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Chinese Journal Of Hospital Statistics
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2023 Vol. 30, No. 4
Published: 2023-08-25
241
Surgical index statistics based on SQL in performance evaluation of the tertiary public hospitals
Tang Zaili，Zhou Wangyan，Li Jun
DOI: 10.3969/j.issn.1006-5253.2023.04.001
Objective
To analyze the meaning of surgical indicators of performance appraisal workers in tertiary public hospitals, use database query statements to achieve indicator statistics, and provide reference for colleagues engaged in hospital statistics.
Methods
The operation indexes of the first page of some medical records were explained and analyzed. The index statistics were completed in SQL. The difference was analyzed between the statistical results of this paper and the results of the performance evaluation platform.
Results
The results of the two statistical methods showed a small difference in the infection rate of Class I incisions, possibly due to factors such as data cleaning and parameter correction on national platforms.
Conclusion
Hospital statisticians can apply the statistical methods and SQL language in this paper to practical work. SQL language is a necessary artifact for big data query statistics in the new era, which is worth learning and promoting.
2023 Vol. 30 (4): 241-247 [
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Research on the current situation of telemedicine operation and management mode in Chinese medical institutions
Li Chenchen，Wang Zhenbo，Huang Guoshu，He Xianying，Jiang Shuai，Zhao Jie
DOI: 10.3969/j.issn.1006-5253.2023.04.002
Guide::
Objective
To analyze the current situation and problems in the operation and management of telemedicine in Chinese hospitals, and to provide reference for optimizing related policies.
Methods
Questionnaire survey data of 223 medical institutions distributed in 26 provinces from October to November 2019 were selected to analyze the contents of telemedicine department setup, institutional construction, operation mode and capital allocation related to infrastructure construction in medical institutions.
Results
Fifty-three point four percent of the hospitals adopted a completely self-managed operation mode, 61.9% of the hospitals set up management departments of telemedicine, 76.0% of the hospitals formulated regulation of telemedicine service management, and 66.5% of the hospitals formulated the system of network and information security. The source of telemedicine equipment and network connection funds was mainly paid by hospitals, 37.2% of the hospitals invested less than 20 000 yuan in purchasing hardware equipment of telemedicine, and 39.9% of the hospitals invested less than 10 000 yuan in network connection of telemedicine.
Conclusion
The hospitals are still the main body of telemedicine service operation. Policy guidance should be strengthened to give full play to hospitals′ subjective initiative, and funding should be ensured to guarantee the quality of service.
2023 Vol. 30 (4): 248-252 [
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36
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253
Research on the influence of centralized volume-based drug procurement policy on drug use in Shandong Province based on ITS model
Chi Ying，Wei Xinjiang，Zhang Huifeng
DOI: 10.3969/j.issn.1006-5253.2023.04.003
Guide::
Objective
To evaluate the influence of centralized volume-based drug procurement policy on drug use in Shandong Province, and provide data support and decision-making reference for the subsequent promotion of drug procurement.
Methods
Based on the purchase data of 25 drugs in Shandong Province from January 2016 to April 2021, this paper analyzed the changes of drug purchase quantity, purchase amount, defined drug dose numbers (DDDs), defined daily dose cost (DDDc) and drug price index (DPI) before and after the implementation of the policy by using discontinuous time series method.
Results
After the policy implementation, drug purchase quantity and DDDs increased with obvious decrease of the purchase amount while DDDc and DPI dropped precipitously.
Conclusion
Centralized volume-based drug procurement policy is helpful to eliminate the phenomenon of "high drug price" and reduce the drug burden. It is suggested to increase the diversity of drugs and coordinate efforts with other mechanisms, so as to truly achieve the policy goal of benefiting people.
2023 Vol. 30 (4): 253-257 [
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35
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258
Application research of Internet medical service and quality safety evaluation
Xu Yanjie，Dong Henglei，Wang Weiping，Xiao Di
DOI: 10.3969/j.issn.1006-5253.2023.04.004
Guide::
Objective
To evaluate the quality and safety of Internet medical service scientifically and rationally.
