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Chinese Journal Of Hospital Statistics
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2018 Vol. 25, No. 5
Published: 2018-10-25
Statistical Methods and Applications
Medical Record Management
Hospital Management
Hospitalization Statistics
Computer Application
Statistical Methods and Applications
321
Research on the forecast of income in large comprehensive public hospital based on grey prediction and artificial neural network model
Zhang Zhongwen,Wang Jiu, Sun Hongwei, Meng Jinliang
DOI: 10.3969/j.issn.1006-5253.2018.05.001
Objective
To comprehensively analyze the influencing factors of hospital business income, and accurately forecast hospital revenues, thus, to provide references for the hospital to compile budget, formulate long-term development strategy, carry out infrastructure construction plan, and promote the development of medical and health undertakings.
Methods
The related data of a regional medical center and statistical yearbook of shandong province was used, and the influencing factors of in-patient income in public hospitals were selected by using the Lasso variable selection method. The influences of the hospital's own development index and the related indexes of national economy and social development on the income of hospital were analyzed, and grey prediction and artificial neural network model were used to predict the inpatient income of large public hospitals.
Results
According to the variable selection, the indicators included in the forecast model of hospital income were regional GDP, number of people at the end of the year, number of hospital admissions, number of hospital operations and number of bed turnover. The increase of regional GDP, number of people at the end of the year, number of hospital admissions, and number of hospital operations helped improve the hospital income. The decrease of bed turnover was beneficial to the increase of the income of large public hospitals. According to the grey prediction, the relative accuracy of each prediction index was above 90%, and the predicted value of hospital inpatient income in 2016 was 245 003 by the artificial neural network.
Conclusion
The combined model of grey prediction and artificial neural network can well predict the income of inpatient in public hospitals. This model takes into account several influencing factors of the predicted variables, therefore, compared with the simple grey prediction method, it is more robust.
2018 Vol. 25 (5): 321-324 [
Abstract
] (
62
)
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344
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325
Comprehensive benefit comparison of cost monitoring indicators of 10 hospitals based on efficacy coefficient method
Li Tiandan, Kong Ping
DOI: 10.3969/j.issn.1006-5253.2018.05.002
Objective
To solve the comprehensive benefit evaluation of different quality indicators in hospital cost monitoring through homogeneity transformation of different quality indicators of hospital cost monitoring.
Methods
The actual value of each monitoring index was converted into a percentage by the calculation of the efficiency coefficient method, and a reasonable amount of score could be obtained by using the same formula. Then we summarized the score.
Results
Of the 10 hospitals evaluated, the one with the highest comprehensive score of cost control (i.e., the best benefit) was H hospital, which ranked first with 720.94 points. The lowest comprehensive score was A hospital, ranking 10th with 620.92 points. The ranking of other hospitals was clear.
Conclusion
We can make an intuitive judgment on the good and bad of each monitoring index through comparing individual scores, and we can evaluate and compare the monitoring indexes of different natures by means of score summarization, and sort and evaluate the overall effect of different hospital cost control.
2018 Vol. 25 (5): 325-326 [
Abstract
] (
50
)
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327
Analysis of epidemiological and etiological characteristics of hand-foot-mouth disease in Binzhou city in 2016
Zhang Haiquan
DOI: 10.3969/j.issn.1006-5253.2018.05.003
Objective
To analyze the Epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in Binzhou city in 2016, and to provide scientific basis for formulating prevention and control strategy.
Methods
Descriptive epidemiological analysis was used to analyze the epidemiological and etiological characteristics of hand-foot-mouth disease in Binzhou city in 2016.
Results
The incidence of HFMD in Binzhou was 7 367 cases, with a reported incidence of 19.9/10 million in Binzhou city in 2016. The peak incidence was 5~8 months. The top 3 districts occurred most in Zouping County, Bincheng District and Yangxin County, accounting for 61.33% (4 518 cases) of the total cases. Male cases (4 405) were more than female cases (2 962), age distribution mainly concentrated in the 0 to 5 years old age group of children, with the number of cases accounting for 88.09% (6490 cases). The occupation distribution was mainly scattered in children and kindergarten children, accounting for 69.69% (5 134 cases) and 26.70% (1 967 cases). Totally 496 cases of laboratory diagnosis were reported, accounting for 6.73% of the total number of cases, including 425 cases of type CVA16 positive, 54 cases of other enterovirus positive, 17 cases of type EV71 positive, respectively accounting for 85.68%, 10.89% and 3.43% of laboratory diagnostic cases.
Conclusion
The incidence rate of HFMD is high in Binzhou city in 2016. We should continue to strengthen the epidemic monitoring and analysis, timely carry out the supervision and inspection of key counties in the epidemic season, with scattered children and preschool children as focus groups, and grasp the changing situation of HFMD pathogens.
