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2020 Vol. 27, No. 3
Published: 2020-06-25
 
 
193 Evaluation of patient-reported outcome and analysis of structural equation model of patients with chronic heart failure
Zhangqing,Tianjing,Yanghong,Renjia,Zhangyanbo,Hanqinghua
DOI: 10.3969/j.issn.1006-5253.2020.03.001
Objective To explore the influencing factors of patient-reported outcome (PRO) with chronic heart failure (CHF),and to provide evidence from PRO for improving the quality of life of patients with chronic heart failure.Methods Totally 366 patients with CHF were assessed with CHF-PRO measure (CHF-PROM) and their CHF electronic case reported form (CHF-eCRF) was recorded.Based on the analysis of univariate and multifactorial factors and the introduction of structural equation model,a causal correlation model for the outcome of PRO treatment was established.Results Multivariate analysis suggested that chronic obstructive pulmonary disease (COPD) and atrial fibrillation were associated with somatic symptoms in patients with heart failure. The independence of patients increased significantly after cardiac surgery.Increased heart rate was a risk factor for anxiety.Central nervous system diseases and coronary heart disease (CHD) were the influencing factors of social support utilization dimension.The PRO structural equation model suggested that patients' physiological symptoms, psychological and therapeutic fields influenced each other.Conclusion The report of clinical outcome in patients with heart failure is a useful supplement to clinical endpoint indicators and provides more comprehensive evidence for clinical diagnosis and treatment and evaluation of curative effect.
2020 Vol. 27 (3): 193-197,201 [Abstract] ( 88 ) HTML (1 KB)  PDF (1040 KB)  ( 311 )
198 Analysis of risk factors of cognitive impairment in patients with chronic schizophrenia
Hu Yuanyuan,Li Songhua,Wu Yueqing.
DOI: 10.3969/j.issn.1006-5253.2020.03.002
Objective To investigate the risk factors of cognitive function impairment in patients with chronie schizophrenia.Methods Totally 216 patients with schizophrenia admitted to our hospital from January 2018 to December 2018 were enolled.The cognitive impairment status of patients was recorded.Multivariate logistic regression was used to analyze the related factors of cognitive impairment in patients with chronic schizophrenia.Results The total score of CCAS was(81.97±15.89),with normal cognitive function in 87cases(43.5%),impaired cognitive function in113cases(56.5%).Univariate analysis showed that there were statistically significant differences in the level of family care,intervention mode,education level,per ca-pita family income,hospitalization frequency,SDSS seore and whether the patients had negative symptoms(P<0.05).There was no statistical significance among age,gender,marriage status and pre-disease accupations(P>0.05).Multivariate logistie regression analysis showed that lack of family care,traditional intervention(as opposed to individual intervention),primary school education and below,family per capita monthly income<3000yuan,hospitalization frequency2times,SDSS score z2points and negative symptoms were the main risk factors.Conclusion There are many risk factors affecting the impairment of cognitive function in patients with chronic schizophrenia.Early detection and early prevention should be established,and appro-priate treatment plans should be developed to improve the living environment of patients and improve the therapeutic effect.
2020 Vol. 27 (3): 198-201 [Abstract] ( 77 ) HTML (1 KB)  PDF (833 KB)  ( 112 )
202 Clinical value of real-time shear wave elastography in evaluating renal function in patients with diabetic kidney disease
Qiu Siying，Jiang Zewen，Wu Chiqiu，Chen Duoduo
DOI: 10.3969/j.issn.1006-5253.2020.03.003

Objective To investigate the clinical value of ultrasound real-time shear wave elastography (SWE) in evaluating renal function in patients with diabetic kidney disease (DKD), and thus to provide evidence for elary diagnosis and clinical treatment of DKD. Methods Sixty-two patients with DKD and 14 cases with normal renal function were collected from June 2016 to May 2019.There were 21,24 and 17 cases in the early nephropathy,clinical nephropathy and uremia groups among the DKD patients,respectively.All subjects received conventional ultrasound,SWE and99mTc-DTPA renal dynamic imaging examination. The differences of conventional ultrasound parameters,mean Young′s modulus Emean) and glomerular filtration rate (GFR) were analyzed. The nonlinear relationship between GFR and Emean was fitted according to the scatter diagram, and the quation was established.Results There was no significant difference in conventional ultrasound parameters (length, physical evidence, volume) between steps groups (P >0.05). SWE parameters-Emean was gradually increased in left kidney, right kidney and both kidneys from the early nephropathy group  (lowest) to the uremia group (highest), and the difference was statisticalally significant compared with the control group (P <0.05). Among the subgroups of DKD,the uremia group was the highest,and the early nephropathy group was the lowest, and the difference between each DKD subgroup was statistically significant (P <0.05). The level of total  GFR in each DKD subgroup decreased, and the difference was statistically significant, compared with that in the control group (P <0.01). As the total GFR level of radiolabels decreases,the average Emean value gradually increases. Growth curve fitting was made to establish the equation E (Y)=exp (5.789-0.417X)(P <0.001), and the fitting effect was good (R2=0.918). The sensitivity ands pecificity were 77.4% and 83.1% while Emean  threshold was 3.53 kPa in the early stage group,sensitivity and specificity were 80.8% and 90.2 while Emean threshold was 4.49 kPa in the clinical nephropathy group,and sensitivity and specificity were 83.5% and 92.6% while Emean threshold was 5.47 kPa in the uremia group,respectively.Conclusion SWE possesses high diagnostic efficiency in the diagnosis of renal dysfunction in DKD,which has important clinical significance in the early diagnosis and treatment of DKD.
