1.Interpreting the Key Differences between CHS-DRG 2.0 and 1.1 from a Clinical Management Perspective
Xinbing LÜ ; Chunhua PAN ; Xifeng SHEN ; Baoyan ZHANG ; Xiang LONG ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2025;44(4):50-55
Objective:Interpret the key differences between the China Health-care Security Diagnosis Related Groups(CHS-DRG)2.0 and CHS-DRG 1.1,and provide reference for optimizing management strategies in medical institutions.Methods:Text analysis was used to import the CHS-DRG 2.0 and 1.1 grouping scheme dictionary data into the SQL database in a structured table format using SQL Server 2014.The key differences between the two schemes in grouping structure,grouping rules,grouping results,and other aspects were identified.Results:CHS-DRG 2.0 version added 26 groups,deleted 3 groups,and refined 10 groups into 20 groups for 14 clinical specialties at the ADRG level compared to CHS-DRG 1.1.Some group codes,names,and grouping rules were adjusted;Adjusted some grouping conditions and grouping results at the DRG level.Conclusion:CHS-DRG 2.0 version has improved grouping efficiency compared to CHS-DRG 1.1,solved some clinical bottleneck problems,and standardized the role of clinical diagnosis in grouping from the perspective of resource consumption.However,it has not completely solved the grouping problems of multi disease co treatment,multi disease treatment,and combined surgery.The adjustment of DRG weights and rates,the follow-up of related supporting policy reforms,and the negative effects of DRG will still pose challenges for medical institutions.
2.Interpreting the Key Differences between CHS-DRG 2.0 and 1.1 from a Clinical Management Perspective
Xinbing LÜ ; Chunhua PAN ; Xifeng SHEN ; Baoyan ZHANG ; Xiang LONG ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2025;44(4):50-55
Objective:Interpret the key differences between the China Health-care Security Diagnosis Related Groups(CHS-DRG)2.0 and CHS-DRG 1.1,and provide reference for optimizing management strategies in medical institutions.Methods:Text analysis was used to import the CHS-DRG 2.0 and 1.1 grouping scheme dictionary data into the SQL database in a structured table format using SQL Server 2014.The key differences between the two schemes in grouping structure,grouping rules,grouping results,and other aspects were identified.Results:CHS-DRG 2.0 version added 26 groups,deleted 3 groups,and refined 10 groups into 20 groups for 14 clinical specialties at the ADRG level compared to CHS-DRG 1.1.Some group codes,names,and grouping rules were adjusted;Adjusted some grouping conditions and grouping results at the DRG level.Conclusion:CHS-DRG 2.0 version has improved grouping efficiency compared to CHS-DRG 1.1,solved some clinical bottleneck problems,and standardized the role of clinical diagnosis in grouping from the perspective of resource consumption.However,it has not completely solved the grouping problems of multi disease co treatment,multi disease treatment,and combined surgery.The adjustment of DRG weights and rates,the follow-up of related supporting policy reforms,and the negative effects of DRG will still pose challenges for medical institutions.
3.Analysis of influencing factors and pathways of postoperative self-efficacy in patients with fragility fracture
Li LI ; Yawen SHEN ; Delong LI ; Fangfang CHENG ; Xifeng YU ; Linlin PAN ; Shuyuan ZHUANG ; Sihong DONG ; Jiao WU ; Yan LIANG ; Yuantong ZANG
Chinese Journal of Nursing 2024;59(24):3003-3008
Objective To investigate the relationship between symptom burden and rehabilitation self-efficacy of patients after fragility fracture surgery,and to study the chain mediating role of social support and perceived stress in the influence of symptom burden on rehabilitation self-efficacy of such patients.Methods Approved by the Ethics Committee of the hospital,168 patients who met the admission criteria after fragility fracture surgery admitted to the Second Affiliated Hospital of Inner Mongolia Medical University from July 2020 to December 2023 were included in the study by convenient sampling method,and general data of the patients were collected.M.D.Anderson Symptom Inventor(MDASI),Self-Efficacy for Managing Chronic Disease 6-Item Scale(SECD6),Social Support Rating Scale(SSRS)and Perceived Stress Scale(CPSS)were used to investigate the above patients,and multiple sets of quantitative data were analyzed for attribution association profile and mediation effect.Results After removing invalid questionnaires,a total of 160 valid questionnaires were collected,with an effective response rate of 95.24%.Correlation analysis showed that symptom burden was negatively correlated with rehabilitation self-efficacy(r=-0.405,P<0.05);social support was significantly positively correlated with rehabilitation self-efficacy(r=0.558,P<0.05);perceived stress was negatively correlated with rehabilitation self-efficacy(r=-0.330,P<0.05);symptom burden was negatively correlated with social support(r=-0.191,P<0.05);social support was negatively correlated with perceived stress(r=-0.280,P<0.05);symptom burden was positively correlated with perceived stress(r=0.376,P<0.05).Mediating effect test showed that the symptom burden of patients after fragility fracture surgery had a direct impact on rehabilitation