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Objective:Cost accounting for its diagnosis items based on virtual standardized clinical chemistry laboratory.Methods:Relevant data of clinical chemistry laboratories from January to June 2019 were extracted from the laboratory information systems of 10 hospitals in Shanghai, and three health economic experts and the directors of their laboratory departments were interviewed in this regard.On such basis, a virtual standardized clinical chemistry laboratory was constructed. The project cost of the virtual laboratory was calculated from the aspects of supplies exhaust, labor and others. The routine clinical chemistry diagnosis items were clustered according to the principle of laboratory methods, and the cost differences of items in the same cluster were compared using paired t test. Results:The cost of rate method and dry chemical method in testing alanine aminotransferase was 5.12 and 11.63 respectively, and that of immune turbidimetry and immune scattering turbidimetry method in testing immunoglobulin G was 20.00 and 22.26 respectively. Cluster analysis was conducted on 214 routine clinical biochemical diagnostic items, of which 202 items were classified into 42 clusters. The average of clinical chemistry items accounted for 91.7%(4 493/4 900)of the total per day. Based on enzymology, the calculation costs of alanine aminotransferase(rate method), aspartate aminotransferase(rate method), cholesterol(enzyme method)and uric acid(enzyme method)was 5.12, 5.10, 5.24 and 5.14 respectively, presenting no statistical difference( P>0.05). Conclusions:Research on the cost accounting method of clinical chemistry laboratory diagnosis items constructed includes labor cost, reflects the technical labor value of medical staff. Cost accounting based on project clustering can provide references for medical service pricing and financial management of hospitals.
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BackgroundCOVID-19, an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), swept through China in 2019-2020, with over 80,000 confirmed cases reported by end of March 2020. This study estimates the economic burden of COVID-19 in 31 provincial-level administrative regions in China between January and March 2020. MethodsThe healthcare and societal cost of COVID-19 was estimated using bottom-up approach. The main cost components included identification, diagnosis and treatment of COVID-19, compulsory quarantine and productivity losses for all affected residents in China during the study period. Input data were obtained from government reports, clinical guidelines, and other published literature. The primary outcomes were total health and societal costs. Costs were reported in both RMB and USD (2019 value). OutcomesThe total estimated healthcare and societal cost associated with the outbreak is 4.26 billion RMB (0.62 billion USD) and 2,647 billion RMB (383 billion USD), respectively. The main components of routine healthcare costs are inpatient care (41.0%) and medicines (30.9%). The main component of societal costs is productivity losses (99.8%). Hubei province incurred the highest healthcare cost (83.2%) whilst Guangdong province incurred the highest societal cost (14.6%). InterpretationThis review highlights a large economic burden of the recent COVID-19 outbreak in China. These findings will aid policy makers in making informed decisions about prevention and control measures for COVID-19. FundingThe author(s) received no financial support for the research, authorship, and/or publication of this article. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSWe searched MEDLINE, EMBASE and Global Health on April 4th, 2020, using key words and medical subject headings including ("coronavirus" OR "SARS-CoV-2" OR "COVID-19") AND ("cost" OR "Economics" OR "resource" OR "productivity loss"). No restrictions on language or publication dates were applied. Our search did not identify any studies which reported the cost of COVID-19. Cost of severe acute respiratory syndrome (SARS), which is an infectious disease caused by another type of coronavirus - the SARS coronavirus - has been assessed by seven studies. The reported healthcare cost of managing SARS per case ranged from $4,151 USD in mainland China to $362,700 USD in Canada. The total healthcare cost and societal cost of the 2013 SARS outbreak in China took up 0.20% and 1.05% of Chinas GDP, respectively. The global cost of SARS was estimated to be US $40 billion, the majority of which was caused by reduced consumer demand for goods and services due to fear associated with SARS. Two studies reported a reduction in total healthcare resource use during the peak of the SARS epidemic in Taiwan, due to peoples fears of SARS. Added value of this studyTo our knowledge, this study presents the first cost-of-illness study of COVID-19. The main cost components considered include identification, diagnosis, treatment and follow-up of COVID-19, compulsory quarantine and productivity loss for all affected residents in China during the study period. The total societal cost of COVID-19 was estimated to be 383 billion US dollars, which is equivalent to 2.7% of Chinas gross domestic product (GDP) in 2019. Healthcare costs accounted for only 0.2% of societal cost for COVID-19, while productivity losses accounted for 99.8%. The majority of productivity losses (99.7%) were attributable to people who were not considered to have had COVID-19 but experienced lost working time due to the government policies in controlling population movement. Implications of all the available evidenceOur findings suggest that the cost of COVID-19 is much larger than the cost of SARS or MERS. Productivity losses far exceeded the healthcare cost of managing COVID-19 patients. Future research is urgently required on the cost-effectiveness of different control measures of COVID-19 (e.g. policies regarding reducing working days, travel restrictions, quarantine and isolation), and development of interventions which can help to maintain the productivity of healthy population during the pandemic.
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The establishment of a scientific and reasonable medical service price dynamic adjustment mechanism is the focus of the current reform of public hospitals in China.This paper analyzed the medical service price reform history in the United States, the price dynamic adjustment of the main body and its process, as well as the development trend of medical service price reform.At the same time, the existing problems of medical service price adjustment in China were briefly analyzed, and put forward 1) the establishment of multi-participant dynamic adjustment model;2) the establishment of the medical service standard value system, strengthening Medicare payment standard construction;3) and gradually changing the current fee-for-service payment system and establishing DRGs and performance based payment mechanism and other policy recommendations.
