1.Policy evolution and development suggestions of patient medical experience in China
Xia LIN ; Limei CHEN ; Songtao DENG ; Yanran SONG ; Benyan LI ; Xinxin CAO ; Hongyun WANG ; Lanting LYU ; Hu CHEN
Chinese Journal of Hospital Administration 2024;40(11):832-837
In 2023, the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the " Notice on carrying out the theme activity to improve medical experience and enhance patient experience", China has entered a new stage of development in the field of medical service improvement. This study, through literature research, sorted out the evolution of China′s patient medical experience-related policies and the shift in concept from satisfaction to medical experience. It divided the historical evolution of patient medical experience policies into four periods: the exploration period, the development period, the policy improvement period, and the new policy implementation period, based on the implementation of reform and opening up, the introduction of new medical reforms, and the proposal of the " theme activity" in 2023. From May to August 2023, interviews were conducted with 20 experts in the field of health management, 20 clinical doctors, and 20 inpatients to discuss China′s experience, deficiencies, and suggestions for improving patient medical experience. Based on the interview materials, this study summarized China′s experience and deficiencies in enhancing patient medical experience from aspects such as resources, systems, concepts, and human resources. It suggested adjusting the structure and layout of medical resources to enhance the balance of high-quality medical resource allocation; establishing a comprehensive evaluation system for patient medical experience; increasing the attention and conceptual understanding of health administrative departments and medical institutions at all levels to optimize patient medical experience, and improving the formulation and connection of supporting policies; caring for medical staff and fully mobilizing their initiative to enhance patient experience, in order to continuously improve patient medical experience.
2.Analysis of factors influencing patients′ medical experience based on grounded theory
Xia LIN ; Benyan LI ; Songtao DENG ; Yanran SONG ; Xinxin CAO ; Limei CHEN ; Hongyun WANG ; Lanting LYU ; Xiaona DAI ; Hu CHEN
Chinese Journal of Hospital Administration 2024;40(11):838-843
Objective:To analyze the factors influencing patients′ medical experience, to provide reference for medical institutions to improve patients′ medical experience.Methods:A stratified sampling method was employed nationwide to select 32 patients and 20 medical staff. From May to August 2023, semi-structured interviews were conducted with them regarding the factors influencing patients′ medical experience. The data from the interviews were analyzed using programmed grounded theory, which led to the identification of factors affecting patients′ medical experience.Results:After three-level coding, four main categories of demographic characteristics, self health characteristics, medical outcome experience, and medical process experience, two core categories of patient related influencing factors and hospital related influencing factors were obtained. Additionally were also obtained.Conclusions:The factors influencing patients′ medical experience are multifaceted and jointly dominated by multiple stakeholders. Medical institutions should adopt a variety of measures to continuously improve patients′ medical experience. When assessing patients′ medical experience, the impact of individual differences among patients on the assessment results should be fully considered.
3.Policy evolution and development suggestions of patient medical experience in China
Xia LIN ; Limei CHEN ; Songtao DENG ; Yanran SONG ; Benyan LI ; Xinxin CAO ; Hongyun WANG ; Lanting LYU ; Hu CHEN
Chinese Journal of Hospital Administration 2024;40(11):832-837
In 2023, the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the " Notice on carrying out the theme activity to improve medical experience and enhance patient experience", China has entered a new stage of development in the field of medical service improvement. This study, through literature research, sorted out the evolution of China′s patient medical experience-related policies and the shift in concept from satisfaction to medical experience. It divided the historical evolution of patient medical experience policies into four periods: the exploration period, the development period, the policy improvement period, and the new policy implementation period, based on the implementation of reform and opening up, the introduction of new medical reforms, and the proposal of the " theme activity" in 2023. From May to August 2023, interviews were conducted with 20 experts in the field of health management, 20 clinical doctors, and 20 inpatients to discuss China′s experience, deficiencies, and suggestions for improving patient medical experience. Based on the interview materials, this study summarized China′s experience and deficiencies in enhancing patient medical experience from aspects such as resources, systems, concepts, and human resources. It suggested adjusting the structure and layout of medical resources to enhance the balance of high-quality medical resource allocation; establishing a comprehensive evaluation system for patient medical experience; increasing the attention and conceptual understanding of health administrative departments and medical institutions at all levels to optimize patient medical experience, and improving the formulation and connection of supporting policies; caring for medical staff and fully mobilizing their initiative to enhance patient experience, in order to continuously improve patient medical experience.
