Evaluation of inpatient services of tertiary comprehensive hospitals based on DRG payment.

Objective: This study aims to evaluate inpatient services in 49 tertiary comprehensive hospitals using indicators from the diagnosis related groups (DRG) payment system. Method: DRG data from 49 tertiary comprehensive hospitals were obtained from the quality monitoring platform for provincial hospitals, and relevant indicators were identified. The analytic hierarchy process (AHP) was used to compute the weight of each indicator. The rank sum ratio method was used to calculate the weight rank sum ratio (WRSR) value and the corresponding probit value of each hospital. The hospitals were divided into four grades based on the threshold value: excellent, good, fair, and poor. Results: Eight indicators of the 49 hospitals were scored, and the hospital rankings of indicators varied. The No. 1 hospital ranked first in the indicators of "total number of DRG", "number of groups", and "proportion of relative weights (RW) ≥ 2". The WRSR value of the No.1 hospital was the largest (0.574), and the WRSR value of the No. 44 hospital was the smallest (0.139). The linear regression equation was established: WRSRpredicted =-0.141+0.088*Probit, and the regression model was well-fitted (F = 2066.672, p < 0.001). The cut-off values of the three WRSRspredicted by the four levels were 0.167, 0.299, and 0.431, respectively. The 49 hospitals were divided into four groups: excellent (4), good (21), average (21), and poor (3). There were significant differences in the average WRSR values of four categories of hospitals (p < 0.05). Conclusion: There were notable variances in the levels of inpatient services among 49 tertiary comprehensive hospitals, and hospitals of the same category also showed different service levels. The evaluation results contribute to the health administrative department and the hospital to optimize the allocation of resources, improve the DRG payment system, and enhance the quality and efficiency of inpatient services.

Status, evaluation, and influencing factors of biosecurity levels in pig farms in China.

BACKGROUND: Animal diseases have always been a serious threat to livestock breeding, and the establishment of a biosecurity barrier is important for disease prevention and control. Based on the investigations conducted in seven provinces located farms, this study aimed to explore the current biosecurity levels of farms in China, construct a biosecurity evaluation system, calculate the biosecurity levels of farms using the rank sum ratio comprehensive evaluation method, and develop an empirical analysis of the factors influencing biosecurity levels. RESULTS: The results show that the greater the cost of biosecurity invested, the greater the level of biosecurity. Male farmers, educational attainment and participation in technical training had a significant positive effect on biosecurity levels. In addition, biosecurity levels first decreased and then increased as the scale of farming increased. The study also found that the more people in the household engaged in farming, the higher the biosecurity level of the farm. And farms that joined cooperatives had higher levels of biosecurity. CONCLUSION: The rank sum ratio method can evaluate the index system, so as to obtain a comprehensive index RSR value that can be compared, and the operation steps are simple and effective. By taking measures such as improving the comprehensive quality of farmers and increasing the investment in human, material and financial resources for biosecurity, the biosecurity level of farms can be effectively improved and animal diseases can be effectively prevented and controlled.

Contribution quality evaluation of table tennis match by using TOPSIS-RSR method - an empirical study.

This paper aims to evaluate the contribution quality of table tennis matches comprehensively and explore the ranking characteristics of evaluation results and the rationality of grading. Through the application of the documentation method, videos, Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Rank Sum Ratio (RSR), the contribution quality evaluation index system of table tennis matches was established. After then, the technical and tactical performances of 38 matches between H (anonymous), who is currently highly concerned and active in the international table tennis world from 2018 to 2020 were comprehensively evaluated. According to research results, H had 8 matches with the Ci value > 0.5 in serve rounds, 4 with the Ci value > 0.5 in receive rounds, and 5 with the RSR value > 0.6 in the comprehensive strength. These findings were generally consistent with the final match results. Furthermore, Pearson Correlation showed that the three indicators were significantly correlated with competition performance (CP) (P < 0.01). Each race could be divided into four grades, and there was a very significant difference among them by variance test (F = 60.281, P < 0.01). Meanwhile, SNK pairwise comparison between four grades had statistical significance (P < 0.05). Therefore, researchers could conclude that the combination of TOPSIS and RSR could objectively and accurately reflect the contribution quality of table tennis matches. This method could be promoted and applied in the competition performance evaluation of other net games.

