2.The sensitization pattern of Blomia tropicalis in allergic respiratory disease in Guangzhou
Xiaoqing LIU ; Peiyan ZHENG ; Chuanxu CAI ; Nili WEI ; Zhifeng HUANG ; Xiangwei ZOU ; Baoqing SUN
The Journal of Practical Medicine 2018;34(10):1720-1724
Objective To investigate the sensitization pattern of Blomia tropicalis in patients with aller-gic respiratory disease and the association between Blomia tropicalis with allergic rhinitis and / or asthma. Meth-ods 330 allergic rhinitis and / or asthma patients sensitized with mites were selected in Guangzhou,and sIgE lev-el in the serum of all recruited patients of Blomia tropical,Dermatophagoide pteronyssinus and Dermatophagoide fa-rina was measured. Results The sensitization rate of Blomia tropicalis was significantly lower than that of Derma-tophagoide pteronyssinus and Dermatophagoide farina(P < 0.001,both). 80.0% Patients were sensitized with both three mites,and only 0.3% patients were of monosensitization to Blomia tropicalis. The sIgE of these three mites were significantly positive correlated with each other(P < 0.001),Dermatophagoide pteronyssinus and Derma-tophagoide farina have strong correlation(r = 0.906),Blomia tropicalis has moderate correlation with Dermatopha-goide pteronyssinus and Dermatophagoide farina(r = 0.540 and r = 0.512,respectively). With the increase of Blomia tropicalis sIgE,the severe sensitization rate(sIgE level:class 5~6)of patients sensitized combined Der-matophagoide pteronyssinus or Dermatophagoide farina significantly increased(P < 0.001). The sIgE level of Der-matophagoide pteronyssinus and Dermatophagoide farina in allergic asthma and rhinitis patients were significantly higher than that of patients with rhinitis or asthma alone(P < 0.001),and the sIgE level of Blomia tropicalis in pa-tients with both allergic asthma and rhinitis or with asthma alone were also significantly higher than that of patients with rhinitis alone(P = 0.006 and P = 0.020,respectively). Conclusion The Blomia tropicalis sensitized pa-tients usually sensitize together with Dermatophagoide pteronyssinus or Dermatophagoide farina,and the degree of Blomia tropicalis sensitized in asthma patients are higher.
3.Impacts of Diagnosis Related Groups and Balanced Score-card on inpatient medical services
Dafa ZHANG ; Xiaohong DENG ; Shuying SHI ; Yuan ZHANG ; Xiangwei MA ; Tao XU ; Hong PENG ; Jing CHEN ; Moning GUO ; Jie ZHENG ; Deyao SUN ; Xiumei ZHANG ; Weiyan JIAN ; Ming LU ; Shengpu DU ; Mu HU
Chinese Journal of Hospital Administration 2011;27(11):801-808
Objective To improve overall value of healthcare industry through setting up critical inpatient medical services strategic plan.Methods Identify major objectives which the local government expects to achieve through strategic map; Standardize inpatient output and assign weight to each group through diagonosis related groups; Translate the objectives of strategic map and result of diagnosis related group to Balanced Score-card; Finally build up strategic map and according action plans.ResultsPreliminarily established 16 objectives、23 measures and 13 tasks in four perspectives including customer,internal work flow,learning and growing and finance.ConclusionThe strategy map and the balanced score-card can help implement full strategic plan of regional inpatient medical services; DRGs is a core management tool of patient-centred service output management; Balanced Score-card is able to realize continuous improvement of Beijing inpatient medical services from macro to micro persoetive.
4.Analysis of the effects of national centralized drug volume-based procurement policy in public medical institutions of the Guangxi Zhuang Autonomous Region
Zheng ZENG ; Liucen WU ; Zhenguang HUANG ; Wenli HE ; Zhengcheng MI ; Xiangwei XIE ; Siduo SU ; Guicheng LIANG ; Yaoling LIAO ; Hongliang ZHANG
China Pharmacy 2024;35(5):518-523
OBJECTIVE To investigate the implementation effects of the national centralized drug volume-based procurement policy (abbreviated as “national centralized procurement policy”) in Guangxi Zhuang Autonomous Region prefecture, and to provide a reference for the future centralized drug procurement work of the medical institution. METHODS Drug procurement data before and after policy implementation were included in the study. The six secondary indicators (such as availability, affordability, and drug safety) and eighteen third-level indicators (such as completion rate of agreed purchase volume, affordability level, drug revenue proportion) were introduced, guided by the policy objectives and issues of concern to policy beneficiaries. Descriptive statistics was adopted to analyze the data before and after policy implementation (in 2019 and 2020) in terms of differences and change trends. RESULTS In terms of accessibility, the participation rate of medical institutions in Guangxi Zhuang Autonomous Region was 92.55%, the proportion of diseases involved and median completed procurement rate were 40.16%, and 287.82% respectively, and the total centralized delivery rate was 97.20%. In terms of affordability, the total reduction amplitude in drug price was 74.80% from 2019 to 2022; the charge for medicine per capita in hospitalization, the proportion of medicine used for outpatient service and hospitalization, decreased by 17.61%, 10.22%, and 20.10% in order; the burden levels on medical fares for patients were all below 1 in addition to chronic diseases, and anti-tumor drugs. In terms of the impact on medicine, the ratio of adverse drug reaction event cases in 2022 was 66.00%, an increase of 1.29% compared to the previous; since the implementation of the policy, 12 drugs from local pharmaceutical enterprises from Guangxi Zhuang Autonomous Region had passed the consistency evaluation, and the market concentration rate of the top 8 pharmaceutical companies was less than 20.00%. In terms of the impact on healthcare and medical insurance, the public medical institutions achieved generic substitution for originator drugs mostly until 2022; about 9.12% of drugs that were non- centrally purchased in the same category were used; 63.39% of people under investigation did not show a need for a second dressing change; drug expenditure decreased by 2.459 billion yuan. CONCLUSIONS The national centralized procurement policy achieves a significant effect in Guangxi Zhuang Autonomous Region. On the other hand, attention should be paid to these suggestions as follows: expanding the category of drugs used in clinic, conducting clinically comprehensive evaluation of selected drugs, and improving reasonable allocation strategy, etc.