1.Correlation analysis on the relationship between hospital financial staffing and hospital's overall size
Jie CHEN ; Wenjie WANG ; Jie WANG ; Fangqi YANG
Chinese Journal of Hospital Administration 2017;33(4):313-315
Objective To learn the present financial staffing at public hospitals in detail,for development of a staffing standard of financial workers at public hospitals.Methods The headcount of financial workers at all tertiary hospitals in China was counted.The correlation between the number of financial workers and the overall size of the hospital was analyzed using SPSS 19.0 software to develop a data model.Results Data analysis showed that the assets,revenue/expenditure,hospital beds,workload,and staff headcount of a hospital are in linear co-relation with the headcount of its financial workers (P < 0.001),and presented a curve that the number of hospital financial workers will vary with the factor of the hospital's overall size.Conclusions The number of hospital financial workers is closely related to the size of the hospital,and the curve can help estimate the number of financial workers of the hospital.
2.Dynamic observation of asthma model induced by allergen in mice from acute inflammation to chronic remodeling
Fangqi ZHANG ; Xinpeng HAN ; Fang ZHANG ; Xuemin YANG ; Dong XIANG ; Zhikui LI
Chinese Journal of Pathophysiology 2017;33(2):380-384
AIM:To dynamically observe and compare the relative changes of the indexes from the process of acute inflammation to chronic remodeling in asthmatic mice induced by ovalbumin ( OVA) .METHODS:Female BALB/c mice (n=60) were randomly divided into normal control group and asthma group .The mice in asthma group were sensi-tized and challenged by OVA , while the mice in normal group received equal volume of normal saline ( NS) .The challenge was performed for 3 consecutive days from the 21th day to observe the response of acute inflammation , and then the mice in different groups were challenged once per week for 5 weeks.Detailed comparisons of the dynamic changes of cell infiltra-tion, cytokine expression and airway remodeling were conducted .RESULTS:Compared with NS group , the mice in OVA group showed a predominantly eosinophilic infiltration into the airway lumen , increased production of Th 2-type cytokines , secretion of epithelial mucus and deposition of subepithelial collagen .In OVA challenge groups , the levels of inflammatory cells and inflammatory factors were remarkably higher in 24 d group, whereas the most obvious changes of goblet cell hyper-plasia and airway remodeling were observed in 52 d group.CONCLUSION:Acute asthma model is sufficiently induced by 3 consecutive days of OVA challenge protocol , which is accompanied with high levels of inflammatory cells and inflammato-ry factors.The OVA challenge protocol once per week for 5 weeks could induce a chronic asthma model with obvious airway remodeling .
3.Discovery of a Residual Focus of Bancroftian Filariasis after Declaration of its Transmission Interruption in Guangxi
Xueming LI ; Yichao YANG ; Kengling HUANG ; Hongbo XU ; Zuying XIE ; Fuzhen MAI ; Shaoming SHANG ; Airong SU ; Shulin LI ; Fangqi OU ; Qinhua WU ; Weiping WU ; Xuehua ZHU ; Zhihua JIANG
Chinese Journal of Parasitology and Parasitic Diseases 1997;0(06):-
Objective To describe the discovery of a residual foci of bancroftian filariasis in Fuchuan County where the disease was announced to have been eliminated, and reveal its epidemiologic feature.Methods The investigation was carried out from August 2007 to March 2008 among residents in Changtang village where the first caseof filariasiswas found and the neighboring villages.They were screened with two thick blood smears.Immunochromatographic technology(ICT) was conducted for those going out but returned and those in surrounding areas.Vector mosquitoes were collected and dissected to find filaria larvae.Historical documents were reviewed and relevant people were interviewed.Results In Changtang administrative village, 1 052 residents were screened and 19 cases with microfilaremia were found in 2 natural villages, with a Mf-positive rate of 1.8%(5.1% in Gangshang and 1.4% in Yinshan respectively).No Mf-positive case was found in 4 119 residents screened in other 3 villages.The average microfilaria density in the 19 cases was 17.37/60 ?l blood.All the 19 cases belonged to 12 families, and 13 cases were relatives to each other, which showed a feature of spatial clustering and family clustering.More patients were identified in the age groups of 20-29 and 50-59, and 57.9% of them were older than 50 years.No larvae were found in 54 Culex pipiens fatigans dissected.Conclusion The Changtang village is identified as a residual focus of bancroftian filariasis with a low, limited endemicity.More cases have been among the elderly with a low average microfilaremia.