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OBJECTIVE:To review economics of budesonide/formoterol and fluticasone/salmeterol for asthma systematically, and to provide evidence-based basis for rational selection of drug to treat asthma. METHODS:Retrieved from Medline,EMBase, EBM reviews (HTA,NHSEED),CBM,CJFD,Wanfang database,researches about pharmacoeconomics of budesonide/formoterol (test group) versus fluticasone/salmeterol (control group)for asthma were collected,and analyzed with qualitative systematic re-view method. RESULTS:A total of 7 researches and 13 comparative data were included,containing 6 682 patients. The incidence of severe acute asthma of test group were lower than those of control group,with significant difference(P<0.05). The total costs and direct costs of test group were lower than those of control group. Good effect had been achieved in test group with low cost. CONCLUSIONS:Budesonide/formoterol is more cost-effective than fluticasone/salmeterol in teenagers patients and adults who fail to control asthma. Due to limitation of included studies,large-scale and high-quality studies are required for further validation of the conclusion.
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The paper reviewed the medical service pricing at home and abroad and progress in the price comparison system,and introduced the price comparison system of Shanghai's medical services. Proposals in the paper include building the price parameters fitting local conditions,and setting prices using the standardized price model;forming a comprehensive price adjustment scheme with reference to international price comparison relations and domestic pricing level; upgrading the fine pricing management level of medical service pricing and improving charging management dimensions;enhancing interactions and assessment of price-related departments to guide public hospitals to enhance.
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Objective The purpose of this study was to investigate the chemical constituents of Pierre. Methods The chemical compositions were isolated by silica gel column chromatography, semi-preparative HPLC,Sephadex LH-20, and MPLC packed with MCI gel, and their structures were identified on the basis of chemical and spectroscopic evidence (NMR and MS) . Results Eight compounds were obtained and determined as fibraurin (1),makisterone A (2),cycloartenol (3),feruloylphenethylamine (4),trans- -feruloyltyramine(5),β-sitosterol(6),1-monopalmitin(7),1-sinapoyl-β-D-glucopyranoside(8). Conclusion Compounds 2-8 were isolated from this plant for the first time.
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Objective To study the distribution of Oncomelania hupensis snails in mountainous regions and the dynamic charaeteristics of the distribution.Methods An environment calledLanbaoclosed to Puge County.Sichuan Provinee WaS selected as the study field.Random sampling was designed to determine the investigation sites.The snails were collected and the hying snaila were identified by the method of dissection in the laboratory.The distribution of snails was analyzed by some statistical indices,such as mean,variance and so on.Then the negative binomial distribution.log-normal distribution and exponential distribution were fitted to the snail data by the method of maximum likelihood estimation to explore the snail distribution in different time.Results The negative binomial distribution was fitted well to the snail data in April,May,July,August,September,November in 2008,and no distribution was fined to the snail data in June,October.December in 2008 and February in 2009.Conclusions The distribution of Oncomelania hupensis in mountainous regions is not simple negative binomial distribution,but pwbably a dynamic process and an uncertain distribution.
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Objective To analyze the concentration, distribution and decreasing trend of niclosamide in soil through soil heaping mixed with niclosamide and the effect of Oncomelania control, and to explore the appropriate dosage for the 'heaping' method. Methods The soil samples were collected from six groups in Tezi township, Puge county, Sichuan Province, and the dosages were 16, 8, 4, 2, 1 and 0 g/m~2, respectively. After ultrasonic extraction, centrifugence and concentration, the samples were finally determined by high-performance liquid chromatography (HPLC). The mortality rate of snails was observed after 3 days and 7 days. Results The standard error and range of niclosamide in soil were large. There was no significant difference in concentration of niclosamide between the surface layer and deep layer of soil (P>0.05). After 5 months, niclosamide still could be determined in groups of 4 g/m~2. The mortality rate of snails decreased as the concentration of niclosamide decreased (P<0.05). After 5 months, in the group of 4 g/m~2 dosage, the 3 and 7 days mortality rate of snails were 5.33% and 9.33% in the surface layer, higher than the control group (P<0.05). Conclusions The heaping method is an efficacious measure of controlling snails and its recommended dosage is 4 g/m~2.
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Aim To investigate the inhibitory effect of hydrogen sulfide on expression of elastin in hypoxic pulmonary hypertensive (HPH) rats. Methods Twenty-four rats were randomly divided into three groups:control group (n=8), hypoxic group (n=8) and hypoxia+NaHS group (n=8). Pulmonary artery mean pressure (mPAP) of three group rats was measured via right ventricular catheterization. Right ventricle and left ventricle+septum of each rats were isolated from intact rats and weight of right ventricle/(weight of left ventricle+septum) ratio was calculated. The percentage of muscularized arteries of small pulmonary arteries was measured using a light microscope. The expression of elastin and TGF-? in pulmonary artery smooth muscle cells was observed with immunohistochemistry. Results mPAP and weight of right ventricle/(weight of left ventricle+septum) ratio were significantly higher in rats of hypoxic group than those of control group (P