Efficiency and equity of bed utilization in China's health institutions: based on the rank-sum ratio method.

OBJECTIVE: The study aimed to analyze the efficiency and equity of bed utilization in Please check if the section headings are assigned to appropriate levels.China's healthcare institutions and to compare and analyze the overall health resource utilization efficiency in recent years and some specific utilization conditions in 2021, to provide empirical experience for the allocation of health care resources in epidemic China. METHODS: To compare and analyze the overall health resource utilization efficiency of the whole country with that of the East, middle, and West in 2021, and to analyze the bed utilization efficiency of different types of healthcare institutions in China and the bed utilization efficiency of various types of specialist hospitals in the country in 2021 by using the rank-sum ratio method. RESULTS: In 2021, the bed utilization rate of China's health institutions was 69.82%, and the number of bed turnover times was 27.65 times; the bed utilization rate of hospitals was 74.6%, and the number of bed turnover times was 26.08 times. The number of hospital bed turnovers was highest in the western region, lowest in the central region, and close to the national average in the eastern region. The average length of stay for discharged patients was the highest in the central region, the lowest in the eastern region, and the same as the national average in the western region. The analysis of rank-sum ratio method shows that among different types of health institutions' bed utilization efficiency (r = 0.935, P = 0.000), general hospitals and traditional Chinese medicine hospitals have the best bed utilization rate, and the bed utilization rate of community health service centers (stations) needs to be improved; while among various types of specialized hospitals' bed utilization efficiency (r = 0.959, P = 0.000), oncology hospitals, thoracic hospitals, and hematology hospitals, children's hospitals have high bed utilization efficiency; leprosy hospitals, cosmetic hospitals, and stomatology hospitals have low bed utilization efficiency. Health technicians per 1,000 population are highest in the western region, lowest in the central region, and lower in the eastern region than in the western region but slightly higher than the national average. The number of beds in health institutions per 1,000 population is the highest in the central region, the lowest in the eastern region, and slightly lower in the northwest than in the central region but higher than the national average. CONCLUSION: China's investment in health funding in the field of health care has been on the rise in recent years. However, there still exists the situation of uneven investment in health expenses and inconsistent medical efficiency among regions. And change such a status quo can be further improved in terms of government, capital, human resources, technology, information system, and so on.

Evaluation of community basic public health service effect in a city in Inner Mongolia Autonomous Region--based on entropy weight TOPSIS method and RSR fuzzy set.