2020 Vol. 27 (3): 202-206 [Abstract] ( 61 ) HTML (1 KB)  PDF (852 KB)  ( 154 )
207  Analysis of epidemiological characteristics of 29354 pr-hospitale mergency cases
HouYuehui,LiangXiaoyu,Wang Xin,LingQiaoqiao,GuoGonglue,MouLicheng
DOI: 10.3969/j.issn.1006-5253.2020.03.004
Objective To provide a reference for local pre-hospital emergency management and resource allocation by analyzing the epidemiological characteristics of pre-hospital emergency cases in the sample area.Methods A retrospective analysis of all pre-hospital emergency cases was conducted in the emergency center in the sample area from August 1st, 2018 to July 31, 2019. Results Among 29,354 pre-hospital emergency cases, the male-female ratio was 1.59∶1, and  the proportion of  [50, 60) years old was the highest, with 16.52%. The mortality rate increased with age.The peak time of onset was January, March, May, June, July, August, and December, and the incidence was the lowest in February.The time period within one day [6∶00,9∶00)  was the highest number of pre-hospital cases, [18∶00,21∶00) Second,[ 3∶00,6∶00)  was the least.The longest time period for the total time of departure was [6∶00,9：00),which was 27.63 ±16.96 minutes.The type of disease was mainly traumatic, reaching47.96%. The cause of trauma was mainly traffic accident, which was 63.45%. Conclusion In the sample area, sufficient emergency resources should be provided during the peak hours of commuting, and the level of emergency treatment, especially the ability of trauma treatment, should be improved.
2020 Vol. 27 (3): 207-210 [Abstract] ( 58 ) HTML (1 KB)  PDF (770 KB)  ( 101 )
211 Establishment of a hospital-based nomogram of the risk of carotid atherosclerosis in patients with hypertension
Shen Qundi
DOI: 10.3969/j.issn.1006-5253.2020.03.005
Objective To establish a predictive model for the risk of carotid atherosclerosis in patients with hypertension and evaluate it. Methods Patients with hypertension in our hospital from June 2016 to December 2018 were analyzed retrospectively.The clinical data, main biochemical indexes and intima-medium thickness value of carotid artery were collected. SPSS 25.0 and R 3.6.1 software were used for statistical analysis, and the prediction model was established and evaluated. Results Univariate and multivariate analysis showed that age ≥ 60 years, elevated low density lipoprotein cholesterol and alkaline phosphatase were independent risk factors for carotid atherosclerosis in patients with hypertension. According to the variables selected by Logistic regression model, the risk nomograph was established. The C-index is 0.770, and the distinguishing ability of the model is good. The AUC calculated by ROC curve is 0.770, and the accuracy of the model is good. The evaluation of Calibration curve and Decision curve shows that the consistency and benefit of the model are still available. Conclusion The accuracy of the nomograph for the risk of carotid atherosclerosis in patients with hypertension is reasonable, which has a certain reference value in the clinical work and individual risk analysis. However, due to the small sample size and the limited source of cases,it still needs to be verified by large sample and multicenter research.