2018 Vol. 25 (5): 327-329 [
Abstract
] (
48
)
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189
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330
Analysis of the prevalence of caries in 2 000 3~6 year-old children in Quzhou
Mao Liangjun, Fang Xin, Ning Bin
DOI: 10.3969/j.issn.1006-5253.2018.05.004
Objective
To investigate and analyze the caries of 2 000 3~6 year-old children in Quzhou, and to explore the factors of children's caries to provide the basis for the prevention of caries in children.
Methods
The dental caries situation of 2 000 3~6 year-old children in Quzhou was investigated by self-designed questionnaire of oral health care and deciduous dental caries checklist.
Results
The prevalence of dental caries in 2 000 Quzhou children increased gradually with the increase of age, and the prevalence of dental caries was more than 50% in children 4 years old and above. The incidence of dental caries (60.48%) of boys was higher than that of girls (46.02%), and the incidence of urban dental caries (62.98%) was higher than that of rural children (43.36%), with statistical significance (
P
<0.001). Children′s dental caries, tooth loss and repair of teeth were gradually increasing with age. Starting brushing the teeth at a late age, fewer times of brushing teeth a day, shorter time of brushing teeth, without the prevention of dental caries, no using of fluoride toothpaste, without hospital oral inspection, eating after brushing at night, habits of eating sugar and snacks, without immediately mouthwash after eating, and not helping children brush teeth are the risk factors for the occurrence of child caries.
Conclusion
The prevalence rate of 3~6 year-old children in Quzhou is high (>50%), and measures should be taken to reduce the morbidity rate actively according to the risk factors of caries in children.
2018 Vol. 25 (5): 330-332 [
Abstract
] (
45
)
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111
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333
Influencing factor analysis of chronic diabetic complications in a community
Liu Jiaming, Kong Deping, Lin Hailing
DOI: 10.3969/j.issn.1006-5253.2018.05.005
Objective
To investigate the influencing factors of chronic complications of diabetes in a community in order to provide basis for the management of chronic diseases in the community.
Methods
Totally 400 volunteers were selected as the study subjects, informed consent forms were signed by the subjects and the questionnaires were completed independently. The patients were divided into two groups according to whether or not they had chronic complications: the observation group (
n
=320) and the control group (
n
=80 cases). Data and relevant indicators of the two groups were analyzed statistically.
Results
Multivariate regression analysis showed age over 50 years old (
OR
=3.456), course of disease 4 years and above (
OR
=2.948), BMI over 24kg/m2 (
OR
=2.821), fasting blood glucose over 7.0mmol/L (
OR
=2.918), drinking 3 times/week and above (
OR
=2.1) are the influencing factors of chronic complications.
Conclusion
Patients aged over 50 years old, with course of disease 4 years and above, BMI over 24 kg/m
2
, fasting blood glucose over 7.0mmol/L, drinking 3 times a week and above, should be screened and detected regularly, in order to minimize the occurrence of chronic complications.
2018 Vol. 25 (5): 333-334 [
Abstract
] (
49
)
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335
Prediction of outpatient number in a hospital in 2018 with the least square method and the seasonal variation method
Ren Xiaochao
DOI: 10.3969/j.issn.1006-5253.2018.05.006
Objective
To predict outpatient number per month in a hospital in 2018 with least square method and seasonal variation method, and to provide a scientific basis for hospital leaders to grasp the work dynamics of the hospital and to make work plans, work objectives and decisions.
Methods
The moving average method was used to calculate the seasonal index of outpatient number per month in a hospital from 2006 to 2017, and the least square method was used to get the linear regression equation and the predicted value of the number of outpatients per month in 2018.
Results
The peak of outpatient number in the hospital in 2018 was March, and the predicted number of outpatients in March was 75 925, with the 95% confidence interval [64 574, 87 276]. The trough period of the number of outpatients in the hospital in 2018 was September, and the predicted value of outpatient number in September was 63 761, with the 95% confidence interval [52 410, 75 112].
Conclusion
The predicted value obtained by the method of moving average seasonal index and the least square method can reflect the change rule of outpatient number per month in our hospital, and provide scientific basis for the leaders of our hospital to make work goals, plans and decisions.
2018 Vol. 25 (5): 335-337 [
Abstract
] (
49
)
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143
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338
Investigation on allergen distribution and related influencing factors in 189 patients with allergic rhinitis in Wenzhou area
Xu Huishuang, Lü Weizhi, Yang Yuyan
DOI: 10.3969/j.issn.1006-5253.2018.05.007
Objective
To investigate the distribution of allergens in 189 patients with (allergic rhinitis, AR) in Wenzhou and to investigate the relevant influencing factors.
Methods
Immunoblotting was used to detect allergen-specific immunoglobulin E (IgE) antibodies and serum total IgE in AR patients, and at the same time, 370 healthy subjects were selected as the control group. The questionnaires were used to investigate the related factors of AR and compared with the control group. Multivariate logistic regression analysis was also performed.
