1.Construction of a personnel highland in prefecture-level hospitals
Fen XU ; Zhen LIU ; Lingli YUAN ; Hong FAN ; Zhenlu HUANG
Modern Hospital 2024;24(2):175-177,180
Professional personnel stands as not only a crucial indicator of a hospital's comprehensive strength but also the primary resource driving high-quality development.In constructing the hospital's personnel highland,Chenzhou First People's Hospital adhered to the principle of"Party exercising leadership over personnel",improved its management mechanism,and pro-posed a new policy of 20 articles for the personnel.These means intensified a clear categorization of personnel,emphasized the integrity,capability,and contribution,and established a comprehensive personnel categorization evaluation system.With these efforts,the hospital is actively constructing a personnel highland in prefecture-level hospitals to provide talent support for the high-quality development of the hospital.
2.Quantitative study on high-touch surface in oral diagnosis and treatment procedures
Dan-Hui XU ; Jian-Fen DING ; Zhou-Rui YANG ; Kai HU ; Xiao-Chi CHEN
Chinese Journal of Infection Control 2024;23(3):351-357
Objective To clarify the high-touch surface in oral diagnosis and treatment procedures,provide basis and guidance for cleaning and disinfection.Methods The direct observation method was used to investigate the tou-ch time and frequency of environmental surfaces in 7 outpatient departments of a tertiary stomatology hospitals in Beijing.The average touch frequency,95%confidence interval and cumulative touch rate were calculated.Results In oral diagnosis and treatment procedures,the average touch frequency of the environmental surface was 26.75 times per procedure,with the highest in endodontics(46.25 times per procedure)and the lowest in the oral mucosal specialty(10.19 times per procedure).The high-touch surface consisted of the shadowless lamp handle,manipula-tion panel and handle on dental unit(doctor's side),computer keyboard and mouse,handle and line front end of three way syringe,as well as dental high speed handpiece and line front end,with average touch frequencies of 3.99,3.85,2.65,1.86,and 1.40 times per procedure.The high-touch surface in all stomatology specialties in-cluded the manipulation panel and handle on dental unit(doctor's side),75%of specialties included computer key-board and mouse,and the shadowless lamp handle has the highest touch frequency in 50%of specialties.The ave-rage touch frequency of the environmental surface was highest(113.50 times per procedure)during crown prepara-tion procedure,and the lowest(8.50 times per procedure)during the orthodontic consultations.Conclusion The high-touch surface of different dental specialties and different diagnosis and treatment procedures are different.Me-dical institutions should take corresponding cleaning,disinfection and management measures according to the actual situation of high-touch surface in stomatology departments,so as to effectively improve the quality of environmental cleaning and disinfection.
3.Long-term Hospitalization Payment in the US.and Germany and the Enlightenment for Average Cost of Beds Based Payment in China
Liying ZHENG ; Bifan ZHU ; Fen LI ; Duo CHEN ; Jiajie XU ; Chunlin JIN
Chinese Health Economics 2024;43(1):92-96
The payment methods,such as Diagnosis Related Group(DRG)for hospitalization and capitation for outpatient treat-ment,have achieved positive results in protecting the rights and interests of insured persons and improving the efficiency of the use of medical insurance funds.However,for patients with chronic diseases and rehabilitation nursing,the hospitalization period is long and the conditions complicated,and the payment method of DRGs is not reasonable.It analyzes the experiences of paying for long-term hospital cases in the US.and Germany from the aspect of reform process,payment method and regulatory measures.In order to pro-vide references for the reform of per-diem payment in rehabilitation nursing and other long-term hospitalized cases,it puts forward suggestions from aspects of realizing value care,reflecting individual differences,exploring complex payment methods,improving data quality and establishing constraint mechanism.
4.The application of percutaneous puncture renal fascia suspension in laparoscopic partial nephrectomy
Qi LI ; Pei ZHENG ; Yusheng WANG ; Guangyuan JING ; Mingrui WANG ; Bo ZHAO ; Tengfei XU ; Xiaoli WANG ; Kaidong WANG ; Xiao PAN ; Fen YIN
Chinese Journal of Urology 2024;45(1):53-54
When partial nephrectomy is performed by posterior abdominal approach, the surgical field is poorly exposed, resulting in increased surgical difficulty and risk of injury.In this study, 28 patients with T 1a stage kidney tumors underwent retroperitoneal laparoscopic partial nephrectomy. Intraoperatively, exposure of the surgical field was achieved using the percutaneous puncture of the renal fascia suspension technique. There were no dissatisfactory exposures due to peritoneal damage during the surgery, no additional tubes were inserted, and no conversions to open surgery were needed. The operation time was (76.5±20.3) minutes, blood loss was (92.1±18.7) ml, renal artery clamping time was (19.5±4.3) minutes. Postoperatively, there were no complications such as bleeding, infection, or hematuria.
