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2019 Vol. 26, No. 3
Published: 2019-06-25
 
 
161 Principal component analysis based on parallel analysis used in the comprehensive comparison of clinical departments
Wang Zhouqiang, Liu Yanqiu, Wu Xiaoqin,Yang Jiannan, Song Zhijian
DOI: 10.3969/j.issn.1006-5253.2019.03.001
Objective To analyze the quality of medical work in 2016 statistically in a certain hospital, to provide reference to parallel analysis of comprehensive strengths among departments for hospital administrators so as to increasingly promote the management level, service level and efficiency, and to provide data support for future business development of the hospital. Methods Ten representative indicators that are able to represent comprehensive strengths were chosen from 4 categories including opening bed number, the number of discharge, and the average hospitalization days etc. SPSS 19.0 software was used to standardize 10 representative indicators, and then vista software was used for parallel analysis, which determined the number of the retained factors. Then, the principal components analysis was used for the comprehensive evaluation of some departments of the hospital, and 2 principal component factors were extracted from 10 representative indicators to study on the impacts of the indicators on the changes of the comprehensive strengths of these departments.Results The comprehensive strength evaluation system in clinical departments contained two principal component factors which were synthetic factor and social benefit and operation cost factor. According to the comprehensive score of principal component analysis, A1, A3 and A17 ranked the top three clinical departments, with advanced technology and better comprehensive strength; A10, A20 and A21 were the last three, with scale insufficiency, staff shortage and underdeveloped technology.Conclusion There is a gap in the comprehensive strength of some clinical departments in the hospital, which needs to be further improved to enhance resource allocation. Principal component analysis(PCA) is a good method to analyze the disparity among departments and find real reasons. The number of retained factors is analyzed with parallel analysis, which ensures the analysis results scientifically and also is a key step. The parallel analysis method provides a new method for extracting the number of factors.
2019 Vol. 26 (3): 161-164 [Abstract] ( 65 ) HTML (1 KB)  PDF (956 KB)  ( 192 )
165 Application of BP neural network and other methods in the study of satisfaction of community health services
Zhuang Haishan, Bao Rui, Miao Yongqing, Wang Xinwang.
DOI: 10.3969/j.issn.1006-5253.2019.03.002
Objective To comprehensively evaluate the satisfaction of community health services with different algorithms, to compare various methods through case analysis, and to provide methods for the satisfaction evaluation of community health services.Methods The entropy weight method was used to calculate the objective weight of each index, and on this basis, linear summation method, gray correlation method and TOPSIS method were used to rank and compare the differences among the community health services from different dimensions of satisfaction. A high precision neural network model of satisfaction was trained and the simulation values was used to predict satisfaction evaluation the results of each dimension. Then the results were sorted and compared with traditional algorithms.Results In the traditional methods, the linear weighting sum method and the gray correlation method were used to evaluate four dimensions of 21 community health service institutions with the best S17  and the worst S2. In the TOPSIS method, the best accessible dimension was S17, and the worst was S9. The other three dimensions were S17  best and S2  worst. The correlation between the results of the three traditional methods was statistically significant, and the correlation coefficient was between 0.894 and 1.000 (P<0.001). In BP neural network, the optimal values of the four dimensions were S17  with the worst S2. The simulation errors of each dimension were 0.003, 0.002, 0.002 and 0.003. The correlation coefficient between BP neural network and the three traditional methods was between 0.891 and 1.000 (P<0.001).Conclusion All the methods are applicable to the satisfaction evaluation of community health services, and decisionmakers can choose different methods to evaluate the satisfaction of community health service institutions according to the actual situation.