self-efficacy(β=-0.402,t=0.148,P<0.05),and had an impact on rehabilitation self-efficacy through 3 mediating pathways:first,the mediating effect of social support alone(β=-0.098,95%CI:-0.112~-0.074);the second was the mediating effect of stress perception alone(β=-0.081,95%CI:-0.104~-0.061);the third is the chain mediating effect of social support and stress perception(β=-0.056,95%CI:-0.074~-0.030).Conclusion The burden of symptoms after fragility fracture surgery has a direct effect on rehabilitation self-efficacy.Symptom burden influences postoperative self-efficacy of patients with fragility fractures through the chain mediation of social support and perceived stress.Early and accurate assessment of symptom burden,stress perception and social support should be conducted.According to needs,the multidisciplinary medical team provides individualized and diversified health education support to actively help and guide the self-regulation of patients'stress perception,so as to reduce patients'symptom burden and promote the improvement of their self-efficacy in the process of rehabilitation.
4.Identification and expression analysis of the YABBY gene family in strawberry.
Tingting YU ; Shurong SHEN ; Yiling XU ; Xinyu WANG ; Yao YU ; Bojun MA ; Xifeng CHEN
Chinese Journal of Biotechnology 2024;40(1):104-121
YABBY proteins are important transcription factors that regulate morphogenesis and organ development in plants. In order to study the YABBY of strawberry, bioinformatic technique were used to identify the YABBY gene families in Fragaria vesca (diploid) and Fragaria×ananassa (octoploid), and then analyze the sequence characters, phylogeny and collinearity of the family members. The RNA-seq data and the quantitative reverse transcription-polymerase chain reaction (qRT-PCR) technique were used to assay the expression patterns of the family members. A green fluorescent protein (GFP) was fused with FvYABBYs and transiently expressed in tobacco leaf cells for the subcellular localization. As the results, six FvYABBY genes and 26 FxaYABBY genes were identified from F. vesca and F.×ananassa, respectively. The FvYABBY genes were grouped into five clades, and five family members were orthologous with AtYABBY genes of Arabidopsis. In F. vesca, all of the FvYABBYs were basically not expressed not expressed in root and receptacle, while FvYABBY1, FvYABBY2, FvYABBY5 and FvYABBY6 were highly expressed in leaf, shoot, flower and achene. In F.×ananassa, FxaYABBY1, FxaYABBY2, FxaYABBY5 and FxaYABBY6 were expressed in achene, and all FxaYABBY were poorly or not expressed in receptacle. Additionally, under the abiotic stresses of low temperature, high salt and drought, the expression of FvYABBY1, FvYABBY3, FvYABBY4 and FvYABBY6 were down-regulated, FvYABBY5 was up-regulated, and FvYABBY2 was up-regulated and then down-regulated. In tobacco leaf cells, the subcellular localization of FvYABBY proteins were in the nucleus. These results provides a foundation for the functional researches of YABBY gene in strawberry.
Fragaria/genetics*
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Arabidopsis
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Biological Assay
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Cold Temperature
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Computational Biology
5.Research on the Application of TOPSIS Combined with RSR Comprehensive Evaluation Method in the Construction of CHS-DRG Operational Performance System
Xinbing LÜ ; Liping MENG ; Chunhua PAN ; Haimei XIE ; Xifeng SHEN ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2024;43(9):23-28
Objective:To explore the role of Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)combined with Rank Sum Ration(RSR)comprehensive evaluation method in establishing the China Healthcare Security Diagnosis Related Groups(CHS-DRG)operational performance system under the CHS-DRG payment system.Methods:SPSSPRO statistical analysis software was used,and TOPSIS method was used to regularly evaluate and rank the CHS-DRG disease groups in the hospital based on five indicators:Case Mix Index(CMI),total weight,average cost per weight,average length of stay per weight,and group profit and loss.RSR method was used to classify the TOPSIS disease group ranking results,establish performance reward standards for different grades of disease groups,and summarize and restore the reward results for each patient in the disease group to each clinical department,ultimately forming a department performance reward plan.The changes in key operational indicators related to medical insurance patients in hospitals were observed to verify the effectiveness of implementing performance reward programs.Results:After the application of TOPSIS combined with RSR comprehensive evaluation method in the construction of CHS-DRG operational performance system,the number of hospital medical insurance patients were increased,CMI value were stabilized,average cost per visit were decreased,average length of stay were shortened,and DRG disease group surplus were increased.Conclusion:The TOPSIS combined with RSR comprehensive evaluation method has played a good role in the construction of the CHS-DRG operational performance system.As a method of hospital economic operation evaluation,it is practical and innovative.
