As a mode of pay for performance,hospital value-based purchasing has been become widespread the US.Medicare managed to encourage the service providers to provide medical services with more value and quality.The implementation background,financing,payment mode and performance evaluation of hospital value-based purchasing were briefly introduced.In the payment reform of China,it also needed to focus on the medical service quality,learn from the performance evaluation system,incentive mechanism and multiple measurement,reasonably design the implementation scheme.

OBJECTIVE:To study the effects of the collaboration application of hospital information system (HIS) andsmart chaininventory automation management system(SPD)in drug distribution enterprises on drug logistics management,and achieve the centralized distribution of drugs. METHODS:Related countermeasures in achieving the informatization and scientiza-tion of drug inventory management after the collaboration application of HIS and SPD were introduced,and effectiveness analysis was conducted for the inventory management by comparing related indicators before and after collaboration application. RESULTS:Through the establishment ofunified receiving platformsystem and barcode technology that combined with HIS and SPD,drug barcode acceptance was achieved;setting drug fixed package and scanning fixed cards in outer packing in theunified receiving platformsystem can achieve automatic out-and into-storehouse and generating purchase plan;the collaboration application of HIS and SPD achieved drug concentration distribution. Compared with before,monthly inventory amount was decreased 27.07%(P<0.05)in the condition that both drug purchases and sales amount were increased,into-warehouse time of pharmacy acceptance was decreased from 6-12 s in each drug to 10-15 s in each order,pharmacy staff dropped from 2.5 to 2 persons. CONCLUSIONS:The collaboration application of HIS and SPD in drug logistics management has improved efficiency of warehouse,reduced drug inven-tory and achieved the informatization and scientization of drug inventory management.

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.

An analysis is made according to policy documents of localities on capitation payment, and by means of literature review and the analysis framework of the World Bank,this paper reviewed studied the following:definition of service package,per capita rate,designated institutions,design of financial regulations,and service supervision.Given the attempts made at localities,most of the schemes are incomplete in design,and defective in capitation measurement methods and dynamic adjustment mechanisms.The authors recommend a systematic design of the capitation payment scheme for better outcomes.

Objective: The main objective of the present study is to develop the risk-adjusted capitation pay-ment standards to compensate health service providers. Methods:Descriptive statistical analysis was conducted to an-alyze the insured's enrollment and visit conditions, and the two-part model was conducted to obtain the appropriate compensation standard using data retrieved from information system of social health insurance for the period of 2014 to 2015 in Shenzhen City. Results:The estimated value of total expenditure per insured person per month is 6. 17 yuan. Age,sex,insurance level and with or without chronic disease or catastrophic disease were elicited as risk adjustors. The whole number insured people were divided into 52 groups by this four risk-adjustment factors whereby the rele-vant payment standards for each group was calculated. Conclusions:By adjusting capitation fee on the grounds of risk of disease and expected expense of medical services of the insured, the capitation payment standards can be calculat-ed virtually. This method will promote the process of capitation payment system reform and also lay a solid foundation for further research.

Objective:To explore the clinical efficacy of dual-kidney transplantation from infant donors to adult recipients.Methods:From December 2012 to November 2020 in Organ Transplant Center First Affiliated Hospital Sun Yat-sen University, rertrospective reviews were conducted for clinical data of 25 pairs of infant donors and adult recipients. The survival rates were calculated for both recipients and transplanted kidneys at Year 1/3/5 post-transplantation. And the postoperative recovery status and the postoperative incidence of adverse events of recipients were observed.Results:The survival rates of recipients were all 95.8% at Year 1/3/5 and those of transplanted kidney and dealth-cancelling transplanted kidney all 87.2%. One case died due to acute inferior-wall cardiac infarction while three others lost renal functions for vascular thrombosis, ureteral stenosis and urinary fistula. Except for loss of renal function and death, the postoperative estimated golmerular fitration rate was (99.35±21.78), (103.11±29.20) and (114.99±28.55) ml/(min·1.73 m 2) at Year 1/2/3 respectively. Conclusions:Selecting proper recipients, standardizing donor acquisition and surgical procedures and strengthening perioperative managements may expand the donor pool. The overall outcomes are excellent for adult recipients with dual-kidney transplantation from donations after infants' death.