BACKGROUND: By analyzing 23 evaluation indicators included in 14 national basic public health service programs in a region of Hohhot City, Inner Mongolia Autonomous Region, China, the performance of basic public health services in the region in 2021 were analyzed to clarify the implementation and conduct of relevant programs. We also use this study as a basis to radiate the work of municipal basic public health services centered on the region and the outstanding problems reflected and to provide theoretical contents and suggestions that can be referred to for the same regions in central and western China as well as worldwide. METHODS: Using the TOPSIS method as the basis for the data analysis method, the evaluation indexes are ranked in terms of their proximity to the idealized target, and combined with the entropy value method, Technique for order preference by similarity to an ideal solution (TOPSIS) and rank-sum ratio (RSR) were used to rank 14 basic health care providers by grade. A comprehensive evaluation of the performance of basic public health services in a region of Hohhot City, Inner Mongolia Autonomous Region in 2021 was conducted through a joint model of entropy -weighted TOPSIS and RSR, making full use of the characteristics and advantages of the fuzzy joint, and conducting a comprehensive analysis from the perspective of the ratio weight and the method of graded calculation, making the study more distinguishable and measureable. RESULTS: In this study, for the regional basic public health services, a total of 23 evaluation indicators of basic public health service projects were included, among which the top three indicators with the weight of the entropy value method indicators were found to include the rate of Chinese medicine health management for the elderly, the rate of health management for the elderly, and the BCG vaccination rate after the analysis of the weight of the indicators; After the entropy-weighted TOPSIS evaluation showed that the Ci values of the regions were found to be between 0.378 and 0.715 through the calculation of the positive and negative ideal values of each indicator; RSR staging method evaluation showed that three community health centers (X2, X10, X12) had excellent evaluations of basic public health services; The number of evaluations as poor and moderate are 2 (X3, X9) and 9 (X1, X4, X5, X6, X7, X8, X11, X13, X14), respectively; Finally, the results of the entropy-weighted TOPSIS method and the fuzzy joint model of RSR staging method are basically consistent with the overall trend of the above two methods, and the reliability and credibility of the research results are high. CONCLUSION: The entropy-weighted TOPSIS and RSR joint model can evaluate the effectiveness of basic public health services in a more comprehensive and holistic way. The results of the RSR staging results and the related weight ratio analysis show that the basic public health service programs in Hohhot, Inner Mongolia Autonomous Region are relatively balanced, but there are some differences; The same genus of elderly Chinese medicine health management rate, health management rate of the elderly, BCG vaccination rate several indicators accounted for a higher weight, its correlation with the key population-related items is high, suggesting that the future key population health service items should be focused on, and future research should be suggested from two key research.

The potential evaluation of groundwater by integrating rank sum ratio (RSR) and machine learning algorithms in the Qaidam Basin.

Groundwater is a vital resource in arid areas that sustains local industrial development and environmental preservation. Mapping groundwater potential zones and determining high-potential regions are essential for the responsible use of the local groundwater resource. When utilizing machine learning or deep learning algorithms to forecast groundwater potential in arid areas, difficulties such as inaccurate and overfitting predictions might occur due to a shortage of borehole samples. In this study, a database of groundwater conditioning factors with a size of 275,157 × 9 was created in the Qaidam Basin, and 85 known borehole samples were collected. The groundwater potential was evaluated using a combination of rank sum ratio (RSR), projection pursuit regression (PPR) and random forest (RF) algorithms, resulting in four models: PPR, RSR-PPR, RSR-RF, and RF. Results indicated that the groundwater potential was higher in mountainous regions surrounding the Qaidam Basin and decreased progressively towards the central and northwestern regions where most industries and facilities are located. The two primary factors, according to the PPR and RF models, were evapotranspiration (0.246, 0.225) and landform (0.176, 0.294). In terms of their ability to accurately forecast the borehole samples, the four models ranked as follows: RF > RSR-RF > RSR-PPR > PPR. The accuracy of the four models in the low-potential area was 0.73 (PPR), 0.60 (RSR-PPR), 0.87 (RSR-RF), and 0.80 (RF), respectively. However, the RF model showed overfitting due to a lack of samples, especially in high-potential regions, which limits its applicability. The RSR-RF method was applied directly to evaluate the entire factor database, avoiding the risk of overfitting caused by a limited number of training samples. The results demonstrate that the RSR-RF model is effective for classifying groundwater potential types in samples and mapping groundwater potential of the study area. This research presents a novel approach for groundwater potential predictions in areas with insufficient sample sizes, providing a reference for policymakers and researchers.

Comprehensive evaluation of water ecological environment in watersheds: a case study of the Yangtze River Economic Belt, China.

