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Chinese Journal Of Hospital Statistics
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2023 Vol. 30, No. 1
Published: 2023-02-25
1
Method of instant feedback report based on REDCap system
Wang Yutong， Liu Huimeng， Wu Lichen，Song Jiangheng，Yan Miaojia，Yang Peiying，Dang Shaonong，Yan Hong， Mi Baibing
DOI: 10.3969/j.issn.1006-5253.2023.01.001
Objective
To create user-defined feedback templates through the REDCap system to achieve instant feedback on research subjects′ survey results in medical research.
Methods
Based on the Custom Template Engine function module embedded in the REDCap system, we constructed investigator-defined feedback templates and applied them in real clinical studies.
Results
The REDCap system was used to create personalized instant feedback reports to summarize and display the results of the study subjects′ indicators in the survey, and to enhance the efficiency of the follow-up study by guaranteeing the subjects′ right to know through pre-defined settings.
Conclusion
Based on the external module of the REDCap system to build an investigator-defined immediate feedback template can realize immediate information feedback during data collection, which fits the needs of clinical studies and follow-up of large cohort studies. Combining the functions of the electronic data collection system with traditional followup studies can become an innovative tool for conducting high-quality medical research.
2023 Vol. 30 (1): 1-5 [
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36
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6
Interactive visual collection of patient self-reported data in medical research by using REDCap system
Liu Huimeng, Wang Yutong, Xiao Jizhen, Zhang Binyan, Cao Suixia, Huo Yating, Liu Jingchun, Yang Peiying, Dang Shaonong, Yan Hong, Mi Baibing
DOI: 10.3969/j.issn.1006-5253.2023.01.002
Objective
To develop a tool with interactive visual data acquisition, patient self-reported data management and standardized data storage based on REDCap electronic data acquisition system.
Methods
The framework of electronic data information acquisition tool was constructed by REDCap, and the association between image and standardized field was completed based on custom image and REDCap external module, so as to realize interactive and visual data acquisition and standardized data storage.
Results
Based on the REDCap system, convenient and accurate collection of self-reported data of patients was realized, including signing electronic informed consent, interactive visual data collection, real-time feedback evaluation report, customized automatic follow-up reminder, etc.
Conclusion
This tool can improve the quality of self-reported data, standardize the storage of selfreported data, improve the efficiency of scientific research and reduce the workload of researchers.
2023 Vol. 30 (1): 6-10 [
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33
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11
Establishment of a cohort study database of vertigo patients based on REDCap system and its follow-up applicatio
Xing Juanli, He Dandan, Wang Jie, Zhu Hailu, Gong Xiaoying, Li Xinyang, Liang Xuanyi, Wang Mingxu，Mi Baibing, Ma Le
DOI: 10.3969/j.issn.1006-5253.2023.01.003
Guide::
It is of great significance to carry out high-quality follow-ups for the clinical treatment and in-depth study of vertigo patients. This study introduces the design and experience of the REDCap system to establish a special disease cohort of vertigo patients and long-term follow-up. An online survey form was designed to collect basic data of patients, and vertigo, dizziness, and disability assessment scale, balance confidence Scale, Pittsburgh Sleep Quality Scale, Hospital Anxiety and Depression Scale were integrated as the main outcome collection tools, and clinical examination results were imported by linking to hospital information system. Five event collection nodes were used before treatment, 1 month after treatment, 3 months after treatment, 6 months after treatment and 12 months after treatment to set and create the aforementioned data collection form, sort out and formulate the research quality control process, set and manage the authority of different researchers, and finally establish a specific disease cohort project for vertigo patients and collect follow-up data. As of 22 June 2022, data on 378 vertigo patients have been collected and further follow-up is planned. The practice found that the follow-up project of the specific disease queue established based on REDCap could realize the simultaneous input of multiple sites and multiple terminals, the realization of medical data entry, quality control and authority management, the construction of follow-up work calendar, and finally the establishment of high-quality and efficient research database. With a simple design process, easy operation, and complete information collection, it provides a free, convenient, efficient, and standardized project management and data collection tool for otolaryngologists to carry out vertigo-related clinical studies.
