Objective:To investigate the payment methods of 5 kinds of chronic diseases in public hospitals of Heze.Methods:8 383 cases of hypertension,diabetes,coronary heart disease,chronic bronchitis and hepatitis B were enrolled from the Municipal Hospital,the Second People's Hospital,the Third People's Hospital,the City Hospital of Traditional Chinese Medicine and the Infectious Disease Hospital in Heze from January 1,2012 to December 31,2015.The information of medical records and the cost of hospitalization were collected and analyzed.Results:The total hospitalization expense,examination fees and other costs of medicare patients were significantly higher than those of the non-medicare patients(P＜0.05),while the drug expenses were significantly lower than that those of non-medicare patients(P＜0.05).As to the medicare patients,hospitalized expense of male patients was significantly higher than that of female(P＜0.05),hospitalized expense and insurance expense of patients over 45 years old were significantly higher than those of patients under 45 years old(P＜0.05),hospitalized expense and insurance expense of retired patients were significantly higher than those of patients on-the-job(P＜0.05),total expense of urban patients were significantly higher than those of rural patients(P＜0.05).Conclusion:Payment of patients with chronic diseases was in relation with hospitalization expenses,which was also related to the social economic characteristics,but it was worth paying attention to avoiding excessive medical treatment and waste of resources,which needed to take comprehensive measures in combination with social situation.

Objective:To study the public health Emergency Operations Centers (EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission.Methods:Literature review was conducted to explore the EOCs of selected countries.Results:The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination.Conclusions:The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.

There is an insufficient supply in essential medicines, so the nation intends to reconsider the designated medicine production. But this will raise certain risks such as negative distribution, monopolies and weakening price signal. Thus the supporting methods should be proposed as below: improving the incentive of enterprises, the efficiency of designated products, and the government administration level to promote the development of the pharmaceutical market and improve the level of public health.

Objective To investigate the curative effect of laparoscopic or laparoscopically-assisted repair of gastrointestinal perforation. Methods Eighteen patients with gastroduodenal perforation underwent laparoscopic full-thickness repair with greater omentum covering. One patient with intestinal perforation underwent double-layer suture.Three patients with intestinal perforation were treated with mini-incisional repair or partial enterectomy.One patient with perforation of the sigmoid colon received laparoscopically-assisted loop sigmoidostomy.Results Laparoscopic repair was successfully accomplished in 18 patients,while laparoscopically-assisted repair was carried out in 3 patients with intestinal perforation and 1 patient with perforation of the sigmoid colon.The operation time was 35～80 min(mean,50 min).No complications occurred.Follow-up observations in 23 patients for 6～24 months(mean,18 months) revealed no recurrence of peptic ulcer in 18 patients with gastroduodenal perforation within 6～8 months and no intestinal obstruction. Conclusions Laparoscopic operations for gastrointestinal perforation is micro-invasive and effective.

The authors first of all make it clear that the establishment of regional medical centers in rural areas was based on the role displayed by the People's Hospital of Jinxiang County in meeting the needs of rural residents for medical services, the great importance attached to rural residents by the central government and the local governments at various levels, and the changes in the needs of rural residents for medical services. Then they argue in greater detail that the establishment of regional medical centers in rural areas is beneficial to more efficiently allocating the limited resources in rural areas, thus reducing the economic burden of and benefiting rural residents; it is also beneficial to more efficiently using the health resources technically and to enhancing the awareness of administration, quality and service delivery within the hospital.

Objective To explore the diagnostic value of NAP activity detection in SLE.Methods Technique of AS-BI was used to NAP staining of peripheral blood smear in patients with newly-diagnosed SLE(30 cases)and normal healthy women(30 cases),to observe positive rate and positive score of NAP.Results The positive rate was(22.1±8.8)% in group SLE,(56.8±9.4)% in group normal;The positive score was(22.2±8.9)in group SLE,(58.2±9.8)in group normal.The positive rate and positive score were much lower in patients with SLE comparing with those in group normal.Differences were statistically significant(P＜0.01).Conclusions The detection of NAP is useful in the patients with newly-diagnosed SLE,but we must go on researching the pathogenesis of NAP activity decreased in SLE.

A detection system for rational drug use is vital for promoting rational drug use clinically, implementing the primary drugs policy of the state, and encouraging constant improvement of both quality of care and medical safety. This paper presented a summary of international experiences on rational drug use, introduced the initial progress to build a detection system for drug use in China, and came up with analysis on measures to further improve existing defects.

Objective To explore the method of the major hospital indexes examination using clinical pathway as an opportunity.Methods Based on the material of our hospital from 2008 to 2010,reference the data of the same level hospital in Xinjiang Uygur Autonomous Region,we set the benchmark and formulated the examination standard of three examination indexes:average length of stay (ALOS),average hospitalization expense and drug proportion.Meanwhile,we took the subentry incentives to give the corresponding reward to clinical departments according to the decreases rate compared with the benchmark monthly.Results ALOS,average hospitalization expense and drug proportion of department and the whole hospital were obviously decreased compared with the same period last year,and the differences were statistically significant (Medical system:t =27.479,14.462,11.362,all P ＜ 0.01 ; Surgical system:t =18.944,16.029,12.071,all P ＜ 0.01).Conclusion After using the examination methods and combining clinical pathway,the effects are obvious,which can effectively shorten ALOS,reduce average hospitalization expense and drug proportion,so as to relieve the patients' economic burden.

Objective To analyze the principal components and trends of total health expenditure from 1995 to 2011 in Xinjiang,in order to put forward policy recommendations to improve health financing.Methods Calculating the total health expenditure in Xinjiang using the financing source method,and analyzing the calculation results.Results Total health expenditure increase in Xinjiang averaged 14.75％ from 1995 to 2011.The total health expenditure in Xinjiang and per capita health expenses maintained a growing trend,and the level of financing was higher than regional economic development,but the health consumption elasticity coefficient was unstable; Residents' individual health burden was gradually decreasing,the health expenses of financing structure were relatively reasonable; Urban and rural residents health care spending grew faster than the per capita income,and the proportion in people's living consumption was found rising.Conclusion It is recommended to continue with the health reform,make full use the policy of strategic health support to Xinjiang,promote primary health service equity,develop economy and improve the urban and rural income,strengthen social health care security systems,tighten macro-control and curb the fast rising trend of health expenses.

Objective To analyze the prevention and control condition of infectious diseases of national health cities of prefecture and county level and non-national health cities in Shandong province according to the requirement to create national health cities.Methods To select 15 cities in Shandong province as the research object,including the 5 prefecture-level national health cities,5 county-level national health cities and 5 non-national health city closer to the national health situation.The survey status of infectious diseases,infectious morbidity and children′s vaccination status were analyzed,respectively.Results From 2005 to 2008,registration reporting rate,timeliness rate,accuracy rate and integrity rate of legal infectious diseases increased to 99％ or more.Direct reporting network coverage rate of 1infectious diseases and public health emergencies reached 100％.No type A and B infectious diseases outbreak occurred.The incidences of hepatitis B,dysentery and tuberculosis of national health city were all lower than the rates of non-state health cities and the national average level.The care rate of mobile children living more than 3 months and the immunization rate reached 100％ at county-level cities.Immunization rates of child 4 vaccines and hepatitis B vaccination were more than 99％ annually in the year 2007 and 2008.Conclusions The status of prevention and treatment of infectious diseases is effective.The national health city had a more powerful emergency response ability in Shandong province.