6.Research on the Application of TOPSIS Combined with RSR Comprehensive Evaluation Method in the Construction of CHS-DRG Operational Performance System
Xinbing LÜ ; Liping MENG ; Chunhua PAN ; Haimei XIE ; Xifeng SHEN ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2024;43(9):23-28
Objective:To explore the role of Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)combined with Rank Sum Ration(RSR)comprehensive evaluation method in establishing the China Healthcare Security Diagnosis Related Groups(CHS-DRG)operational performance system under the CHS-DRG payment system.Methods:SPSSPRO statistical analysis software was used,and TOPSIS method was used to regularly evaluate and rank the CHS-DRG disease groups in the hospital based on five indicators:Case Mix Index(CMI),total weight,average cost per weight,average length of stay per weight,and group profit and loss.RSR method was used to classify the TOPSIS disease group ranking results,establish performance reward standards for different grades of disease groups,and summarize and restore the reward results for each patient in the disease group to each clinical department,ultimately forming a department performance reward plan.The changes in key operational indicators related to medical insurance patients in hospitals were observed to verify the effectiveness of implementing performance reward programs.Results:After the application of TOPSIS combined with RSR comprehensive evaluation method in the construction of CHS-DRG operational performance system,the number of hospital medical insurance patients were increased,CMI value were stabilized,average cost per visit were decreased,average length of stay were shortened,and DRG disease group surplus were increased.Conclusion:The TOPSIS combined with RSR comprehensive evaluation method has played a good role in the construction of the CHS-DRG operational performance system.As a method of hospital economic operation evaluation,it is practical and innovative.
7.Research on the Application of TOPSIS Combined with RSR Comprehensive Evaluation Method in the Construction of CHS-DRG Operational Performance System
Xinbing LÜ ; Liping MENG ; Chunhua PAN ; Haimei XIE ; Xifeng SHEN ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2024;43(9):23-28
Objective:To explore the role of Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)combined with Rank Sum Ration(RSR)comprehensive evaluation method in establishing the China Healthcare Security Diagnosis Related Groups(CHS-DRG)operational performance system under the CHS-DRG payment system.Methods:SPSSPRO statistical analysis software was used,and TOPSIS method was used to regularly evaluate and rank the CHS-DRG disease groups in the hospital based on five indicators:Case Mix Index(CMI),total weight,average cost per weight,average length of stay per weight,and group profit and loss.RSR method was used to classify the TOPSIS disease group ranking results,establish performance reward standards for different grades of disease groups,and summarize and restore the reward results for each patient in the disease group to each clinical department,ultimately forming a department performance reward plan.The changes in key operational indicators related to medical insurance patients in hospitals were observed to verify the effectiveness of implementing performance reward programs.Results:After the application of TOPSIS combined with RSR comprehensive evaluation method in the construction of CHS-DRG operational performance system,the number of hospital medical insurance patients were increased,CMI value were stabilized,average cost per visit were decreased,average length of stay were shortened,and DRG disease group surplus were increased.Conclusion:The TOPSIS combined with RSR comprehensive evaluation method has played a good role in the construction of the CHS-DRG operational performance system.As a method of hospital economic operation evaluation,it is practical and innovative.