2023 Vol. 30 (1): 11-18 [
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31
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19
Application of DRG and DIP based on relational database in hospital pediatric discipline construction
Liu Yuanting, Fang Jiawei, He Liping, Huang Guobiao, Liang Zhimin
DOI: 10.3969/j.issn.1006-5253.2023.01.004
Objective
To study the construction of digital image processing(DIP) and diagnosis related grouping(DRG) combined system based on relational database, and apply it to pediatric discipline construction in public general hospitals, and explore the development direction of discipline construction.
Methods
By applying the evaluation system of DRG and DIP provided by the government platform and associated with the hospital medical record homepage database, the corresponding evaluation indexes of DRG and DIP for pediatric inpatients from 2018 to 2020 were calculated, and the win-win measures for medical insurance expense control and discipline development were discussed.
Results
From 2018 to 2020, the ability, efficiency and safety of hospital treatment of difficult and severe patients had not changed much. The case mix index(CMI) was maintained at 0.45-0.47 (general pediatrics) and 1.43-1.54 (neonatology), respectively, and the time and cost efficiency index was 0.74-0.87. There were no deaths in the medium-low risk group, except that the proportion of difficult patients in neonatology decreased from 24.68% to 17.71% in 2020. The medical insurance cost was controlled well and by 2020, there was no loss in the general and neonatology departments. Some of the high-CMI- diseases admitted had development potential, such as "viral brain, spinal cord and meningitis without comorbidities" in the general department of pediatrics and "neonatal respiratory distress syndrome" and "premature infant with serious problems" in the department of neonatology.
Conclusion
The combination of DRG and DIP is the approach of understanding the development trend of the discipline construction and well-controlling medical insurance cost, as well as grasping the future development orientation of the discipline, without depending on other software companies.
2023 Vol. 30 (1): 19-25 [
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26
Comprehensive evaluation of attending physician′s service ability based on CRITIC-TOPSIS and CRITIC-RSR
Xu Yanjie, Zhu Xiaowei
DOI: 10.3969/j.issn.1006-5253.2023.01.005
Objective
To evaluate the medical service ability of attending physicians scientifically and reasonably.
Methods
CRITIC-TOPSIS and CRITIC-RSR methods were used to evaluate the medical service ability of 20 attending physicians of breast cancer surgery in a tertiary hospital in Tianjin in 2020.
Results
The top five in evaluating the service ability of attending physicians by CRITIC-TOPSIS method were M, E, D, H, and O, and the bottom five were N, T, Q, L, and F. The top five in evaluating the service ability of attending physicians by CRITIC-RSR method were H, D, E, J and C, and the bottom five were T, N, Q, L and A. The results of the two evaluation methods were not completely the same. Most of the attending physicians′ evaluation rankings were similar, and the ranking of M and O attending physicians was quite different.
Conclusion
The application of the combination of CRITIC-TOPSIS and CRITIC-RSR can overcome the limitations of strong subjectivity and single evaluation method, and comprehensively evaluate the service ability of attending physicians more clearly and accurately.
2023 Vol. 30 (1): 26-29 [
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32
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30
Construction of competency evaluation index of the specialist group leaders in the operating room
Li Shuling, Ye Jianfang
DOI: 10.3969/j.issn.1006-5253.2023.01.006
Objective
To construct the competency evaluation index of specialist group leaders in the operating room in a general hospital.
Methods
Through literature review and 2 rounds of Delphi expert consultation, Boolean logic search and restricted search screening indexes were used to determine the evaluation indexes and weights of the competency of specialist group leaders in the operating room in general hospitals.
Results
The effective recoveries of the two rounds of expert correspondence questionnaires were 93.62% (44/47) and 100.00% (44/44), the authority coefficients were 0.823 and 0.864, and the coordination coefficients were 0.043-0.406. The final competency included 5 first-level indicators, 11 second-level indicators and 45 third-level indicators, including professional knowledge, professional skills, management ability, comprehensive ability and professional quality.
Conclusion
The competency evaluation system provides quantitative indicators for the selection of specialist group leaders in the operating room, and is conducive to the assessment and evaluation of specialist group leaders and the development of training plans from an overall perspective.