Methods
TOPSIS and RSR, comprehensive evaluation methods based on CRITIC, were used to evaluate the quality and safety of Internet medical services in a tertiary hospital in Tianjin from January to December 2022.
Results
The fuzzy joint results of the two methods showed that the evaluation effect showed an increasing trend month by month. The top 3 months were December, November and October 2022, and the bottom 3 months were February, January and March 2022.
Conclusion
The fuzzy combination of TOPSIS method and RSR method based on CRITIC weighting can improve the objectivity and accuracy of evaluation results, and has high applicability for comprehensive evaluation of Internet medical service and quality safety.
2023 Vol. 30 (4): 258-262 [
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37
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263
Vulnerability assessment of rural families for elderly care based on risk exposure, sensitivity and coping ability
Ma Yang，Sun Zekun，Li Zeyu，Xu Mingdan，Xia Hongyan，Liu Haixia
DOI: 10.3969/j.issn.1006-5253.2023.04.005
Guide::
Objective
To evaluate the vulnerability of rural families in Shandong Province based on risk exposure, sensitivity and coping ability, and to provide a theoretical basis and policy reference for the management of the vulnerability of rural elderly families.
Methods
Firstly, the evaluation index system of the vulnerability of rural families was constructed from the three dimensions of "exposure level, sensitivity and coping ability". Then, elderly people aged 60 years old and above in rural areas of Shandong Province were selected as the survey subjects to investigate the vulnerability status of elderly care. K-means cluster analysis was used to divide the rural elderly in the survey area into three levels of vulnerability: high, medium and low.
Results
The elderly with high vulnerability and medium vulnerability accounted for 32.5% and 47.8%, respectively, the elderly with low vulnerability accounted for 19.7%, and there were significant differences in the vulnerability of rural elderly people in different ages, education levels, occupations and marital status (P<0.05).
Conclusion
There is a certain vulnerability of the rural elderly family pension security in survey areas. It is necessary to focus on the highly vulnerable elderly and provide multilevel elderly care services according to the degree of vulnerability.
2023 Vol. 30 (4): 263-268 [
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Analysis and prediction of mortality difference of malignant tumors in urban and rural residents
Wei Fei，Wang Qi，Wang Jifu，Li Zhiguo，Hu Zhiyong，Li Rui
DOI: 10.3969/j.issn.1006-5253.2023.04.006
Guide::
Objective
To analyze the mortality level and change trend of malignant tumors in urban and rural residents in China from 2009 to 2020, and predict the cancer mortality of urban and rural residents from 2021 to 2025.
Methods
The relevant data of malignant tumors in urban and rural residents in the death cause monitoring data set were selected to calculate the mortality rate, standardized mortality rate and other related indicators; joinpoint software was used to analyze the time trend of mortality; the GM (1,1 ) grey prediction model was established to predict the mortality rate of malignant tumors in urban and rural residents.
Results
The mortality of malignant tumors was 159.00/100 000 in urban areas and 153.78/100 000 in rural areas. The standardized mortality rate was 129.77/100 000 in urban areas and 131.50/100 000 in rural areas. The gap of malignant tumor mortality between urban and rural areas was gradually narrowing, but the order of malignant tumor death was different. From 2009 to 2020, the mortality rate of malignant tumors among urban and rural residents showed an overall upward trend, and the standardized mortality rate showed a downward trend. The mortality rate of urban and rural malignant tumors continued to increase from 2021 to 2025.
Conclusion
The mortality of lung cancer and colorectal cancer in urban residents is high, while the mortality of liver cancer, gastric cancer and colorectal cancer in rural residents is high. Targeted prevention and control measures should be implemented to reduce the cancer mortality in urban and rural areas.
2023 Vol. 30 (4): 269-274 [
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275
Association of childhood trauma with anxiety, depression and suicidal tendency in people living with HIV/AIDS
Jin Juan，Yang Peiying，Li Xuemin，Gao Jinjing，Luo Peipei，Zhang Yuan，Yin Jinling，Mi Baibing，Zhang Yan
DOI: 10.3969/j.issn.1006-5253.2023.04.007.
