Objective:To establish an outpatient operation simulation model by using pediatric outpatient data of a third-level maternal and child health hospital in Shenzhen, then to explore and improve hospital management problems.Methods:The hospital information system was used to extract the parameters of the pediatric outpatient data, and the AnyLogic simulation model was used to compare the hospital operation data and simulation data. Through the ideal operation status of the model and the actual state data of the hospital, the problems that were easily overlooked and difficult to investigate were identified. Then the problems were confirmed through on-site tracking investigations, improve process execution, and reduce waiting and congestion.Results:The gap between simulation data and hospital operation data was reflected in the waiting links of the first visit, inspection project and report interpretation. The process transformation of these three links could be the key to improving the overall service capability.Conclusions:Simulation and field tracking are effective ways to explore process problems. The method that simulation model is used to realize the method path of "big data→simulation→site tracking→management analysis improvement" , is suitable for the application and research of hospital process problem discovery.

OBJECTIVE: The study investigated to compare health care utilization and expenditures between diabetic patients with and without depression in Taiwan. METHODS: Health care utilization and expenditure among diabetic patients with and without depression disorder during 2000 and 2004 were examined using Taiwan's population-based National Health Insurance claims database. Health care utilization included outpatient visits and the use of inpatient services, and health expenditures were outpatient, inpatient, and total medical expenditures. Moreover, general estimation equation models were used for analyzing the factors associated with outpatient visits and expenditures. Multiple logistic regression analysis was applied for identifying the factors associated with hospitalization. RESULTS: The average annual outpatient visits and annual total medical expenditures in the study period were 44.23–52.20; NT$87,496–133,077 and 30.75–32.92; NT$64,411–80,955 for diabetic patients with and without depression. After adjustment for covariates, our results revealed that gender and complication were associated with out-patient visits. Moreover, the time factor was associated with the total medical expenditure, and residential urbanization and complication factors were associated with hospitalization. CONCLUSION: Health care utilization and expenditures for diabetic patients with depression were significantly higher than those without depression. Sex, complications, time, and urbanization are the factors associated with health care utilization and expenditures.
Cohort Studies* ; Delivery of Health Care* ; Depression* ; Health Expenditures* ; Hospitalization ; Humans ; Inpatients ; Logistic Models ; National Health Programs ; Outpatients ; Patient Acceptance of Health Care* ; Taiwan ; Time Factors ; Urbanization

Objective: To learn the evaluation of the regional medical imaging resources sharing center by medical staff of a regional hospital group in Shenzhen city. Methods: The group established a regional medical imaging resources sharing center in January 2016. One year later, a cross-sectional study was made on its medical staff using questionnaires. Such statistical methods as descriptive statistics and analytic hierarchy process among others were used to learn the self-identified overall effects for such a shared model. Results: The questionnaire was responded by 24 medical imaging clinicians, 23 medical imaging technicians and 152 clinical doctors respectively. The comprehensive evaluation weight coefficient of the medical staff to the shared model was 0.692 2, whereas that to the distributed(conventional)model was 0.307 8. With regard to the shared model, 84.3%(43/51)of the clinical doctors held the imaging transmission as faster. 55.3%(84/152), 54.2%(13/24) and 53.6%(12/23) of the clinical doctors, imaging clinicians and technicians held the imaging quality as better than before. Respectively 95.8%(23/24)and 91.3%(21/23)of the imaging clinicians and technicians held their ability to read images or competence as improved. 54.2%(13/24)and 52.2%(12/23)of the imaging clinicians and technicians respectively held the cost performance of income as decreased. Conclusions Compared with the conventional management model, the medical staff tend to embrace the shared management model, but they complained greater stress, and less satisfaction.