2023 Vol. 30 (1): 30-35 [
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28
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36
Comprehensive evaluation of utilization efficiency of hospital nursing human resources based on data envelopment analysis
Shen Dayan， Li Longti， Lü Fanfan， Li Xia
DOI: 10.3969/j.issn.1006-5253.2023.01.007
Guide::
Objective
To evaluate the utilization efficiency of nursing human resources, so as to provide reference for decision makers to adjust and optimize the allocation of health resources.
Methods
CCR model and BCC model of data envelopment analysis (DEA) were used to comprehensively evaluate the nursing human resources of 52 clinical departments in a tertiary general hospital in 2021. Comprehensive efficiency value, pure technical efficiency value and scale efficiency value were calculated for efficiency analysis, and the optimal value of resource adjustment was analyzed by projection value.
Results
The average comprehensive efficiency of 52 clinical departments in the hospital was 0.89, among which 23 departments were relatively effective with DEA, accounting for 44.23%. The resource input-output of these departments reached the best combination and was in the state of constant return to scale. The comprehensive efficiency DEA of 55.76% departments was less than 1, indicating that the nursing manpower in the above departments had different degrees of low efficiency. According to the projected values of the input-output indicators, the projected values of the input of these departments were greatly reduced compared with the original values, and the resource input was relatively redundant or the output was relatively insufficient. From the perspective of large departments, the nursing manpower efficiency of rehabilitation series departments and comprehensive departments of women and children′s facial features was higher, while that of emergency and critical care departments was lower.
Conclusion
It is suggested that the hospital should further optimize the allocation of nursing human resources and strive to improve the technical ability of nurses for weak departments, give full play to the performance lever, and realize the allocation of nursing manpower throughout the hospital, so as to improve the efficiency of nursing and maximize the input and output of nursing resources.
2023 Vol. 30 (1): 36-42 [
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19
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43
Influence of DRG system on hospital charge decomposition behavior based on game model
Fang Jinming, Tao Hongbing
DOI: 10.3969/j.issn.1006-5253.2023.01.008
Guide::
Objective
To analyze the influence of DRG system on hospital charge decomposition with the game model.
Methods
By analyzing the definition of decomposition charge, the behavior strategy of the game subjects, and the structure of hospital diagnosis and treatment expenses, this paper constructs the supervision game models of medical insurance on the decomposition charge behavior of hospitals under the fee-for-service payment and the DRG payment respectively, and obtains the equilibrium solution of the game model.
Results
Under Nash equilibrium, the probability of hospital charge decomposition is equal under the fee-for-service payment and the DRG payment, but its essence is different, because under the DRG payment, the probability of medical insurance inspection is less than that under fee-for-service payment. If the medical insurance maintains the original inspection probability, the probability of hospital charge decomposition will decrease.
Conclusion
The reform of DRG system leads to the reduction of the motivation for hospitals to carry out decomposition charges, and reduces the supervision pressure of medical insurance on hospital decomposition charges. The insurance managements can reduce the administrative investment and appropriately shift the focus of supervision. In addition, strengthening the education of medical ethics, increasing the coverage of supervision and speeding up the process of scientific pricing can also reduce the behavior of hospital charge decomposition.
2023 Vol. 30 (1): 43-47 [
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48
Distribution characteristics of patients with esophageal cancer with over-long hospitalization days in a tertiary hospital in Henan Province
He Xianying，Cui Fangfang，Ma Qianqian，Zhao Jie
DOI: 10.3969/j.issn.1006-5253.2023.01.009
Guide::
Objective
To analyze the distribution characteristics of esophageal cancer patients with extra-long hospitalization days, so as to provide data support for shortening the average hospitalization days.
Methods
Data from the first pages of medical records of inpatients discharged between 2013 and 2016 were selected from a tertiary comprehensive hospital, and patients staying over 30 days were retrospectively analyzed on the items such as age, gender, payment method and so on.
Results
Among 22 197 discharged patients with esophageal cancer, 2 267 patients (10.2%) were with extra-long hospitalization. There were 1 598 male patients (70.49%) and 669 female patients (30.51%); patients aged 61 to 70 years old accounted for the largest proportion, with 966 cases (42.61%)，followed by those aged 51 to 60 years old with 657 cases (28.98%); the average length of hospital stay in patients with surgery (47.81 days) was higher than that in patients without surgery (41.72 days), with a statistically significant difference (Z=-7.429, P<0.05); in the composition of various hospitalization expenses for patients with extra-long hospitalization days, the top five expenses were western medicine expenses (50.62%), radiation expenses (20.51%), treatment expenses (6.98%), laboratory expenses (6.37%) and material expenses (5.93%).