The Yangtze River Economic Belt, an inland economic zone with global influence, has shown a trend of prosperous economic development in recent years. Economic development, water pollution, resource depletion, and other environmental problems continue to emerge. The steady state of the water ecological environment is an important aspect of ecological security. To investigate the regional water ecological security state, this study constructs a comprehensive evaluation indicator system within the framework of "driving force-carrying source-state-management" (DCSM). The entropy weight method was used to determine the weight of each indicator, and the weighted rank sum ratio model was introduced to classify the water ecological environment of the Yangtze River Economic Belt from 2010 to 2019. Finally, an adversarial interpretative structure model is used to refine the ranking of each region. The results show that the bearing state and driving force subsystems are closely related to the water ecological environment. The top three indicators are wastewater discharge of industrial added value of 10,000 yuan, water consumption per 10,000 yuan of industrial gross product, and water consumption per 10,000 yuan of tertiary gross domestic product. In addition, there are clear differences in the water ecological environment of the Yangtze River Economic Belt. The classification results show that Zhejiang and Jiangsu are rated as "excellent''; Yunnan, Guizhou, Anhui, and Jiangxi are in the "good" level; and Sichuan, Hunan, Chongqing, and Hubei are in the "medium" level. Shanghai is "poor." As a whole, the downstream is superior, the upstream is second, and the midstream is poor in an asymmetric "U"-shaped distribution. During the study period, the overall state of water ecology in the Yangtze River Economic Belt was at a medium level and has not yet reached a safe and steady state. The performance of areas with traditional industrialization as the main development path was poor. Therefore, it is necessary to pay attention to the overall water ecological security in the basin in the future, strengthen the regulatory role of the government's water ecological management, promote reform of traditional industries and resource-based regions, and achieve the sustainable development of the water ecological environment.

Comprehensive evaluation of the effectiveness of iodine deficiency disorders prevention and control in Xinjiang Production and Construction Corps from 2014 to 2020 using TOPSIS and RSR methods / 中华地方病学杂志

Objective:To discuss the comprehensive evaluation of the effectiveness of iodine deficiency disorders prevention and control in Xinjiang Production and Construction Corps (Corps for short) using technique for order preference by similarity to an ideal solution (TOPSIS) and rank-sum ratio (RSR) methods, and identify weaknesses in the prevention and control of iodine deficiency disorders in the Corps at present.Methods:The monitoring data on iodine deficiency disorders in the Corps from 2014 to 2020 were collected from the Disease Control and Prevention Center of the Corps. Six indexes were selected, including the consumption rate of qualified iodized salt, the coverage rate of iodized salt, the qualified rate of iodized salt, the appropriate percentage of urinary iodine in children, the goiter rate of children and the appropriate percentage of urinary iodine in pregnant women. The TOPSIS method and RSR method were combined to comprehensively evaluate the prevention and control effect of iodine deficiency disorders in the Corps.Results:The results of TOPSIS method showed that the control effect was from superior to inferior in the order of 2020, 2018, 2016, 2019, 2015, 2017 and 2014. Based on the RSR method, the control effect was divided into three levels: 2018 and 2020 (with an estimated RSR value of ≥0.525) in the first level (good), 2014 (estimated RSR value < 0.007) in the third level (poor), and other years (0.007≤estimated RSR value < 0.525) in the second level (medium). Referring to the monitoring data, the appropriate percentage of urinary iodine in children and pregnant women in the middle years was the weak point. Conclusions:TOPSIS method combined with RSR method can accurately and reasonably evaluate the effectiveness of prevention and control of iodine deficiency disorders in the Corps, the evaluation results are consistent with the actual situation. It is found that the appropriate iodine nutrition levels of children and pregnant women are the weak points in the prevention and control of iodine deficiency disorders in the Corps.

Assessment of maternal services in China based on WHO's comprehensive evaluation model.