Guide::
Objective
To explore the relationship between childhood trauma experience and anxiety, depression and suicide risk in HIV/AIDS patients, and to provide evidence support and epidemiological basis for early identification and intervention of psychological problems of people living with HIV/AIDS (PLWHA).
Methods
Participants were recruited at an AIDS outpatient department. The generalized anxiety disorder scale-7 items (GAD-7) was used to assess patients′ anxiety levels; patient health questionnaire-9 items (PHQ-9) was used to assess patients′ depression; the brief international neuropsychiatric interview suicide questionnaire section was used to assess suicide risk; and the childhood trauma questionnaire was used to assess childhood trauma. Count data were described with frequency and composition ratios, and comparisons between groups were made using chi-square tests, and the strength of association was expressed by OR and its 95% confidence interval(CI).
Results
Among the 470 patients investigated, 64.7% of PLWHA had traumatic childhood experiences, and the prevalence of childhood emotional and physical abuse was higher than that of patients without anxiety symptoms (P<0.05); 54.5% of PLWHA suffered from depressive symptoms. Those who were emotionally and physically abused in childhood had 4.8 times (OR=4.792, 95% CI:1.896-12.110) and 3.1 times (OR=3.130, 95% CI:1.430-6.851) the risk of suicidal ideation than those who were not, respectively.
Conclusion
PLWHA with childhood traumatic experiences are more likely to develop anxiety depression and increase the risk of suicide. Special attention should be paid to the mental health status of PLWHA, especially those who have experienced childhood emotional and physical abuse, and appropriate psychological interventions should be designed as early as possible to prevent suicide and other adverse events.
2023 Vol. 30 (4): 275-280 [
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Influencing factors of the inclusion of deficit medical records under the diagnosis intervention packet
Ma Yingli
DOI: 10.3969/j.issn.1006-5253.2023.04.008
Objective
To explore the influencing factors of the inclusion of the deficit medical records under the diagnosis-intervention packet (DIP).
Methods
A retrospective study was conducted on the home page contents of 21 436 deficit medical records in a tertiary public hospital from January to June 2022, and the influencing factors of DIP inclusion were analyzed.
Results
The most type of deficit medical records was the normal rate group, accounting for 84.27%. The type of medical insurance was medical insurance for residents, accounting for 87.45%. The number of deficit medical records was the the largest in the department of pediatrics, accounting for 9.00%, and the department of gastroenterology was the second, accounting for 8.31%. Among the factors influencing of the inclusion of deficit medical records under DIP, DIP grouping error accounted for 33.08%, high cost of medicine, medical consumables and inspection accounted for 15.05%, major diagnosis coding error accounted for 12.57%, correct inclusion with disease type score deviation accounted for 8.48%, and major surgical coding error accounted for 3.09%. Others accounted for 27.73%.
Conclusion
Medical institutions and medical insurance departments should strengthen cooperation and communication with third-party software development company. When coding, the medical record coders should avoid blindly retrieving the codes from computers, and code accurately according to coding rules. Medical institutions should strengthen clinical behavior control, promote rational diagnosis and treatment, and reasonably control medical resources and costs.
2023 Vol. 30 (4): 281-284 [
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ICD-9-CM-3 coding and case analysis of cerebrovascular intervention operation
Zhou Qin，Feng Hun，Li Aiping，He Zhichen，Liu Haoyi，Zhang Sisi
DOI: 10.3969/j.issn.1006-5253.2023.04.009
Objective
To investigate the ICD-9-CM-3 coding in cerebrovascular interventional operation.
Methods
The characteristics of common cerebrovascular interventional surgery were sorted out, and ICD-9-CM-3 coding was performed according to the international classification principle of surgery and operation and typical case analysis.
Results
For ischemic cerebrovascular disease, extracranial percutaneous balloon dilatation is classified in 00.61, and extracranial percutaneous stent placement is classified in 00.63 or 00.64; Intracranial percutaneous balloon dilatation is classified in 00.61, and intracranial percutaneous stent placement is classified in 00.65; Percutaneous thrombectomy is classified in 39.74; Percutaneous cerebrovascular hemolysis is classified as 99.10 or 99.20 according to different thrombolytic agents. Interventional embolization for hemorrhagic cerebrovascular disease is classified as 39.72, 39.75 or 39.76 according to different interventional material.
