Objective:To explore the evaluation index system of the competency of economic management personnel at different levels in public hospitals,in order to provide a basis for the training and evaluation of economic management personnel in public hospitals.Method:Based on the literature research method,the onion model"outermost layer-middle layer-core layer"is used as the logical framework to preliminarily construct the initial index pool.At the same time,combined with the expert consultation method and hierarchical analysis method,the competence index system of high-level,middle-level economic management personnel is constructed and endowed with weight.The scoring questionnaire was designed,and Xinhua hospital in Shanghai was selected as a case for the empirical study,so as to improve the evaluation index system.Results:The competency index system of grass-roots,middle-level and high-level economic managers in public hospitals is constructed,including 3 first-level indicators,18 second-level indicators and corresponding weights.The economic management personnel of the case hospital have a high competence level,and the positive relationship between rank and competence.Conclusion:The competency index system constructed is characterized by scientificity,practicability and reliability;with the rise in rank,there are obvious differences in the importance and content of the competency elements of economic managers at all levels.Therefore,the training system of economic management personnel at different ranks can be constructed through differentiated strategies to improve the level of competence.

Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.

Objective:To explore the evaluation index system of the competency of economic management personnel at different levels in public hospitals,in order to provide a basis for the training and evaluation of economic management personnel in public hospitals.Method:Based on the literature research method,the onion model"outermost layer-middle layer-core layer"is used as the logical framework to preliminarily construct the initial index pool.At the same time,combined with the expert consultation method and hierarchical analysis method,the competence index system of high-level,middle-level economic management personnel is constructed and endowed with weight.The scoring questionnaire was designed,and Xinhua hospital in Shanghai was selected as a case for the empirical study,so as to improve the evaluation index system.Results:The competency index system of grass-roots,middle-level and high-level economic managers in public hospitals is constructed,including 3 first-level indicators,18 second-level indicators and corresponding weights.The economic management personnel of the case hospital have a high competence level,and the positive relationship between rank and competence.Conclusion:The competency index system constructed is characterized by scientificity,practicability and reliability;with the rise in rank,there are obvious differences in the importance and content of the competency elements of economic managers at all levels.Therefore,the training system of economic management personnel at different ranks can be constructed through differentiated strategies to improve the level of competence.

Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.

Driven by the two-wheel wheels of high-quality development of public hospitals and DRG/DIP payment reform,the operation mode of hospitals urgently needs to shift to the intensive mode of"cost reduction and efficiency increase".As the hub of hospital business operation and an important center of resource integration,the lean management of operating room affects the realization of high-quality development goals of"three transformations and three improvements".Based on the perspective of value chain,it discusses the difficult problems of operating room cost management in public hospitals from three aspects:operation cost motivation,execution cost motivation and structural cost motivation.Then,it puts forward corresponding management strategies to promote lean management of operating room,and help public hospitals to strengthen cost control and improve operational efficiency.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

Driven by the two-wheel wheels of high-quality development of public hospitals and DRG/DIP payment reform,the operation mode of hospitals urgently needs to shift to the intensive mode of"cost reduction and efficiency increase".As the hub of hospital business operation and an important center of resource integration,the lean management of operating room affects the realization of high-quality development goals of"three transformations and three improvements".Based on the perspective of value chain,it discusses the difficult problems of operating room cost management in public hospitals from three aspects:operation cost motivation,execution cost motivation and structural cost motivation.Then,it puts forward corresponding management strategies to promote lean management of operating room,and help public hospitals to strengthen cost control and improve operational efficiency.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

Driven by the two-wheel wheels of high-quality development of public hospitals and DRG/DIP payment reform,the operation mode of hospitals urgently needs to shift to the intensive mode of"cost reduction and efficiency increase".As the hub of hospital business operation and an important center of resource integration,the lean management of operating room affects the realization of high-quality development goals of"three transformations and three improvements".Based on the perspective of value chain,it discusses the difficult problems of operating room cost management in public hospitals from three aspects:operation cost motivation,execution cost motivation and structural cost motivation.Then,it puts forward corresponding management strategies to promote lean management of operating room,and help public hospitals to strengthen cost control and improve operational efficiency.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.