BACKGROUND: To understand the trend of equalization in maternal services and to guide policy-makers regarding resource allocation and public health policy in China. METHODS: Twelve indicators, including maternal services needs, utilization, and resource allocation, were collected from China Health Statistical Year Book 2010 and 2020. WHO's comprehensive evaluation model and the non-integral Rank Sum Ratio (RSR) method were used to analyze, rank, and categorize maternal services of 31 provinces (cities, autonomous regions) in China. RESULTS: All provinces (cities, autonomous regions) are grouped into relative balance areas, low input areas, resource shortage areas, overutilization areas, and resource waste areas. In 2019, there were 18 provinces (cities, autonomous regions) in the relative balanced area, and more than one-half had achieved equal development. Compared to 2009, the resource shortage area decreased from three to zero, and the resource waste area increased from four to six. Among the provinces (cities, autonomous regions) with a type change compared with 2009, eight changed to a relative balance areas, and four showed an improvement. CONCLUSION: Under the policy guidance of promoting the equalization of public health services, maternal services are gradually realized. However, several provinces (cities, autonomous regions) still have problems such as the mismatch between resource input and health needs, resource waste, over-utilization, etc. Therefore, specific policies should be formulated according to the actual types to promote the transformation into equalization regions.

DRG medical service performance evaluation based on entropy weight TOPSIS and rank sum ratio method / 中华医院管理杂志

Objective:To evaluate medical service performance of the DRG pilot public hospitals in a city was carried out by using the entropy weight TOPSIS and the rank sum ratio method, so as to provid the decision-making basis for the DRG pilot reform and the high-quality development of public hospitals.Methods:The case-mix index(CMI) value, the number of DRG groups, the time consumption index, the cost consumption index, and the low-risk mortality rate were obtained from the first page of medical records of 21 DRG pilot hospitals in a city from January 2019 to December 2020.The entropy weight TOPSIS method and the rank sum ratio method were used to evaluate the medical services performance of 21 DRG pilot hospitals.Results:The CMI value and the number of DRG groups in 21 DRG pilot hospitals increased from 0.81 and 353 in 2019 to 0.86 and 369 in 2020 respectively, and the time consumption index decreased from 0.98 to 0.92. The entropy weight TOPSIS method and the rank sum ratio method had good consistency and correlation with the hospital performance evaluation results from 2019 to 2020 ( P<0.05). The overall ranking of the performance evaluation of pilot hospitals in 2020 was higher than that in 2019, the tertiary hospitals were higher than secondary hospitals, and hospitals were higher than maternal and child health care hospitals. Conclusions:The DRG payment reform had promoted the quality and efficiency of medical services in the city.

Analysis of the barrier-free levels of village clinics of a city in the aging era / 中华医院管理杂志

Objective:To evaluate the barrier-free level of village clinics of a city in the aging era, for references in improving the barrier-free medical environment for the elderlies.Methods:The village dectors of 156 village clinics in 12 counties of a city were selected as the objects of a questionnaire survey from Dec.2020 to Jan.2021, with 6 evaluation indexes established, each set with 1-10 points. This questionnaires was used to survey the barrier-free construction levels of village clinics. The data were statistically analyzed by rank sum ratio and quadrant graph model.Results:The barrier-free buildings of such clinics scored 32.86 points in average. Among the six indexes, the barrier-free access and doors(7.21 points) scored the highest, and the barrier-free parking space(4.71points) and toilets(3.28 points) scored the lowest. All the counties of the city fell into four categories, including 2 counties with high degree of aging-high level of accessibility, 4 counties with low degree of aging-high level of accessibility, 4 counties with low degree of aging-low level of accessibility, and 2 counties with high degree of aging-low level of accessibility, according to the quadrant graph model built based on the aging degrees and the barrier-free levels of village clinics.Conclusions:The barrier-free level of the village clinics in a city needs to be further improved, and the barrier-free transformation of parking space and toilets should also be strengthened in the future. The government should take different measures in view of conditions of each county to improve the accessibility of village clinics and facilitate the health care-seeking of elderlies.

Evaluation of the quality of COVID-19 prevention and control by a novel comprehensive evaluation model in a tertiary general hospital: a prospective observational study.