2020 Vol. 27 (3): 211-214 [Abstract] ( 72 ) HTML (1 KB)  PDF (1031 KB)  ( 140 )
215 Investigation analysis on risk factors of poor prognosis of acute cerebral infarct patients after treatment with venous thrombolysis 
Wu Qiaoling, Huang Danhong, Ye Tengfang
DOI: 10.3969/j.issn.1006-5253.2020.03.006

Objective To explore the prognosis and is risk factors of acute cerebral infardt (ACI) patients after the treatment with venous thrombdlysis.Methods Totally 178 ACI patients after treatment of venous thrombolysis were caried out a following-up survey within 3 months.These patients were divided into the good prognosis group(102 cases)and the por progno-sis group(76 cases)according to the evaluation of prognosis. The incidencerate o por prognosis of ACI patients after venous thrmbolysis treatment was descriled, and the risk factors of por prognosis were screened.Results The incidence rate of poor prognosis of ACI patients after enous thrombolyis reatment was 42.70%(76/178).The risk factos of por prognosis included hypertension(OR =6.589),thrombolysis time window(OR=3.162),NIHSS score before thrombolsis(OR=6.058),blod glucse before thrombolysis(OR=3.452)and cerebral hemorhage after thrombolysis(OR =4.039),but improwement of neuro-logical symptoms after 24h of thromblysis(OR=0.135)was the protective factors of poor prognosis. Conclusion ACI patients sill have a high incidence mte of por prognosis after venous thrombolyis. To aim directly at these above high risk factors,ACI patients should be caried out venous thrombolyis in the thrombolysis time window, and prevention measures should be early a-doped, to improve prognosis of ACI patients.
2020 Vol. 27 (3): 215-217 [Abstract] ( 90 ) HTML (1 KB)  PDF (758 KB)  ( 107 )
218 Analysis of 661 death cases in a hospital from 2009 to 2018
Li Zhun,Bing Yanjie,Mou Yuying，Zhang Zhibin,ChenXueqin,Pan Weibing
DOI: 10.3969/j. issn.1006-5253.2020.03.007
Objective To analyze the mortality and cause of death of hospitalized patients in a hospital from 2009 to 2018, understand  its  characteristics  and  changes, and   provide  corresponding  evidence  for  the  measures  to  reduce  the  mortality  ofpatients. Methods  First  page data  of  inpatient  death  records  were  collected  from the fourth table of health statistics and the medical  cord  management  statistics  system of Guangdong  Province  from 2009 to 2018, and   the  diseases  were classified according to ICD-10.And Excel 2016, SPSS 20.0 and R2.11.1 were used to analyze the data. Results Totally 135026 patients  were  discharged from 2009 to 2018, and 661 deaths  were  reported,  with  the  fatality  rate  0.49%. There  was   no statistically  significant difference  in  the  annual  mortality. Totally 64168 male patients were discharged fromthe hospital,with the mortality rate 0.62% and 70858 female  patients  were  discharged  from  the  hospital, with the mortality rate 0.37%. There  was  significant  difference  inthe  mortalityrate  between  male  and  female. The  top  five  death  causes  were  craniocerebral  injury, cerebral hemorrhage,pneumonia, chronic  obstructive  pneumonia, bronchial and lung malignancies. Conclusion  Corresponding  measures  should be taken toimprove the hospital's service capacity and reduce mortality.
2020 Vol. 27 (3): 218-220，225 [Abstract] ( 65 ) HTML (1 KB)  PDF (768 KB)  ( 149 )
221 Analysis of hospitalization expense of missed abortion patients in clinical pathway from tertiary hospitals
Liao Jierong,Lin Denan
DOI: 10.3969/j.issn.1006-5253.2020.03.008

Objective To analyze the hospitalization expenses under the missed abortion clinical pathway managementmodel,and to provide a basis for controlling the 
unreasonable growth of medieal expenses and realizing the effective use of medical resources.Methods The data of clinical path with missed abortion patients from 
tertiary hospitals of Shenzhenwere colleeted,descriptive analysis,cluster analysis and single factor analysis of variance(anova) were  used  to analyze  the  medical expenses  structure and compare the medical expenses level. Results  The cost of hospitalization  varied greatly among patients withmissed  abortion  in  clinical pathway in different hospitals.  Diagnosis expenses, comprehensive medical service expenses  and treatment expenses were the main components  of the hospitalization expenses for the missed abortion patients.The results showedthat,in hospitals with high total hospitalization expenses,the expenses of all 
items were higher or the expenses of some itemswere higher than those in other hospitals.Conclusion With the implementation of clinical pathway treatment for the
 same disease,there is a large gap in medical charges between hospitals,and the distribution difference of various medical expenses is different.Hospitals should 
strengthen clinical pathway management,standardize diagnosis and treatment behavior,guarantee medical quality,and control unreasonable increase of
 hospitalization expenses
2020 Vol. 27 (3): 221-225 [Abstract] ( 77 ) HTML (1 KB)  PDF (990 KB)  ( 151 )
226 Analysis of external causes of 15254 hospitalized patients with injury and poisoning
Mai Hongfen,Huang Jianqiang, Liang Yu.