Conclusion
In order to reduce the economic burden of patients with esophageal cancer, it is suggested that the hospital should control the length of stay of elderly patients and surgical patients in the department and strengthen the management of rational drug use.
2023 Vol. 30 (1): 48-51 [
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25
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52
Analysis on the change trend of outpatient volume in a tertiary hospital from 2013 to 2021
Song Yanlong，Cheng Jing， Wei Rui
DOI: 10.3969/j.issn.1006-5253.2023.01.010
Guide::
Objective
To analyze the dynamic change law of outpatient volume through statistics, and provide reference for hospital decision-making and medical resource allocation.
Methods
The outpatient volume of a large-scale tertiary general hospital in a certain area from 2013 to 2021 was collected, and the monthly and quarterly outpatient volume were dynamically analyzed by seasonal index.
Results
The number of outpatients increased year by year. The monthly seasonal index was the highest in December, reaching 115.91%, and the lowest in February, reaching 78.40%. The quarterly seasonal index was the highest in the fourth quarter, reaching 104.99%, and the lowest in the first quarter, reaching 93.53%.
Conclusion
There are obvious periodicity and regularity in the change of outpatient visits with months and seasons. Hospitals should optimize the allocation of health resources and improve the efficiency of medical services according to the change of outpatient visits.
2023 Vol. 30 (1): 52-54 [
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55
Analysis of inpatient medical income in tertiary public hospitals based on structural change degree
Lin Jianchao
DOI: 10.3969/j.issn.1006-5253.2023.01.011
Guide::
Objective
To analyze the internal structure and changes of average inpatient cost in national tertiary public hospitals in China, so as to provide reference for optimizing the average hospitalization cost structure and controlling the growth of medical cost.
Methods
The data were collected of the average cost of inpatients in tertiary public hospitals in China from Health Statistical Yearbook, and the changes of the average cost of inpatients in tertiary public hospitals from 2014 to 2019 were analyzed by using the structural change degree method for statistical analysis.
Results
From 2014 to 2019, the average inpatient cost of tertiary public hospitals increased year by year, in which the proportion of drug cost decreased year by year, and the proportion of health materials cost increased year by year. Medicine cost, sanitary cost and operation cost were the three main cost items in the structural change of average inpatient cost in tertiary public hospitals, and the cumulative contribution rate of the three items was more than 70%.
Conclusion
The income structure of inpatients per time in tertiary public hospitals has changed greatly, the management of drug income has been significantly improved, and the technical value and service value of medical staff have not been significantly improved. It is suggested to further strengthen inspection, control the use of health materials, improve the medical service price reform system, and to further enhance the technical value and service value of medical staff.
2023 Vol. 30 (1): 55-58 [
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Application of bi-directional link note software in the analysis of epidemiological investigation reports of public health emergencies
Liu Huimeng， Li Rui， Wang Yutong， Ji Zhenhao， Mi Baibing，Chen Fangyao，Shen Mingwang， Qi Xin，Pei Leilei， Zeng Lingxia，Hou Tiejun， Zhuang Guihua
DOI: 10.3969/j.issn.1006-5253.2023.01.012
Guide::
Objective
To introduce the application of bi-directional link note-taking software in the analysis and diagnosis of public health emergencies.
Methods
Based on the practical experience of COVID-19 prevention in Xi′an, Shaanxi Province from December 2021 to January 2022, we used a bi-directional link note-taking software named Obsidian to extract key information from the massive flow investigation reports. This note-taking software has the powerful function of searching, connecting, and visualizing case relationships, which are helpful for the assessment of COVID-19.
Results
Based on the powerful functions of the bi-directional link note software, key information can be extracted from the massive reports. This may help to quickly identify the transmission chain and determine the development trend of the aggregated epidemic, and identify potential risk loci.