8.Research on the Application of TOPSIS Combined with RSR Comprehensive Evaluation Method in the Construction of CHS-DRG Operational Performance System
Xinbing LÜ ; Liping MENG ; Chunhua PAN ; Haimei XIE ; Xifeng SHEN ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2024;43(9):23-28
Objective:To explore the role of Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)combined with Rank Sum Ration(RSR)comprehensive evaluation method in establishing the China Healthcare Security Diagnosis Related Groups(CHS-DRG)operational performance system under the CHS-DRG payment system.Methods:SPSSPRO statistical analysis software was used,and TOPSIS method was used to regularly evaluate and rank the CHS-DRG disease groups in the hospital based on five indicators:Case Mix Index(CMI),total weight,average cost per weight,average length of stay per weight,and group profit and loss.RSR method was used to classify the TOPSIS disease group ranking results,establish performance reward standards for different grades of disease groups,and summarize and restore the reward results for each patient in the disease group to each clinical department,ultimately forming a department performance reward plan.The changes in key operational indicators related to medical insurance patients in hospitals were observed to verify the effectiveness of implementing performance reward programs.Results:After the application of TOPSIS combined with RSR comprehensive evaluation method in the construction of CHS-DRG operational performance system,the number of hospital medical insurance patients were increased,CMI value were stabilized,average cost per visit were decreased,average length of stay were shortened,and DRG disease group surplus were increased.Conclusion:The TOPSIS combined with RSR comprehensive evaluation method has played a good role in the construction of the CHS-DRG operational performance system.As a method of hospital economic operation evaluation,it is practical and innovative.
9.Research on the Application of TOPSIS Combined with RSR Comprehensive Evaluation Method in the Construction of CHS-DRG Operational Performance System
Xinbing LÜ ; Liping MENG ; Chunhua PAN ; Haimei XIE ; Xifeng SHEN ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2024;43(9):23-28
Objective:To explore the role of Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)combined with Rank Sum Ration(RSR)comprehensive evaluation method in establishing the China Healthcare Security Diagnosis Related Groups(CHS-DRG)operational performance system under the CHS-DRG payment system.Methods:SPSSPRO statistical analysis software was used,and TOPSIS method was used to regularly evaluate and rank the CHS-DRG disease groups in the hospital based on five indicators:Case Mix Index(CMI),total weight,average cost per weight,average length of stay per weight,and group profit and loss.RSR method was used to classify the TOPSIS disease group ranking results,establish performance reward standards for different grades of disease groups,and summarize and restore the reward results for each patient in the disease group to each clinical department,ultimately forming a department performance reward plan.The changes in key operational indicators related to medical insurance patients in hospitals were observed to verify the effectiveness of implementing performance reward programs.Results:After the application of TOPSIS combined with RSR comprehensive evaluation method in the construction of CHS-DRG operational performance system,the number of hospital medical insurance patients were increased,CMI value were stabilized,average cost per visit were decreased,average length of stay were shortened,and DRG disease group surplus were increased.Conclusion:The TOPSIS combined with RSR comprehensive evaluation method has played a good role in the construction of the CHS-DRG operational performance system.As a method of hospital economic operation evaluation,it is practical and innovative.
10.Research on the Application of TOPSIS Combined with RSR Comprehensive Evaluation Method in the Construction of CHS-DRG Operational Performance System
Xinbing LÜ ; Liping MENG ; Chunhua PAN ; Haimei XIE ; Xifeng SHEN ; Xiaokun GENG ; Yingfeng WU
Chinese Health Economics 2024;43(9):23-28
Objective:To explore the role of Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)combined with Rank Sum Ration(RSR)comprehensive evaluation method in establishing the China Healthcare Security Diagnosis Related Groups(CHS-DRG)operational performance system under the CHS-DRG payment system.Methods:SPSSPRO statistical analysis software was used,and TOPSIS method was used to regularly evaluate and rank the CHS-DRG disease groups in the hospital based on five indicators:Case Mix Index(CMI),total weight,average cost per weight,average length of stay per weight,and group profit and loss.RSR method was used to classify the TOPSIS disease group ranking results,establish performance reward standards for different grades of disease groups,and summarize and restore the reward results for each patient in the disease group to each clinical department,ultimately forming a department performance reward plan.The changes in key operational indicators related to medical insurance patients in hospitals were observed to verify the effectiveness of implementing performance reward programs.Results:After the application of TOPSIS combined with RSR comprehensive evaluation method in the construction of CHS-DRG operational performance system,the number of hospital medical insurance patients were increased,CMI value were stabilized,average cost per visit were decreased,average length of stay were shortened,and DRG disease group surplus were increased.Conclusion:The TOPSIS combined with RSR comprehensive evaluation method has played a good role in the construction of the CHS-DRG operational performance system.As a method of hospital economic operation evaluation,it is practical and innovative.

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