Conclusion
The surgical site, operation, disease nature and interventional material should be considered for the correct classification of cerebrovascular intervention operation. Incomprehension of the connotation of the operations and dependence too much on computers easily lead to miscoding.
2023 Vol. 30 (4): 285-288 [
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Analysis of disease composition of inpatients in a psychiatric hospital from 2012 to 2021
Ji Yan
DOI: 10.3969/j.issn.1006-5253.2023.04.010
Objective
To understand the disease composition of inpatients in a hospital and to provide a theoretical basis for the prevention and treatment of mental diseases and the development of the hospital.
Methods
Inpatient information from 2012 to 2021 was collected from a hospital information management system, and the main diagnosis of discharge was used as an indicator for retrospective statistical analysis.
Results
Among the 5 985 patients, there were 3 041 males and 2 944 females, with a male to female ratio of 1.03∶1. The age was mainly distributed between 40 and 59 years old, and the top ten disease patents accounted for 91.98%, namely schizophrenia, bipolar disorder, dissociative (conversion) disorder, depressive episode, mental and behavioral disorders due to alcohol use, recurrent depressive disorder, brain damage and dysfunction and other mental disorders due to somatic diseases, mental retardation, manic episodes, and other anxiety disorders. The comparative analysis of the data from 2012 to 2016 and 2017 to 2021 showed that the rank and proportion of diseases had changed.
Conclusion
Schizophrenia is the main admission disease in psychiatric hospitals, so we can analyze and study the changes in the composition of psychiatric diseases in a timely manner to provide a scientific basis for hospital management and decision-making.
2023 Vol. 30 (4): 289-293 [
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Analysis of influencing factors of prolonged hospitalization days in hepatitis B cirrhotic patients with esophagogastric variceal bleeding
Chen Yingzi，Li Shuangshuang，Bi Xiaojie，Chen Chaochao，Zheng Yuwei
DOI: 10.3969/j.issn.1006-5253.2023.04.011
Objective
To study the influencing factors of prolonged hospitalization days in patients with hepatitis B cirrhosis and esophagogastric variceal bleeding, to provide a basis for reducing the occurrence of prolonged hospitalization days.
Methods
A retrospective study was conducted to collect the information of 1 201 patients with hepatitis B cirrhosis and esophagogastric variceal bleeding who underwent endoscopic tissue glue injection combined with ligation in Taizhou Hospital Affiliated to Wenzhou Medical University from January 2013 to June 2022. We defined more than 29 days of hospitalization as ultralong hospitalization days (n=63 cases). Multivariate logistic regression analysis was used to screen out independent risk factors, and the area under the receiver operating characteristic curve (ROC) was used to evaluate the value of combined detection for statistical description.
Results
Logistic regression analysis showed that the days from onset to surgery ≥8, number of department transfers≥2 times, complicated with hemorrhagic shock and hospital infection were independent risk factors for ultralong postoperative hospitalization, and the ROC curve area was 0.877, so there was clinical value in it.
Conclusion
When the time from onset to operation lasts 8 days and above, and the number of postoperative transfers is twice and above complicated with hemorrhagic shock and nosocomial infection, patients with hepatitis B cirrhosis and esophagogastric variceal bleeding are more likely to have prolonged postoperative hospital stay, which needs to cause clinical attention and early prevention.
2023 Vol. 30 (4): 294-298 [
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Rational use of statistical models for traditional meta-analysis
Zhang Tiansong
DOI: 10.3969/j.issn.1006-5253.2023.04.012
Meta-analysis is a common statistical technique used to combine findings, results, and data of several independent studies. The selection of the appropriate statistical model is critically important in the process of traditional meta-analysis, but in practice some researchers usually choose the models by mistake. In this paper we introduce some new views of the statistical models, and show some cases that were incorrect or correct selection of models in some published articles of domestic and foreign journals, and we also provide some recommendations and evidence for rational use of the model.