Conclusion
The epidemic analysis based on bi-directional link notetaking software has the characteristics of rapid, accurate visualization. Our study provided experience for timely and accurate analysis of the mass epidemic information in the future.
2023 Vol. 30 (1): 59-63 [
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22
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Research on the preprocessing method of health examination data in prefecture-level hospitals based on SAS software
Zhang Lijun， Huang Yanyan，Pu Yang， Chen Ke，Xu Fan， Luo Xiangli,Shi Qiuling
DOI: 10.3969/j.issn.1006-5253.2023.01.013
Guide::
Objective
To systematically analyze the data characteristics of the current health examination data, and to realize the data preprocessing by using Excel and SAS software macro process.
Methods
Based on the physical examination data from the physical examination data platform of a municipal tertiary hospital from October 2017 to December 2020, the characteristics of the current physical examination data were summarized through data combing, and the corresponding preprocessing rules were formulated. Based on Excel and SAS software, the specific data preprocessing scheme, operation process and macro code were proposed. data characteristics were summarized through data sorting, preprocessing rules were formulated, and specific solutions, operation procedures and macro codes were proposed based on Excel and SAS software.
Results
The batch column names of physical examination data were converted by Excel and SAS software, making them conform to the variable name naming rules of SAS software. Multiple data sets with different structures were realized without truncation value, which ensured the integrity of the database. By deleting missing variables and observation, combining duplicate variables and identifying duplicate observation
2023 Vol. 30 (1): 64-70 [
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Comparative analysis of ICD-10 and ICD-11 coding in valvular heart disease
Pang Hui，Liu Junfeng
DOI: 10.3969/j.issn.1006-5253.2023.01.014.
Guide::
Valvular heart disease refers to the structural and/or functional abnormalities of the heart valve, and it is a group of important cardiovascular diseases, which can be divided into two categories: rheumatic and non-rheumatic. Through case analysis, this paper lists the coding and searching methods of heart valve diseases in ICD-10 and ICD-11, analyzes and compares the change characteristics of the coding and classification axis system of ICD-10 and ICD-11 of heart valve diseases, expounds the similarities and differences of their classification from the detail to the general so as to reflect the advantages of ICD-11 coding system, and plays a positive role in the gradual promotion of ICD-11 in China.
2023 Vol. 30 (1): 71-74 [
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27
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75
Visual analysis of research hotspots of cardiovascular diseases based on UK Biobank database from 2016 to 2022
Wang Aimin，Wang Fenglin，Huang Yiming，Xu Yaqi，Zhang Wenjing，Cong Xianzhu，Su Weiqiang，Gao Mengyao，Li Shuang，Ge Jiayu，Zhang Chunhui，Kong Yujia，Shi Fuyan，Wang Suzhen
DOI: 10.3969/j.issn.1006-5253.2023.01.015
Guide::
Objective
To analyze the research hotspots and development trends of cardiovascular diseases based on UK Biobank database from 2016 to 2022, and to provide scientific reference for researchers to carry out research on cardiovascular diseases.
Methods
The literatures on cardiovascular disease research based on UK Biobank database were retrieved from 2016 to 2022 in the Web of Science core set database in our study. Citespace 6.1.R 2 and VOSviewer 1.6.18 software were used to visually analyze the research hotspots and development trends of cardiovascular diseases from countries, institutions, keywords, etc.
Results
Two hundred and eighty-four literatures were included in this study and the overall number of publications was on the rise. The author with the highest number of publications was S.PETERSEN. The country with the largest number of publications was the UK, keyword emergence analysis indicated that the research trend in recent 5 years mainly focused on risk factor analysis (“adiposity”“body mass index”), genome-wide association study, and disease prognosis analysis (“therapy”“all-cause mortality”). In addition, the research on risk factors such as smoking, gene expression and bias control methods such as Mendelian randomization were hot spots of research on cerebrovascular diseases based on the UK Biobank database at this stage.
Conclusion
At present, cardiovascular disease research based on the UK Biobank database is in a rapid development period. There are many researches in this field in UK and in the United States. In recent five years, research trends and hotspots in this field mainly focus on risk factor analysis, gene expression, disease prognosis analysis and bias control methods of cardiovascular diseases.
2023 Vol. 30 (1): 75-80 [
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