5.Research on the Compensation Mechanism Reform in Shanghai Public Hospitals under the Background of Medical-Pharmaceutical Separation
Jiajie XU ; Fen LI ; Bifan ZHU
Chinese Health Economics 2024;43(9):35-39
Objective:To review the relevant policies and progress of Shanghai in public hospital compensation,analyze the current situation and time series of the compensation situation of public hospitals in Shanghai,and propose policy suggestions to improve the compensation mechanism for public hospitals,so as to provide references for promoting high-quality development of public hospitals.Methods:Horizontal and longitudinal descriptive statistical analysis were conducted to compare the revenue,expenditure and salary data of public hospitals in Shanghai from 2018 to 2022.Results:Shanghai has gradually optimized the revenue and expenditure structure of public hospitals under the combined effects of removing markups on medical consumables and drugs,adjusting prices of medical services,centralizing volume-based procurement,and reforming the salary system.However,the rising proportion of medical material revenue and proportion of inspection and test revenue have occupied the growth space of medical service revenue,and the medical service income cannot fully compensate for personnel expenditure.Conclusion:It is suggested to further optimize the financial compensation method,optimize the adjustment mechanism of medical service prices,strengthen the refined operation and management of public hospitals,and improve supporting policies.
6.Research on the Compensation Mechanism Reform in Shanghai Public Hospitals under the Background of Medical-Pharmaceutical Separation
Jiajie XU ; Fen LI ; Bifan ZHU
Chinese Health Economics 2024;43(9):35-39
Objective:To review the relevant policies and progress of Shanghai in public hospital compensation,analyze the current situation and time series of the compensation situation of public hospitals in Shanghai,and propose policy suggestions to improve the compensation mechanism for public hospitals,so as to provide references for promoting high-quality development of public hospitals.Methods:Horizontal and longitudinal descriptive statistical analysis were conducted to compare the revenue,expenditure and salary data of public hospitals in Shanghai from 2018 to 2022.Results:Shanghai has gradually optimized the revenue and expenditure structure of public hospitals under the combined effects of removing markups on medical consumables and drugs,adjusting prices of medical services,centralizing volume-based procurement,and reforming the salary system.However,the rising proportion of medical material revenue and proportion of inspection and test revenue have occupied the growth space of medical service revenue,and the medical service income cannot fully compensate for personnel expenditure.Conclusion:It is suggested to further optimize the financial compensation method,optimize the adjustment mechanism of medical service prices,strengthen the refined operation and management of public hospitals,and improve supporting policies.
7.Research on the Compensation Mechanism Reform in Shanghai Public Hospitals under the Background of Medical-Pharmaceutical Separation
Jiajie XU ; Fen LI ; Bifan ZHU
Chinese Health Economics 2024;43(9):35-39
Objective:To review the relevant policies and progress of Shanghai in public hospital compensation,analyze the current situation and time series of the compensation situation of public hospitals in Shanghai,and propose policy suggestions to improve the compensation mechanism for public hospitals,so as to provide references for promoting high-quality development of public hospitals.Methods:Horizontal and longitudinal descriptive statistical analysis were conducted to compare the revenue,expenditure and salary data of public hospitals in Shanghai from 2018 to 2022.Results:Shanghai has gradually optimized the revenue and expenditure structure of public hospitals under the combined effects of removing markups on medical consumables and drugs,adjusting prices of medical services,centralizing volume-based procurement,and reforming the salary system.However,the rising proportion of medical material revenue and proportion of inspection and test revenue have occupied the growth space of medical service revenue,and the medical service income cannot fully compensate for personnel expenditure.Conclusion:It is suggested to further optimize the financial compensation method,optimize the adjustment mechanism of medical service prices,strengthen the refined operation and management of public hospitals,and improve supporting policies.
8.Analysis of urinary iodine level in Hashimoto thyroiditis patients
Xiaodie Li ; Yongxia Xu ; Fen Wang ; Wenlu Guo ; Wei Jia ; Xuefeng Wang ; Lang Lang ; Defa Zhu
Acta Universitatis Medicinalis Anhui 2024;59(1):144-148
Objective :
To analyze the difference of urinary iodine level in Hashimoto thyroiditis ( HT) patients, and to explore the possible relationship between urinary iodine level and HT under different iodine nutritional sta- tus,so as to provide some references for reasonable iodine intake in HT patients.