DOI: 10.3969/j.issn.1006-5253.2020.03.009
Objective To analyze the external causes of injury and poisoring inpatients,and provide a basis for formula-ting preventive and control measures.Methods ICD-10 coded V01-Y98 was used to retrieve the data of injury and poisoning inpatients, and EXCEL software was used to process and analyze the data. Results The external causes of15,254injured and poi-soned hospitalized patients were in order.The top five external causes of injury and poisoning were fall(29.2%),exposure toinanimate mechanical forces(16.3%),injury of motorcyclists in traneport accidents(12.6%),exposure to hot and sealdingmaterials(6.8%)and other land transport accidents(5.0%).Among them, the fall has ranked first for 5 consecutive years, and the proportion has increased year by year. Fallen patients over the age of 60 accounted for 38% of the total number of fallenpatients,mainly females (0.68:I male to female ratio), and the main injury  site was femoral fracture (36.1%). ConclusionThe entire society should strengthen safety awareness, take targeted measures, and actively reduce  the  incidence of injuries andpoisoning. Special attention  should be paid  to the occurrence  and prevention of fall  in the elderly.
2020 Vol. 27 (3): 226-228 [Abstract] ( 68 ) HTML (1 KB)  PDF (758 KB)  ( 283 )
229 Analysis of clinical features of 357 elder patients with vertebral compression fracture 
Liu Yuanyuan, Sun limin,WangBingchen
DOI: 10.3969/j.issn.1006-5253.2020.03.010
Objective To analyze the basic situation and clinical characteristics of patients over 50 years old undergoing compression  fracture surgery in our hospital in  the past five years, so as to provide a reference for the prevention and treatment of spinal fracture in elderly patients in this area. Methods The data  of  patients who received spinal fractures surgery in the hospital from Jan. 2014 to Dec. 2018 were collected through hospital medical record system. Clinical  parameters such as gender, age,diseharge date,fracture site,fracture segment,surgical procedure,length of stay,and the total cost of stay were analyzed. Results Totally 357 patients with the maximum age of 96 years old and the average age of7 3.59±9.73 years old were included in the retrospective survey.  The number of female surgical patients was higher than that of male patients every year, with statistically significant difference(P<0.05). There  was no  difference between the fracture sites; however,there was significant changes between surgical methods  (P<0.05). Single segment fractures were dominant, and the most common segment was T11-L2 segment, accounting for 64.4%. Conclusion The incidence of spinal fractures among elderly patients is  higher in  female patientsthan that in male, especially with a higher incidence in over60years old patients.T he highest proportions are T12 and L1,segment fractures. Active  prevention and treatment should be carried out to reduce the occurrence of spinal fractures.
2020 Vol. 27 (3): 229-231，235 [Abstract] ( 71 ) HTML (1 KB)  PDF (1931 KB)  ( 135 )
232 Analysis on disease spectrum of hospitalized children in amaternal and child health care hospitai from 2015 to 2019 
SunHongxia, Wang Fang.
DOI: 10.3969/j.issn.1006-5253.2020.03.011
Objective To amalyze disease constitution of hospitalized children in a maternal and child health care hospital from 2015 to 2019,and provide reference for the medical and preventive healh care of children.Methods A retrospective analysis was performed on pediatric inpatients aged 0 to 14 years old in our hospital from 2015 to 2019.Results Among hospitalized pediatric patients from 2015 to 2019,there were 78 21l boys (63.13%) and 45672 girls (36.87%),with a male/female ratio of 1.71:1. In the disease composition of pediatric inpatients,the top five systematic diseases were respiratory system diseases 28 919 cases(23.34%), perinatal diseases 27780 cases (22.42%),mental and behavioral disorders 13 054 cases (10.54%),neurological diseases 12 819 cases (10.35%) and congerital abnormalities 9227 cases (7.45%).The top three diseases of respiratory system diseases were pneumonia 15 115 cases (52.27%), upper respiratory infection 3 502 cases (12.11%) and acute capillary bronchitis 2770 cases (9.58%).The top three diseases of perinatal diseaes were neonatal respiratory distress 6706 cases (24.14%), neonatal jaundice 4517 cases (16.26%) and neonatal pneumonia 3 219 caes (11.59%). Mental and behavioral disorders mainly ocrcured in childhood autism 9482 cases (72.64%) and mental retardation 3 308 cases (25.34%).Concusion Respiratory system diseases,perinatal diseases,mental and behavioral disorders are the focus of pediatric disease prevention and treatment.Mental and behavioral disorders and tumors are on the rise in recent yars, which should also be paid more attention to.
