchasing procedure of aseptic high-value consumables can be improved from the aspects of management system,information management,personnel training and etc.

Design and implementation of medical insurance little catalogue warning function in HIS / 医疗卫生装备

Objective To execute medical insurance little catalogue warning in HIS to prevent the doctor from providing medical service beyond medical insurance coverage.Methods Medical insurance little catalogue was established to regulate the boundaries for medical services available for different patients,and corresponding software was embedded into the medical workstation to call medical insurance little catalogue so as to realize warning for the boundaries and reimbursement rate.Results The function decreased the doctor's workload and the patient's cost while enhanced the doctor's efficiency and the doctor-patient relationship.Conclusion The function is easy to realize with high feasibility,and thus is worthy promoting practically.

Research on the design of Web Service based system integration technology in hospital charging management system / 中国医学装备

Objective:To realize the hospital charging interface integration and sharing by using Web Service based system integration technology for resolving the problems the length of the shortcomings of low efficiency of payment and settlement in hospital.Methods: Using a service-oriented (SOA) open and loose coupling architecture, all agreements provide application services for XML-based standards. It can realize the integration of charging and making price and payment accurately, conveniently and quickly.Results: The integration platform based on Web service can apply complex heterogeneous system, support custom adapter connection, reduce the coupling between the module and improve the versatility of system data.Conclusion: The system is safe and reliable, and has a good sharing compatibility features. It can be able to upgrade and functions expansion. The application of integration technology will greatly improve the medical staff's working efficiency, provide convenience of patients, and reduce the hospital operation maintenance cost.

Psychological stress analysis and countermeasures of a university graduate student after the full implementation of the charging system / 中华医学教育探索杂志

Objective To investigate the graduate students' mental pressure after the full im-plementation of the charging system and explore effective countermeasures of alleviating the psycho-logical pressure. Methods 413 full-time graduate students of Grade 2014 were randomly selected in a university of Shandong province. The graduate students' psychological pressure scale and self-designed questionnaire survey were used. The data were analyzed using SPSS 17.0 software, statistical descrip-tion of the survey data, independent sample t test, ANOVA. Results ①The psychological pressure of full-time graduate students at their own expense was in themedium pressure level; ②The economic pressure and academic pressure of the male graduate students were higher than those of the female graduate students (P=0.000,P=0.042), the rural economic pressures were greater than urban students graduate students graduate students (P=0.000); Professional graduate economic pressures were greater than academic graduate students (P=0.027);There is difference in the pressure of interpersonal commu-nication among different majors (P=0.016); ③78.75% (315/400) of the graduate students tuition fees, living expenses were mainly from their parents and the national and school awards; ④The percentage of those who completely agreed with the following view: full charge than at public expense is more advantageous to graduate education, comprehensive charge is advantageous to the education career development and comprehensive charge embodies the fairness of education was 84.75% (339/400), 71.25% (285/400) and 68.00% (272/400). Conclusion The full-time graduate students at their own expense have a more rational understanding of the charging policy; economic and academic pressures are the two outstanding pressure sources of the graduate students at the present stage. Graduate should improve their ability to cope with stress, and government and schools should take various measures to help students relieve stress.

The Implementation and Generalization of Matching between Computerized Physician Order Entry and Charging Items / 中国卫生经济

Objective: To investigate effective matching between computerized physician order entry and charging items in the hospital. Methods: Standard data of computerized physician order has been established, in which physician order items and charging items have been matched. It has effectively solved the problems in the process of computerized physician order entry. Results and Conclusion: The implementation of matching computerized physician and costs has effectively controlled the errors and missing of costs, which released the complaint of patients and received the good reputation and welcome, the compliance of doctors using computerized physician order entry has been obviously improved, meanwhile, it has provided new application experiences for implementing the following charging of national medical services prices in hospitals.

Adjustment and Experience of the Pre-hospital Emergency Charging Method / 中国卫生经济

Pre-hospital care is an important part of the health care system. Nowadays , there are many defects in the pre-hospital emergency charging method in China. It analyzes the effectiveness and impact of adjustment the charging method. There will be a preliminary study of hospital first aid fees adjustment of changing the current method from front-line staff receiving cash to entrusting the local hospital, charge with real-time settlement of health insurance for the convenience of the patient and reduce the workload of health insurance agencies, make financial emergency center management more standardized and efficient.

Application of resonance charging circuit to electro-hydraulic impulse apparatus for waste water treatment / 医疗卫生装备

The application of resonance charging circuit to electro-hydraulic impulse apparatus for treating wastewater is introduced in this paper.The circuit permits the graduating increase of current without influence from time.The unique change of voltage on capacitor is favorable for the recovery of electric strength of electro-hydraulic impulse apparatus.The theory and design method of resonance charging circuit are provided.

Factors Influencing the Intention of Admission into a Charged Nursing Home for the Elderly / 예방의학회지

OBJECTIVES: To gather information about the factors which influence the interest and intention of admission into charging nursing homes for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. METHODS: A face-to-face interview survey was carried out with 328(men 159, women 169) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. microgram/g RESULTS: The mean age and years of education of the study population was 67.8 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children in the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission(3.07+/-1.39) into a CNH was lower than that of interest(3.22+/-1.33)(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons(beta=0.107), lower level of activity in daily life(beta=0.447), and longer years of education(beta=0.447) with 32.7% of R2. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred "elderly hospital" or "elderly health center" to CNH. CONCLUSIONS: Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, through CNH.

Research on Issues of Fee Charging in Informatized Hospital / 医疗卫生装备

Objective To discuss the issues encountered in fee charging,mainly the automatic recognition of charging agent.Methods Based on No.1 Military Medical Project,the present status of fee charging in the hospital was analyzed.The single disease payment system and charging system adapting to all kinds of medical insurance policies were designed,whose payment decomposition flow was introduced.Results The payment decomposition flow,compatible with all medical payment regulations in China,was applied in the outpatient department charging system of General Hospital of PLA.Conclusion The payment decomposition flow,is gifted with universal validity for complicated charging conditions in China.

Outpatient Emergency Response System / 医疗卫生装备

Objective To design an emergency response charging system for normal running of the hospital outpatient registering and charging information system when a serious failure occurs in hospital information system(HIS).Methods An independent emergency response line and an emergency response database server were set,modifying the original system to a new one with auto-reminding of switching function,and creating an interface to the emergency response system to save the basic data into the emergency response database.Through the emergency response controlling program,data were downloaded in time,and the increased operation data were sent to the main server after the problem was solved.Results The workstations could be rapidly switched to emergency state to keep normal outpatient registering and charging operation.Conclusion The method can fulfill the requirements of a hospital with a continuous outpatient registering and charging system and a complete database.It makes the information system of our hospital more efficient and credible.[Chinese Medical Equipment Journal,2008,29(2):48-49]