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2020 Vol. 27, No. 1
Published: 2020-02-25
 
 
1 Study and realization of data standard for regional medical and health indicators in Shenzhen
Lin De′nan，Tang Xuemin，Zhu Suisong，Wu Xiaoyun，Guo Zhiwu，Chen Yongchao，Chen Yan，Zhao Chengwen，Zhou Xiaoming，Wei Peiqun，Jiang Bixuan，Huang Wuzhou，Hu Jinhui，Yang Yan，Liao Jierong，Wu Qingping
DOI: 10.3969/j.issn.1006-5253.2020.01.001
Objective To carry out data quality project in Shenzhen city, to realize standardization of regional medical statistical indicators and informatization of data collection, so as to ensure accuracy, integrity, timeliness and consistency of data.Methods System theory and control theory were used to standardize the data source and collection process of medical and health  statistical indicators.Results The meaning, statistical caliber, statistical algorithm and operation scripts of 53 key medical and health statistical indicators of outpatient emergency treatment and hospitalization were standardized. Through testing and verification, the standard document Specifications for Data on Health and Medical Statistics was formulated and released. By means of informatization, the informatization of data collection, standardization of operation and homogeneity of results of 53 indicators of public hospitals in the city were realized.Conclusion Study and realization of data standard for regional medical and health indicators in Shenzhen ensured the consistency of statistical results between the hospital and the central platform, improved data quality, provided technical support for the implementation of health industry standard, and maximized the value of medical data information.
2020 Vol. 27 (1): 1-5 [Abstract] ( 89 ) HTML (1 KB)  PDF (1289 KB)  ( 639 )
6 Standardization research and realization of key statistical indicators in outpatient
Lin De′nan，Tang Xuemin，Zhu Suisong，Wu Xiaoyun，Guo Zhiwu，Chen Yongchao，Chen Yan，Zhao Chengwen，Huang Wuzhou，Zhou Xiaoming，Yang Yan，Liao Jierong，Wu Qingping.
DOI: 10.3969/j.issn.1006-5253.2020.01.002

Objective To carry out data quality project in Shenzhen city to realize standardization of key medical statistical indicators of outpatient and emergency treatment and informatization of data collection.Methods System theory and control theory were used to standardize the data source and collection process of medical and health statistical indicators.Results The meaning, statistical caliber, statistical algorithm and operation scripts of 23 key medical and health statistical indicators of outpatient, emergency treatment were standardized. Through testing and verification, the standard document .Specifications for Data on Health and Medical Statistics was formulated and released. By means of informatization, the informatization of data collection, standardization of operation and homogeneity of results of public hospitals′ indicators in the city were realized.Conclusion Study and realization of data standard for key medical statistical indicators of outpatient and emergency treatment in Shenzhen ensured the consistency of statistical results between the hospital and the central platform and improved data quality.
2020 Vol. 27 (1): 6-14 [Abstract] ( 77 ) HTML (1 KB)  PDF (976 KB)  ( 219 )
15 Standardization research and realization of key statistical indicators in hospitals
Lin De′nan，Tang Xuemin，Zhu Suisong，Wu Xiaoyun，Guo Zhiwu，Chen Yongchao，Chen Yan，Hu Jinhui，Huang Wuzhou，Wei Peiqun，Zhou Xiaoming，Jiang Bixuan，Yang Yan，Liao Jierong，Wu Qingping
DOI: 10.3969/j.issn.1006-5253.2020.01.003
Objective To carry out data quality project in Shenzhen city to realize standardization of key medical statistical indicators of hospitalization and informatization of data collection.Methods System theory and control theory were used to standardize the data source and collection process of medical and health statistical indicators.Results The meaning, statistical caliber, statistical algorithm and operation scripts of 30 key medical and health statistical indicators of hospitalization were standardized. Through testing and verification, the standard document "Specifications for Data on Health and Medical Statistics" was formulated and released. By means of informatization, the informatization of data collection, standardization of operation and homogeneity of results of public hospitals′ indicators in the city were realized.Conclusion Study and realization of data standard for key medical statistical indicators of hospitalization in Shenzhen ensured the consistency of statistical results between the hospital and the central platform and improved data quality.
2020 Vol. 27 (1): 15-27 [Abstract] ( 88 ) HTML (1 KB)  PDF (948 KB)  ( 201 )
28 Analysis of influencing factors of pressure injury in laparoscopic gastrointestinal patients during operation
Chen Shushu, Cai Yujie, Huang Yuechao.