Objective To assess the safety and the curative effect of the combination of minipercutaneous nephrolithotomy (mini-PCNL) and ureteroscopic lithotripsy (URL) in the treatment of nonhydronephrotic staghorn calculi. Methods The clinical data of 53 eases with non-hydronephrotic staghom calculi treated by mini-PCNL combined with URL were retrospectively analyzed. Results Fifty-three cases (64 renal units) were performed first-stsge operation, 9 renal units were stone free in first-stage operation, 33 renal units were stone free in second-stage operation, other 13 renal units were stone free in third-stage operation. A complete stone clearance rate of 85.9%(55/64) was achieved, and after one to three sessions of mini-PCNL and extracorpereal shock wave lithotripsy afterwards that increased to 95.3% (61/64). Blood transfusion was performed in 3 cases, no major complication was noted in the patients. Conclusions The combination of mini-PCNL and URL has more advantages, less invasions, easier recovery and less complications. It provides a new minimally invasive way for non-hydronephrotic staghorn calculi.

Objective To explore emergency treatment methods for acute renal failure caused by negative imaging ureterolith. Methods There were 36 cases of acute renal failure caused by negative imaging ureterolith, which were finally diagnosed by ureteroscope examination. The negative imaging ureterolith were broken by air pressure ballistic curve shock wave,and taken out of ureter by ureteroscope. All cases were put double-J in ureter. Results Thirty-six cases were got success relieves of ureter obstruction in 24 hours. The urine volume of them were increased, symptoms of urinemia were disappeared, BUN and creatinine were normal after operations. Conclusions The treatment and diagnosis methods by ureteroscope for acute renal failure caused by negative imaging ureterolith are quick and safety, which can treat both side ureterolith at the same time and get reliable and safe effect with less trauma. It should be the first choice to treat acute renal failure caused by negative imaging ureterolith.

Objective To evaluate the clinical applications of rigid dilatation using double catheter method for ureteric stenosis.Methods The clinical data of 51 ureteric stenosis patients who had underwent rigid dilatation using double catheters method were retrospectively analyzed. Results Among the 51 patients,the ureteroscopy successfully went through the stricture in 46 cases(90.2%),and all patients had no ureteral perforation or laceration.Among the 5 patients in whom ureteroscopy did not go successfully through the stricture,2 cases were placed double J tube,2 cases underwent percutaneous nephrolithotomy,and 1 case underwent two stage ureteral stricture resection and religation.All patients were examined by ultrasound examination 3 months after the treatment,and the degree of hydronephrosis was partial remission. Conclusions The double catheters method is a safe and effective way for rigid dilatation for ureteric stenosis,and it is worth popularizing.

Since the new medical reform,the scale of public hospitals at all levels and types in China has grown rapidly,resulting in a series of problems such as continued increase in financial burden,excessive growth in health expenses,and serious imbalance in the distribution of social basic medical insurance funds.Due to the ambiguous understanding of the connotation of the scale of China's public hospitals and the underlying driving forces of growth,and the traditional economic explanation of the growth of public hospital scale in China is not convincing.In view of this,revealing the essential driving framework for the scale growth of public hospitals in China from a new economic perspective has become a key theoretical issue to guide the next stage of high-quality development of public hospitals in China.It used the complex system modeling method to measure the growth of China's public hos-pitals since the new medical reform,and summarized the increasingly complex institutional spectrum of contempo-rary public hospitals.Drawing on the perspectives of the system's own costs and system change costs in new insti-tutional economics,starting from the analysis of system costs,it is proposed that under the premise of price regula-tion,it is the best strategy for public hospitals to compensate for institutional costs through scale growth.Finally,based on the three situations of prisoner's dilemma game,deer hunting game,and rule-abiding game experienced by public hospitals since the new health reform,the development path of public hospitals from single scale growth to extended scale growth,and then to collaborative scale growth was summarized.