1.Preliminary discussion on classroom experimental teaching of basic economics for undergraduates majoring in health administration
Chinese Journal of Medical Education Research 2016;15(4):390-393
We conducted complete competition market experiment in the classroom,meanwhile simulated market transactions,and at the end of the experiment taught the experiment theory and economics theory.After the class we carried out a survey to investigate the necessity of teaching methods and the help of theoretical understanding.It was found that the experimental results of the classroom experiment were quite robust compared with the theoretical predictions of the fully competitive market,and the market operating efficiency was also higher.Students affirmed the necessity of experiment teaching and thought that experiment was helpful to understanding the learning theory.
2.Teaching case study of health economics for undergraduates majoring in health administration
Youli HAN ; Guangying GAO ; Junli ZHU
Chinese Journal of Medical Education Research 2006;0(10):-
Objective To study teaching cases of health economics in the context of health reform and development in China.Method Preparing for lessons in groups,information collection,experiences summary,and field research.Result Three productions:a teaching plan,a case collection,and a guideline of case teaching.Discuss It is useful to improving students’ ability to contact theory with practices and enhance teacher’s teaching and researching ability,but it also needs further improvement.
3.Experimental Economics Study on Profit Allocation Mechanism in Vertical Integration of Regional Medical Delivery System
Yunque BO ; Siyu LIU ; Youli HAN
Chinese Health Economics 2017;36(7):9-12
Objective:Based on the framework of reference point contract theory,the experimental economics methodwas used to explore the medical institution managers' motivation and reflection of the profit allocation in vertical integrated?medical service system.Methods:Z-tree software was applied to design the experimental program.40 undergraduate students majoring in health management were recruited as the subjects.Sharing rates and effort levels were collected and calculated by Excel 2007 and SPSS 17.0.Results:The median of sharing rate hospital managers allocated to community health centers?was 35.00%.The median of effort level that community health center directors chose was 8.00.The proportion of sharing rates equal to or less than 50.00% accounted for 98%.The proportion of the highest effort level was 23.50%.The correlation between sharing rate and effort level was significant(P<0.05).Conclusion:In the process of establishing vertical integration of medical service system,sharing rates and effort levels were closely related while the community health centers' effort was shading.
4.Progress of international health policy: Bibliometric analysis based on CiteSpace
Miaojie QI ; Yunque BO ; Youli HAN
Chinese Journal of Health Policy 2017;10(7):6-12
Objective: The main objective of this research paper is to analyze the research focus and trend in the health policy and services between 2010 and 2016, with a view to providing a reference for the research on health policy and service in China to tackle a number of challenges and opportunities for future studies.Methods: This article retrieved English literature about the Health Policy & Services from the Web of Science (2010-2016), and analyzed the records with Citespace by general analysis, word frequency and centrality.Results: A total of 22,716 articles were obtained.The three keywords with the highest frequency of word frequency were: care, quality of life and healthcare, and Quality of life had the highest centrality.Keywords could be divided into five clusters: health measurement;health factor;health intervention;medical insurance;health intervention evaluation.Conclusions: Foreign health policy research focused on health and health care;focusing on measuring the impact of health outcomes;and committed to improving the health and quality of life of the population.
5.Association of genetic polymorphisms in the FGB promoter region with idiopathic deep venous thrombosis
Shengbin HAN ; Jian DONG ; Hui JIN ; Bin YANG ; Fang YIN ; Youli WANG
Chinese Journal of General Surgery 2015;30(4):272-275
Objective To probe the association between possible single nucleotide polymorphism (SNP) in the FGB promoter region and idiopathic deep venous thrombosis.Methods A prospective analysis was performed in both IDVT group and control group (120 cases each) followed by a duplex examination using gene sequencing technique and restriction fragment length polymorphism (RFLP) in the promoter region of fibrinogen gene β.Possible SNPs in this region were detected arranged before HardyWeinberg equilibrium test and Linkage disequilibrium (LD) analyses.Ultimately,we compared the genotype frequencies between the two groups and undertook a multiple Logistic regression.Results Six kinds of SNPs were determined in the promoter region of β-fibrinogen gene:-148C/T,-249C/T,-455G/A,-854G/A,-993C/T and-1420G/A.A stronger linkage disequilibrium was confirmed between-993C/T and -455G/A (r2 =0.699) ;-993C/T and-148C/T (r2 =0.509) ;-455G/A and-148C/T (r2 =0.556).Statistical differences of genotype frequencies between two groups were observed in-148C/T,-249C/T,-455G/A and-1420G/A polymorphisms (all P < 0.05).Conclusions The risk of IDVT was 4.579 times higher with every 1 g/L increase of fibrinogen concentration.Allele-148T,-455G and-1420A are IDVT risk factors.-993C/T may indirectly affect IDVT through linkage disequilibrium with-455G/A and-148C/T.