4.RBRVS-based performance appraisal: application at a hospital
Jie CHEN ; Bo PANG ; Xiaoren ZHANG ; Fangqi YANG
Chinese Journal of Hospital Administration 2018;34(9):765-769
With the resource based relative value scale (RBRVS) application at a hospital cited as an example, the paper covered its use in performance appraisal for optimal performance-based distribution as follows. In view of hospital specifics, such appraisal indexes as the quantity, quality, technical difficulty and cost control are quantified as key indicators, to form its own RBRVS scores and weights. In combination of the case mixed index as well, such factors as specific appraisal, quality of care and research/teaching work are taken into account for the purpose of rational and optimal pay for performance.
5.Survey of RBRVS-based performance appraisal methods at 12 public hospitals
Jie CHEN ; Xiaoren ZHANG ; Bo PANG ; Fangqi YANG ; Hui ZHAO
Chinese Journal of Hospital Administration 2018;34(9):770-773
Objective To learn the initial application of RBRVS related performance appraisal at public hospitals in China. Methods 12 tertiary public hospitals which took the lead to introduce RBRVS models, via third-party cooperation, in medical stuff performance assessment over one year were surveyed. The study summarized their design emphases of RBRVS performance appraisal, covering such aspects as appraisal level, accounting method, conceptual design, points setup and items charged as cost. Descriptive statistics was used to analyze the data so acquired. Results As shown in the performance appraisal level, most hospitals were found with defects in refining levels, as eight hospitals only appraise down to the department level, three to diagnostic group level, and only one hospital to individuals. Of these hospitals, over eight hospitals used RBRVS to elevate the efficiency and inventiveness of employees, while half of these hospitals reported the method can improve service, reduce cost and enhance quality of care. Conclusions Public hospitals enjoy advantages via third-party cooperation RVRBS method in RVRBS-related reforms. Introduction of this method calls for localization design based specifics and management goals of public hospitals.
6.Moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity: a randomized controlled trial.
Qimiao HU ; Pengpeng GU ; Xia JIANG ; Fangqi JIANG ; Jinfei ZHUANG ; Haisong ZHENG ; Guanhu YANG ; Songhe JIANG ;
Chinese Acupuncture & Moxibustion 2017;37(11):1177-1182
OBJECTIVETo evaluate the clinical therapeutic effects and safety on moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity during the dog days.
METHODSOne hundred and sixty patients of moderate and severe persistent allergic rhinitis were randomized into a No.1 treatment group, a No.2 treatment group, a No.3 treatment group and a placebo group, 40 cases in each one. The same acupoints were used in the four groups, named Dazhui (GV 14), Dingchuan (EX-B1), Feishu (BL 13), Pishu (BL 20), Mingmen (GV 4), Gaohuang (BL 43), Shenshu (BL 23) and Qihai (CV 6). In the three treatment groups, the fine powder of the ingredients (,,,) of compoundformula was used. In the No.1 treatment group, the herbal paste (ginger-prepared paste) was prepared with ginger juice and the above herbal powder. In the No.2 and No.3 treatment groups, the herbal paste (honey-prepared paste) was prepared with honey with the above herbal powder. In the placebo group, the pseudo-herbal paste of the same appearance was prepared with millet powder and distilled water. The acupoint application was given for 2 h in the No.1 and No.2 groups and was for 6 h in the No.3 treatment group and the placebo group. The acupoint application therapy was given once every week during the dogdays, continuously for 5 weeks. The total nasal symptom score (TNSS), the score of the rhinoconjunctivitis quality of life questionnaire (RQLQ) and the count of blood eosinophils (EOS) were observed in the patients of the 4 groups before and after treatment. The clinical therapeutic effects were compared among the 4 groups. The incidences of the skin adverse reactions were observed in each treatment group.
