Delicacy management proves a pressing need in cost management of medical service items in the current hospital operation.This paper first covered the methodology and system of hospital costing.It went on to describe the costing for four major medical service items in a quarter in 2011 using the activity-based costing method with the ultrasonographic section of a large hospital as an example.The outcomes were compared to the traditional costing method and the statutory pricing standards,resulting in the proposal and recommendation on reforming the costing methodology of service item pricing,and applying the activity-based costing management of medical service items in the hospital.

Hospitalization expenses constitute the main part of the compensation of medical insurance.The aim of this paper is to analyze the variation of medical expenses of hospitalized patients with medical insurance in different modes of accounting,find the influencing factors in accounting quotas on hospitalization expenses,and set up a scientific and reasonable mode of accounting with a full consideration of the huge demands of medical resources.

Some non treatment variables that affect the outcome of a disease are often called covariates. These covariables should be considered in the design and analysis of clinical trials to obtain unbias conclusion. To ensure that any observed treatment effect is not influenced by an imbalances in baseline characteristics, both preadjustment and postadjustment are provided in the design stage and analysis stage of the trials respectively. They can improve the credibility of the trial results and increase the statistical efficiency. Based on a few papers published about adjustment for covariates and some documentations of the International Conference on Harmonization (ICH), we review the concepts, methods and procedures for adjustment of treatment effects for the influence of covariates. The statistical issues on the application of adjustment are especially discussed in great depth.

Objective: To research effect of different doses of Changle on the structure and function of rat liver.Methods: 180 healthy Wistar rats were divided into 5 experimental groups according following doses: 0.1,0.2,2.0,10.0 and 20.0 mg*kg-1,respectively, and the control group given physiological saline for six months. The changes of liver structure were examined by means of normal histological chemistry and transmission electron microscope(TEM). Results: The body weight of animal was linearly increased with the decrease of administered doses, gradual reduction of glycogen in hepatocytes and infiltration of inflammatory cells in the portal area were found in the group of 20.0 mg*kg-1. Changes of ultrastructure showed there were dense bodies and lysosomes containing dense granules in Kupffer cell and hepatocyte,and they were increased along with doses adding. Nuclei deformed, ALP and GPT in serum were rose in the group of 20.0 mg*kg-1. Different doses of Changle could lead to distinct biological effects. Conclusion: Long-termed administration of 20.0 mg*kg-1 Changle can lead to damage of structure and function of rat liver.

Objective:To probe into the long-term effect of La(NO3)3 fed orally on gast ric mucosa of rats.Methods:The gastric mucosa of rats was studied after La(NO3)3 was administe red orally for a long-term,by the use of ordinary histological technology and m orphometry.Results:In the groups of 20 mg·kg-1 and 10 mg·kg-1,the cytopl asma of more parietal cells lying in the top of the gastric gland was loose.Proporti on of cell types of the gastric gland was related to the doses. The acid mucus l evel of the mucous neck cells of male rats in the groups of 20 mg·kg-1 an d 10 m·kg-1 decreased. In the groups of 2 mg2kg-1, 0.2 mg·kg -1 and 0.1 mg*kg-1,the acid mucus level of the mucous neck cells of both male and female rats increased.Conclusion:La(NO3)3 fed orally for a long-term could injure gastric muc osa in higher dose (20 mg·kg-1,10 mg·kg-1) but promote the protect ive action of the gastric mucosa in lower dose (0.2 mg·kg-1,0.1 mg·kg- 1).

Source data and its source documents are the foundation of clinical research. Proper source data management plays an essential role for compliance with regulatory and GCP requirements. Both paper and electronic source data co-exist in China. Due to the increasing use of electronic technology in pharmaceutical and health care industry, electronic data source becomes an upcoming trend with clear advantages. To face new opportunities and to ensure data integrity, quality and traceability from source data to regulatory submission, this document demonstrates important concepts, principles and best practices during managing source data. It includes but not limited to: (1) important concepts of source data (e.g., source data originator, source data elements, source data identifier for audit trail, etc.); (2) various modalities of source data collection in paper and electronic methods (e.g., paper CRF, EDC, Patient Report Outcomes/eCOA, etc.); (3) seven main principles recommended in the aspect of data collection, traceability, quality standards, access control, quality control, certified copy and security during source data management; (4) a life cycle from source data creation to obsolete is used as an example to illustrate consideration and implementation of source data management.

