The position competency of students majoring in health information management was assessed by inves-tigating its trainees, graduates, related staff and experts with questionnaires according to the position competency theory, based on which, the basic health information management curriculum system framework was constructed with certain suggestions put forward for it.

Objective To analyze main influencing factors of hospitalization expenses by support vector machine modeling,and explore effective influence factors analysis methods of medical expenses. Methods Random selection of six hospitals in Zhejiang province.Using hospital electronic medical record system of the hospitals and selecting three kinds of typical diseases of internal medicine and surgery,to build the support vector machine model,BP neural network model,and multiple linear regression model for comparison of analysis results.The SVM model is used to analyze three various diseases.Results The support vector machine model based on radial basis kernel function scored the highest prediction accuracy on the hospitalization expenses,up to 96.07%.In a mixed analysis of different diseases,analysis results of all three models pointed the main influence factors of hospitalization expense as days of stay,disease types,and hospital coding for the surgery.In the analysis by diseases individually,the influencing factors, though varying with diseases, key factors remain the same. Conclusion The support vector machine in the influence factor analysis is feasible in hospitalization expenses.According to the analysis results,the single disease payment system can be made rationally, which can effectively control excessive growth of medical expenses.

ObjectiveTo probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations.MethodsOne of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object.Within this district,the data of their revenue,expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis.ResultsThe percentage of service revenue among the total revenue has dropped from 68.34％ before the system was in place to 65.44％ after,reducing 4.24％.The percentage of drug revenue has dropped from 71.68％ before to 63.57％ after,reducing 11.31％.The percentage of service surplus has dropped from 15.81％ before to - 23.07％ after,reducing 245.94％.The total standard workload has increased 61.77％.Average medical expense per outpatient and per inpatient has reduced 32.85％ and 57.18％,from 71.44yuan and 2642.08 yuan before to 48.33 yuan and 1131.28 yuan after respectively.ConclusionThe deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism,further adjust the revenue-expenditure structure,set up the system of rational drug use,and effectively reduce the medical expense of patients.

Objective To assess early clinical safety and efficacy of transfemoral transcatheter aortic valve replacement (TF-TAVR) for pure aortic regurgitation (PAR). Methods The clinical data of PAR patients who underwent TAVR in Wuhan Asia Heart Hospital and Wuhan Asia General Hospital from January 2018 to October 2022 were retrospectively analyzed. Patients were divided into a TF-TAVR group and a transapical transcatheter aortic valve replacement (TA-TAVR) group. The clinical data of the patients were analyzed. Results A total of 54 patients were enrolled, including 34 males and 20 females with an average age of 74.43±6.87 years. The preoperative N-terminal pro-B-type natriuretic peptide level was lower [808.50 (143.50, 2 937.00) pg/mL vs. 2 245.00 (486.30, 7 177.50) pg/mL, P=0.015], and the left ventricular end-diastolic diameter (56.00±6.92 mm vs. 63.07±10.23 mm, P=0.005) and sinus junction diameter (32.47±4.41 mm vs. 37.65±8.08 mm, P=0.007) were smaller in the TF-TAVR group. There was no death in the two groups during the hospitalization. Only 1 new death within postoperative 1 month in the TF-TAVR group (cerebral hemorrhage). A total of 2 new deaths in the TF-TAVR group (1 patient of sudden cardiac death and 1 of multiple organ failure), and there was no death in the TA-TAVR group within postoperative 3 months. There was 1 new death in the TA-TAVR group (details unknown), and there was no death in the TF-TAVR group within postoperative 6 months. There was no statistical difference between the two groups in the all-cause mortality and the cumulative survival rate during the follow-up period (P>0.05). The incidence of high atrioventricular block was 36.0% in the TF-TAVR group and 10.3% in the TA-TAVR group (P=0.024). There were no significant differences between the two groups in the perivalvular leakage (≥moderate), valve in valve, a second valve implantation, valve migration, cerebrovascular events, major vascular complications, complete left bundle branch block, new permanent pacemaker implantation or transferring to surgery (P>0.05). However, the incidence rates of complete left bundle branch block and new permanent pacemaker implantation were higher in the TF-TAVR group, accounting for 56.0% and 40.0%, respectively. Conclusion TF-TAVR is a safe and feasible treatment for PAR patients, which is comparable to TA-TAVR in the early postoperative safety and efficacy.