1.Study on the Web-based Courseware Construction of Medical Physics
Hong WU ; Xiaolin LI ; Zhigang GAI ; Jianqiang LIU ; Yuanyuan FENG
Chinese Journal of Medical Physics 2010;27(2):1814-1815,1824
The entry of the modern information technology and the appearance of the new teaching medium cause the new ed-ucational pattern innovations, bring the life and vitality to the medical physics education in medicine institutions of higher learning. This paper analyzed the current situation of the modern information technology application in medical physics teach-ing briefly, put forward several problems about the modern information technology application in medical physics teaching, and discussed the medical physics network course construction in medicine institutions of higher learning.
2.Analysis of the influence of age on average medical expenses under the diagnosis related group and prospective payment system model
Chao LI ; Yuanyuan GAI ; Qi PAN ; Tong CHEN
Chinese Journal of Geriatrics 2021;40(11):1425-1428
Objective:To study the influence of patients' ages on average medical expenses under the diagnosis related group and prospective payment system(DRG-PPS)model.Methods:Medical records of 52 987 selected patients at a third-tier general hospital in Beijing were collected from January 1 to December 31, 2019, and were then divided into three age groups based on age, the elderly group, the middle-aged group and the young group, and one-way ANOVA was used to determine differences in medical expenses between the same DRG group and different age groups.Related-sample nonparametric tests and linear regression were carried out for the three age groups to estimate the influence of the age factor on the medical expenses of different DRG groups.Results:First, the data of the three age groups in the same DRG group were analyzed by one-way ANOVA.The P values of the DRG groups were less than 0.05, except for the cb39 crystal surgery DRG group; Then, the data of the three age groups in different DRG groups were analyzed with the nonparametric test( P=0.021, less than 0.05); Finally, linear regression analysis was also used to analyze the case data of the three age groups.The p value was less than 0.05, and the standardized influence coefficient was 0.173, suggesting age was positively correlated with hospitalization expenses. Conclusions:Age affects average hospitalization expenses.After the implementation of the DRG-PPS model, the payment of DRG patients should be standardized with the inclusion of the age factor.
3.Study on an age-adjusted cost model of the prospective payment system under diagnosis-related groups
Chao LI ; Suowei WU ; Ji LUO ; Yuanyuan GAI
Chinese Journal of Geriatrics 2023;42(11):1357-1362
Objective:To analyze the adjustment of the amount of medical insurance reimbursement with the addition of the age factor, making the system more in line with the actual clinical resource consumption.Methods:Data were collected from the first page of medical records of 54 535 inpatients discharged from hospital between January 1 th, 2021 and December 31 th, 2021.First, the paired t-test was used to verify any statistical difference between the standard payment amounts before and after adjustment based on the model and the actual hospitalization expenses.Secondly, the actual cost was compared with the cost after the model-based adjustment and the current benchmark cost(before adjustment), respectively.The standard deviations of the two groups were compared to assess the difference between the benchmark cost and the actual cost before and after adjustment. Results:Through the Blom formula, the actual cost, adjusted benchmark cost and current benchmark cost data were normalized.After normalization, the actual expenses and the adjusted benchmark cost as well as the actual expenses and the current benchmark cost were compared, respectively, using the paired t-test, producing a P value of 0.97 for the former pair and a P value of 0.93 for the latter pair, both greater than 0.05, and the benchmark cost before and after adjustment could reflect the actual clinical resource consumption.However, the effect of benchmark cost adjustment was assessed by analyzing the standard deviation of the difference between paired values of the two groups.The standard deviation of paired values between the actual expense and the adjusted benchmark cost was 0.68, lower than the standard deviation of paired values between the actual expense and current benchmark cost, which was 0.7. Conclusions:With the inclusion of the age factor, the model can reasonably adjust the current benchmark cost based on the patient's age and verify that the adjusted benchmark cost can more accurately reflect the actual clinical resource consumption compared with the current standard.However, further improvement of the payment adjustment model is still needed.
4.Study on the cost adjustment model for patients of different age groups under the diagnosis-related group prospective payment system
Chao LI ; Yuanyuan GAI ; Suowei WU ; Deming YAO
Chinese Journal of Geriatrics 2024;43(7):876-881
Objective:To explore the cost adjustment model based on age coefficient and to make the payment standard more consistent with the actual resource consumption in clinical settings partially address the issue of targeting elderly patients that may arise after the implementation of DRG-PPS payment.Methods:The study analyzed data from all discharged patients in a hospital in 2022.Case rate coefficients were calculated for different age groups(young-middle-aged group, early elderly group, and high-aged elderly group)using the DRG(Diagnosis-related Group)rate formula to adjust the payment standard.The statistical significance of the difference between the actual cost and the current payment standard(within-group difference)was determined using the paired t-test in SPSS software.The Wilcoxon rank sum test was then used to determine the statistical significance of the difference between the actual cost and the adjusted payment standard(between-group difference).To assess the applicability of the age coefficient adjustment model, 11 disease groups were selected, and the Wilcoxon rank sum test was used to determine if there was a statistical difference between the adjusted and non-adjusted groups.The effectiveness of the adjustment was judged based on the standard deviation. Results:There was no significant difference between the actual hospitalization costs and the current standards(Group 1)and the actual hospitalization costs and the adjusted payment standards(Group 2)( P values were 0.928 and 0.949, both greater than or equal to 0.05).The results of the rank sum test showed a statistical difference between the two groups( P value of less than 0.05).Group 1 had a median of -1 644.57, a mean of -999.04, a mean standard error of 70.35, and a standard deviation of 15 024.62.Group 2 had a median of -1 641.88, a mean of -998.50, a mean standard error of 70.32, and a standard deviation of 15 019.24. Conclusions:Both the current and adjusted rates accurately reflect the true cost of hospitalization for patients.However, the adjusted standard is more closely aligned with the actual costs and the model remains valid.partially address the issue of targeting elderly patients that may arise after the implementation of DRG-PPS payment.
5.Selection and Optimization Management of in Vitro Diagnostic Reagents for Clinical Examination in Beijing Hospital
Jingchen SONG ; Chuanbao LI ; Yuanyuan GAI ; Suowei WU ; Lei LIU ; Xuying LI ; Zhixuan GUO ; Deming YAO
Journal of Modern Laboratory Medicine 2024;39(3):194-198
Objective To form the in vitro diagnostic reagents(IVD)selection and optimization management plan and management database,and optimize the IVD management work.Methods Through the analysis of the policy background and the current management status of the IVD clinical laboratory in Beijing Hospital,the selection and optimization management plan for existing and newly applied laboratory IVD was formulated based on clinical needs.The IVD of the whole hospital was selected and optimized by combing projects,open bidding,innovative quotation methods,on-site review and other steps.The IVD management database and qualification database of Beijing Hospital was formed,and the effect from the aspects of compliance,work efficiency and cost control was evaluated.Results The selection and optimization of 1 737 IVDs in the whole hospital were completed according to the formulated IVD selection and optimization management plan.The implementation of management plan improved the work efficiency.The content of review in an average meeting was increased by more than 10 times,and the frequency of new applications for IVD access was accelerated,while the IVD cost was reduced,and the average purchase amount of the whole hospital was reduced by about 15%.The prices of key IVD products were lower after selection than before selection,and the difference was significant(t=2.493,P=0.034).Conclusion The management scheme of IVD selection and optimization was feasible,and it could achieve the goal of ensuring compliance,improving efficiency and reducing costs.