BACKGROUND: Prevention and control (P&C) of Corona Virus Disease 2019 (COVID-19) is still a critical task in most countries and regions. However, there are many single evaluation indexes to assess the quality of COVID-19 P&C. It is necessary to synthesize the single evaluation indexes reasonably to obtain the overall evaluation results. METHODS: This study was divided into three steps. Step 1: In February 2020, the improved Delphi method was used to establish the quality evaluation indexes system for COVID-19 P&C. Step 2: in March 2020, the CRITIC method was used to adjust the Order Relation Analysis (G1) method to obtain the subjective and objective (S&O) combination weights. The comprehensive evaluation value was obtained using the weighted Efficacy Coefficient (EC) method, weighted TOPSIS method, weighted rank-sum ratio (RSR) method, and weighted Grey Relationship Analysis (GRA) method. Finally, the linear normalization method was used to synthesize the evaluation values of different evaluation methods. Step 3: From April 2020 to May 2021, this evaluation method was used to monitor and assess COVID-19 P&C quality in critical departments prospectively. The results were reported to the departments monthly. RESULT: A quality evaluation indexes system for COVID-19 P&C was established. Kendall's consistency test shows that the four evaluation method had good consistency (χ2 = 43.429, P<0.001, Kendall's consistency coefficient = 0.835). The Spearman correlation test showed that the correlation between the combined evaluation results and the original method was statistically significant(P < 0.001). According to the Mann-Kendall test, from March 2020 to May 2021, the mean value of COVID-19 P&C quality in all critical departments showed an upward trend (P < 0.01). CONCLUSIONS: The combined comprehensive evaluation method based on the S&O combined weight was more scientific and comprehensive than the single weighting and evaluation methods. In addition, monitoring and feedback of COVID-19 P&C quality were helpful for the improvement of P&C quality.

Evaluation of Policy Effectiveness by Mathematical Modeling for the Opioid Crisis with Spatial Study and Trend Analysis.

The current opioid epidemic in the US presents a great problem which calls for policy supervision and regulation. In this work, the opioid cases of five states were used for trend analysis and modeling for the estimation of potential policy effects. An evaluation model was established to analyze the severity of the opioid abuse based on the entropy weight method (EWM) and rank sum ratio (RSR). Four indexes were defined to estimate the spatial distribution of development and spread of the opioid crisis. Thirteen counties with the most severe opioid abuse in five states were determined using the EWM-RSR model and those indexes. Additionally, a forecast of the development of opioid abuse was given based on an autoregressive (AR) model. The RSR values of the thirteen counties would increase to the range between 0.951 and 1.226. Furthermore, the least absolute shrinkage and selection operator (LASSO) method was adopted. The previous indexes were modified, incorporating the comprehensive socioeconomic effects. The optimal penalty term was found to facilitate the stability and reliability of the model. By using the comprehensive model, it was found that three factors-VC112, VC114, VC115-related to disabled people have a great influence on the development of opioid abuse. The simulated policies were performed in the model to decrease the values of the indicators by 10%-50%. The corresponding RSR values can decline to the range between 0.564 and 0.606. Adopting policies that benefit the disabled population should inhibit the trend of opioid abuse.

Comprehensive Evaluation of Rehabilitation Medical Service Quality in Tertiary General Hospitals in Gansu, China / 中国康复理论与实践

Objective:To investigate the quality of rehabilitation medical service in tertiary general hospitals in Gansu Province. Methods:Stratified sampling was used to sample tertiary general hospitals in Gansu Province for on-site surveys in 2017. A quality evaluation index system was established in the view of medical service providers, including 17 indicators, based on Donabedian model and experts' opinions. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Rank-sum Ratio were applied to make a comprehensive evaluation on the overall service quality of the hospital rehabilitation medical service. Results:A total of 27 tertiary general hospitals were sampled, in 13 cities/prefectures of Gansu Province. For the structure quality, the compliance rate of the business operation area and the number of beds in the rehabilitation medicine department were 77.78% and 51.85% respectively; while the compliance rates of the physicians, therapists and nurses were all less than 50%. For the process and results quality, the compliance rates were all more than 85%. For the overall quality of rehabilitation medical service, five hospitals were classified as Good, located in Lanzhou, Tianshui and Jiayuguan; 18 hospitals were classified as Medium, located in Longnan, Longdong, Lanzhou and surround, Linxia and Hexi regions; four hospitals classified as Poor, located in Lanzhou and Tianshui. Conclusion:The overall quality of rehabilitation services in the tertiary general hospitals of Gansu Province needs to be improved, and the development of rehabilitation services is uneven in various regions. Comprehensive evaluation provides an important reference to promote the rational distribution of rehabilitation medical resources and improve the quality of rehabilitation medical services.