DOI: 10.3969/j.issn.1006-5253.2020.01.004
Objective To explore the influencing factors of pressure injury in laparoscopic gastrointestinal surgery.Methods Totally 214 cases of patients who underwent laparoscopic gastrointestinal surgery in our hospital from October 2016 to May 2019 were enrolled in this study. Patients' clinical data were retrospectively analyzed, to investigate the incidence of stress injury, and to analyze the risk factors of pressure injury in laparoscopic gastrointestinal surgery with logistic regression analysis.Results Among the 214 patients who underwent laparoscopic gastrointestinal surgery, 26 cases of concurrent stress injury occurred during the operation, and the incidence rate was 12.15%, including 19 cases of stage 1 pressure injury, 2 cases of stage 2 pressure injury, and 5 cases of deep tissue injury. Univariate analysis showed that there was a correlation between the occurrence of pressure injury in laparoscopic gastrointestinal surgery and the movement of the body during surgery, breathing method, skin condition of the compression site, and operation time with significant statistical differences (P<0.05). There was no correlation between the occurrence of stress injury in laparoscopic gastrointestinal surgery and gender, age, BMI index, smoking history, and steroid use without significant statistical differences (P>0.05). Multivariate logistic regression analysis showed that the patients' intraoperative position shift (OR=1.594), breathing method (OR=2.765), skin abnormalities at the compression sites (OR=3.452), and one-hour operation time and above (OR=1.234) were independent risk factors for pressure injury in laparoscopic gastrointestinal surgery (P<0.05).Conclusion There is a certain risk of pressure injury in patients undergoing laparoscopic gastrointestinal -surgery. The movement of the body during the operation, breathing method, abnormal skin at the compression site, and one-hour operation time and above are independent risk factors for stress injury in laparoscopic gastrointestinal surgery. So it is necessary to further develop  specific coping strategies to avoid the occurrence of stress injuries and ensure the health of patients.
2020 Vol. 27 (1): 28-31 [Abstract] ( 74 ) HTML (1 KB)  PDF (947 KB)  ( 190 )
32 Research on the correlations between antibiotics use in early life and pediatric asthma
Fu Lingsu, Huang Dike,Zhang Keyun.
DOI: 10.3969/j.issn.1006-5253.2020.01.00５
Objective To explore the effect of antibiotics on pediatric asthma (6 to 10 years old) in early life (0 to 1 years old). Methods A retrospective study was conducted. Three hundred and fifty children with asthma in our hospital from October 2015 to October 2018 were selected as the case group, and 350 non-asthmatic children who underwent health examination during the same period were selected as the control group. Results The use of antibiotics in early life was a risk factor for pediatric asthma. The use rate of antibiotics in asthmatic children was 84.3% in the case group and 52.0% in the control group. The χ2 test results showed that when antibiotics were used more than twice, or when macrolides and cephalosporins were used, the risk of pediatric asthma was increased significantly, with P<0.05. The multinomial logistic regression analysis showed that, comparisons between severe onset and mild onset, when antibiotics were used four times or more, they were more likely to suffer from severe illness (OR=3.012,95%CI=1.084-8.370).Compared with moderate onset and mild onset, when antibiotics were used four times or more and three times, they were more likely to cause moderate illness(OR=2.813，95%CI=1.358-5.826) and (OR=2.337，95%CI=1.139-4.796). The macrolide type antibiotics was more prone to moderate onset (OR=2.870，95%CI=1.483-5.555). Conclusion The use of antibiotics in early life is a risk factor for increasing the incidence of pediatric asthma. And the number and type of antibiotics used are related to the severity of asthma.
2020 Vol. 27 (1): 32-35 [Abstract] ( 102 ) HTML (1 KB)  PDF (890 KB)  ( 135 )
36 Variation trend analysis of patients received breast surgery in a hospital in Ningbo from 2004 to 2018
Wang Fangfang，Tao Yang，Zhang Songze，Chen Gun，Dai Yuefei.
