1.Impact of two DRG performance management approaches on the operations of neurology and neuro-surgery departments
Yongji MENG ; Quan WEN ; Minlan ZHANG ; Linling QIN ; Qin LYU
Modern Hospital 2025;25(2):266-269
Objective To examine the impact of two DRG performance management approaches on the operations of neu-rology and neurosurgery departments.Methods DRG discharge case data were collected from a tertiary hospital in Laibin City between January 2022 and April 2024.The Interrupted Time Series(ITS)was used to analyze the impact of the two types of DRG performance management on financial performance,service capacity and efficiency,patient burden,and profitability of the neurology and neurosurgery departments.Heatmap clustering analysis was employed to compare the changes in disease surplus rates before and after the two management models,and non-parametric tests were conducted to analyze the impact of departmental transfers on hospitalization costs.Results The change in the ITS(Interrupted Time Series)slope coefficient for operational effi-ciency was significant in the neurology department but not in neurosurgery.The change rates of disease surplus in the two depart-ments were classified into five categories,with similar trends observed in diseases with closely related weights.Furthermore,hos-pitalization costs for certain diseases significantly increased following the transfer of patients from one department to the other(P<0.05).Conclusion Significant differences exist in the impact of different DRG(Diagnosis-Related Group)performance management approaches in the same department,and the same DRG performance management approach has varying effects on dif-ferent departments.Departmental transfer is a key factor influencing hospitalization costs.
2.Impact of two DRG performance management approaches on the operations of neurology and neuro-surgery departments
Yongji MENG ; Quan WEN ; Minlan ZHANG ; Linling QIN ; Qin LYU
Modern Hospital 2025;25(2):266-269
Objective To examine the impact of two DRG performance management approaches on the operations of neu-rology and neurosurgery departments.Methods DRG discharge case data were collected from a tertiary hospital in Laibin City between January 2022 and April 2024.The Interrupted Time Series(ITS)was used to analyze the impact of the two types of DRG performance management on financial performance,service capacity and efficiency,patient burden,and profitability of the neurology and neurosurgery departments.Heatmap clustering analysis was employed to compare the changes in disease surplus rates before and after the two management models,and non-parametric tests were conducted to analyze the impact of departmental transfers on hospitalization costs.Results The change in the ITS(Interrupted Time Series)slope coefficient for operational effi-ciency was significant in the neurology department but not in neurosurgery.The change rates of disease surplus in the two depart-ments were classified into five categories,with similar trends observed in diseases with closely related weights.Furthermore,hos-pitalization costs for certain diseases significantly increased following the transfer of patients from one department to the other(P<0.05).Conclusion Significant differences exist in the impact of different DRG(Diagnosis-Related Group)performance management approaches in the same department,and the same DRG performance management approach has varying effects on dif-ferent departments.Departmental transfer is a key factor influencing hospitalization costs.
3.Analysis of risk factors of recurrent uveitis and establishment of prediction model
Jin, GONG ; Ping, WANG ; Guanghai, QIN ; Qingguo, YANG ; Ting, ZHAO ; Linling, WANG
Chinese Journal of Experimental Ophthalmology 2014;32(7):627-630
Background Replase of uveitis is a primary cause of vision damage.To predict recurrentassociated factors for uveitis is very critical for the prevention and management of uveitis.Objective This study was to explore the risk factors of recurrent uveitis and establish the prediction model of recurrent uveitis.Methods Clinical data of recurrent uveitis patients who were diagnosed in Renhe Hospital of Three Gorges University from July 1,2010 to June 30,2011 were retrospectively reviewed.The demography characteristics of the patients were collected and the disease was followed-up under the informed consent.Kaplan-Meier method was used to estimate the disease recurrence rate and to plot relapse-free survival curve at different levels of predictive factors.Multivariate Cox proportional hazards model was used to select independent risk factors of relapse and establish the prediction model for recurrent uveitis.Results Total 825 cases of recurrent uveitis were included and followed up for 1 month to 38 months,with a median following-up time of 16 months.Relapse of uveitis was identified in 149 cases (18.1%)during the following-up duration.The relapse-free survival time was from 1 month to 38 months,and the 1-,2-and 3-year cumulative recurrence-free survival rates were 87.3%,82.8% and 80.9%.Multivariate Cox proportional hazards regression analysis showed that immunosuppression withdrawal(X1) (β =0.940,Waldx2 =12.018,P =0.001),oral steroid withdrawal (X2) (β =1.334,Wald x2 =18.450,P < 0.001),colds (X3) (β =0.642,Wald x2 =11.988,P =0.001),work and study stress(X4) (β=0.285,Wald x2 =4.925,P=0.026) and excessive alcohol and tobacco(X5) (3--0.541,Wald x2 =4.718,P =0.030) were the independent risk factors for recurrence of uveitis.The risk of recurrence in patients with uveitis function model expression was h (t)=h0 exp (2.559 X1 +3.797 X2 + 1.901 X3 + 1.331 X4 +1.719 X5).Conclusions Replase of uveitis is an interaction of many factors,and immunosuppression withdrawal,oral steroid withdrawal,colds,work and study stress,excessive alcohol and tobacco are independent risk factors for recurrence of uveitis.An intervention according to the controllable factors is one of the important ways to prevent the recurrence of uveitis.

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