2020 Vol. 27 (3): 232-235 [Abstract] ( 74 ) HTML (1 KB)  PDF (825 KB)  ( 376 )
236 Impact of non-ventilated hospital-acquired pneumonia on patient clinical outcomes and medical cost:a propensity score-matched analysis
Chen Zhihui,Wu Hongmei,Wang Chenhong,Xu Ziqin,Gao Shengchun, Chen Le
DOI: 10.3969/j.issn.1006-5253.2020.03.012
Objective To estimate the impact of hospital-acquired pneumonia (HAP)on patient clinieal outcomes andmedical cost. Methods Medical records of patients  discharged from Wenzhou people's hospital between May 1,2017 and June 7，2018 were reviewed. Patients were divided into  two groups according  to  whether with hospital-acquired pneumonia. We developed a HAP propensity model and  matched cases with  non-HAP by propensity score at a 1:6 ratio.The differences were comparedinhospital mortality, length of stay and medical cost before and after matching. Results Among 44937patients,314 HAP cases were identified. Before matching,the in-hospital mortality rates were 3.6% (15/415) for those with HAP and 0.1%(56/44623) for those without HAP (OR=28.9,95%CI:15.0-55.7). After matching,HAP patients had higher mortality( 3.9%vs1.2%；P=0.003)，longer length of stay[(M=24,IQR=17)vs(M=8，IOR=9)days;P<0.001],and higher medical cost[(M=33450.2,IQR=31572.3)vs(M=11375.9，IQR=14230.9)；P<0.001]compared with  matched non-HAP. HAP was  significantly associated with in-hospital mortality (OR=3.2，95%Cl:1.5～6.8),inecreased length of stay(absolute  difference =19.9, 95% Cl:17.2～22.6) and  higher medical cost (absolute difference=30438.4,95%CI:26367.0～34509.7).Conclusion Patients with HAP contribute to higher in hospital mortality,longer  length of stay and higher medical costs compared with non-HAP patients.
2020 Vol. 27 (3): 236-241 [Abstract] ( 83 ) HTML (1 KB)  PDF (1136 KB)  ( 132 )
242 Work mode of medical and health statistics based on database management structure 
Tian Qi.
DOI: 10.3969/j.issn.1006-5253.2020.03.013
Objective To solve the problems in hospital statistical work quickly and accurately. Methods Data Center warehouse was established by using  database  management structure, and SQL statement was used for query and statistical indicators. Results Data warehouse can quickly and accurately  obtain the data  and indicators needed for statistical work. Conclusion Health statistical work mode based on database management structure is highly operable, It can solve  the problem that the hospital information system is operated by its own business and the SQL language of database is easy to learn and popularized.The working mode can be popularized and copied for the statistical work of each hospital.
2020 Vol. 27 (3): 242-245 [Abstract] ( 77 ) HTML (1 KB)  PDF (20372 KB)  ( 27 )
246 Evaluation on treatment quality of breast cancer based on intervention studies 
Bao Xiaoqiang,Li Jingkun,Tian Yuan,Liu Mengyang,Liu Meina.
DOI: 10.3969/j.issn.1006-5253.2020.03.014
Objective To establish the intervention measures of breast cancer quality of care, to analyze the influence of the intervention measures on the utilization  rate of he indicators for breast cancer,and to provide theoretical guidance for improving the quality of care for breast cancer. Methods Patients with invasive breast cancer were included in this study and the utilization rates of each quality indicator were calculated. Intervention  measures were established based on the results of evaluation and the intervention was executed twice within 35 months. The change of utilization  rate of  indicators before and after the intervention was estimated using interrupted time series. Results We obtained 3282 eligible patients and evaluated the quality of care for breast cancer based on nine indicators.The intervention measures included information feedback and conference intervention. The level of utilization  rate of sentinel lymph node biopsy increased by 25.52% (P=0.003) and the utilization rate of sentinel lymph node biopsy showed an ascending trend by 1.12%per month after the initial intervention.The utilization rate of at least 10 axillary lymph node dissections showed an aseending trend by 1.37% per month after the  second intervention.Conclusion The compliance of sentinel lymph node biopsy and at least 10 axillary lymph node dissections can be improved by the  evaluation of treatment quality and the implementation of intervention measures. The evaluation of treatment quality based on intervention studies can  improve  the utilization rate of quality indicators,avoid postoperative comorbidities,reduce postoperative recurrence rate,and improve the quality of eare for breast cancer.