2019 Vol. 26 (3): 165-168 [Abstract] ( 55 ) HTML (1 KB)  PDF (916 KB)  ( 107 )
169 Evaluation and application of disease diagosis related groups based on weighted ranksum ratio method
Yan Liqin, Chen Guangxin, Zhao Hang, Wei Jian
DOI: 10.3969/j.issn.1006-5253.2019.03.003
Objective To evaluate the performance of inpatient medical services in hospitals and clinical departments through the weighted ranksum ratio method for related indicators in the DRGs index system, and formulate relevant management methods to improve the level of hospital medical services.Methods With the use of dividing machine of Beijing version and DRGs related indicators, the comprehensive evaluation and analysis of the clinical departments in the hospital were carried out by using the weighted ranksum ratio evaluation method from three aspects of capability, efficiency and quality.Results Seven departments were analyzed according to the weighted ranksum ratio method, in which A and D departments were classified as "excellent classes", B, F, and E departments were classified as "good classes", and C and G departments were classified as "poor classes".Conclusion The weighted ranksum ratio method makes the hospital's assessment of the clinical department become objective, visual and operable, which clearly reflects the ranking and development of each department in the hospital.
2019 Vol. 26 (3): 169-171 [Abstract] ( 70 ) HTML (1 KB)  PDF (879 KB)  ( 123 )
172 Influencing factors and countermeasures of postherpetic neuralgia
Weng Xun, Zhang Li
DOI: 10.3969/j.issn.1006-5253.2019.03.004
Objective To discuss the influencing factors and countermeasures of postherpetic neuralgia.Methods Totally 546 patients with herpes zoster were selected in our Hospital from December 2015 to December 2017. The clinical data of patients were collected, the influencing factors of postherpetic neuralgia occurrence in herpes zoster was investigated, and its countermeasures was analyzed.Results  Of the 546 herpes zoster patients, 120 patients had postherpetic neuralgia and the incidence was 21.98%. Univariate analysis showed that, age, sex, diabetes mellitus, herpes zoster typing, lesion area, prodromal pain, acute pain degree and initial treatment time were associated with postherpetic neuralgia in herpes zoster (P<0.05). Logistic multivariate analysis showed that, aged over 50 years old, diabetes mellitus, lesion area over 5%, prodromal pain and initial treatment time less than 3 days were the independent risk factors for postherpetic neuralgia in herpes zoster (P<0.05).Conclusion The risk of postherpetic neuralgia in herpes zoster is high, and it is related to many factors. In particular, the intervention should be strengthened in patients over 50 years old, with diabetes mellitus, skin lesion area over 5%, prodromal pain, and initial treatment time less than 3 days, etc.
2019 Vol. 26 (3): 172-174 [Abstract] ( 75 ) HTML (1 KB)  PDF (886 KB)  ( 194 )
175 Application of SAS macro program in sorting data about time stratified casecrossover design
Li Ning, Ji Wei, Yu Yanfeng, Han Hangtao, Fan Mingsuo, Zhang Liang.
DOI: 10.3969/j.issn.1006-5253.2019.03.005
Objective To develop a SAS macro program to sort data about time stratified case-crossover design.Methods An example of data sorting about child's pneumonia incidence, temperature, PM10 and SO2 was used to design and verify the SAS macro program named time stratified (IN_DSN=, OUT_DSN=, DATE_VAR=, LAG_EFFECT=, LAG_VARS=, COUNTS_VAR=).Results Parameters including input data set, output data set, date variable, lag effect, lag effect related variables and frequency variable can be specified respectively in the SAS macro program, and then SAS will sort the data automatically and output the time stratified casecrossover design data set.Conclusion The application of SAS macro program time stratified is simple, convenient, flexible and efficient. It can avoid errors in data sorting process of time stratified casecrossover design and has certain practicality.
2019 Vol. 26 (3): 175-178 [Abstract] ( 79 ) HTML (1 KB)  PDF (888 KB)  ( 412 )
179 Comprehensive evaluation on the single disease quality of acute myocardial infarction with the TOPSIS method
Zhu Changcong, Deng Naimei, Li Qinghua.