Results
All the 189 patients showed positive total serum IgE. The distribution of allergens was the highest in the inhaled allergens, house dust mites, accounting for 51.32%, followed by shrimp, crab and other food allergens, accounting for 14.29%. In 17 influencing factors, 8 factors including history of asthma, history of allergies, smoking, parental allergic rhinitis, floating population, dust or chemical gas contact occupations, daily window ventilation and frequent cleaning had statistically significant difference compared with the control group (
P
<0.05). Multivariate logistic analysis found that allergic history, smoking, history of asthma, parental allergic rhinitis, floating population, dust or chemical gas contact occupations and pets were AR high risk factors (
P
<0.05). Daily window ventilation, frequent cleaning and regular exercise were effective protective factors for AR (
P
<0.05).
Conclusion
In Wenzhou, house dust mites are the main allergens. The main risk factors are allergic history, history of asthma, pets, parents suffering from AR, and smoking.
2018 Vol. 25 (5): 338-341 [
Abstract
] (
47
)
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203
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342
Investigation on KAP of tertiary prevention of hypertension in undergraduates of clinical medicine
Wang Weisi, Song Jiayin, Qin Ying, Yang Weishan, Gu Hongmei
DOI: 10.3969/j.issn.1006-5253.2018.05.008
Objective
To discover some deficiencies which the clinical undergraduates have in the related contents of the tertiary prevention of hypertension, and to provide some reference to strengthening relevant learning in the school, so as to carry out hypertension prevention work more effectively in the future.
Methods
A self-designed questionnaire survey was conducted on the stratified cluster sample of clinical medicine undergraduates from freshman to senior year in Mudanjiang Medical University.
Results
The basic mastery ratio of the knowledge of tertiary prevention of hypertension of the higher grade clinical undergraduates (75.86%) was higher than that of the lower grade group (42.06%). The proportions of the substantially correct attitudes of the two groups were both above 60%, and the proportions of their basically correct behaviors were both less than 50%.
Conclusion
There is room for clinical undergraduates to improve their mastery of the tertiary prevention of hypertension and education should be strengthened with various methods.
2018 Vol. 25 (5): 342-343 [
Abstract
] (
49
)
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127
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344
Surveillance of death causes among residents in Huangshan city of Anhui province in 2017
Zhang Qinghe, Hu Xiaoshen, Cheng Shaoguang, Wang Haibo
DOI: 10.3969/j.issn.1006-5253.2018.05.009
Objective
To explore the mortality and main death causes of residents in Huangshan city, and provide scientific references for formulating strategies of disease control.
Methods
The death cases were collected from ″Information System for Death Cause Register and Management″. Mortality and age-standardized mortality were calculated by Death Statistics and Analysis Tool.
Results
The mortality and age-standardized mortality was 648.15 /10
5
and 481.44/10
5
of Huangshan city in 2017. Males′ mortality was higher than females′ with significant differences (
χ
2
=110.20,P
<0.01). There was a low level of mortality in the 5-15 age group, and there was a rising trend with age increase for people over 15 years old. The chronic diseases accounted for 81.41% of the total death causes. Malignant tumor, heart disease, cerebrovascular disease, respiratory disease and injury and poisoning were five top death causes. Furthermore, malignant tumor and cerebrovascular disease were the top death cause of male and female respectively.
Conclusion
The chronic diseases, especially malignant tumors, cardiovascular and cerebrovascular diseases, and respiratory diseases were main death causes of Huangshan city. Promotion of healthy lifestyles through public participation, led by the government and multisectoral collaboration, is an important component of health and disease prevention.
2018 Vol. 25 (5): 344-346 [
Abstract
] (
64
)
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368
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347
Detection and analysis of serum 25-hydroxyvitamin D levels in 477 primary school students
Mou Xialian
DOI: 10.3969/j.issn.1006-5253.2018.05.010
Objective
To investigate the distribution of the serum levels of 25-hydroxyvitamin D(25-(OH)-VD).
Methods
The serum 25-(OH)-VD levels of 477 pupils were measured by chemiluminescence method, and the results were statistically analyzed.
Results
Among the 477 primary school students in this survey, the average level of 25-(OH)-VD was (16.93±6.45) ng/ml, and the proportion of 25-(OH)-VD deficiency reached 67.92%. The lack of serum 25-(OH)-VD levels in girls was significantly higher than that in boys (74.89% vs 62.02%;
P
<0.05). The serum 25-(OH)-VD level deficiency rate of pupils aged 10 to 13 was significantly higher than that of 7 to 9 year-old pupils (76.11% vs 60.56%;
P
<0.05).
Conclusion
The nutritional status of vitamin D in primary school students in Wenxin Street, Xihu District, Hangzhou City is relatively deficient, and the status of vitamin D deficiency in primary school students of different genders and ages is different.