RESULTSAfter treatment, the scores of TNSS and RQLQ were all reduced as compared with those before treatment in the three treatment groups (<0.05,<0.01), in which, the improvements in the No.3 treatment group were better than those in the No.1 treatment group and the No.2 treatment group (both<0.05). After treatment, the count of EOS was all reduced as compared with that before treatment in the three treatment groups (all<0.05). The differences were not significant statistically among the three treatment groups (all>0.05). The total effective rate was 85.0% (34/40) in the No.3 treatment group, better than 76.3% (29/38) in the No.1 treatment group, 71.8% (28/39) in the No.2 treatment group and 5.0% (2/40) in the placebo group (<0.05,<0.01). The incidences of the skin adverse reaction in the No.3 treatment group and the No.2 treatment group were lower than those in the No.1 treatment group (both<0.01).
CONCLUSIONThe acupoint application of the different intensity relieves the symptoms and improves the living quality in the patients of moderate and severe persistent allergic rhinitis. The stimulation of the ginger-prepared herbal paste is strong and induces skin blisters after 2 h herbal application. The stimulation of the honey-prepared herbal paste is moderate and does not induce blisters. The 6 h stimulation of the honey-prepared herbal paste is mild and the therapeutic effect is optimal.
7.Characteristics of Participants for Developing Emergency Health Systems Guidance Based on AGREE-HS
An LI ; Gezhi ZHANG ; Xue CHEN ; Fangqi LIU ; Danping ZHENG ; Weixuan BAI ; Wei YANG ; Dongfeng WEI ; Nannan SHI ; Mengyu LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):157-163
The formulation method of emergency health systems guidance (HSG) is crucial, directly impacting the efficiency and effectiveness of responses in emergencies. A scientifically sound, systematic, and easily executable guidance document can assist health institutions at all levels in quickly coordinating resources, standardizing emergency response processes, and safeguarding public health. This study employed the Appraisal of Guidelines for Research and Evaluation for Health Systems (AGREE-HS) to analyze the characteristics of participants in developing emergency HSGs represented by the COVID-19 emergency HSG. The results showed that in the 34 HSGs included in this study, the item participants received the lowest score. Within this item, criterion 1 (diversity of development group) scored the highest (3.13±1.55), while criterion 5 (prevention of funding agency influence) scored the lowest (1.21±0.47). There were differences (P<0.05) in measures taken to mitigate funding agency influence between the six standard HSGs developed by the World Health Organization (WHO) and the four emergency HSGs. Additionally, differences (P<0.05) existed in the development group members, background, conflicts of interest, and preventive measures between the six WHO standard HSGs and the 34 emergency HSGs, as well as between the HSGs developed by the WHO and those developed by countries. The participants in developing emergency HSGs were influenced by various factors, including limited time for guideline development, modes of participation, scarce evidence, and uncertainties in expected outcomes. There is a need to downplay extensive requirements concerning the composition of group members, institutional diversity, and conflicts of interest, emphasizing the roles of key participants like government officials and professionals who can provide rapid, practical guidance in emergency situations.
8.Characteristics of Recommendations for Emergency Health Systems Guidance Based on AGREE-HS
Gezhi ZHANG ; Cuifang LIU ; Danping ZHENG ; Xue CHEN ; An LI ; Fangqi LIU ; Dongfeng WEI ; Wei YANG ; Nannan SHI ; Mengyu LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):164-170
Recommendations, consensus-based syntheses of the best available evidence, constitute the core content of a guideline. This paper analyzes the characteristics of emergency health systems guidance documents (HSGs), represented by the coronavirus disease-2019 (COVID-19) emergency HSG, regarding the item "recommendations" and its eight evaluation criteria in the Appraisal of Guidelines for Research and Evaluation for Health Systems (AGREE-HS). The World Health Organization (WHO) standard HSGs were used as reference to explore the characteristics of emergency HSGs that are different from non-emergency HSGs. The results showed that the “recommendations” scored second after “topic” among the five items. Criterion 7 relating to operability scored higher than others among the eight criteria, and criterion 3 dealing with ethical principles scored lower than other criteria. Compared with the standard HSGs, the emergency HSGs showed decreased scores (P<0.05) of the item recommendations and the criteria of this item except criterion 4 concerning equity promotion. Among the HSGs with different developers, those developed by the WHO had higher (P<0.05) scores of recommendations than nationally developed HSGs, as evidenced by criterion 4, criterion 5 involving acceptability to and alignment with sociocultural and political interests, and criterion 8 for updating plans. The HSGs regarding global or country strategy scored higher (P<0.05) on criterion 2 relating to comprehensiveness than those involving specific guidance on clinical or material issues. Overall, the emergency HSGs, represented by the COVID-19 emergency HSGs, differ from the standard HSGs in a number of ways in terms of their recommendations. Emergency HSGs have more condensed content and weaker articulation of expected outcomes. They incline to put more emphasis on updating plans, rather than comprehensiveness or integrative requirements in terms of ethics, equity, and sociocultural and political interests.