DOI: 10.3969/j.issn.1006-5253.2019.03.006
objective To evaluate the quality of single disease of acute myocardial infarction comprehensively in tertiary general hospitals in Jiangsu Province in the first quarter of 2018, and to provide decision basis for the health administrative departments and the hospitals to strengthen the quality management of single disease of acute myocardial infarction.Methods The quality of single disease of acute myocardial infarction was evaluated with TOPSIS method in tertiary general hospitals in Jiangsu Province in the first quarter of 2018.Results  In the comprehensive evaluation of the quality of single disease of acute myocardial infarction of tertiary general hospitals in Jiangsu Province, H21 hospital was the best, and H11 hospital was the worst.Conclusion Hospitals with poor quality of comprehensive evaluation should speed up the construction and certification of the chest pain center, promote the standardization of diagnosis and treatment of acute myocardial infarction, and improve the overall treatment level of acute myocardial infarction.
2019 Vol. 26 (3): 179-181 [Abstract] ( 56 ) HTML (1 KB)  PDF (876 KB)  ( 101 )
182 Quick-drying hand disinfectant versus six step hand washing method in the clinical application: a systematic review
Lü Danping
DOI: 10.3969/j.issn.1006-5253.2019.03.007
objective To evaluate the effect of clinical application of quickdrying hand disinfectant versus six step hand washing method.Methods Main databases were electronically searched from the inception of each database up to 31 December 2016. Randomized clinical trials (RCTs) of quick-drying hand disinfectant versus six step hand washing method for the clinical application were included. The Cochrane risk of bias tool was used to assess the risk of bias and the Jadad rating scale was used to assess the quality of included studies. The Cochrane Collaboration's RevMan5.3 software was used for metaanalysis.Results Six studies met the inclusion criteria. The metaanalysis results showed that the comparison of quickdrying hand disinfectant and six step hand washing method was applied in clinics, the compliance rate odds ratio was 30.26, with 95% confidence interval［5.46,167.64］, and the difference was statistically significant (P<0.001). The washing time mean difference was -132.72, with 95% confidence interval ［-214.58, -50.85］, and the difference was statistically significant (P=0.001). There is no significant difference in the qualified rate of hand washing and the bacteria number after washing hands (P>0.05).Conclusion Compared to six step hand washing method, quickdrying hand disinfectant for the clinical application can effectively improve the medical staff hand washing compliance, shorten the washing time and has significant effect.
2019 Vol. 26 (3): 182-185 [Abstract] ( 62 ) HTML (1 KB)  PDF (1576 KB)  ( 117 )
186 Effect of information based transformation and optimization of clinical pathway in a hospital
Gu Xiaoming, Shi Quan, Lu Yi
DOI: 10.3969/j.issn.1006-5253.2019.03.008

 objective To promote the efficient and extensive application of clinical pathway information, to play the role of clinical pathway as a medical quality control and management tool, to ensure medical security, to improve the homogenization level of medical service quality, and to gradually improve proportion clinical pathway discharges accounting for over 50% of the total number of hospital discharges.Methods Information based clinical pathway was redesigned, in the mean time, key nodes of the information based clinical pathway were reconstructed under new operational mode, realtime indicators of the pathway execution rate were added, and as a result, complete information based supervision was gradually realized.Results The number of demographics of diseases under clinical pathway increased from 78 categories in 2017 to 328 categories in May 2018. The population of digital clinical pathway completed accounted for nearly 50% of the hospital discharges from January to May 2018. Four diseases (removal of internal fixation device of fracture patients, nasal fracture, ureteral calculi, and large intestine polyps) were selected out of 9 diseases for the decrease in average hospitalization period, average expense per head, average pharmaceutical expense per head, and average pharmaceutical percentage. The 2.0 version of the clinical pathway was statistically different from the nondigital clinical pathway (Ｐ<0.05).Conclusion The standardized digital clinical pathway has shortened the average hospitalization period to a large extent, reduced medical expenses, standardized medical treatment to the greatest extent, and will play a greater role in future hospital management.