2018 Vol. 25 (5): 347-348 [
Abstract
] (
40
)
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155
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Medical Record Management
349
Continuing education of medical records staff and the improvement of the management level of medical records
Zhou Di
DOI: 10.3969/j.issn.1006-5253.2018.05.011
The modern hospital management put forward higher requirements for case management. This paper concerned continuing education on medical records managers, and reviewed from three aspects. First, the case management work requires the staff to have a variety of work abilities. Second, there are problems in the management of medical records and the necessity of continuing education of medical records managers. Thirdly, We should carry out countermeasures for implementing continuing education. Medical record management workers should enhance their own business quality through multi-channel and flexible learning methods. At the same time, they should strengthen their cultural ethics and legal knowledge, so that the medical record management work can better serve the society and serve the clinic.
2018 Vol. 25 (5): 349-350 [
Abstract
] (
53
)
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145
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351
Analysis on data quality of medical record front sheet in a hospital in 2017
Wang Xiaoqin, Cui Xuedan
DOI: 10.3969/j.issn.1006-5253.2018.05.012
Objective
To find out data quality defects on patient medical record front sheet (MRFS) through descriptive statistical analysis in a hospital in 2017, and to identify the causes for the problems and suggest remediation to improve the reporting quality.
Methods
Totally 60 642 in-patient medical records were collected from a hospital in 2017 and 70 items on MRFS were statistically analyzed. The incompletion rate and error rate were calculated.
Results
The highest incompletion rate and the highest error rate both occur on the item of other information, and a variety of errors present.
Conclusion
The data quality of MRFS is unsatisfactory. It directly affects the ranking of the performance analysis of hospitalization service of the third-class comprehensive hospital in shandong province. To improve the quality of MRFS, it depends on effort and cooperation from clinicians, network information technicians, and the final medical record checkers.
2018 Vol. 25 (5): 351-354 [
Abstract
] (
54
)
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(1 KB)
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(937 KB) (
264
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Hospital Management
355
Shandong Province set up provincial specialized hospital as a lead unit medical alliance SWOT analysis and countermeasure research
Wang Cuijuan, Wang Shengfang, Liu Kai,Qu Huayan, Shang Ming
DOI: 10.3969/j.issn.1006-5253.2018.05.013
To analyze the strengths, weaknesses, opportunities and threats of the medical alliance of the provincial specialist hospital in Shandong province. This medical association has its advantages of location, specialty, post and prospect, and is subject to management system, medical insurance policy, the scientific level of hospital management, and many other restrictions. We should make full use of opportunities, deal with various challenges, do a good job of top-level design, information platform construction and personnel training and transportation, so as to gradually set up their own brand, move down high quality medical resources, and truly realize the rational allocation of health resources.
2018 Vol. 25 (5): 355-357 [
Abstract
] (
64
)
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(1 KB)
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(908 KB) (
428
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358
Application of hospital-home nursing information management mode in preventing puerperal depression
Lin Fei, Ji Jianying, Cai Lili, Zheng Congxia
DOI: 10.3969/j.issn.1006-5253.2018.05.014
Objective
To explore the effect of hospital-home nursing information management mode in preventing puerperal depression.
Methods
Totally 174 parturients were randomly assigned into two groups, with 87 in each group. The control group received the routine nursing management mode, and the observation group received the hospital-home nursing information management mode. Indicators such as postpartum depression of the two groups were compared and the differences between the two groups were analyzed.
Results
The EPDS score and depressive tendency rate of the observation group were lower than those of the control group (EPDS score: 8.70±1.03 in the observation group and 6.72±0.79 in the control group, with
t
=14.23 and
P
＜0.01; depressive tendency rate: 3.45% in the observation group and 12.64% in the control group, with
χ
2
=4.97 and
P
=0.03), with statistical significance. APGAR score in the observation group was higher than that in the control group(APGAR score: 8.70±1.03 in the observation group and 6.72±0.79 in the control group, with
t
=14.23 and
P
＜0.01 ), and the family care lack rate in the observation group was lower than that in the control group(the family care lack rate: 4.60% in the observation group and 17.24% in the control group, with
χ
2
=7.15 and
P
=0.01), with statistical significance.
Conclusion
The hospital-home nursing information management model can effectively prevent postpartum depression and increase maternal family care.
2018 Vol. 25 (5): 358-360 [
Abstract
] (
60
)
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(1 KB)
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(926 KB) (
125
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361
Effect of motivational interview combined with procedural health education management on drug compliance of patients with mental depression
Ding Zhujie, Li Yun, Cai Minke
DOI: 10.3969/j.issn.1006-5253.2018.05.015
Objective
To explore the effect of motivational interview combined with procedural health education management on drug compliance of patients with mental depression.
Methods
The patients with mental depression were randomly divided into two groups, 72 cases in each group. The control group was treated with traditional health education model, and the observation group was managed with the combination of motivational interview and procedural health education. Drug compliance and depression degree of patients were compared and the differences were analyzed.