6.The clinical efficacy of composite acoustic therapy in patients of sudden deafness with tinnitus.
Zhao LIU ; Yong LIANG ; Chen YANG ; Youli LIU ; Yanfei LI ; Xiaoyan HAN ; Linyan ZENG ; Pingxiang HE
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(4):330-333
OBJECTIVE:
To determine whether the composite acoustic therapy is effective to treat tinnitus in patients with sudden deafness and to explore the mechanisms.
METHOD:
Ninety-six cases (96 ears) were divided into experimental group and control group, and all the patients underwent drug treatment. The patients in experimental group were given personalized composite acoustic therapy in the first 30 days, music therapy in next 31-90 days, however, the patients in control group were not given sound therapy. Additionally, pure tone audiogram, tinnitus pitch and loudness as well as questionnaires (including THI, VAS, and SAS) were conducted for each patient before treatment, at day 30 and day 90 posttreatment.
RESULT:
Eighty-nine patients (n = 47 for experimental group and n = 42 for control group) completed the trial. The results of day 30 posttreatment showed there were no significant differences in VAS and hearing recovery rate between these two groups, but THI and SAS showed significant differences. The results of day 90 posttreatment showed significant differences in VAS (P < 0.05), THI (P < 0.01) and SAS (P < 0.01), and no significant difference of hearing recovery rate was detected. The most significant changes of VAS appeared in the first 30 days of treatment. The hearing and tinnitus recovery in experimental group were better for the first 30 days of treatment than for the next 31-90 days, and similar results were obtaind in control group. (P < 0.01).
CONCLUSION
Composite acoustic treatment combined with drug therapy can improve the tinnitus and anxiety symptoms of patients with sudden deafness, and the effect on hearing recovery still need to be confirmed in further studies.
Acoustics
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Anxiety
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Hearing Loss, Sudden
;
complications
;
therapy
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Hearing Tests
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Humans
;
Surveys and Questionnaires
;
Tinnitus
;
complications
;
therapy
;
Treatment Outcome
7.Clinical characteristics of tinnitus complaint: an analysis of 453 patients.
Zhao LIU ; Yong LIANG ; Pengcheng SUN ; Chen YANG ; Youli LIU ; Yanfei LI ; Xiaoyan HAN ; Pingxiang HE ; Lin ZENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(10):889-892
OBJECTIVE:
To evaluate the clinical characteristics of tinnitus complaint.
METHOD:
The information of 628 patients with subjective tinnitus was collected using questionnaires from October, 2013 to June, 2014. Among them, 453 cases were included in this study, whose quality of life and sleep were significantly affected. Then we elucidated the features of tinnitus, tinnitus incentives and systemic diseases and analyzed their relationship.
RESULT:
The proportion of the patients complaint was highest in gruop ≤ 30 y. The patients with tinnitus complaint were more likely to have persistent tinnitus with higher loudness VAS scores than their counterparts. 65.4% of the total patients had at least one treatment (52.2% of patients can tolerate, and only 13. 2% can not tolerate). More patients had cranial Ming on the left than on the right ear. The proportion of patients with polyphony in bilateral tinnitus was higher than those with unilateral tinnitus (P < 0.05). Moreover, 59% patients had tinnitus inducing factors, and 44% patients had systemic comorbidities (The three most frequently involved systems were otolaryngologic, cardiovascular and digestive system). There was no significantly statistical difference of the tinnitus severity between patients with other systematic diseases and those without.