 
2019 Vol. 26 (3): 186-189 [Abstract] ( 61 ) HTML (1 KB)  PDF (1165 KB)  ( 104 )
190 Analysis of talent demand of a hospital in Xinjiang from the perspective of talent mobility
He Di, Mao Ying, Zhang Chen
DOI: 10.3969/j.issn.1006-5253.2019.03.009
objective To analyze the current situation and demand of talent mobility in a hospital in Xinjiang, to provide the basis for the demand of hospital talents, and to put forward countermeasures and suggestions for establishing the mechanism of talent introduction, training and retention.Methods Based on the data provided by the Medical Record Statistics Department and the Personnel Department of a hospital in Xinjiang, six indicators related to the mobility of talents were selected, and the database was established by Microsoft Excel for data analysis.Results Data from 2013 to 2018 indicated that the proportion of medical technicians in hospital has increased, and the proportion of administrative logistics personnel has decreased. Mobile personnel were mainly those with master's degree or junior title, or without job titles. The hospital strengthens the construction of talent team through recruitment, introduction of subject leaders, selection of talents for further training, and awarding honorary titles. The professional titles and educational background of the hospital staff are better than the average level of the whole country and the autonomous region, but lower than the international standards of medical care ratio and professional title ratio. There are problems such as imbalance of personnel structure, shortage of high-quality professional and technical personnel, and talent drain.Conclusion Hospitals should introduce, train and retain talents as a way to meet the needs of talents.
2019 Vol. 26 (3): 190-194 [Abstract] ( 56 ) HTML (1 KB)  PDF (899 KB)  ( 101 )
195 Implementation quality analysis of missed abortion clinical pathway
Lin Denan, Liao Jierong
DOI: 10.3969/j.issn.1006-5253.2019.03.010
Objective To evaluate the quality of implementation of the clinical pathway management model for missed abortion in tertiary hospitals.Methods Discharged patients of missed abortion from terciary hospitals of Shenzhen in 2017 were selected as the research objects. The indicators of participation rate of clinical pathway and the average hospitalization days of each hospital were statistically analyzed. The patients were included in the classification according to whether there were other diagnostic classifications. The outliers of total hospital expenses were removed and the normality test was performed.Results The admission rate of missed abortion was low in some hospitals, and the average days of hospitalization of patients who entered the clinical pathway were not consistent with the national standard. After the outliers were removed, the total hospital expenses were in normal distribution (P>0.05). In addition, the level of medical expenses varied greatly among hospitals.Conclusion Only by constantly improving the implementation quality of the clinical pathway and achieving refined management of the clinical pathway can we ensure the quality of medical care, realize the reform effect of cost control, and provide guarantee for the reform of payment system.
2019 Vol. 26 (3): 195-198 [Abstract] ( 68 ) HTML (1 KB)  PDF (890 KB)  ( 171 )
198 Effect of improving the efficiency of preexamination specialists in rescuing patients with acute ischemic stroke
Zhu Liyan, Li Jinxian
DOI: 10.3969/j.issn.1006-5253.2019.03.011
Objective To analyze the effect of improving the efficiency of preexamination specialists in rescuing patients with acute ischemic stroke.Methods Totally 83 patients with acute ischemic stroke who were admitted to our hospital were selected from Aug. 2016 to May. 2018, and they were randomly divided into the observation group (n=47) and the control group (n=36) according to the different nursing methods. The control group received routine preclinical triage, while the observation group improved the efficiency of the preclinical triage specialists, and the time of doctors' appointments, the time of nurses' pre-examination
2019 Vol. 26 (3): 198-200 [Abstract] ( 66 ) HTML (1 KB)  PDF (882 KB)  ( 226 )
201 Influence of systematic family following up intervention on treatment compliance of arteriosclerosis obliterans patients of lower extremities after discharge
Zhang Min, Xu Yuanyuan
DOI: 10.3969/j.issn.1006-5253.2019.03.012
Objective To explore the effect of treatment compliance after discharge of arteriosclerosis obliterans (ASO) patients of lower extremities with systematic family following up intervention.Methods Totally 164 ASO patients of lower extremities were randomly divided into the control group and the observation group, 82 cases in each group. The control group was given routine discharge health education and following up survey, and the observation group was given systematic family following up intervention measures. The indexes of treatment compliance, incidence rate of complications, and regular referral rate and rehospitalization rate were compared between the two groups after intervention.Results After 6 months intervention, the levels of medication compliance, self monitoring, living habit change and psychological adjustment in the observation group were all higher than those in the control group (P<0.05). The incidence rates of reembolization, infection and ischemia in the observation group were respectively 2.44%, 1.22% and 1.22%, all lower than those in the control group (12.20%, 8.54% and 9.76%, P<0.05). The regular referral rate in the observation group was 82.93%, higher than that in the control group (63.41%, P<0.05). The rehospitalization rate in the observation group was 6.10%, lower than that in the control group (17.07%, P<0.05).Conclusion Systematic family following up intervention for ASO patients of lower extremities could raise treatment compliance after discharge, cut down the incidence rate of complications and the rehospitalization rate, and improve the regular referral rate. It is good for improving the prognosis.