2020 Vol. 27 (3): 246-250 [Abstract] ( 55 ) HTML (1 KB)  PDF (1130 KB)  ( 117 )
251 Analysis of infection status of "three catheters"in ICU and application of hospital infection control chart from 2015 to 2019
Guan Xianhua, Chen Hongping, Zhang Haiying.
DOI: 10.3969/j.issn.1006-5253.2020.03.015
Objective To explore the application value of nosocomial infection control chart in ICU,and to provide guidance for nosocomial infection control. Methods From  January 2015 to December 2019, the monthly "three catheters" infection monitoring records of ICU ward in our hospital were collected, SPSS was used to make  statistical analysis of the collected data,and the hospital sense control chart was used to monitor the "three catheters" infection in ICU, in order to find  problems  for improvement.Results From January 2015 to December 2019, 30-96 cases of new patients were admitted to ICU of our hospital every month, with 0-5 new cases of CLABSI every month,with the total time of central venous catheterization and with 202-449 days every month,and with the incidence of CLABSI 0-14.71 cases per thousand catheter day.And 0-6 new cases per month occurred,with the total time of urethral catheterization 213-449 days every month, with  the incidence of CAUTI 0-19.01 cases per thousand catheter day.While 0-5 new cases per month of VAP oecurred, with the total time of using ventilator every  month,and the incidence of VAP was 0-19.01 cases per thousand catheter day. Every month, the data monitoring points of CLABSI, CAUTI and VAP incidence  fell within the control limit, fluctuated on and off the central line, and there was no abnormal arrangement of data points. Every month,the incidences of CLABSI, CLABSI,CAUTI and VAP were different datapoints outside the warning limit,the rest were within the warning limit without abnormal arrangement, and "three catheters" infection was under control.Conclusion With the help of hospital quality control chart,we can scientifically and intuitively analyze the status of "three catheters" infection in ICU,which has the characteristics of simple operation,intuitive results and timely detection of problems. It can be widely used in the  daily monitoring of ICU hospital infection.
2020 Vol. 27 (3): 251-255 [Abstract] ( 65 ) HTML (1 KB)  PDF (18532 KB)  ( 14 )
256 Analysis of influencing factors on the change of medical service capability of a tertiary hospital from the perspective of DRGs 
He Guobin,Guo Jiayi,Wu Youmei,Zheng Pan,Zhu Jingjing,Xu Minhui.
DOI: 10.3969/j.issn.1006-5253.2020.03.016
Objective To explore the change of hospital medical service capability and coping strategies from the perspective of DRGs. Methods Factor index  analysis  method and direct standardization method were used to analyze the changes and influencing factors of hospital business indicators in 2017 and 2018. Results  In 2018,the total amount of DRGs in the hospital was113430.12, with an increase of 10.94%. The increase was mainly affected by the increase  of discharge  times, followed by the decrease of CMI.After eliminating the department composition ratio, the standardized CMI in 2018 was higher than that in 2017. Conclusion On the whole, the business development of a certain hospital still belongs to the "scale and quantity type", which needs to adjust the business  structure through the coordination at the hospital level and the fine management at the section level, and change to the "quality and efficiency type", so as to  realize the healthy and sustainable development of the medical service capacity.
2020 Vol. 27 (3): 256-258 [Abstract] ( 75 ) HTML (1 KB)  PDF (628 KB)  ( 183 )
259 Predictions on the mortality rate of children under five in Guangzhou based on ARIMA model
Liu Tao.
DOI: 10.3969/j.issn.1006-5253.2020.03.017
Objective To analyze and predict the mortality rate of children under five (U5MR) in Guangzhou, and to provide scientific basis for the  improvement of  children's  health care.  Methods SPSS 19.0 was used to establish an integrated mobile average autoregression(ARIMA)model for the time series composed of U5MR in Guangzhou from 2001 to 2017. After obtaining the relative optimal fitting model,the short-term prediction of U5MR in Guangzhou  was carried out. Results The ARIMA(1,2,0) model has a good effect on U5MR fitting in Guangzhou. The prediction with the mode 1shows that the data of Guangzhou from 2018 to 2020 conforms to the U5MR trend ,and the actual values fall into the confidence interval of the fitting model. Conclusion The ARIMA model  is suitable  for  fitting the time change trend of U5MR and has strong practical value for short-term U5MR prediction in Guangzhou.
2020 Vol. 27 (3): 259-261 [Abstract] ( 95 ) HTML (1 KB)  PDF (1366 KB)  ( 99 )
262 Investigation analysis on risk factors of suicide behavior of bipolar disorder patients 
Zhou Fang.
