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Objective To describe and analyze the current situation of the four same type of departments in an hospital in order to provide a reference for the construction of"the most cost-effective medical care".Methods The CN-DRG were used to automatically group and compare the medical capacity and inpatient service efficiency of the hospital department groups,and in the refined analysis,one DRG disease group of in situ cancer and non-malignant disease loss uterine surgery and single species uterine fibroid was included,and the Kruskal-Wallis H test was used to further compare the differences in length of stay and various costs.Results It included a total of 22630 patients,whose weights varied from a maximum of 3948.62 in diagnostic group 1 to a minimum of 133.55 in diagnostic group 11.The cost consumption indexes ranged from a minimum of 0.89 in diagnostic group 5 to a maximum of 1.04 in diagnostic group 2,while the time consumption indexes ranged from a minimum of 0.48 in diagnostic group 11 to a maximum of 0.81 in diagnostic group 5.When comparing the diagnostic groups,there were statistically significant differences(P＜0.05)in hospitalization days,total cost,diagnostic cost,therapeutic cost,and cost of supplies.Specifically,when comparing the diagnostic and treatment groups within departments,the differences in hospitalization days and all costs were statistically significant(P＜0.05)in departments 1 and 2,the differences in diagnostic cost,therapeutic cost,and cost of supplies were statistically significant(P＜0.05)in department 3.Conclusion There exists a notable disparity in the extent to which each diagnostic and treatment group contributes to the hospital's service capacity and cost variability.Consequently,it is necessary to reasonably evaluate the length of hospital stay and medical cost of patients to achieve the highest cost-effective medical treatment.
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Objective:To establish an evaluation index system for training effect of order-oriented clinical medical students in Xinjiang by employers, so as to lay a foundation for training effect evaluation.Methods:On the basis of questionnaires and interviews with the training requirements of employers, Delphi method was used to determine the index system and weight.Results:The training requirements of employing units for the ability of free and directional medical students in autonomous regions were in turn competent for work, knowledge and practical ability, and good moral quality. The cultivation requirements for students' personal qualities of free and directional medical students were good interpersonal communication and moral quality. After three rounds of Delphi expert consultation, the evaluation index system was established, and three dimensions (knowledge, professional ability, professional ethics literacy), nine secondary indicators and 33 tertiary indicators were screened out, and the weights were determined.Conclusion:The evaluation index of training effect of directional clinical medical students established by Delphi expert consultation method needs further validation. Through the follow-up empirical application in directional clinical students, the evaluation index system can be constantly improved, which can also provide reference for the establishment of evaluation index system for other positions.
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Objective To research the reliability and validity of the N-QOL Chinese version system.Methods A total of 260 nocturia patients were surveyed by the Chinese version of N-QOL and the reliability and validity of the Chinese version of N-QOL were assessed.Results Cronbach's α of the total questionnaire and two dimensions were 0.899,0.672 and 0.799,respectively.The split-half reliability was 0.828 and re-test reliability was 0.796.The correlation coefficients of scores of the items with its subordinate dimensionality were 0.595～0.854,and those with the total scores were 0.578～0.754.Two common factors were found through exploratory factor analysis,which explained the percent of 57.20％ rotation sums of squared loadings.Conclusions The reliability and validity of the Chinese version of N-QOL were good,so it could be used to evaluate the life quality of nocturia patients.
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Objective To compare the efficacy of add-on adefovir dipivoxil (ADV) therapy and switch-to entecavir (ETV) monotherapy in chronic hepatitis B (CHB) patients with suboptimal response to lamivudine (LAM).Methods A prospective study was performed in 120 CHB patients from Zhuji People' s Hospital and the First Affiliated Hospital of Zhejiang University School of Medicine during June 2010 and June 2011.All patients previously received more than 24 weeks LAM treatment,but HBV DNA was still positive.Patients were randomized assigned to two groups:60 patients received add-on ADV therapy and another 60 switched to ETV monotherapy.Both groups were treated for 48 weeks.Liver and kidney function,alpha-fetal protein (AFP),HBV serum markers,HBV DNA and prothrombin time (PT) were examined,and ultrasonography or CT scan of liver was performed every 1-3 months.x2 test was used to compare the HBV DNA negative rates,HBeAg seroconversion rates,resistance rates and adverse reaction at week 48 between two groups.Results Thirty-three out of 38 patients (86.8％) with baseline HBV DNA 103-105 copies/mL became HBV DNA negative after add-on ADV treatment for 48 weeks,twenty-seven out of 39 patients (69.2％) with baseline HBV DNA 103-105 copies/ml became HBV DNA negative after switch-to ETV treatment.There was a statistical difference between two groups (x2 =4.578,P ＜ 0.05).Sixteen out of 22 patients (72.7％) with baseline HBV DNA ＞ 105 copies/mL became HBV DNA negative after add-on ADV treatment for 48 weeks,while only 52.4％ (11/21) patients achieved HBV DNA negative in the switch-to ETV group.There was also a statistical difference between two groups (x2 =4.865,P ＜0.05).None of patients in add-on group developed virological breakthrough and resistance,while 5 patients in switch-to ETV group developed virogical breakthrough and 3 patients developed genetic mutation.Among them,rtM204V + rtL180M + rtS202G mutation was detected in 2 patients,and rtM204V + rtL180M +rtT184A mutation was detected in 1 patient; all mutations happened in the baseline HBV DNA ＞ 105 copies/mL group.Conclusion The add-on ADV therapy is better in viral inhibition than switch-to ETV therapy for CHB patients with suboptimal response to LAM,and it can reduce the occurrence of drug resistance.
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Death education that began in the western countries,starting with the rise of thanatolography,is the important content of modern education which can not be ignored.This paper summarized the definition,content,subjects and course of death education by reviewing the literatures,aiming to provide some reference for the death education at present in our country.
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ObjectiveTo explore the scientific and effective management of subsidization for students in poverty and to build a rational, scientific-supporting system of poor students. MethodsAnalyzing the data of the poverty status and funding, of poor students in 2006-2009 in an independent Institute ResultsAmong all the means of subsidization for students in poverty, study aid covers most and the number of students who get this aid is increasing while there are fewer national scholarships and living subsidies. ConclusionSupporting system of poor students is not perfect enough, and institutions of higher learning should find the practical way to help our poor students complete their studies successfully.