A comprehensive evaluation of the effects of health education on iodine deficiency disorders based on the fuzzy combined RSR-TOPSIS methods / 公共卫生与预防医学

Objective To comprehensively evaluate the health education effects of iodine deficiency disorders in different areas of Tianjin, and to provide a reference for improving the quality of iodine deficiency disorders health education. Methods The rank sum ratio method (RSR), TOPSIS and fuzzy combination were used to comprehensively evaluate the effect of health education intervention on iodine deficiency disorders in 16 areas of Tianjin. Results The evaluation results of RSR, TOPSIS and fuzzy combination method ranked N, D, and E areas in the last three places, while G, F, and P areas ranked first, second, and third. Combined with the RSR method, it was shown that in the evaluation of the effects of iodine deficiency health education interventions in 16 areas, the health education effect in G, F and P areas was classified as superior, the health education effect in D ,E and N areas was classified as inferior, and other areas were moderate. Conclusion The fuzzy combined RSR-TOPSIS method avoided the limitation of using either RSR or TOPSIS alone and made the conclusion more objective and accurate, and provided comprehensive quantitative results for the health education of iodine deficiency diseases in different areas of Tianjin. This fuzzy combination method objectively evaluated the intervention effect of health education in different areas, which provides a reference for improving the quality of health education for iodine deficiency disorders.

Assessment of essential public health services in China based on WHO′s comprehensive evaluation model / 中华医院管理杂志

Objective@#To understand the current equalization in essential public health services in China, and to provide recommendations for health resource allocation and public health policy making.@*Methods@#WHO′s comprehensive evaluation model, and the Rank Sum Ratio (RSR) method were used to analyze, rank and categorize essential public health services.@*Results@#Thirty-one provinces (cities, autonomous regions) in China were grouped into five categories, namely, relatively balanced area, low input area, resource shortage area, over utilization area and resource waste area.@*Conclusions@#The equalization of essential public health services in China is gradually being realized, but there are still setbacks such as mismatch between health needs and resource input, waste and over-utilization of resources. To correct these problems, relevant recommendations on health policy making for different areas were given.

Discussion on nursing performance evaluation based on diagnosis-related groups / 中华医院管理杂志

Objective To explore the scientificity and feasibility of using weighted rank-sum ratio (RSR) method based on diagnosis-related groups ( DRGs) indicators in nursing performance evaluation. Methods Homepage data of medical records were extracted from inpatients discharged in 2017, and " CN-DRGs" burster was used to obtain the DRGs data. Data of medical safety were obtained from the nursing adverse event management system, while data of nursing grading information and medical expenses were obtained from the hospital information system, and the patient satisfaction was obtained in a questionnaire survey. Based on the indicators available, the weighted RSR was applied to evaluate the nursing performance from the 11 dimensions, namely workload, nursing competence, nursing quality, nursing personnel allocation, patient satisfaction, etc. Results The results of the weighted RSR showed that 43, 39, and 6 wards of total 88 wards of the hospital were rated as excellent, medium and poor grades respectively. The results of ANOVA showed that the difference of the 3 grades was significant (F=170. 391, P<0.001). The nursing performance evaluation results were consistent with the actual situation. Conclusions The evaluation of nursing performance with weighted RSR method based on DRGs indicators prove its practical application value, as this method can not only provide data support for nursing personnel allocation, but also provide reference for nursing quality evaluation and supervision.