2019 Vol. 26 (3): 201-203 [Abstract] ( 44 ) HTML (1 KB)  PDF (938 KB)  ( 92 )
204 Performance appraisal of automated outpatient pharmacy based on the balanced score card principle
Chen Jing, Zhang Jing
DOI: 10.3969/j.issn.1006-5253.2019.03.013
objective To provide a reference to other automated outpatient pharmacy, with the introduction of performance appraisal of Sir Run Run Shaw Hospital which is affiliated to the Medicine College of Zhejiang University.Methods The key and difficult problems to conduct the performance appraisal were collected. Then the key indicator was chosen by using the balanced score card principle and the performance evaluation formula was established. Finally, the comparison between before and after the performance appraisal was conducted on three aspects including customer relationship, internal business processes and learning & growth.Results The satisfaction degree of outpatients on services climbed from 3.80 to 4.49 points. While complaints dropped from 3 times to 1. Besides, the satisfaction degree of pharmacists ascended from 3.79 to 4.71 points. All work in outpatient pharmacy was completed effectively. And the progress in scientific research is being continuously made.Conclusion The balanced score card is feasible for establishing performance appraisal in automated outpatient pharmacy. Since then, the enthusiasm of pharmacists had been aroused, the efficiency and the quality of service has been improved through performance appraisal.
2019 Vol. 26 (3): 204-206 [Abstract] ( 56 ) HTML (1 KB)  PDF (874 KB)  ( 129 )
207 Analysis of risk factors affecting the occurrence of acute stress disorder in patients with traumatic hip fracture
Xu Xiaoling, Xu Xiangxiang, Xu Shuying, Ren Jingnan
DOI: 10.3969/j.issn.1006-5253.2019.03.014
objective To investigate the risk factors affecting PTSD in patients with hip fractures.Methods The data of 212 patients who received surgery in this hospital from Jan. 2014 to Oct. 2016 were collected and the risk factors affecting the occurrence of PTSD were analyzed retrospectively.Results 1) The total score range of PTSD in the whole group was from 17 to 64, with an average of (31.18 + 11.76) points. Among them, the scores of three dimensions of reexperience, avoidance and high vigilance were (9.62+3.78), (11.64+4.48) and (9.91+4.55) respectively. Average scores of each dimension entry were (1.93±0.76), (1.67±0.65), and (1.99±0.92) respectively. 2) The univariate analysis results showed that there were statistically significant differences in the dimensions of PTSD among different occupations, education levels and payment methods (P<0.05). The reexperience score and the total score of PTSD of the female were significantly higher than those of the male and the avoidance score of the unmarried patients was significantly higher than that of the married patients (P<0.05), with statistically significant differences. 3) With PTSD score as the dependent variable, the significant indicators in the univariate analysis as independent variables, the stepwise multiple linear regression is conducted to get the regression equation as Y=28.889-3.294X1+1.408X2+9.115X3(Y: PTSD total score, X1: degree of education, X2: occupation, and X3:affected site). Conclusion The education level, the occupation and injury sites are the most important risk factors of PTSD in patients with hip fracture.