DOI: 10.3969/j.issn.1006-5253.2020.01.006
Objective To understand the changes of the patient composition of breast disease operation in Ningbo city from 2004 to 2018, analyze the pathological features of breast carcinoma, and explore the changes of age composition of breast diseases. Methods Totally 7,916 lesions were selected from 7,099 patients who underwent breast surgery and obtained pathological results in a hospital in Ningbo from 2004 to 2018. The basic conditions of the patients were analyzed retrospectively, and the changes in the nature and composition of masses at all ages and the changes in the composition of breast diseases and breast malignant tumors in different years were observed.Results In the past 15 years, the number of patients undergoing breast disease surgery has increased significantly. The number of breast fibroadenoma and breast cancer has increased significantly, but the composition ratio of breast fibroadenoma has not changed significantly. The composition ratio of breast malignant tumor has decreased, from 44.7% in 2004 to 16.6% in 2018. Conclusion The disease composition of hospitalized patients with breast diseases has changed. The proportion of breast malignant tumors showed a downward trend. We should continue to strengthen the understanding of breast malignant tumors and further look for relevant risk factors and preventive measures.
2020 Vol. 27 (1): 36-39 [Abstract] ( 65 ) HTML (1 KB)  PDF (892 KB)  ( 121 )
40 Analysis of theophylline use in a tertiary hospital from 2009 to 2017
He Zhi, Han Yu.
DOI: 10.3969/j.issn.1006-5253.2020.01.007
Objective To evaluate the use of theophylline drugs in a hospital, and to provide reference for optimizing rational use of theophylline derivates in clinic. Methods Statistical analysis was made on the quality regulation, DDD, DDDs, sales amount and DDDc of theophylline preparations in a hospital from 2009 to 2017.Results From 2009 to 2017, among the patients of the hospital, the sales of doxofylline and doxofylline tablets for injection showed a linear upward trend, and their DDs showed an increasing trend; the usage of aminophylline tablets declined year by year; the usage of theophylline sustainedrelease preparations and Aminophylline Injection showed a steady trend. The daily average cost of oral aminophylline tablets was only 0.09～0.15 yuan. Conclusion The use of theophylline drugs in this hospital is basically reasonable. In the treatment of chronic obstructive pulmonary disease, acute bronchial asthma and chronic bronchial asthma, theophylline drugs still need to be further optimized.
2020 Vol. 27 (1): 40-42 [Abstract] ( 68 ) HTML (1 KB)  PDF (969 KB)  ( 132 )
43 Analysis of antipyretic and analgesic drug use on orthopedics and general surgery patients in a hospital from 2017 to 2018
Lu Ping, Ni Dongjie, Guo Liangjun, Wang Xiang.
DOI: 10.3969/j.issn.1006-5253.2020.01.008
Objective To investigate the use of Analgesics in a hospital from 2017 to 2018 so as to provide reference for standard management and clinic rational use of analgesic drugs.Methods  A retrospective analysis method was used to retrieve the prescription information of analgesic drugs for a medical institution from 2017 to 2018 for drug utilization research (DUR) including the amount of sort analysis, serial number ratio (B/A) analysis, DDDs analysis, DUI and other indicators. The rationality analysis of the use of analgesic drugs in this medical institution in the past two years was analyzed from the macro perspective. Results  The top three drugs in the medical institution from 2017 to 2018 were flurbiprofen, propacetamol and lornoxicam; the top three DDDs were lornoxicam, flurbiprofen, and propaceta, and its DDDs accounted for 93.55% of the total DDDs of all study drugs; lornoxicam′s serial number ratio B/A was the largest, and the smallest was flurbiprofen; most analgesic drugs DUI value was close to 1, among them the largest value was about 1.3 for lornoxicam, indicating that the dosage was a bit large. Conclusion The application of analgesic drugs in this medical institution from 2017 to 2018 is basically reasonable, but there are also some unreasonable drugs. There is still potential in optimizing the utilization of analgesic drugs, which needs further improvement.
2020 Vol. 27 (1): 43-46 [Abstract] ( 69 ) HTML (1 KB)  PDF (956 KB)  ( 388 )
47 Analysis of risk factors for convulsions after hip replacement in elderly patients with femoral neck fracture
Ye Yang, Gan Xihong, Pan Xuanxuan, Cai Chengfang.