Exploration of clinicians′professional competency evaluation based on DRGs indexes / 中华医院管理杂志

Objective To evaluate the professional competency of the clinicians with DRGs indexes. Methods The homepages of medical records of the hospital from January to June in 2018 were extracted, and the conventional evaluation indexes ( i. e. percentage of drug expenditure, percentage of medical consumables expenditure, and percentage of antimicrobials application ) of each clinician were obtained. " CN-DRGs" burster was used to calculate the DRGs indexes. The weighted RSR was applied to evaluate the professional competency of the resident physicians. Results A comprehensive evaluation of the professional competency of 438 resident clinicians was conducted. 218, 190, and 30 clinicians fell into excellent, medium and poor categories respectively. The results of ANOVA showed that the differences of the 3 categories were significant ( F =664. 863, P <0. 001 ). Conclusions The evaluation of clinicians′professional competency based on DRGs was reasonable, objective and feasible, proving its importance for the establishment of a scientific and standardized clinicians evaluation system.

Analysis of 2017 evaluation results of medical radiation protection monitoring program in China by using the fuzzy combined method of TOPSIS and rank sum ratio / 中华放射医学与防护杂志

Objective To analyze 20 indicators for the evaluation of medical radiation protection monitoring in 31 provinces,municipalities or autonomous regions in 2017 and provide technical support and reference for further optimization of medical radiation protection monitoring projects.Methods According to " medical radiation protection monitoring assessment score sheet for medical and health institutions",a full range of analysis and evaluation was carried out of medical radiation protection monitoring and implementation at nationwide medical and health institutions by using fuzzy combined method of TOPSIS and rank sum ratio.Results TOPSIS method and rank sum ratio weighted fuzzy joint analysis showed that the top three indicators,in descending order,were management of provincial implementation plans,management of project leaders in various cities and management of funds whereas the lowest three indicators were completion of radiotherapy equipment commissioning,innovation and highlights and tcoverage of radiotherapy equipment.Conclusions The fuzzy combined application of TOPSIS method and rank sum ratio method can provide the comprehensive quantitative result for the implementation of medical radiation protection monitoring in 2017,objectively evaluate the implementation of various indicators,summarize the highlights and bottlenecks of work in 2017,and provide technical support and reference for further optimization of medical radiation protection monitoring.

Application of biclustering algorithm in adverse drug reaction monitoring system of China.

PURPOSE: Signal evaluation is considered to be a tedious process owing to the large number of disproportional signals detected. This study aimed to apply a biclustering algorithm in the spontaneous reporting system of China and to obtain the optimal parameters. The biclustering algorithm is expected to improve the efficiency of signal evaluation by identifying similar signal groups. METHODS: Information component (IC) was the method used for disproportionality analysis. By using IC thresholds of various strengths (0.05-4.00), the original quantitative data matrix was transformed into 80 different binary data matrices, where each cell contained either a 1 or 0. The biclustering results were obtained using a total of 720 Bimax algorithm parameters (minimal number of columns and rows was 3, 4, or 5). Next, the optimal parameters were determined through the comprehensive evaluation of the rank sum ration. Finally, we examined the biclustering results under the optimal parameters and evaluated the effect of biclustering analysis on adverse drug reaction (ADR) data in China. RESULTS: The optimal strength of the IC threshold was 0.80, and the minimum number of rows and columns was 3. After taxonomic evaluation, we also found that 1836 biclusters (42.8%) contained similar drugs or similar ADRs, which accounted for 72.3% of signals unevaluated. CONCLUSIONS: Applying biclustering analysis in spontaneous reporting system could provide support in confirming unrecognized ADRs, identifying rare ADRs, and screening drug-ADR pairs, which need more attention. Biclustering algorithm could improve the efficiency of signal detection and evaluation in China.