2023 Vol. 30 (4): 299-303 [
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Appropriate use of funnel plots for traditional meta-analysis
Zhang Tiansong
DOI: 10.3969/j.issn.1006-5253.2023.04.013
Meta-analysis is the statistical combination of results from two or more studies, but the results are influenced by some factors including publication bias. Funnel plots and tests for funnel plot asymmetry have been widely used to examine bias in the implementation of meta-analysis, but they are often wrongly used by some researchers. In this paper we introduce some basics about funnel plots and contour-enhanced funnel plots, and show some cases of incorrect or correct use of funnel plots in some published articles in domestic and foreign journals, and we also provide some recommendations for rational use of funnel plots and asymmetry tests of funnel plots.
2023 Vol. 30 (4): 304-308 [
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309
Quality assessment tools of study for meta-analysis
Xu Ji, Deng Hongyong
DOI: 10.3969/j.issn.1006-5253.2023.04.014
The quality evaluation of clinical research literature is an important aspect of metaanalysis. In this article, we provide a review of research methodological quality (risk of bias) evaluation tools, introduce commonly used evaluation tools for randomized controlled trials and nonrandomized intervention studies, and summarize common misuse cases through case analyses. This provides a reference for the rational selection of literature quality evaluation tools.
2023 Vol. 30 (4): 309-311 [
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Efficacy of internet-based self-help interventions on addescents with depression: a systematic review and meta-analysis
Yan Bo1, Zheng Xiaohui1, Luo Shiyun1, Lai Yuting1, Tan Jingyi1, Lin Aihua
DOI: 10.3969/j.issn.1006-5253.2023.04.015
Objective
To evaluate efficacy of Internet-based self-help interventions on adolescent depression compared with the negative control group and the conventional treatment group.
Methods
Fourteen databases (including Pubmed, CNKI, etc.) were retrieved to collect the randomized controlled trials (RCTS) meeting the inclusion and exclusion criteria. The intervention was the Internet-based self-help intervention, and the control groups were the conventional treatment group and the negative control group. The search time was from the establishment of the databases to January 1, 2023. Two researchers independently screened references according to inclusion and exclusion criteria, and assessed references with ROB 2.0 and Jadad. Related information was collected according to the study protocol. The Meta-analysis was performed by CMA 3.0 software (using random effects model). SMD and 95%CI were used as effect indicators. Subgroup analysis was used to explore possible sources of heterogeneity (indicated by I
2
). GRADE was used to rate the certainty of evidence.
Results
The results were reported according to the PRISMA 2020 criteria. Eight RCTs (1 947 subjects aged from 10 to 19 who were screened for depression scales or diagnosed by clinicians) were finally included. The results of meta-analysis showed that Internet-based self-helped interventions may help to lower the score of measured depression scale among adolescent patients (SMD=-0.33, 95%CI: -0.57, -0.08; I
2
=73.41). Egger′s tests suggested no significant publication bias(P=0.25). Internet-based self-help interventions may modify depressive symptoms in adolescents compared with the negative control group (SMD=-0.41, 95%CI: -0.72, -0.10). Intervention with longer duration (>6 weeks) may be effective (SMD=-0.67 , 95%CI: -0.97, -0.38). After the intervention, a short-term follow-up (within six months) showed that the beneficial effect might be maintained (SMD=-0.21, 95%CI: -0.41,-0.01), while the long-term follow-up results showed no intervention effect. The intervention based on non-clinical recruitment might be effective (SMD=-0.45, 95% CI:-0.75, -0.15), while the intervention based on clinical recruitment did not show an intervention effect. The evidence was of moderate quality, suggesting that the study results might be close to the actual effect.
Conclusion
Internet-based self-help intervention is more effective than that the negative control group in adolescents with depression, and may help to relieve the symptoms of depression in adolescents. It is worth noting that most of the included studies were conducted in developed countries and regions. In the future, relevant studies on Chinese adolescents should be considered, especially well-designed RCT studies with long-term follow-up to further enrich and improve the current evidence.
2023 Vol. 30 (4): 312-320 [
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