DOI: 10.3969/j.issn.1006-5253.2020.01.009
Objective To investigate the incidence of sputum after hip replacement in elderly patients with femoral neck fracture and related risk factors.Methods Totally 146 cases of patients with femoral neck fractures who underwent hip replacement surgery in a hospital in Wenzhou from April 2017 to April 2019 were enrolled in the study. The incidence of postoperative delirium was statistically analyzed. The clinical data of the patients were collected. The risk factors of spasticity after hip replacement in elderly patients with femoral neck fracture were analyzed by logistic multiple regression. Results Of the 146 elderly patients with femoral neck fracture, 39 had sputum after hip arthroplasty, with an incidence of 26.71%. Multivariate logistic regression analysis showed that patients aged≥75 years old (OR=7.683), injury to surgery interval>3 d (OR= 7.831), average nighttime sleep time≤5 h (OR=4.137), general anesthesia (OR=5.023), anesthesia time≥2 h (OR =5.960), intraoperative blood loss≥300 mL (OR=5.458), and postoperative hypoxemia (OR=12.794) were high risk factors for sputum after hip replacement in elderly patients with femoral neck fracture (P<0.05). Conclusion Patients undergoing hip arthroplasty after senile and general anesthesia of the femoral neck fracture are at high risk for sputum. Arranging surgery, increasing sleep time, shortening anesthesia time, reducing intraoperative blood loss, and preventing postoperative hypoxemia as soon as possible after injury can help reduce postoperative delirium.
2020 Vol. 27 (1): 47-50 [Abstract] ( 79 ) HTML (1 KB)  PDF (951 KB)  ( 210 )
51 Analysis of disease composition of inpatients in a stomatological hospital in 2014—2018
He Qian, Zhou Yang, Luo Chuanyue, Deng Runzhi.
DOI: 10.3969/j.issn.1006-5253.2020.01.010
Objective To analyze the disease constitution and trends of inpatients from 2014 to 2018, and to understand the social medical needs for rational allocation of medical resources. Methods A retrospective study was carried out on the clinic data in Nanjing Stomatological Hospital from 2014 to 2018. Results Among the 15 696 inpatients, the top 3 type of diseases were oral and maxillofacial tumors, salivary gland disease, and dental and alveolar surgery, with a composition ratio of 39.6%, 17.6%, and 13.7%, respectively. The number of inpatients with oral and maxillofacial tumors, dental and alveolar surgery and dentomaxillofacial deformities has increased significantly over the years.Conclusion The treatment of oral and maxillofacial tumors and salivary gland diseases is the focus of work. It is necessary to increase the number of day care wards to improve the effective utilization of medical resources. For specialized hospitals, attention should be paid to improving the internal and external consultation system to improve the quality and safety of medical services.
2020 Vol. 27 (1): 51-54 [Abstract] ( 76 ) HTML (1 KB)  PDF (915 KB)  ( 139 )
55 Study on the effect of stigma on the health-promoting lifestyle of readmitted patients with stroke
Fei Nan
DOI: 10.3969/j.issn.1006-5253.2020.01.011
Objective To investigate the effect of stigma on the health-promoting lifestyle of readmitted patients with stroke, and provide a basis for improving the clinical stroke patient nursing. Methods With the use of the method of convenient sampling, 273 patients with stroke readmitted to a tertiary hospital in Ningbo from March 2017 to March 2019 were selected as research objects. The general data questionnaire, the Stigma Scale for Chronic Illness, the Health Promoting Life style Profile Ⅱ were used for investigation. Results The score of stigma of readmitted patients with stroke was (46.79±16.57). The score of health-promoting lifestyle was (125.93±35.82). There was a negative correlation between them (r=-0.299,P<0.05). The marital status, stigma, monthly family income per capita and the number of stroke recurrence of the patients were the main factors affecting the health-promoting lifestyle (P<0.05). Conclusion The health-promoting lifestyle of readmitted patients with stroke is low.We should focus on the health-promoting lifestyle of readmission patients with stroke, adopt targeted behavioral guidance and intervention according to the situation of each patient, improve the health promoting lifestyle of patients, and avoid or reduce the recurrence of stroke.
2020 Vol. 27 (1): 55-58 [Abstract] ( 65 ) HTML (1 KB)  PDF (898 KB)  ( 183 )
59 Pareto diagram analysis of the site of injury and causes in 35 498 injury inpatients
Li Qiuxia, Huang Xuefang.