Methods :
A total of 101 hospi- talized HT patients were selected as HT group and divided into 3 groups according to thyroid function : HT group with hyperthyroidism (41 cases) .There were 25 cases in HT group with normal thyroid function.There were 35 cases in HT combined with hypothyroidism group.In addition,30 healthy subjects were selected as control group. Serum levels of thyroid stimulating hormone(TSH) ,triiodothyronine(T3 ) ,thyroxine (T4 ) ,thyroid peroxidase an- tibody (TPOAb) and thyroglobulin antibody (ATG) were detected by chemiluminescence assay.The size and mor- phological structure of thyroid organs were examined by ultrasonography.Urinary iodine was determined by catalytic spectrophotometry with arsenic and cerium.The nutritional status of iodine was classified into iodine deficiency ( < 100 μg/ L) ,iodine adequacy( 100 -199 μg/ L) ,iodine adequacy (200 -299 μg/ L) and iodine excess ( ≥ 300 μg/ L) .Non-parametric test was used to compare urinary iodine level between HT group and control group,one- way ANOVA and t test were used to compare urinary iodine level between HT group and control group ,and Spearman correlation analysis was used to compare the correlation between urinary iodine level and T3 ,T4 ,TSH, ATG and TPOAb under different iodine nutrition status.
Results :
Compared with control group,ATG and TPOAb levels in HT group increased (P<0. 001) ,and urinary iodine levels increased (P<0. 05) ,with statistical signifi- cance.Compared with the control group in different thyroid function states,only the HT group with hypothyroidism increased the urinary iodine level (P<0. 01) ,and the difference was statistically significant.Spearman correlation analysis showed that urine iodine level was positively correlated with ATG and TPOAb levels in iodine excess condi- tion (P<0. 05) ,and urine iodine level was positively correlated with TSH level in iodine sufficient condition and iodine excess condition in HT patients (P<0. 05) .
Conclusion
The urinary iodine level of HT patients was high- er than that of normal people.When the urinary iodine level of residents is ≥ 300 μg/ L,iodine intake is prone to HT.When the urinary iodine level of HT patients is ≥ 200 μg/ L,iodine consumption is prone to hypothyroidism, and iodine intake should be limited.
9.Research on the Compensation Mechanism Reform in Shanghai Public Hospitals under the Background of Medical-Pharmaceutical Separation
Jiajie XU ; Fen LI ; Bifan ZHU
Chinese Health Economics 2024;43(9):35-39
Objective:To review the relevant policies and progress of Shanghai in public hospital compensation,analyze the current situation and time series of the compensation situation of public hospitals in Shanghai,and propose policy suggestions to improve the compensation mechanism for public hospitals,so as to provide references for promoting high-quality development of public hospitals.Methods:Horizontal and longitudinal descriptive statistical analysis were conducted to compare the revenue,expenditure and salary data of public hospitals in Shanghai from 2018 to 2022.Results:Shanghai has gradually optimized the revenue and expenditure structure of public hospitals under the combined effects of removing markups on medical consumables and drugs,adjusting prices of medical services,centralizing volume-based procurement,and reforming the salary system.However,the rising proportion of medical material revenue and proportion of inspection and test revenue have occupied the growth space of medical service revenue,and the medical service income cannot fully compensate for personnel expenditure.Conclusion:It is suggested to further optimize the financial compensation method,optimize the adjustment mechanism of medical service prices,strengthen the refined operation and management of public hospitals,and improve supporting policies.
10.Research on the Compensation Mechanism Reform in Shanghai Public Hospitals under the Background of Medical-Pharmaceutical Separation
Jiajie XU ; Fen LI ; Bifan ZHU
Chinese Health Economics 2024;43(9):35-39
Objective:To review the relevant policies and progress of Shanghai in public hospital compensation,analyze the current situation and time series of the compensation situation of public hospitals in Shanghai,and propose policy suggestions to improve the compensation mechanism for public hospitals,so as to provide references for promoting high-quality development of public hospitals.Methods:Horizontal and longitudinal descriptive statistical analysis were conducted to compare the revenue,expenditure and salary data of public hospitals in Shanghai from 2018 to 2022.Results:Shanghai has gradually optimized the revenue and expenditure structure of public hospitals under the combined effects of removing markups on medical consumables and drugs,adjusting prices of medical services,centralizing volume-based procurement,and reforming the salary system.However,the rising proportion of medical material revenue and proportion of inspection and test revenue have occupied the growth space of medical service revenue,and the medical service income cannot fully compensate for personnel expenditure.Conclusion:It is suggested to further optimize the financial compensation method,optimize the adjustment mechanism of medical service prices,strengthen the refined operation and management of public hospitals,and improve supporting policies.


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