2019 Vol. 26 (3): 207-210 [Abstract] ( 57 ) HTML (1 KB)  PDF (893 KB)  ( 77 )
211 Investigation and analysis of continuing nursing demand of the maintenance hemodialysis patients with renal failure
Fang Weilian
DOI: 10.3969/j.issn.1006-5253.2019.03.015
objective To investigate and analyze the continuing nursing demand of the maintenance hemodialysis (MHD) patients with renal failure.Methods Eighty MHD patients with renal failure were selected in our hospital from June 2016 to June 2018, and the continued nursing demand of all patients was assessed by the selfmade MHD patient care demand questionnaire.Results In this study, all of the 80 patients with MHD renal failure had demand, and the demand rate for health education, specialist nurses and psychological support were 100%, 95%, and 90% respectively. In terms of health education, the demand rate of MHD knowledge was the highest, higher than those of diet and exercise, and blood pressure control (P<0.05). In terms of specialist nurses, the demand rates of arteriovenous fistula and complication prevention were higher than those of MHD evaluation guidance and catheter care (P<0.05). In terms of psychological support, the demand rate of family support was the highest, higher than those of psychological counseling, MHD exchanges and MHD lectures (P<0.05). In the demand for continued nursing followedup way of MHD patients, the demand rate of internet platform was the highest, higher than those of the regular home visits and books (P<0.05), and the demand rates of the telephone and short message, and regular home visits were higher than that of books (P<0.05).Conclusion MHD patients with renal failure have multiple and larger demand for continue nursing, so the health education based on MHD knowledge, specialized nursing based on arteriovenous fistula health care and psychological support based on family support should be strengthened, and the followup mode of network platform should be adopted as far as possible, in order to meet the needs of patients.
2019 Vol. 26 (3): 211-214 [Abstract] ( 58 ) HTML (1 KB)  PDF (894 KB)  ( 178 )
215 Correlation between social support level and posttraumatic stress disorder in surgical inpatients
Lü Yuying
DOI: 10.3969/j.issn.1006-5253.2019.03.016
objective To investigate the correlation between social support and post-traumatic stress disorder (PTSD) in surgical inpatients, and to understand the role of positive emotions such as hope, optimism and selfefficacy in the incidence of PTSD.Methods The demographic data, social support and the incidence of post traumatic stress disorder in 200 inpatients were collected.Results Totally 197 questionnaires were collected from 200 questionnaires, and the recovery rate was 98.5%. Among the 197 patients, 22 cases had PTSD, and the incidence rate was 11.2%. The average score was (30.9 +10.4). There was a positive correlation between social support and hope, optimism and selfefficacy (r=0.301, r=0.367, r=0.318, P<0.05), and a negative correlation between social support and PTSD (r=-0.227, P<0.05).Conclusion Social support has a good preventive effect on the occurrence of PTSD in hospitalized patients. Optimism, hope and selfefficacy are the important guarantees for patients to prevent PTSD.
2019 Vol. 26 (3): 215-217 [Abstract] ( 58 ) HTML (1 KB)  PDF (928 KB)  ( 88 )
218 Study on the incidence of preterm birth and risk factors and their influence on perinatal outcomes
Hong Xiu, Sheng Xiaoyuan
DOI: 10.3969/j.issn.1006-5253.2019.03.017
objective To investigate the incidence of preterm birth, analyze the risk factors of preterm birth, and summarize the influence of preterm birth on perinatal outcomes, so as to provide scientific reference for etiology research and prevention of preterm birth. Methods Retrospective analysis of the clinical data of 140 preterm mothers (preterm group) and 1634 normal mothers (control group) who met the inclusion criteria and were examined in the obstetrics and gynecology clinic of our hospital from January to December, 2018,to observe the perinatal outcomes of preterm and normal mothers, single factor analysis and multifactor Logistics stepwise regression were used to analyze the risk factors of premature delivery.Results The preterm birth rate was 7.89% (140/1774),there was no significant difference in the delivery mode between preterm and normal mothers (P>0.05);The incidence of birth defects, perinatal death and neonatal asphyxia of premature infants in the preterm group was higher than that in the normal control group, with statistically significant differences (P<0.05);By single factor 2 test analysis, history of abortion, gestational hypertension, manual workers, placenta previa, premature rupture of membranes, breech is a risk factor for preterm delivery occurs, the difference was statistically significant (P<0.05);According to multifactor Logistics stepwise regression analysis, gestational hypertension (OR=29.702, P<0.05), manual labor (OR=2.582, P<0.05), placenta previa (OR=42.229, P< 0.05), breech position (OR=5.448, P<0.05), and premature rupture of membranes (OR=5.783, P<0.05) are high risk factors for premature delivery.Conclusion The high risk factors of preterm birth are complex, and preterm birth will affect the perinatal outcomes of mothers and infants to some extent.