DOI: 10.3969/j.issn.1006-5253.2020.01.012
Objective To analyze the position of injuries and the external causes of injuries in a hospital according to ICD-10 classification, to provide a reliable basis for the hospital to reasonably allocate medical resources and strengthen the prevention, treatment of injury diseases in the area. Methods The Pareto map method of management was used to analyze the external causes of diseases and  the position of injuries in 35 498 hospitalized patients in a hospital in the past 10 years. Results During the 10 years, the number of injured patients admitted to a hospital has been increasing year by year. Using Pareto Diagram Analysis, it was found that the main factors of injury site were head injury, lower extremity injury, shoulder and upper extremity injury, and various kinds of poisoning;the main factors of external causes of injury were traffic accidents, falls, bruises, glass and knife cuts, and machine accidents. Conclusion Pareto chart was used to analyze the external causes of diseases and the position of injuries of inpatients, and to find out the prevalence of diseases among injured patients in this area. It can provide data support for hospitals and relevant departments to further improve the first aid system, optimize the allocation of resources, and further improve the work of injury prevention and control.
2020 Vol. 27 (1): 59-63 [Abstract] ( 67 ) HTML (1 KB)  PDF (1406 KB)  ( 154 )
64 Analysis of deaths of inpatients in a tertiary teaching hospital from 2012 to 2018
Lu Jianjun, Li Heng′ai, Hu Fang, Zhou Yingling.
DOI: 10.3969/j.issn.1006-5253.2020.01.013
Objective To explore the trend of death causes in hospitalized patients by statistical analysis of the deaths of inpatients in a tertiary teaching hospital in Guangzhou from 2012 to 2018. Methods Totally 3243 deaths during the study period were retrieved from the medical record information system. Information including age, sex, and major diagnosis of death was analyzed by SPSS 23.0. Results From 2012 to 2018, there were 3,243 cases of deaths. The average malefemale ratio of deaths was 1.59. The number of death cases over 60 years old was more than half of the total death cases (57.63%). For patients aged 30 to 69 years old, the proportion of death of male was higher than that of female, with the largest difference (3.33%) in the 40 to 49 age group. The main causes of death were tumors, circulatory diseases and respiratory diseases, which exceeded 65% in each studied year. The proportion of deaths caused by tumor diseases showed a downward trend, while that caused by injury and poisoning increased significantly. Conclusion Tumor, circulatory and respiratory diseases are still the main diseases leading to the death of hospitalized patients. It is necessary to pay attention to the prevention and treatment of diseases in elderly patients, and take measures against the increasing numbers of injuries and poisoning leading to the deaths of inpatients.
2020 Vol. 27 (1): 64-66 [Abstract] ( 71 ) HTML (1 KB)  PDF (877 KB)  ( 177 )
67 Retrospective analysis of malignant tumor inpatients in a hospital of Yongkang City from 2009 to 2018
Lü Zhitiao, Lü Zhiliang, Hu Huiqun.
DOI: 10.3969/j.issn.1006-5253.2020.01.014
Objective To analyze the distribution characteristics of malignant tumors in a hospital in Yongkang, and to provide evidence for local cancer prevention and treatment. Methods Data of patients with malignant tumors hospitalized in a hospital in Yongkang from 2009 to 2018 were collected and analyzed. Results In the past ten years, the number of inpatients with malignant tumors increased, with an average annual increase rate of 12.84%. The top 10 malignant tumors in 10 years were lung cancer, stomach cancer, intestinal cancer, liver cancer, thyroid cancer, breast cancer, esophageal cancer, prostate cancer, cervical cancer and leukemia, accounting for 79.49% of all cancer inpatients. Male malignant tumors were lung cancer, gastric cancer and intestinal cancer, while female malignant tumors were lung cancer, breast cancer and thyroid cancer. The top 10 malignant tumors accounted for 89.19% of the population over 40 years old. Conclusion In Yongkang City, health intervention should be focused on the middle-aged and elderly people over 40 years old to prevent and reduce the occurrence of lung cancer, gastric cancer, intestinal cancer, liver cancer, breast cancer, cervical cancer and other tumors, while great attention should be paid to the rapidly rising thyroid cancer.
 
2020 Vol. 27 (1): 67-69 [Abstract] ( 73 ) HTML (1 KB)  PDF (1535 KB)  ( 385 )
70 Effect evaluation of pilot reform of countylevel public hospitals based on propensity score matching
Zhang Yaoguang,, Miao Zhiwen1, Zhou Zhongliang2, Xue Ming1, Xu Ling3. 