Hexafluoroisopropanol (HFIP)-induced sodium dodecyl sulfate/dodecyltrimethylammonium bromide (SDS/DTAB) catanionic surfactant coacervate extraction method coupled with high performance liquid chromatography (HPLC) was used to detect the migration of phthalates from disposable tablewares to drinking water. The concentration factors are larger than 82 and extraction recoveries over 53%for water samples spiked with 100 or 200 ng/mL phthalates. Limit of detection is in the range of 1.0–2.6 ng/mL. Good linearity with correlation coefficients larger than 0.9985 is obtained in the concentration of 20–1500 or 40–3000 ng/mL. Relative recoveries are from 82.4%to 123.6%for water samples spiked with 30/60, 250/500, and 1500/3000 ng/mL phthalates, respectively. Relative standard deviations (RSDs) are 0.4%–7.4% for intraday precision (n ? 5) and 0.6%–7.8% for interday precision (n ? 3). Four of studied phthalates are found in the drinking water samples prepared from four kinds of tablewares.

Objective: This study aimed to analyze the high medical expenses of hospitalized medical insurance patients for the first ten systemic diseases.Methods: We investigated the medical expenses for the first ten systemic diseases among 10 900 hospitalized medical insurance patients of a hospital,calculated the average expenses and total payment for the treatment of each of the systemic diseases that involved 5% of the total patients,computed their percentage in the total expenses,and compared them with those of all the other hospitalized cases.Results: The medical cost of the 5% of the first 10 hospitalized systemic diseases accounted for 21%-29.9% of the total expenses of all the hospitalized patients,4.3-6.0 times that of the average expenses,and 30.8%-54.9% paid by the patients themselves.In addition,the hospital stay of these patients was 1.5-4.7 times that of the average.Conclusion: The high medical expenses involving 5% of the hospitalized patients with the first 10 systemic diseases amounted to a quarter of those paid by all the hospitalized patients.Effective measures have to be taken to keep high hospitalization expenses at a reasonable level.

OBJECTIVE To analyze the epidemiological characteristics,the efficiency of the surveillance system for nosocomial infections in our hospital,the sensitivity,specificity and timeliness of case reporting and to evaluate the efficiencies of the monitoring and reporting system.METHODS We reviewed the nosocomial infection reporting data in the year of 2005 and identified all the reported cases,confirmed cases and under-reported cases.Sensitivity and specificity of the reporting system were calculated based on these data.RESULTS The incidence of nosocomial infection was 3.04% in 2005.A majority(72.07%) of the cases were reported within 7 days of occurrence.Respiratory tract infection accounted for 57.75% of all nosocomial infections and was by far the most common site of concern.The rates of false positive reporting ranged from 14-37% and were statistically significantly associated with the sites of the infection(P

Objectives: To investigate the affecting factors on expenditure in Medical insurant inpatients. Methods: 593 medical insurant inpatients, who were from Feb 1, 2001 to Feb 31, 2002 in Nanjing Jinling hospital, were enrolled in this study. The inpatient expenditure was analyzed from the aspect of operation or not, age, and payment mode, used the descriptive analysis and multi factor analysis on affecting factors of the total expense, self bearing expense, and self affording expense. Results: The hospitalized days, operation or not, severity of disease were important affecting factors. The self bearing expense of medical insurant inpatients was associated with hospitalized days, operation or not, and total expense. While the self affording expense of them was associated with expense of drug, hospital bunk, radiation and others. Conclusions: We can control these associated affected factors to lighten the economic weight of patients, and to reduce the ratio of individual payment.