ObjectiveTo systematically explore the current practical status, core predicaments, and optimization paths of effective contract fulfillment by family doctors in Shanghai from the perspective of informatization, and to provide empirical support and policy references for the high-quality development of contracted services. MethodsA mixed research approach was adopted. The connotation of effective contract fulfillment, the current status of informatization support, and the priority of demand were comprehensively analyzed through policy document review, in-depth interviews with key informants, and a questionnaire survey covering 45 community health service centers across all 16 districts of Shanghai. ResultsThe family doctor contract service in Shanghai has formed a dual-core framework of “accurate contracting” and “substantive service delivery”, yet challenges persist in system interoperability, health data integration, and the limited diversity of service outreach tools. The comprehensive utilization rate of the information integration terminal in the 45 surveyed community health service centers was merely 50.74%. Three prioritized demands were identified: horizontal connectivity between the Hospital Information System (HIS) and the public health system for contract status updates, integration of “medical-prevention-management” information, and automated generation of health assessments. Based on these findings, this study proposed a closed-loop fulfillment pathway of “tag generation-task management-service delivery-data return”. ConclusionTo facilitate the high-quality development of contracted services, it is recommended to transform the concept of contracted services and promote the integration of medical care and disease prevention through information system construction from a holistic perspective. Concurrently, municipal top-level design and district-level platform development should be reinforced to refine data governance and application. Furthermore, substantial efforts should be devoted to cultivating interdisciplinary talents bridging clinical practice and information technology, thus strengthening the convergence of clinical and information operations.

To analyze the factors affecting the cost of hospitalization for patients and provide insights using the intrauterine lesion surgery group (DRG code NE19) as an example.

Objective To discuss the effects of resistant starch (RS ) on metabolism of type 2 diabetes mellitus (T2DM ) . Methods The databases of Pubmed ,Ovid ,Embase and Cochrane Library were retrieved for search the randomized controlled trials (RCTs) on RS intervention on T2DM .The retrieval time was until June 21 ,2016 .The literature quality was assessed by using the bias risk evaluation tool recommended by Cochrane collaboration net .The related data were integrated and analyzed by using the Stata 12 .0 software .Results A total of 909 articles were retrieved out ,in which 6 articles met the included criteria and 308 cases were included as the research subjects .All the studies demonstrated that fasting blood glucose(FBG) in the patients with T2DM was decreased significantly after RS intervention .Four studies detected postprandial blood glucose and considered that postprandial glucose was decreased significantly after RS intervention (P=0 .023 ,P=0 .010 ,P<0 .05 ,P=0 .045) .Three studies .reported the related data of fasting total cholesterol(TC) and triglyceride(TG) ,but the study results were greatly different from each other .3 stidies indicated that compared with control group ,the HDL-C level of the RS group was significantly increased (P<0 .05) ,while the level of LDL-C had no obvious difference .In Bodinham′s .study ,HDL-C and LDL-C had no obvious difference between the two groups .The study by Gargari′s and Bodinham′s .thought the level of TNF-αin the RS group was significantly decreased (P<0 .05 , P=0 .013) ,however ,the former thought that the level of IL-6 in the RS group was also decreased ,while the latter thought that compared with the control group ,the IL-6 level had no significant difference .Conclusion RS can increase insulin sensitivity inT2DM patients ,and improves glucolipid metabolic disorder .