DOI: 10.3969/j.issn.1006-5253.2020.01.015
Objective To understand the effect of county-level public hospital reform, and provide evidence for improving the medical reform policy. Methods Quantitative analysis method and multi-source data were used to analyze the impact of county-level public hospital reform on service ability, income, expenses and average cost per visit. Results The resources, the number of beds, medical personnel and equipment of hospitals of the reform group have increased, more than those of the non-reform group. Outpatient and inpatient services in county-level public hospitals increased significantly in the reform group than those in the control group. The average hospitalization and average daily hospitalization expenses of county-evel public hospitals in the reform group were slightly higher than those in the control group. Conclusion County-level public hospital reform effectively improved the service capacity and efficiency of the hospital, while the cost control need to be further strengthened.
 
2020 Vol. 27 (1): 70-73 [Abstract] ( 64 ) HTML (1 KB)  PDF (889 KB)  ( 100 )
74 Application of FOCUS-PDCA model in reducing the drug repercussion rate in the outpatient pharmacy of our hospital
Li Yan, Zhang Jinjie, Gai Keke, Gao Xinfu, Lü Guangyao, Wang Bin.
DOI: 10.3969/j.issn.1006-5253.2020.01.016
Objective To reduce the drug repercussion rate in the Outpatient Pharmacy of our hospital and to promote rational drug use. Methods The drug repercussion rate from January 2017 to March 2018 was analyzed by trend diagram. In the second quarter of 2018, FOCUS-PDCA model was applied in pharmacy management, and the drug repercussion rate in the third quarter of 2018 after the management and before the management was compared and analyzed. Results After the application of FOCUS-PDCA model, the quantity of drug repercussion , drug repercussion rate, the amount of refund, the repercussion rate decreased from 448, 1.496‰, 151 134.76, and 2.958‰ to 124, 0.416‰, 44 132.53, and 0.875‰ respectively, with statistical significant difference (P＜0.05). At the same time, team members had significant improvement in professional skills, cohesion, and problemsolving abilities and so on.Conclusion FOCUS-PDCA model can effectively reduce the drug repercussion rate in the outpatient pharmacy, which is an advanced management model worthy of promotion.
2020 Vol. 27 (1): 74-78 [Abstract] ( 71 ) HTML (1 KB)  PDF (1388 KB)  ( 70 )
79 Application of Power BI visualization tool to build performance evaluation system in a hospital
Fu Jianfei, Lu Yunfei, Zhang Qingyu, Ye Lirong, Ge Haibo, Li Yiping, Chen Xueqin.
DOI: 10.3969/j.issn.1006-5253.2020.01.017
Objective To provide a fast and rich visualized-template analysis method for the hospital statisticians. Methods The hospital performance data from January 1, 2017 to June 30, 2018 were extracted. After data import, data type conversion, data relationship, and data modeling method, using the builtin visualization template, combined with the actual demand and display effect, the study constructed a series of delicate visualized reports from the overall technical difficulty of medical services, medical efficiency, medical safety, and key specialist capabilities. Results The study produced several reports such as an overview of clinical department data indicators, RW distribution of clinical department, clinical department surgery, and detailed query of clinical department medical records. These reports have the characteristics of high degree of visualization, rich chart, convenient and quick customization. Conclusion Power BI has the characteristics of not relying on IT department, low threshold and a high degree of customization, rich visual template and easy function to understand, and can be used as the preferred tool for hospital statisticians to analyze hospital performance data.
2020 Vol. 27 (1): 79-83 [Abstract] ( 67 ) HTML (1 KB)  PDF (1972 KB)  ( 621 )
84 Analysis of bed efficiency index after the correction of CD rate and its affecting factors
Wang Leilei, Liang Xuexian, Song Jun.
DOI: 10.3969/j.issn.1006-5253.2020.01.018
Objective To evaluate the bed efficiency index after correction of each month and each department of a tertiary hospital in 2018, to analyze the reasons for its high efficiency or low efficiency operation, and analyze the influencing factors of the adjusted bed efficiency index, so as to provide reference for the rational allocation of beds in the hospital. Methods The "normalization method" was adopted to calculate the bed efficiency index of each month and each department of a tertiary hospital in 2018, and the CD rate was used for correction.Multiple linear regression method was used to analyze the influencing factors of bed efficiency index after correction. Results For the beds efficiency index in every month, the highest was in July and the lowest was in February.Indexes in every month except that in February were all higher than 0.9.In the adjusted bed efficiency index of all departments, while some department beds were running with high efficiency, there were also some departments with vacant beds. The efficiency index of ICU was the highest (4.06). The linear regression analysis found that the higher the initial number of patients, the number of patients admitted, and the number of patients undergoing two or three types of incision surgery, the higher the emergency admission rate, the higher the bed efficiency index after correction, and the higher the bed efficiency. The more cases of grade 3 and 4 operations, the lower the bed efficiency index. Conclusion Reasonable allocation of hospital beds could be carried out efficiently through administrative intervention and the improvement of medical service mode, and through making use of affecting factors of bed efficiency index.
