1.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.
2.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.
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.Surveillance of bacterial resistance in tertiary hospitals across China:results of CHINET Antimicrobial Resistance Surveillance Program in 2022
Yan GUO ; Fupin HU ; Demei ZHU ; Fu WANG ; Xiaofei JIANG ; Yingchun XU ; Xiaojiang ZHANG ; Fengbo ZHANG ; Ping JI ; Yi XIE ; Yuling XIAO ; Chuanqing WANG ; Pan FU ; Yuanhong XU ; Ying HUANG ; Ziyong SUN ; Zhongju CHEN ; Jingyong SUN ; Qing CHEN ; Yunzhuo CHU ; Sufei TIAN ; Zhidong HU ; Jin LI ; Yunsong YU ; Jie LIN ; Bin SHAN ; Yunmin XU ; Sufang GUO ; Yanyan WANG ; Lianhua WEI ; Keke LI ; Hong ZHANG ; Fen PAN ; Yunjian HU ; Xiaoman AI ; Chao ZHUO ; Danhong SU ; Dawen GUO ; Jinying ZHAO ; Hua YU ; Xiangning HUANG ; Wen'en LIU ; Yanming LI ; Yan JIN ; Chunhong SHAO ; Xuesong XU ; Wei LI ; Shanmei WANG ; Yafei CHU ; Lixia ZHANG ; Juan MA ; Shuping ZHOU ; Yan ZHOU ; Lei ZHU ; Jinhua MENG ; Fang DONG ; Zhiyong LÜ ; Fangfang HU ; Han SHEN ; Wanqing ZHOU ; Wei JIA ; Gang LI ; Jinsong WU ; Yuemei LU ; Jihong LI ; Qian SUN ; Jinju DUAN ; Jianbang KANG ; Xiaobo MA ; Yanqing ZHENG ; Ruyi GUO ; Yan ZHU ; Yunsheng CHEN ; Qing MENG ; Shifu WANG ; Xuefei HU ; Wenhui HUANG ; Juan LI ; Quangui SHI ; Juan YANG ; Abulimiti REZIWAGULI ; Lili HUANG ; Xuejun SHAO ; Xiaoyan REN ; Dong LI ; Qun ZHANG ; Xue CHEN ; Rihai LI ; Jieli XU ; Kaijie GAO ; Lu XU ; Lin LIN ; Zhuo ZHANG ; Jianlong LIU ; Min FU ; Yinghui GUO ; Wenchao ZHANG ; Zengguo WANG ; Kai JIA ; Yun XIA ; Shan SUN ; Huimin YANG ; Yan MIAO ; Mingming ZHOU ; Shihai ZHANG ; Hongjuan LIU ; Nan CHEN ; Chan LI ; Jilu SHEN ; Wanqi MEN ; Peng WANG ; Xiaowei ZHANG ; Yanyan LIU ; Yong AN
Chinese Journal of Infection and Chemotherapy 2024;24(3):277-286
Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5%were gram-positive and 70.5%were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3%,76.7%and 77.9%,respectively.Overall,94.0%of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8%of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2%in the isolates from children and 95.7%in the isolates from adults.The resistance rate to carbapenems was lower than 13.1%in most Enterobacterales species except for Klebsiella,21.7%-23.1%of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1%to 13.3%.The prevalence of meropenem-resistant strains decreased from 23.5%in 2019 to 18.0%in 2022 in Pseudomonas aeruginosa,and decreased from 79.0%in 2019 to 72.5%in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.
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.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.
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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