Results
Before management, there was no significant difference between the two groups (
P
>0.05). After management, the drug compliance of the observation group was higher than that of the control group (score of compliance: 26.94 ±3.47 in the observation group and 21.67 ±2.93 in the control group with t=9.85and
P
<0.001; the drug compliance rate: 84.72 in the observation group and 66.67 the control group with
χ
2
=6.38 and
P
=0.01). The depression degree of the observation group was lower than that of the control group (HAMD score: 6.25 ±0.41 in the observation group, and 9.36 ±1.48 in the control group, with
t
=17.18 and
P
＜0.001; SDS score: 35.36±3.28 in the observation group and 43.26 ±3.87 in the control group, with
t
=13.21 and
P
＜0.001). The difference value between the scores before and after management of the observation group was higher than that of the control group (the difference value of drug compliance score: 7.11 ±1.02 in the observation group, and 3.27 ±0.38 in the control group with
t
=29.93 and
P
＜0.001; the difference value of HAMD score: 7.23±0.95 in the observation group and 4.62 ±0.52 in the control group with
t
=20.45 and
P
＜0.001; the difference value of SDS score: 11.21 ±1.06 in the observation group and 6.40 ±0.99 in the control group, with
t
=28.14 and
P
＜0.001). The difference was statistically significant.
Conclusion
Motivation interview combined with procedural health education management can effectively enhance the drug compliance of patients and alleviate the depression degree of patients with mental depression.
2018 Vol. 25 (5): 361-363 [
Abstract
] (
60
)
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(1 KB)
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(925 KB) (
128
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364
Cross-sectional investigation analysis on fatigue condition, job burnout and turnover intention of midwives
Ye Lixia
DOI: 10.3969/j.issn.1006-5253.2018.05.016
Objective
To explore the status levels of fatigue condition, job burnout, coping styles, self-efficacy and turnover intention of midwives.
Methods
Forty midwives were chosen as research objects, and 40 maternity nurses were randomly chosen as the control group. Both groups were evaluated by the scales of fatigue condition, job burnout, coping styles, self-efficacy and turnover intention. The scores of dimensions of scales were compared between the two groups.
Results
The scores of body fatigue (5.27±1.69), mental fatigue (3.40±1.35) and total scores(8.68±1.52) of fatigue in the midwife group were obviously higher than those in the maternity nurse group (4.36±1.51, 2.70±1.14, 7.06±1.33,
P
<0.05). The scores of emotional exhaustion (28.46±5.80) and depersonification (7.98±3.40) in the midwife group were higher than those in the maternity nurse group (24.68±4.35, 6.52±2.77,
P
<0.05), while the score of personal accomplishment (31.42±3.71) in the midwife group was lower than that in the maternity nurse group (33.74±4.15,
P
<0.05). The scores of positive response (30.25±3.52) and self-efficacy (25.19±5.08) in the midwife group were lower than those in the maternity nurse group (32.04±3.67, 28.30±4.42,
P
<0.05), while the scores of negative coping (33.65±3.69) and turnover intention (14.37±2.91) in the midwife group were higher than those in the maternity nurse group (31.39±2.50, 12.18±2.64,
P
<0.05).
Conclusion
Compared with maternity nurses, the midwives have lower levels of self-efficacy and coping styles, higher levels of fatigue condition and job burnout, and a stronger turnover intention.
2018 Vol. 25 (5): 364-366 [
Abstract
] (
59
)
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157
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367
Effect of cluster management on nursing quality of ICU patients undergoing mechanical ventilation under the concept of humanistic care
Fang Ping, Li Na
DOI: 10.3969/j.issn.1006-5253.2018.05.017
Objective
To explore the effect of cluster management on nursing quality of ICU patients with mechanical ventilation under the concept of humanistic care.
Methods
Totally 240 patients with ICU mechanical ventilation were randomly divided into two groups with 120 cases in each group. The control group was treated with conventional cluster nursing mode, and the observation group was treated with cluster management under the concept of humanistic care. The differences of nursing quality indexes were compared between the two groups before and after the management.
Results
Before the management, the indexes of the two groups were similar, and the difference was not statistically significant (
P
>0.05). After the management, the anxiety state scores of the patients in the observation group (3.74 ±0.66) were significantly lower than those in the control group (
P
>0.05). The scores of treatment compliance (7.89 ±0.48), family satisfaction (8.72 ±0.73) and the difference between before and after management in the observation group were significantly higher than those in the control group (
P
<0.05).
Conclusion
The cluster management under the concept of humanistic care can meet the psychological and physiological needs of patients and promote the nursing quality of patients with ICU mechanical ventilation.