 
2020 Vol. 27 (1): 84-87 [Abstract] ( 63 ) HTML (1 KB)  PDF (880 KB)  ( 406 )
88 Effectiveness analysis on control in the patients′ hospitalization costs and hospitalization days under the system of payment by disease score
Zhan Lincheng, Su Huaguan, Lu Zhilue, Jiang Yuhui, Chen Qiabin.
DOI: 10.3969/j.issn.1006-5253.2020.01.019
Objective To explore the effect of implementing the policy of payment by disease score to control the patients′ hospitalization costs and hospitalization days. Methods By using the key information in the medical record homepage and medical insurance settlement fee, this paper makes a comparative analysis on the indicators of hospitalization costs,hospitalization days, the cost structure, and medical insurance costs of urban or rural patients before and after the implementation of payment by disease score. Results The average hospitalization costs and average hospitalization days were lower than those before the implementation of payment by disease score, and the differences were statistically significant (P<0.05). In the patient cost structure, drug cost, consumable cost and other costs all decreased, while technical labor cost increased, and the difference was statistically significant (P<0.05). Conclusion The payment by disease score can effectively reduce the average hospitalization costs and average hospitalization days, and promote the optimization of the structure cost, but it still needs to be strengthened in the aspect of controlling the cost of urban medical insurance patients.
2020 Vol. 27 (1): 88-90 [Abstract] ( 58 ) HTML (1 KB)  PDF (870 KB)  ( 222 )
91 Case analysis of disease and surgery coding for schwannoma
Chen Fang, Guo Jiayi, Yuan Jianlie, Xu Minhui, Zheng Pan, Wu Lijuan, Liu Jihong.
DOI: 10.3969/j.issn.1006-5253.2020.01.020
Schwannoma is a benign tumor of peripheral and central nerves, which belongs to the nerve tumors. Due to the lack of clinical medical knowledge, the lack of familiarity with the disease types and surgical methods of schwannoma, the over-reliance on computer coding, the lack of code review and quality control in the coding system, and other reasons, schwannoma is often miscoded as benign tumor at the site of disease. This paper introduces the clinical features, diseases and surgical codes of schwannoma, and analyzes the reasons of coding errors through a retrospective study of 3 typical cases of schwannoma, and summarizes the coding ideas of schwannoma. Medical institutions should attach great importance to coding, constantly improve the professional ability and responsibility of the coders, and improve the accuracy of disease and surgical coding through the establishment of specialist coders and the establishment of the code review mechanism on the front page of medical records.
2020 Vol. 27 (1): 91-93 [Abstract] ( 84 ) HTML (1 KB)  PDF (879 KB)  ( 353 )
94 ICD-10 coding method for naming diseases by human nametaking ophthalmology as an example
Zhang Rui,Yang Fan.
DOI: 10.3969/j.issn.1006-5253.2020.01.021
Many diseases in ophthalmology are named after people's names. These diseases are usually named after foreign ophthalmologists who reported the disease for the first time. Clinicians often use English names directly as the diagnosis of these diseases, such as Coats′ disease, Fuchs syndrome, Leber's hereditary optic neuropathy, Duane syndrome, etc. In order to search for the correct codes of these diseases, this paper explores the coding search methods of these ophthalmic diseases, and finds that their codes are H35.0, H20.8, H47.2 and H50.8, respectively. It is concluded that there are generally two methods of selecting leading words for disease coding named by human names: name and clinical manifestations. Choosing persons' names as leading words requires searching for the authoritative Chinese transliteration names of these foreign ophthalmologists in the literature, and using authoritative Chinese transliteration names as leading words to search for codes; choosing clinical manifestations as leading words requires a full understanding of the etiology, development, diagnosis, treatment and prognosis of these diseases in the medical literature, to grasp the clinical manifestations of these diseases.
2020 Vol. 27 (1): 94-96 [Abstract] ( 66 ) HTML (1 KB)  PDF (871 KB)  ( 376 )
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