1.A Study on methods of risk-adjusted capitation fee of risk pooling for outpatient services in basic medical insurance:A case study of Shenzhen City
Lihuan AI ; Ronghai WU ; Li XIAO ; Zhiguo ZHANG
Chinese Journal of Health Policy 2017;10(9):39-45
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.
2.Case study of clinic facility layout optimization at public hospitals
Zhiguo ZHANG ; Donghua LI ; Lihuan AI ; Junling CHEN ; Guanhua WU ; Juan XU ; Li XIAO
Chinese Journal of Hospital Administration 2016;32(6):441-443
Hospital cases were collected from 18 hospitals regarding their clinic facility layout optimization when they implement the National Healthcare Improvement Initiative.These data were used to learn the implementation at such hospitals,and summarize problems and experiences of the Initiative,for reference of sustained improvements.
3.Surgical management of acute calculous cholecystitis in over 80 years of age patients
Yu CHENG ; Xiaohui RAO ; Sheng ZHANG ; Zhiguo AI ; Yunfan LUO ; Yu DENG ; Xiaoping LUO
Chinese Journal of General Surgery 2018;33(7):567-570
Objective To explore the clinical characteristics of acute calculous cholecystitis in over 80 years old patients.Methods A retrospective study was made on the clinical data of 71 cases diagnosed as acute calculous cholecystitis and receiving surgical treatment from Sep 2006 to Sep 2016.Patients were divided into three groups:Early LC group (25 patients),PTGD group (29 patients),the staged LC group (17 patients) after PTGD.Results There was statistically significant difference in the gallbladder wall thickness,operation time and blood loss between the two LC groups.There was no statistically significant difference between the two LC groups in other baseline data and hospital stay,hospital cost,rate of postoperational complication,rate of conversion to open procedure between the two LC groups.There was statistically significant difference between the early LC group and PTGD group in the baseline data.Logistic regression analysis indicated that the TG13 grade was an important influence factor for treatment selection of PTGD (OR=3.957,P=0.015,95%CI:1.30-12.043).Conclusion Laparoscopic cholecystectomy was safe for good risk over 80 years old patients.For poor risk patients,PTGD is recommended before a LC attempt.
4.Association analysis of PPP1R3A gene polymorphism with schizophrenia in Uygur Chinese population.
Xinyu SHI ; Zhiguo AN ; Lele SUN ; Bin XU ; Daibin MU ; Songnian FU ; Hongxing HU ; Xiao LUO ; Wen DU ; Ping YAN ; Lu JIN ; Dan NIE ; Limu-Ershaer-Ai KAO ; Yongyong SHI ; Qingzhong. YI
Chinese Journal of Nervous and Mental Diseases 2019;45(6):356-360
Objective To explore the correlation between exon region polymorphism of PPP1R3A gene and schizophrenia in Uygur Chinese population. Methods PPP1R3A gene exon region DNA amplification was performed using multiple PCR targeted capture next-generation sequencing method in 528 patients with schizophrenia and 576 healthy controls of Uyghur descent, Illumina HiSeq X Ten was used for sequencing, the symptoms of schizophrenia were assessed by positive and negative symptoms scale (PANSS). Results The allelic and genotypic distributions in rs1800000 of PPP1R3A gene between patients with schizophrenia and healthy controls had significant difference (P<0.05), rs1799999 in genotype frequency between the female case and control groups showed significant difference (P<0.05). Furthermore, the allelic distributions of rs8192686 between male cases and controls had significant difference (P<0.05). Conclusion PPP1R3A gene rs1800000 may be associated with the development of schizophrenia in Uygur Chinese population; rs1799999 may be a risk factor for susceptibility of female Uygur Chinese schizophrenia; The C allele at rs8192686 may be associated with male Uygur Chinese schizophrenia.