2018 Vol. 25 (5): 367-369 [
Abstract
] (
55
)
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(1 KB)
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(920 KB) (
180
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370
Evaluation and analysis of implementation effect of clinical pathway in a hospital of Tai′an in 2017
Cao Bingyan, Liu Gang
DOI: 10.3969/j.issn.1006-5253.2018.05.018
Objective
To explore the management implementation effect of clinical pathway for providing hospitals with reference in their management.
Methods
The retrospective method was adopted in this paper to analyze the differences of the average length of stay (ALOS), total hospitalization expenses, nursing costs, charges for medicine and cost of consumables of the patients in the clinical pathway group and the non clinical pathway group, who suffered bronchopneumonia, cerebral infarction, unstable angina pectoris, senile cataract or thyroidnodules.
Results
The Mann-Whitney test showed that there was a statistically significant difference between the two groups in the total hospitalization expenses, nursing costs, charges for medicine, cost of consumables and the average length of stay (
P
<0.05).
Conclusion
The implementation of clinical pathway management is helpful for standardizing the diagnosis and treatment services, controlling medical expenses and reducing the average length of stay.
2018 Vol. 25 (5): 370-372 [
Abstract
] (
68
)
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(1 KB)
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(923 KB) (
118
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373
Effect of different education management on self-management behavior of postoperative thyroid cancer patients
Zhu Xiaowei
DOI: 10.3969/j.issn.1006-5253.2018.05.019
Objective
To investigate the effect of different education management on self-management behavior of postoperative thyroid cancer patients.
Methods
Seventy-four patients with thyroid carcinoma were randomly divided into two groups: the control group (
n
=37) with conventional health education mode and the observation group (
n
=37) with normalized health education management under the concept of health quotient. The changes of self-management behavior and health quotient were observed and the differences were analyzed.
Results
The indexes before management in the two groups were similar, and there was no significant difference between the two groups (
P
>0.05). The scores and the total score of self-management behavior in the observation group (73.68 ±6.82) were significantly higher than those in the control group (
t=5.22,P
<0.001) and the scores and the total score of healthy quotient in the observation group (68.88 ±5.43) were significantly higher than those in the control group (
t=3.34,P
<0.001). The difference of each index before and after management was higher than that of the control group (
P
<0.05).
Conclusion
The standardized health education management under the concept of health quotient can improve the self-management behavior of patients with thyroid cancer after operation, its effect is better than that of conventional health education mode, and it has positive significance for the rehabilitation of patients.
2018 Vol. 25 (5): 373-375 [
Abstract
] (
44
)
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(1 KB)
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(923 KB) (
164
)
376
The effect of active warming intervention in the operation room on maternal hypothermia after planned cesarean
Liu Yuan, Xu Hongtao, Hu Ying, Liu Suhui
DOI: 10.3969/j.issn.1006-5253.2018.05.020
Objective
To explore the effect of active warming intervention in the operation room on maternal hypothermia after planned cesarean.
Methods
Healthy expectant mothers in the hospital from January 2017 to June 2017 were randomly divided into the observation group with 62 patients and the control group with 58. The parturients in the control group adopted the routine heating measures. In the observation group, the parturients were treated with active warming intervention including warmed IV fluids and forced air warming blankets by the nurses of the operation room. The temperature of body nucleus, the incidence of hypothermia, the tremor degree, the comfort of temperature and the Apgar score of the newborn were compared between the two groups.
Results
Core temperature and thermal comfort scores of patients in the experimental group were significantly higher than those in the control group (
P
<0.01).The incidence of hypothermia and the tremor degree of patients in the experimental group were significantly lower than those in the control group (
P
<0.01). However, there was no statistically significant difference between the two groups in Apgar score (
P
>0.05).
Conclusion
Active warming intervention in the Operation Room may have a beneficial effect on maternal hypothermia after planned cesarean, but the relevant efficacy was not shown in Apgar score.
2018 Vol. 25 (5): 376-380 [
Abstract
] (
64
)
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(1 KB)
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(969 KB) (
182
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Hospitalization Statistics
381
Statistics and risk factors of nosocomial infection in elderly patients with respiratory diseases in recent three years
Chen Wenying, Wang Jia, Zhou Xuan
DOI: 10.3969/j.issn.1006-5253.2018.05.021
Objective
To analyze the incidence of nosocomial infection of the elderly patients with respiratory diseases in the last three years in Zhejiang Hospital, and to explore the risk factors of infection, and to provide reference for the prevention of nosocomial infection.
Methods
The clinical data of 4233 cases of elderly patients with respiratory system diseases in Zhejiang Hospital from January 2015 to June 2017 was analyzed retrospectively, with 452 cases of nosocomial infection in the study group and the rest in the control group. Single factor analysis and Logistic regression model were used to analyze the risk factors of nosocomial infection. 452 patients with nosocomial infection were included in the study group, and the remaining patients were included in the control group. Single factor analysis and Logistic regression model were used to analyze the risk factors of nosocomial infection.