DOI: 10.3969/j.issn.1006-5253.2020.03.018

Objective To explore the risk factors of suicide behavior of bipolar disorder (BPD)patients, and proride prevention measures for it. Methods Totally 540 BPD  patients were carried out a follow-up survey,and these patients were divided into the suicide behavior group (194 cases) and the non-suicide behavior group(346 cases)according to suicide behavior. The risk factors of suicide behavior of BPD patients were respectively screened  by single factor and  multiple  factors  stepwise Logistic regression methods.Results The rate of suicide behavior in these 540 cases of BPD was 35.93%.The risk factors of suicide behavior of BPD  patients included female (OR=1.846)，family suicide history (OR=3.117),history of major trauma (OR=4.154)，depression degree (OR=5.254)，poor  interpersonal relationships (OR=2.801) and a sense of worthlessness or guilt(OR=3.615). Conclusion BPD patients have a high  rate of suicide behavior, and  there are many independent riskf actors affecting suicide behavior.  Psychiatrists  should  pay atteation, and prevention measures  should be adopted early, to  reducesuicidal tendencies and suicide behavior.
2020 Vol. 27 (3): 262-264 [Abstract] ( 51 ) HTML (1 KB)  PDF (627 KB)  ( 126 )
265 Investigation analysis on characteristics and correlated risk factors of drug resistance of pulmonary tuberculosis in middle aged and old patients 
Mao Xiaoyan,Cheng Murong,Xu Yuehuan.
DOI: 10.3969/j.issn.1006-5253.2020.03.019
Objective To explore the characteristics and correlated risk factors of drug resistance of pulmonary tuberculosis in midde-aged and old patients. Methods Totally 645 middle aged and old patients with pulmonary tuberculosis were carried out a retrospective survey, and these patients were divided into the  drug resistance group and the sensitive group according to the result of drug sensitivity test. The differences of different factors  were compared between  the  two groups, and the risk factors of drug resistance of pulmonary tubereulosis were screened by multiple factors logistic regression method. Results The  incidence rate of pulmonary tuberculosis in middle aged and old patients was 21.24% (137/645)，and mainly in multidrug resistance(61.31%). Multiple factor  result showed that the risk factors of drug resistance of pulmonary tubereulosis mainly included floating population (OR=2.824)，complicated with  underlying  diseases(OR-3.473)，retreatment (OR-4.108), merged cavity (OR=4.522), bad treatment compliance (OR=2.550) and unreasonable drug use(OR=5.317). Conclusion Middle-aged and elderly patients with pulmonary tubereulosis have a high incidence rate of drug resistance, and mainly in multidrug resistance. The  above risk factors should be considered,and the preventive measures should be adopted,to cut down the incidence rate of drug  resistance of pulmonary  tuberculosis.
2020 Vol. 27 (3): 265-267,271 [Abstract] ( 51 ) HTML (1 KB)  PDF (635 KB)  ( 89 )
268 Self-care ability of the elderly in daily life and its influencing factors in Shandong Province 
Song Yongyan, Yang Huan,Hu Xihou.
DOI: 10.3969/j.issn.1006-5253.2020.03.020
Objective To explore the self-care ability of the elderly in daily life in Shandong Province and its related factors, and to provide theoretical basis  for promoting  the health of the elderly and improving the quality of life.Methods Based on the follow-up survey data of health influencing factors of the elderly in China in 2014, the present situation of the self-care ability of the elderly in Shandong Province was investigated. The Logistic regression model was used to analyze  the  main factors affecting the self-care ability of daily life of the elderly,and the countermeasures and suggestions for maintaining and improving the ability of self-care of the daily life of the elderly were put forward.Results The proportion of the elderly with complete ability of daily living was 74.42%. Age, marital status  and self-assessment of health status were the main influencing factors of self-care ability in daily life of the elderly. Conclusion The elderly in  Shandong  Province have good self-care ability. The older they are, the less married they are, and the worse their health status is, the greater the risk of ADL amage. It is  necessary to pay more attention to the ability of daily living of the elderly and the elderly without a spouse, and to earry out individualized health  educationat the  same time to strengthen the prevention and control of chronic diseases and the health self-management of the elderly.
2020 Vol. 27 (3): 268-271 [Abstract] ( 66 ) HTML (1 KB)  PDF (636 KB)  ( 252 )
272 Quality analysis of homepage data of inpatient cases of public tertiary hospitals in Henan Province
Liu Xinkui,Yang Linpeng,Shang Xiaoping, Dong Yichao.