2019 Vol. 26 (3): 218-220 [Abstract] ( 51 ) HTML (1 KB)  PDF (896 KB)  ( 119 )
221 Investigation of risk factors and strategy of peripherally inserted central cathetersrelated thrombosis in gastroenteric tumor patients
Peng Danhong, Yang Xiuying, Yang Meijuan
DOI: 10.3969/j.issn.1006-5253.2019.03.018
objective To explore the risk factors and strategy of peripherally inserted central cathetersrelated thrombosis in gastroenteric tumor patients.Methods Totally 2 450 gastroenteric tumor patients with peripherally inserted central catheters were included in this retrospective study which were divided into two groups, the thrombosis group (87 cases) and the nonthrombosis group (2 363) according to whether the catheterrelated thrombosis happened or not during the catheter indwelling time.
2019 Vol. 26 (3): 221-224 [Abstract] ( 71 ) HTML (1 KB)  PDF (894 KB)  ( 141 )
225 Health status and health service utilization of leftbehind children under 5
Cai Min, Feng Wen
DOI: 10.3969/j.issn.1006-5253.2019.03.019
objective To learn about health status and health service utilization and problems of left-behind children under 5, and to provide evidence for promoting their healthy growth.Methods The data of the 5th national health services survey of China in 2013 were used to analyze the morbidity, treatment, hospitalization, and utilization of public health service of left-behind children in different left-behind state.Results Two-week morbidity rate of left-behind children was 10.5%, little higher than that of rural non left-behind children 9.6%, and ARI accounted for 82.3%. Morbidity rates of ARI and diarrhea etc. were higher than those of non leftbehind children. 87% of two-week illness left-behind children saw doctors, and 9.4% used self-treatment. The proportion of self-treatment was lower and visit was higher than that of non left-behind children. Hospitalization rate of left-behind children was 8.0%, and had little difference with that of non left-behind children 7.9%. The proportion of left-behind children that should be hospitalized while without hospitalization was 7.2%, higher than that of non left-behind children 6.7%. Public health status was well, and the establishment rate of planned immunization card and the immunization rate were at high level, close to those of non leftbehind children. While the physical examination rate was 71.2%, lower than that of non left-behind children 73.5%. The caretakers impact the finding and processing mode of illness: medical neglect existed in the father care, and overuse existed in grandparent care.Conclusion More attention should be paid to the left-behind children's physical and psychological health and to the caregivers' health education, in order to improve the service level of primary medical institution, and promote left-behind children′s health status.