4.Analysis of factors influencing patients′ medical experience based on grounded theory
Xia LIN ; Benyan LI ; Songtao DENG ; Yanran SONG ; Xinxin CAO ; Limei CHEN ; Hongyun WANG ; Lanting LYU ; Xiaona DAI ; Hu CHEN
Chinese Journal of Hospital Administration 2024;40(11):838-843
Objective:To analyze the factors influencing patients′ medical experience, to provide reference for medical institutions to improve patients′ medical experience.Methods:A stratified sampling method was employed nationwide to select 32 patients and 20 medical staff. From May to August 2023, semi-structured interviews were conducted with them regarding the factors influencing patients′ medical experience. The data from the interviews were analyzed using programmed grounded theory, which led to the identification of factors affecting patients′ medical experience.Results:After three-level coding, four main categories of demographic characteristics, self health characteristics, medical outcome experience, and medical process experience, two core categories of patient related influencing factors and hospital related influencing factors were obtained. Additionally were also obtained.Conclusions:The factors influencing patients′ medical experience are multifaceted and jointly dominated by multiple stakeholders. Medical institutions should adopt a variety of measures to continuously improve patients′ medical experience. When assessing patients′ medical experience, the impact of individual differences among patients on the assessment results should be fully considered.
5.Effect of Wine Processing on Odour Formation of Polygonatum cyrtonema Rhizoma by GC-MS
Minmin LIU ; Ying LIU ; Tao ZHANG ; Lanting XIA ; Min HUANG ; Yating XIE ; Yaling DENG ; Aiyuan KANG ; Hongmin REN ; Jinlian ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(17):166-173
ObjectiveBy exploring the volatile components, polysaccharide composition and changes in the contents of five carbohydrate components of Polygonatum cyrtonema rhizoma before and after processing, and then the effect of yellow rice wine on the odour formation of P. cyrtonema rhizoma was investigated. MethodThe volatile components of P. cyrtonema rhizoma before and after processing were detected by headspace gas chromatography-mass spectrometry(HS-GC-MS), and sample data were subjected to principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) using SIMCA 14.1, then the differences between these components of P. cyrtonema rhizoma before and after processing were screened according to the principle of variable importance in the projection(VIP) value>1. Crude carbohydrate components in raw and wine-processed P. cyrtonema rhizoma were subjected to oxime and silylation, the carbohydrate components were analyzed by gas chromatography-mass spectrometry(GC-MS/MS), and the relative contents of various components were calculated by peak area normalization, then quantitative analysis of four carbohydrate components was also carried out. ResultA total of 23 volatile components were identified from the raw products and the wine-processed products, including 15 components in raw products and 20 components in wine-processed products. Among them, 2-methylbutyraldehyde and isovaleraldehyde had a sweet odor and their contents increased after processing, but the contents of hexanal and caproic acid decreased, new components such as 2-acetylfuran and 5-methylfuranal were produced after processing. PCA and OPLS-DA results showed that there were significant differences between raw products and the wine-processed products, a total of 13 differential compounds were screened out, of which 7 showed an upward trend in relative content and 6 showed a downward trend. A total of 7 carbohydrate components, including 5 monosaccharides and 2 disaccharides, were identified in raw products and the wine-processed products. The results of determination showed that the contents of fructose, glucose, mannose and sucrose in P. cyrtonema rhizoma increased after wine-processing, and their increases were 4.54, 1.51, 2.93, 3.66 times, respectively. ConclusionAfter processing, the increase of aromatic flavor of P. cyrtonema rhizoma may be related to the increase of the contents of aldehydes such as 2-methylbutyraldehyde and isovaleraldehyde, while the decrease of raw flavor may be related to the decrease of the contents of volatile components such as hexanal and hexanoic acid, the increase of sweet flavor may be related to the increase of the contents of monosaccharides and oligosaccharides such as fructose and sucrose.
6.Factors Associated with Macular Staphyloma Area on Ultra-widefield Fundus Images
Xinmei ZHANG ; Emmanuel Eric PAZO ; Aoqi ZHANG ; Lanting YANG ; Guangzheng DAI ; Xianwei WU ; Yang XIA ; Amit MESHI ; Wei HE ; Tiezhu LIN
Korean Journal of Ophthalmology 2022;36(3):210-217
Purpose:
To assess the feasibility of applying ultra-widefield fundus (UWF) images for macular staphyloma area (MSA) measurement and investigate the associated factors with MSA.
Methods:
This is a retrospective study. MSA was measured by UWF imaging. Central foveal thickness, subfoveal choroidal thickness, subfoveal scleral thickness were measured on spectral domain optical coherence tomography. Intraclass correlation coefficients of MSA measurement would be evaluated. Multiple linear regression analysis was used to analyze the associated factors with MSA.