Results
A total of 572 microorganisms was detected in 452 cases of nosocomial infection, including gram positive bacteria 189(33.05%), gram negative bacteria 347(60.66%), and fungi 36(6.29%). And 394 patients(87.17%) were infected with single pathogens, and 58(12.83%) patients were with mixed infection. The three most widely distributed sites were respiratory tract(56.19%), urogenital tract(21.24%), and blood (13.05%). Logistic analysis showed that the age of 70 years old and above(
OR=1.804, 95% CI:
1.478~2.197), diabetes mellitus(
OR=1.908, 95% CI
:1.557~2.338), bedridden(
OR=1.639, 95% CI:
1.281~2.097), hospitalization time 2 weeks and above (
OR=1.405, 95% CI:
1.153~1.713), and invasive procedures(
OR=1.954, 95% CI:
1.579~2.419) were risk factors of nosocomial infection in elderly patients with respiratory diseases.
Conclusion
Patients with senile respiratory diseases aged 70 years or above, with diabetes mellitus, bedridden, hospitalization time 2 weeks and above, and invasive operation should be the focus of prevention and control.
2018 Vol. 25 (5): 381-383 [
Abstract
] (
45
)
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(1 KB)
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(924 KB) (
135
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384
Investigation and analysis of post-traumatic stress disorder syndrome in critically ill patients
Wang Yan, Wu Xiaoqing, Lei Guihua
DOI: 10.3969/j.issn.1006-5253.2018.05.022
Objective
To study the incidence of post-traumatic stress disorder syndrome in critically ill patients and analyze the risk factors.
Methods
Totally 200 critically ill patients who underwent emergency treatment in our hospital from January 2017 to May 2018 were selected as the subjects. The post-traumatic stress disorder self-rating scale and the Eysenck Personality Questionnaire Simple Scale and other scales were used to determine the incidence of post-traumatic stress disorder, the severity of pain, the coping style, the social support status and personality and the correlation was analyzed.
Results
Of the 200 critically ill patients, 59 patients (29.5%) had post-traumatic stress disorder syndrome. The incidence of post-traumatic stress disorder syndrome in female patients with ISS score≥16 was higher than that in male patients with ISS score<16. The difference was statistically significant (
P
<0.05). There was no significant correlation between age and post-traumatic stress disorder syndrome, and the difference was not statistically significant (
P
>0.05). The pain VAS score and negative coping score of patients with post-traumatic stress disorder syndrome were higher than those of patients without post-traumatic stress disorder syndrome, and the positive response score of patients with post-traumatic stress disorder syndrome was lower than that of patients without post-traumatic stress disorder syndrome (
P
<0.05). The support utilization degree, subjective support score, social support total score, and N scale score of the post-traumatic stress disorder syndrome group were higher than those of the non post-traumatic stress disorder group. The E scale score of the post-traumatic stress disorder syndrome group was lower than that of the non post-traumatic stress disorder group after trauma, with statistical significance (
P
<0.05). There were no significant differences in Objective support scores, L scale scores, and P scale scores between the two groups (
P
>0.05). The post-traumatic stress disorder syndrome was positively correlated with pain and neuroticism. The correlation coefficient was 0.533 and 0.446 (
P
<0.05). The post-traumatic stress disorder syndrome was negatively correlated with positive coping style, subjective social support, and introversion and extroversion. The correlation coefficients were -0.410, -0.658, and -0.341.
Conclusion
Critically ill patients have higher risk of stress disorder syndrome after trauma, and strong pain, emotional instability, and introversion are risk factors for post-traumatic stress disorder syndrome.
2018 Vol. 25 (5): 384-387 [
Abstract
] (
43
)
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(1 KB)
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(951 KB) (
124
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388
Analysis of the distribution characteristics of 1 344 patients with overlength hospitalization in a hospital
Wu Hongpeng, Zhang Zongwang
DOI: 10.3969/j.issn.1006-5253.2018.05.023
Objective
To provide data support for the hospital management department to reduce inefficient or ineffective hospitalization days, we analyzed the situation of patients with overlength hospitalization.
Methods
A retrospective survey and descriptive statistical analysis were carried out on the patients with overlength hospitalization in a hospital in 2017.
Results
The patients with overlength hospitalization accounted for 1.03% of the discharge number in the same period, and the average hospitalization day was 60.5 days. The excess length of hospitalization days was mainly distributed in the 42~50 day group. This city was the main source of ultra long hospital days, accounting for 95.54%. The way of leaving hospital was mainly from medical advice, accounting for 83.78%. The sex ratio of men and women patients with overlength hospitalization was 1.87:1, and the average age was 53 years old, mainly in two age groups over 60 years old and 45~59 years old. The per capita cost of 1344 cases of overlong hospitalization was ?100226, and the payment method was mainly medical insurance. The number of patients were mainly from Department of radiotherapy, Department of neurosurgery and Department of orthopedics. The first five diseases in super long hospitalization days in the descending order were injury and poisoning, affecting health status and factors related to health care institutions, tumor, circulatory system diseases, and perinatal diseases.