CONCLUSION
Patients with tinnitus complaint were younger in age (≤ 30 y) and more likely to have persistent tinnitus with higher loudness VAS scores Predisposing factors are closely associated with mental or physical trauma. The accompanied diseases can be classified by organ system.
Humans
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Quality of Life
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Surveys and Questionnaires
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Tinnitus
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diagnosis
;
physiopathology
8.Implications of Reciprocity Mechanism Based on Gift Exchange Game for Physicians'Altruistic Behavior Incentives
Chinese Health Economics 2024;43(1):1-3
Objective:To propose ideas for designing an incentive system that aligns with the unique characteristics of the medi-cal industry while maintaining altruism.Methods:The concepts of reciprocal altruism theory and gift exchange game experiments are introduced from the field of economics to incentivize physicians'altruistic behavior.Results:It proposes the indirect reciprocal altru-ism theory,which focuses on the three-party principal-agent relationship between physicians,patients,and management in the medical field.The compensation incentive concept that measures health value is also introduced.Additionally,it constructs a model for the incentive mechanism of physicians'altruistic behavior based on the three-party gift exchange game.Conclusion:Based on the concept of value-based incentives for physicians'altruistic behavior,it develops an incentive system that caters to the unique characteristics of the medical industry and promotes its high-quality development.
9.Analysis of the performance of the"Clinic-pharmacy separation" reform at a Beijing hospital
Xinghua ZUO ; Shitang XIE ; Youli HAN ; Yong CHEN
Chinese Journal of Hospital Administration 2017;33(11):808-811
Objective To analyze the effects of the " Clinic-pharmacy separation" reform in Beijing. Methods Following the chronological order, 60-month operational data of a pilot hospital from 2012 to 2016 were analyzed. These data included medical statistics reports, financial information, HIS information,authority information,and patients′satisfaction on site. Results Pilot hospital showed that its medical work efficiency continued to grow. During 2013 -2016, its outpatients volume growth rate ranged 3.53% ~15.20%, and its number of discharged patients growth rate ranged 3. 12% -8. 48%. The hospital harvested 12.21 million yuan of converted income from September 2012 (when the reform was in place to cancel the drug markup and collect medical service fees) to August 2013,scoring a smooth shift of revenue sources. Medical insurance fund expenditure did not increase as a result. The percentage of drug expense was significantly decreased,dropping over 15% in 5 years. Outpatient drug fees and inpatient drug fees continued to decline year by year. Patients expressed higher satisfaction over medical services due to longer time of consultation with physicians. Conclusions " Clinic-pharmacy separation" reform has achieved the following objectives. The revenue is maintained stable; Patients flow is diverted under guidance, with less financial burden; and medical insurance expenditure is under control. We propose to improve the performance incentive and constraint mechanism for drug prescriptions by physicians.
10.Research on Influencing Factors of Percutaneous Coronary Stent Implantation by Group Settlement Based on CHS-DRG
Bozhao YANG ; Youli HAN ; Haiyang MA ; Qian GENG ; Wenbin WEI
Chinese Hospital Management 2023;43(12):20-24,28
Objective To analyze the data of percutaneous coronary stent implantation related groups in certain hospi-tal of Beijing,so as to provide data support for promoting CHS-DRG payment reform and provide guidance and reference for its refined management.Methods The case data of local medical insurance patients in Beijing who received percutaneous coronary stent implantation from January 2020 to December 2021 in certain hospital were statistically analyzed,collect the medical insurance settlement information of the selected patients,and analyze the factors that affect their entry into FM19 group settlement.Results There are differences in the factors affecting FM19 inclusion in different reform stages,overtransfer personnel is a new independent factor that interferes with the group settlement in the actual operation stage.Some special operation codes may interfere with cases entering FM19 group due to pri-ority effect among disease groups.Conclusion The grouping settlement conditions of CHS-DRG are more complex,patients with different expense types need to be specifically analyzed according to the current grouping scheme and reimbursement policy.At present,there are relatively few disease groups settled by package for urban residents,and they continue to be affected by the rule of grouping priority.However,it is necessary to fully implement and strengthen the cost control of disease groups for urban employees,and rationally optimize the diagnosis and treat-ment plan to finely control medical costs.