9.Characteristics of Topic for Emergency Health Systems Guidance Based on AGREE-HS
Xue CHEN ; An LI ; Fangqi LIU ; Danping ZHENG ; Gezhi ZHANG ; Nannan SHI ; Wei YANG ; Dongfeng WEI ; Mengyu LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):171-177
The clear definition of the topic in emergency health systems guidance (HSG) ensures the relevance, scientific rigor, and practicality of the guidance, providing a clear direction and a framework for a rapid and effective public health response. This study used the Appraisal of Guidelines for Research & Evaluation-Health Systems (AGREE-HS) to demonstratively evaluate the global COVID-19 emergency HSGs and World Health Organization (WHO) standard HSGs, aiming to explore the characteristics of topic in emergency HSGs. The results showed that in the 34 HSGs included, the item topic received the highest score. Specifically, criterion 4 relating to relevant and applicable factors scored the highest (5.59), while criterion 3 concerning the prioritization of health system challenges scored the lowest (2.76). There were differences (P<0.05) in criterion 1 between standard HSGs and overall emergency HSGs, as well as between WHO and national emergency HSGs. Criterion 3 also showed differences (P<0.05) between standard HSGs and emergency HSGs, as well as between WHO and national emergency HSGs. Criterion 4 displayed differences (P<0.000 1) between WHO and national emergency HSGs. No differences were observed in intra-group or inter-group comparisons of different emergency HSG subcategories (P<0.05). Overall, emergency HSGs represented by the COVID-19 emergency HSG focus on detailing the challenges faced by the health system, including the natures of challenges, affected populations, and other relevant and applicable factors, while aligning with stakeholder concerns. The prioritization is downplayed, with emphasis placed on rapid responses to and flexible handling of urgent issues. Influenced by factors such as the evidence base, phase timing, and effectiveness, the topic setting shows variations.
10.Characteristics of Emergency Health Systems Guidance Based on AGREE-HS
Danping ZHENG ; Wei YANG ; Nannan SHI ; Dongfeng WEI ; An LI ; Gezhi ZHANG ; Xue CHEN ; Fangqi LIU ; Zhaoshuai YAN ; Weixuan BAI ; Xinghua XIANG ; Yaxin TIAN ; Mengyu LIU ; Huamin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):137-148
This study used the Appraisal of Guidelines Research & Evaluation-Health Systems (AGREE-HS) to demonstratively compare 34 global coronavirus disease-2019 (COVID-19) health systems guidance documents (HSGs) and 6 World Health Organization (WHO) standard HSGs. The comparison involved topic, participants, methods, recommendations, and implementability, with the aim of exploring the characteristics of emergency HSGs. The results showed that the emergency HSGs had an overall average score of 49%, with topic having the highest score, recommendations having the second highest score, and participants having the lowest score. The standard HSGs had an overall average score of 79%, with high scores in all items. The emergency HSGs had lower scores in participants, methods, recommendations, and implementability than the standard HSGs (P<0.001), while the COVID-19 emergency HSGs developed by the WHO had higher score in topic than the standard HSGs (P<0.05). Compared with those released by countries, the COVID-19 emergency HSG developed by the WHO showed superiority in all items and overall scores (P=0.000 2). This indicates that emergency HSGs, represented by the COVID-19 emergency HSG, place equal emphasis on topic and recommendations as standard HSGs but have low requirements in terms of expert participation, evidence support, and comprehensive consideration in the time- and resource-limited context. They have the characteristics of prominent topics, clear purposes, orientation to demand, keeping up with the latest evidence, flexible adjustment, and timeliness, emphasizing immediate implementation effects, weakening long-term effects, and focusing on comprehensive benefits. Additionally, developers, types, and report completeness are important influencing factors.