Objective:To analyze the impact of diagnosis-intervention packet payment (DIP) reform on hospitalization service capacity and patients′ economic burden, for references for promoting China′s medical insurance payment reform.Methods:Data were collected from the discharge summarizes of 116 545 hospitalized patients from a tertiary hospital in Guangdong Province. Among them, there were 42 534 cases before the DIP reform (January 2016 to December 2017) and 74 011 cases after the reform (January 2018 to December 2020). The all-cause in-hospital mortality rate, length of hospital stay, disease severity, readmission rate within 30 days, total hospitalization costs, and patient out of pocket expenses were used as evaluation indicators for hospitalization service capacity and patient economic burden. Intermittent time series analysis was conducted to examine the changes in indicators before and after DIP reform.Results:The slope of the change trend of all-cause in-hospital mortality rate and readmission rate within 30 days before and after DIP reform was not statistically significant ( P<0.05); The length of hospital stay showed a decreasing trend before the reform ( P=0.047), but the trend after the reform was not statistically significant ( P=0.776); The change trend of disease severity before the reform was not statistically significant ( P=0.682), but showed a significant upward trend after the reform ( P=0.012); The total hospitalization costs significantly increased during the reform ( P<0.001), but the trend of change after the reform was not statistically significant ( P=0.431); The patient′s out of pocket expenses showed an upward trend before the reform ( P=0.001), but the change trend after the reform was not statistically significant ( P=0.757). Conclusions:DIP reform could help hospitals improve their inpatient service capabilities and enhance their functional positioning; Strengthen medical cost management and control the increase in economic burden on hospitalized patients.

Objective:To analyze the impact of diagnosis-intervention packet payment (DIP) reform on hospitalization service capacity and patients′ economic burden, for references for promoting China′s medical insurance payment reform.Methods:Data were collected from the discharge summarizes of 116 545 hospitalized patients from a tertiary hospital in Guangdong Province. Among them, there were 42 534 cases before the DIP reform (January 2016 to December 2017) and 74 011 cases after the reform (January 2018 to December 2020). The all-cause in-hospital mortality rate, length of hospital stay, disease severity, readmission rate within 30 days, total hospitalization costs, and patient out of pocket expenses were used as evaluation indicators for hospitalization service capacity and patient economic burden. Intermittent time series analysis was conducted to examine the changes in indicators before and after DIP reform.Results:The slope of the change trend of all-cause in-hospital mortality rate and readmission rate within 30 days before and after DIP reform was not statistically significant ( P<0.05); The length of hospital stay showed a decreasing trend before the reform ( P=0.047), but the trend after the reform was not statistically significant ( P=0.776); The change trend of disease severity before the reform was not statistically significant ( P=0.682), but showed a significant upward trend after the reform ( P=0.012); The total hospitalization costs significantly increased during the reform ( P<0.001), but the trend of change after the reform was not statistically significant ( P=0.431); The patient′s out of pocket expenses showed an upward trend before the reform ( P=0.001), but the change trend after the reform was not statistically significant ( P=0.757). Conclusions:DIP reform could help hospitals improve their inpatient service capabilities and enhance their functional positioning; Strengthen medical cost management and control the increase in economic burden on hospitalized patients.

OBJECTIVETo investigate the effects of CysLT receptor agonist leukotriene D4(LTD4) and antagonists on activation of microglia BV2 cells.

METHODSThe expression of CysLT1 and CysLT2 protein was determined by Western blotting and immunostaining in microglia BV2 cells. BV2 cells were pretreated with or without CysLT1 receptor selective antagonist montelukast, CysLT2 receptor selective antagonist HAMI 3379, or CysLT1/CysLT2 receptor dual antagonist BAY u9773 for 30 min, then the cells were treated with LTD4 for 24 h. Cell viability was detected by MTT reduction assay. Phagocytosis and mRNA expression of IL-6 were determined by fluorescent bead tracking and RT-PCR, respectively.

RESULTSIn BV2 cells, LTD4 did not affect proliferation but significantly enhanced phagocytosis and increased IL-6 mRNA expression in a concentration-dependent manner. LTD4 at 100 nmol/L induced a 1.4-fold increase of phagocytic index and a 2-fold up-regulation of IL-6 mRNA expression (P<0.01). HAMI 3379 and BAY u9773 (100 nmol/L) further increased LTD4-induced phagocytosis; BAY u9773 and montelukast decreased LTD4-induced IL-6 mRNA expression, while HAMI 3379 had no effect on that.

CONCLUSIONLTD4 activates BV2 cells in vitro and enhances IL-6 mRNA expression mediated by CysLT1 receptor, LTD4 induces phagocytosis which might be negatively regulated by CysLT2 receptor in BV2 cells.

Acetates ; pharmacology ; Cell Line ; Cell Proliferation ; Cyclohexanecarboxylic Acids ; pharmacology ; Humans ; Interleukin-6 ; metabolism ; Leukotriene Antagonists ; pharmacology ; Leukotriene D4 ; pharmacology ; Microglia ; cytology ; metabolism ; Phagocytosis ; Phthalic Acids ; pharmacology ; Quinolines ; pharmacology ; Receptors, Leukotriene ; metabolism ; SRS-A ; analogs & derivatives ; pharmacology