Conclusion
The supervision of key departments and key diseases is strengthened, and patients with hospitalization days over 30 days should be regularly reported. We should establish the two level early warning mechanism of the hospital, pay attention to the age and disease spectrum, accelerate the construction of medical union, dredge the referral channels, and shorten the average hospitalization days.
2018 Vol. 25 (5): 388-391 [
Abstract
] (
82
)
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259
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392
Risk factors of multidrug-resistant bacterial infection of patients in the department of infectious disease
Wu Hongdi
DOI: 10.3969/j.issn.1006-5253.2018.05.024
Objective
To explore the risk factors of multidrug-resistant bacterial (MDRB) infection of patients in the department of infectious disease and nursing strategy.
Methods
A retrospective study was carried out in 150 patients with bacterial infections in the department of infectious disease from the hospital. Eighty-seven cases were with MDRB infection and belonged to the MDRB group, and remaining 113 cases were not with MDRB infection and belonged to the non-MDRB group. Single factor analysis and binary logistic analysis were used to analyze clinical data relations with the MDRB infection, in order to identify risk factors. The nursing strategy was made according to the risk factors.
Results
The differences in age, diabetic nephropathy, heart failure, dialysis age, length of stay, skin infection and antibacterial drug combination trauma, operation, length of stay, mechanical ventilation, central venous catheteration, indwelling catheter (gastric tube, urinary catheter and so on), parenteral nutrition and use time of broad-spectrum antimicrobial agents between the MDRB group and the non-MDRB group were statistically significant (
P
<0.05). The binary logistic analysis showed that operation (
OR:3.587 95%CI
:1.687~7.627), length of stay≥7 (
OR:14.466,95%CI
: 6.900~30.329), central venous catheteration (
OR:2.853,95%CI:
1.025~7.940), indwelling catheter (gastric tube, urinary catheter and so on) (
OR:2.848,95%CI
:1.550~5.231) and use time of broad-spectrum antimicrobial agents≥3 (
OR:10.423,95%CI
:5.336~20.360) were the risk factors of MDRB infection (
P
<0.05).
Conclusion
The risk factors of patients with MDRB infection in the department of infectious disease indicated that medical staff should pay close attention to MDRB infection status of high-risk patients, in order to reduce the MDRB infection rate.
2018 Vol. 25 (5): 392-394 [
Abstract
] (
60
)
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(1 KB)
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(933 KB) (
152
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395
Distribution and drug resistance of pathogens causing urinary tract infections in a primary hospital
Chen Jingdan
DOI: 10.3969/j.issn.1006-5253.2018.05.025
Objective
To discuss the distribution and drug resistance of pathogens causing urinary tract infections in primary hospitals.
Methods
Totally 451 patients with urinary tract infection were selected from January 2015 to December 2017 in our Hospital. All patients were given pathogenic bacteria urine culture, the distribution and drug resistance of pathogens in urine culture positive patients were statistically analyzed.
Results
68 cases of urine culture were positive in 451 patients with urinary tract infection. Among them, 49 cases were with gram negative bacilli (72.06%), 4 with gram-positive cocci (5.88%), and 15 with fungi (22.06%). The most common factors were diabetes, urinary calculi or hydronephrosis, indwelling urethral catheterization and benign prostatic hyperplasia. Gram negative bacilli were mainly Escherichia coli (71.43%). Gram positive cocci were mainly Enterococcus faecium (75%), and fungi were mainly Candida albicans (33.33%). Escherichia coli in Gram-negative bacilli was resistant mainly to ampicillin and other drugs. The Enterococcus faecium in gram positive cocci was resistant mainly to penicillin G and ampicillin. Candida tropicalis was resistant to a variety of antimicrobial agents in fungi. However, none of the other fungi showed serious resistance to various antibiotics.
Conclusion
There are many kinds of pathogens causing urinary tract infections in primary hospitals. Among them, Escherichia coli is the main drug and its drug resistance is different. Rational drugs should be used to treat different pathogens, and emphasis should be put on the intervention of diabetes, urinary tract stones or hydrops, indwelling catheterization,and hyperplasia of prostate and so on.
2018 Vol. 25 (5): 395-398 [
Abstract
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61
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(1 KB)
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(948 KB) (
308
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Computer Application
399
Application of Tableau in visual analysis of medical data
Bai Ling
DOI: 10.3969/j.issn.1006-5253.2018.05.026
To visualize the health data using Tableau in Beijing in 2017. The view results can scientifically help understand medical information and behavior, get the implied value of health care data. It is convenient to communicate and understand the results of large data analysis, and can provide decision support for management department.
2018 Vol. 25 (5): 399-401 [
Abstract
] (
52
)
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(1 KB)
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(1984 KB) (
329
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