1.Study on bundled payment for breast cancer based on the medical record homepage data of 31 792 inpatient cases
Xin TIAN ; Xiaoyuan BAO ; Zijun ZHOU
Chinese Journal of Hospital Administration 2020;36(3):193-197
Objective:To explore influencing factors of hospitalization cost for breast cancer inpatients, develop an applicable standard using bundled payment approach, so as to provide reference for health insurance organizations to formulate reasonable imbursement method.Methods:31 792 inpatients′ medical records from 16 tertiary hospitals in Beijing, 2015 were included in the present study. Non-parametric tests and logistic regression model for ordinal categorical variable were applied to explore potential influencing factors. Decision tree model was performed to yield case-mix related groups.Results:The breast cancer inpatients were classified into 17 groups based on the following factors: surgical treatment/non-surgical treatment, surgical modality, radiology treatment, lymphadenectomy, comorbidity. RIV(reduction in variance)was 0.26. CV(coefficient of variation)was 0.24~0.97.Conclusions:It was feasible to apply the case-mix bundled payment method as a reimbursement method for breast cancer inpatients. The present study served as reference for formulating related policies.
2.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
3.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
4.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
5.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
6.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
7.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
8.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
9.Assessment of Methodological and Reporting Quality of Hospital Infections Prediction Model
Jiao SHAN ; Xiaoyuan BAO ; Zhizhong GONG ; Yulong CAO
Chinese Hospital Management 2024;44(11):55-59
Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.
10.Analysis of influencing factors for pancreatic endocrine and exocrine insufficiency after pancreaticoduodenectomy
Zhenghua CAI ; Gang LI ; Shanhua BAO ; Xiaojie BIAN ; Yinyin FAN ; Xiaoyuan CHEN ; Yudong QIU
Chinese Journal of Digestive Surgery 2020;19(4):414-420
Objective:To investigate the influencing factors for pancreatic endocrine and exocrine insufficiency after pancreaticoduodenectomy.Methods:The retrospective case-control study was conducted. The clinicopathological data of 168 patients who underwent pancreaticoduodenectomy in the Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2016 to December 2017 were collected. There were 96 males and 72 females, aged (64±13)years, with a range from 38 to 75 years. Of the 168 patients, 36 had pancreatic endocrine insufficiency while 8 had pancreatic exocrine insufficiency preoperatively. All patients underwent pancreaticoduodenectomy. Observation indications: (1) surgical situations and follow-up; (2) analysis of influencing factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy; (3) analysis of influencing factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy. Follow-up using out-patient examination and telephone interview was performed to detect postoperative condition of blood glucose control, diet and nutrition, tumor recurrence and metastasis up to June 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were described as M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the chi-square test. Multivariate analysis was conducted using the Logistic regression model. Results:(1) Surgical situations and follow-up: all the 168 patients underwent pancreaticoduodenectomy successfully and recovered well after operation. All patients were followed up for 6 months. The level of fasting and postprandial blood glucose of the 168 patients after surgery were 7 mmol/L(range, 5-9 mmol/L) and 10 mmol/L(range, 7-14 mmol/L), respectively. The defecation frequency was (2.4±1.2)times per day. No tumor recurrence or metastasis occurred in either patient. One hundred and thirty-two of the 168 patients were included in the study excepting patients with pancreatic endocrine insufficiency before operation. At postoperative 6 months, 47 patients developed pancreatic endocrine insufficiency, with an incidence of 35.61%(47/132). One hundred and sixty of the 168 patients were included in the study excepting patients with pancreatic exocrine insufficiency before operation. At postoperative 6 months, 68 patients had pancreatic exocrine insufficiency, with an incidence rate of 42.50%(68/160). (2) Analysis of influencing factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy. Results of univariate analysis showed that gender, metabolic syndrome, chronic pancreatitis, excision point, and postoperative chemotherapy were the related factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy ( χ2=5.300, 6.270, 4.473, 4.392, 5.397, P<0.05). Results of multivariate analysis revealed that male and metabolic syndrome were independent risk factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy [ hazard ratio ( HR)=5.252, 5.364, 95% confidence interval ( CI): 1.362-6.382, 1.891-12.592, P<0.05)]. (3) Analysis of risk factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy. Results of univariate analysis showed that body mass index (BMI), chronic pancreatitis, total bilirubin, excision point, postoperative pancreatic fistula as grade B or C, and pancreatic fibrosis were related factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy ( χ2=1.691, 4.910, 7.763, 5.605, 4.663, 7.700, P<0.05). Results of multivariate analysis showed that BMI<18.5 kg/m 2, chronic pancreatitis, total bilirubin ≥171 μmol/L were independent risk factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy ( HR=3.695, 5.231, 7.623, 95% CI: 1.232-7.324, 2.161-6.893, 1.562-5.235, P<0.05). Conclusions:Male and metabolic syndrome are risk factors for pancreatic endocrine insufficiency after pancreaticoduodenectomy. BMI<18.5 kg/m 2, chronic pancreatitis, and total bilirubin ≥171 μmol/L are risk factors for pancreatic exocrine insufficiency after pancreaticoduodenectomy.