Results:
In total, 135 eyes of 92 patients were enrolled. The mean age was 64.73 ± 10.84 years. Mean MSA on UWF image was 279.67 ± 71.70 mm2. Intraclass correlation coefficients of MSA measurement was 0.965 (95% confidence interval [CI], 0.946 to 0.977; p < 0.001). In the multiple linear regression analysis, after adjusting for subfoveal choroidal thickness, best-corrected visual acuity, central foveal thickness, and subfoveal scleral thickness, the factors independently related to MSA were axial length (β = 8.352; 95% CI, 3.306 to 13.398; p = 0.001), sex (β = -26.673; 95% CI, -51.759 to -1.586; p = 0.037), age (β = 1.184; 95% CI, 0.020 to 2.348; p = 0.046).
Conclusions
It is feasible to measure MSA on UWF image. Female, longer axial length, and older age may indicate larger MSA.
7.The present situation of clinical application management and assessment of medical technology in China
Xia LIN ; Fei BAI ; Lanting LYU ; Dun JIN ; Yongjun TENG ; Xuecheng GAO
Chinese Journal of Hospital Administration 2020;36(2):99-102
New " management measures and regulations for medical technology clinical use and research" was officially implemented on November 1, 2018. Under the background of the adjustment of the national medical technology clinical application management system, the authors collected and analyzed the research on the clinical application management and evaluation of medical technology from 30 tertiary public hospitals in 8 provinces, as well as other data, summarized the current status and problems, attempted to provide reference for the optimization and system construction of medical technology management and evaluation system in China.
8.Analysis on the decision-making need of new technology access of tertiary public hospitals in China
Xia LIN ; Lanting LYU ; Libo TAO ; Yushan JIANG ; Shixiong LIU ; Fei BAI
Chinese Journal of Hospital Administration 2020;36(2):95-98
Objective:To analyze the differences in information needs of doctors, middle managers, and hospital leaders in tertiary public hospitals in the process of new technology access.Methods:From January to October 2018, 1 200 doctors and hospital administrators from 30 tertiary public hospitals in 8 provinces were selected. The importance scores of different positions for decision-making information demand of new technology introduction were collected through questionnaire survey, and the scores were analyzed by SPSS 25.0 software. Descriptive statistical analysis was performed.Results:1 032 valid questionnaires were obtained. Hospital-level leaders, middle-level managers, and doctors scored higher on the clinical application, safety, and effectiveness of technology at home and abroad(more than 4 points, maximum 5 points). Hospital-level leaders and middle-level managers had higher scores on effectiveness, evidence quality, possibility of being covered by medical insurance, ethics and relevant indicators of strategic level, while doctors had higher scores on health economics and organizational indicators.Conclusions:There are some differences in the information demand for new technology access among different positions in tertiary public hospitals. Understanding the decision-making needs of different positions is conducive to promoting the actual implementation of hospital-based health technology assessment standards in China′s public hospitals.
9.Study on the economic evaluation of hospital-based health technology assessment
Lanting LYU ; Wenkai SHI ; Xia LIN ; Fei BAI
Chinese Journal of Hospital Administration 2020;36(2):103-107
Different from the traditional health technology assessment(HTA), hospital-based health technology assessment(HB-HTA) is mainly based on the perspective of the hospital to carry out economic analysis, commonly used cost-effectiveness analysis combined with budget impact analysis methods. It pays attention to the current medical costs and effects, and supports the hospital′s internal health technology access, purchase pricing, elimination and other decisions. In the context of deepening the reform of medical insurance payment mode in China, the hospital internal medicine decision-making based on HB-HTA is particularly important. Based on the economic characteristics of health technology, the authors analyzed the differences between HB-HTA and traditional HTA in carrying out economic evaluation, introduced the steps, contents, indicators and methods of HB-HTA economic evaluation, and put forward relevant strategic suggestions.
10.Study on new medical technology access index system for tertiary public hospitals
Xia LIN ; Lanting LYU ; Dun JIN ; Yongjun TENG ; Na LI ; Fei BAI
Chinese Journal of Hospital Administration 2019;35(5):384-387
Objective To establish a scientific and comprehensive evaluation index for new technology access in tertiary public hospital, so as to provide a tool for new technology access management system and scientific basis for decision-making. Methods This study collected data from eight provinces nationwide including 30 tertiary public hospital based new technology access application, catalogued dimensions of application. It also referred to the European Union, Denmark, Canada and other countries in forming the hospital health technology assessment form, along with two rounds of Delphi expert consultation. Results The new medical technology access index system of China′s tertiary public hospitals was preliminarily formed, including 5 first-level indexes and 24 level-2 indexes. Conclusions The two rounds of expert advice have a high degree of consistency, indicating that the indicators are in line with the actual situation of hospital management in China, yet with rooms of constant improvement in practice.

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