2019 Vol. 26 (3): 225-228 [Abstract] ( 45 ) HTML (1 KB)  PDF (901 KB)  ( 139 )
229 Analysis of gestational diabetes mellitus in Aksu area of Xinjiang and Lishui area of Zhejiang province
Zhou Lingyun, Zhao Wanxia
DOI: 10.3969/j.issn.1006-5253.2019.03.020
Objective To compare the incidence of gestational diabetes mellitus (GDM) and maternal and infant outcomes between Aksu District of Xinjiang and Lishui District of Zhejiang.Methods Data were investigated of pregnant women who received 75 g oral glucose tolerance test (OGTT) from Akesu Maternity and Child Health Care Hospital and Lishui City Maternity and Child Health Care Hospital. The GDM incidences and maternal outcomes in both regions were compared.Results The incidence of GDM in pregnant women in Aksu area of Xinjiang was significantly higher than that in Lishui, Zhejiang Province, and the difference was significant (P<0.05). In the groups of 30 to 34 years old, 35 to 39 years old and 40 years old and above, the incidence of GDM in the Aksu area of Xinjiang was significantly higher than that in the Lishui area of Zhejiang province
2019 Vol. 26 (3): 229-231 [Abstract] ( 50 ) HTML (1 KB)  PDF (880 KB)  ( 139 )
232 Status and influencing factors of poor eyesight among urban high school students of Qingdao
Zheng Zhaoxuan，Bai Mutian，Kong Yujia，Li Wei，An Hongqing
DOI: 10.3969/j.issn.1006-5253.2019.03.021
Objective To investigate the present situation and analyze its main influencing factors of poor eyesight among urban high school students of Qingdao.Methods Stratified random cluster sampling was used among urban high school students of Qingdao for visual examination, questionnaire and statistical analysis.Results The detection rate rose with grade (χ2=9.529, P=0.02); grade, screen time, outdoor exercise time, genetic history, the awareness of protecting eyesight, and the knowledge of vision protecting were the major influencing factors (P<0.05); among them, senior grades, long-term vision, and genetic history were risk factors. Longterm outdoor physical exercise, conscious vision protection, and understanding of vision protection knowledge were protective factors.Conclusion It is necessary to ensure effective outdoor physical exercise, improve students' active consciousness and knowledge of vision protection, effectively control screen time, and strengthen the monitoring of the eyesight of adolescents with genetic factors.
2019 Vol. 26 (3): 232-235 [Abstract] ( 60 ) HTML (1 KB)  PDF (888 KB)  ( 215 )
236 Some understandings of coding of diseases
Yong Juan, Xu Shourong, Ku Xiaoling
DOI: 10.3969/j.issn.1006-5253.2019.03.022
Objective In order to improve the accuracy of the coding,this paper summarizes the disease coding problems and the coding undersdandings.Methods Through the error rate of coding in a hospital in 2017 and specific coding examples, we illustrated several elements in the understanding of coding.Results The coding understandings include the principle of embodying the main coding of diseases and the cause of the diseases, the principle of combining coding that reflects the intrinsic link between diseases, and the principle of not relying on the medical record home page information and computer dictionary library.Conclusion The rate of coding errors in the hospital is high,and in order to improve the accuracy of the coding, the coders should master the pinciples of coding, and need to read and analyze the medical records carefully, ask for clinical advice, find medical data from various ways to get the closest clinical codes, and continuously improve the coding level.
2019 Vol. 26 (3): 236-238 [Abstract] ( 51 ) HTML (1 KB)  PDF (943 KB)  ( 174 )
239 Effect of medical record filing management on disease diagnosis related groups and quality of the first page of medical records
Yang Yanmei
DOI: 10.3969/j.issn.1006-5253.2019.03.023
Objective To explore the measures to improve the filing rate of 3 working days of common medical records and 7 working days of death medical records, and the influence on the related grouping of disease diagnosis (DGRs) and its ability index.Methods Data of 82 770 discharged medical records from January to December 2015 and 85 451 discharged medical records from January to December 2017 were randomly derived from our hospital's electronic medical record system. The measures of medical record archiving management were formally implemented in January 2017. The archiving rate before and after the implementation of medical record archiving measures, and the data of DRGs related indicators were statistically analyzed. And the quality of the front page of medical records was analyzed.Results The timely filing rate of medical records was 67.46% in 2015, 93.59% in 2017, and 78.3% in DRGs group increased to 98.4%. There was statistical significance in data comparison (P<0.05). The defect rate of the front page of medical records decreased from 39.49% to 9.31%. There was statistical significance for the comparison (χ 2= 20 455.24, P<0.05). CMI increased from 0.83 to 1.24.Conclusion The establishment of effective medical record management system and reward and punishment system is an effective measure to improve the efficiency of medical record filing, improve the quality of the front page of medical records, and have a positive significance for DRGs.
2019 Vol. 26 (3): 239-240 [Abstract] ( 61 ) HTML (1 KB)  PDF (175 KB)  ( 349 )
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