DOI: 10.3969/j.issn.1006-5253.2020.03.021
Objective To understand the quality control situation on the front page of medical records of public tertiary hospitals in Henan Province, and lay a foundation for  the smooth performance appraisal and DRG work of public hospitals. Methods Henan Provincial Center for Quality Control of Medical Records conducted  a  survey on the management of medical records across the province. Through the Henan Provincial Platform for Medical Record Quality Control, we collected the  home page data of hospitalization records of public tertiary hospitals in Henan Province in 2018, and made a classified statistical analysis from the home page  quality control situation,home page quality control method and home page quality score. Results (1)Data showed that 62.7%of public tertiary hospitals have  carried out the quality control work on the front page of medical records,among which provincial specialized hospitals were significantly better than  provincial  general hospitals (x2=4.047，P=0.044).(2)The hospitals that adopted manual quality control on the first page of medical records accounted for 39.2%, and the  hospitals that adopted information method accounted for 23.5%,among which municipal general hospitals were better than municipal specialized  hospitals  in  information of homepage quality control.(3)the results showed that the quality of the front page of general hospitals was significantly  better than that of  specialist hospitals(t=2.784，P=0.021；t=2.238，P=0.033).Conclusion Inspection and supervision should be strengthened to promote hospitals  at all levels  to pay attention to the quality control of the firstpage of medical records,realize the refinement and information management of public tertiary hospitals, and  improve the qualityof the first page of medical records.
2020 Vol. 27 (3): 272-274,279 [Abstract] ( 81 ) HTML (1 KB)  PDF (1633 KB)  ( 110 )
275 Improvement of the three-day filing rate of outpatient medical records with PDCA method 
Huang Yanhong,Tu Chuanfa, Wang Lihong.
DOI: 10.3969/j.issn.1006-5253.2020.03.022
Objective To explore the effect of PDCA on improving the three-day filing rate of outpatient medical records.Methods The goal of three-day filing rate  was  determined,the reason of low three-day filing rate was analyzed with brain-storming method,and the change of three-day filing rate of outpatient medical  records was analyzed comparatively before (2018) and after (2019)the improvement by PDCA method.  Results In the first quarter,  the second quarter, the  third quarter and the fourth quarter of 2019, the three-day filing rate of the hospital was 75.71%, 87.48%, 95.87% and 96.57% respectively, which was 20.05%, 22.35%, 30.07% and 31.87% higher than that in 2018. In the fourth quarter of 2018, only 21.62% (8/37) departments had a three-day filing rate of 90%, while  in  the fourth quarter of 2019,97.56%( 40/41) of the improved departments had a three-day filing rate of 90%. Conclusion The effective measures  to improve  the  three-day filing rate of outpatient medical records are  to feedback and publish data through  wechat group and important hospital meetings, strengthen the  legal awareness of medical staff, strengthen the timely communication and cooperation between medical record management personnel and clinical medical  staff,and improve the template of electronic medical records.Through the implementation of PDCA method,the filing rate of three-day medical records can be  effectively improved.
2020 Vol. 27 (3): 275-279 [Abstract] ( 56 ) HTML (1 KB)  PDF (2946 KB)  ( 234 )
280 Application of Power BI in hospital data analysis 
Guo Zhiwu.
DOI: 10.3969/j.issn.1006-5253.2020.03.023
Power BI is an easy-to-learn and highly effective self-service data analysis tool,which is widely used in varous industries. This paper introduces the functional  characteristics of Power BI, the steps of data analysis and visualization, thapplication scenarios and analysis cases of Power BI in hospital data analysis. Power  BI is the preferred tool to hospital data a naysis,and it has a wide application prospect in hospital data analysis.
2020 Vol. 27 (3): 280-283 [Abstract] ( 69 ) HTML (1 KB)  PDF (13078 KB)  ( 46 )
284 Review of the mainstream evaluation system of Chinese hospitals   
Ma Xianying, Yang Iei.
DOI: 10.3969/j.issn.1006-5253.2020.03.024
Hospital evaluation is an important means to measure the overall strength and level of a hospital. Its purpose is to strengthen the quality of medical serviee, improve the scientific management level of the hospital,and promote the construction and development of the hospital. This paper will analyze the mainstream  evaluation system of hospitals in China, so as to improve the understanding of hospital ranking work and provide references for the  construction and  development of hospitals.
2020 Vol. 27 (3): 284-288 [Abstract] ( 70 ) HTML (1 KB)  PDF (641 KB)  ( 291 )
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