Colorectal Cancer (CRC) statistics are updated by American Cancer Society every 3 years based on morbidity provided by the population cancer registry and mortality provided by the National Center for Health Statistics. In 2023, about 153 020 people will be diagnosed with CRC and 52 550 will die from the disease, including 19 550 cases and 3 750 deaths among people under 50 years old. The magnitude of the decline in CRC incidence has changed, from 3%4% per year in 20002010 to 1% per year in 20112019. The proportion of rectal cancer increased from 27% in 1995 to 31% in 2019, and CRC incidence was migrating to the left colon. From 2011 to 2020, CRC mortality overall decreased by 2% per year, but CRC mortality increased by 0.5%3.0% per year in the native Americans under 50 years old and under 65 years old. In summary, despite the continual decline in overall mortality, CRC is rapidly shifting towards younger, more advanced stages and development in the left colon/rectum. In this paper, the important contents of the updated data are sorted out and briefly interpreted. At the same time, compared with the present situation of CRC in our country, we can reveal and analyze the cause of the rising incidence of CRC to provide reference for CRC diagnosis and treatment.

Objective To apply the risk matrix to assess the risk of nosocomial infection management in upper second-class general hospitals.Methods The incidence rate, infection site, increased length of hospital stay, increased hospitalization cost, outcome, and monthly incidence variation coefficient of patients with nosocomial infection in each department in 2021 were used to quantify the probability of occurrence and consequence indicators, and the risk identification of internal medicine, surgery, and obstetrics and gynecology and children systems was carried out. Percentile method (P₂₀, P₄₀, P₆₀, P₈₀) was used to grade the occurrence possibility and consequence, establish the risk matrix table, and analyze and determine the high-risk departments.Results The high-risk departments in internal medicine were oncology department, geriatric disease department, general medicine department and infectious disease department; the high-risk departments in surgical medicine were neurosurgery department, otolaryngology department and orthopedics department; the high-risk departments in gynecology and pediatrics system were obstetrics and gynecology.Conclusion The risk assessment model of nosocomial infection based on risk matrix truly and objectively reflects the risk of nosocomial infection in various departments of primary hospitals, which suggests that primary hospitals should give priority to the prevention and control strategy of nosocomial infection in high-risk general departments, and pay attention to key departments such as neonatology.

Objective To explore the structure and importance ranking of average hospitalization costs for patients with depression, and to provide a basis for improving the structure of patients′ hospitalization costs and effective cost control.Methods Information on the hospitalization costs of patients with depression in a tertiary hospital in Guangzhou City from 2018 to 2023 was collected, and the degree of association, composition ratio, and change of each cost with the average hospitalization costs per-time were evaluated by using the degree of structural variation and new gray correlation analysis.Results From 2018 to 2023, the average hospitalization cost per-time of patients with first gradually increased and then decreased, the proportion of diagnostic fee and examination fee continued to increase, and the proportion of nursing fee and drug fee continued to decrease. The degree of structural change of average hospitalization cost per-time during the 6-year period was 33.84%, and the degree of annual average structural change was 5.64%. The top 3 contributors to the structural change were drug fee (26.77%), diagnostic fee (23.43%) and medical service fee (19.77%), and the cumulative contribution of the three amounted to 69.97%. The results of the new gray correlation analysis showed that the treatment fee (0.939) had the greatest impact on the average hospitalization cost per-time of depressed patients, followed by the diagnostic fee (0.883), the examination fee (0.866) and the medical service fee (0.817).Conclusion Treatment fee, diagnostic fee and examination fee are the main factors affecting the hospitalization cost of depressed patients, and the income of nursing fee and drug fee continues to decrease. It is recommended to continuously optimize the cost structure and establish a reasonable, stable and efficient cost control program.

Objective To understand the influencing factors of perioperative death of elective surgery patients in a hospital, and to provide data reference for hospitals to strengthen perioperative management and reduce postoperative mortality.Methods The information of patients who underwent elective surgery from January 1, 2020 to December 31, 2022 was retrieved from the medical record homepage management system of a tertiary general hospital, and the main diagnosis, surgical method, surgical department and causes of postoperative death were retrospectively analyzed.Results From 2020 to 2022, 81 722 patients underwent elective surgery in the hospital, of which 103 patients died after the surgery, with a mortality rate of 0.13%; the top three primary diseases were circulatory system disease, tumor minor and congenital disease, accounting for 85.43%; the main surgical types of patients who died after elective surgery cardiac surgery, aortic surgery and craniocerebral surgery, accounting for 46.07%; postoperative death cases were mainly concentrated in the departments of cardiothoracic surgery, cardiovascular surgery, cardiovascular medicine, vascular surgery, neurosurgery and intervention; the main cause of death was surgical complications, accounting for 44.66%, followed by primary disease aggravation and other diseases after the surgery, accounting for 32.04% and 23.30% respectively.Conclusion The relevant surgical departments should strengthen the management of preoperative, intraoperative and postoperative perioperative patients. The functional departments should carry out special management for the departments with more deaths of elective postoperative patients, which is of great significance to reduce the postoperative mortality of patients undergoing elective surgery.

Objective To investigate the factors affecting hospitalization costs of hospitalized patients with chronic obstructive pulmonary disease (COPD), so as to reduce the burden of patients, promote the rational allocation of medical resources, and provide a basis for formulating healthcare policies.Methods The medical record homepage data of chronic obstructive pulmonary hospitalized patients in a tertiary general hospital in Beijing from 2019 to 2022 were selected to study the influencing factors of the hospitalization costs through descriptive analysis, rank sum test, correlation analysis, and multifactor regression analysis.Results Male patients (66.0%) outnumbered female patients (34.0%) among 1 053 COPD patients, the proportion of patients aged 60-89 years old was the highest (82.8%), the number of medicare-paid patients was the highest (88.2%), emergency admissions (57.1%) were higher than outpatient admissions (42.9%), and the percentage of hospitalization days with 10-19 days was the the most (45.3%). The high incidence seasons of chronic obstructive pulmonary disease were fall and winter (51.9%), and common comorbidities were coronary heart disease (78.3%), hypertension (73.0%), and pulmonary heart disease (48.5%). Chinese and Western medicine (36.75%), medical services (29.57%), and diagnosis (22.82%) accounted for the largest share of hospitalization costs. There was a statistical difference in hospitalization costs for variables of age, medical payment method, number of hospitalization days, comorbidities of hypertension, coronary heart disease, respiratory failure, pulmonary heart disease, treatment with antimicrobials, and ventilator-assisted therapy (P<0.05) . Regression analysis showed that the older the age, the longer the hospitalization days, the higher the number of comorbidities, the more use of antimicrobial drugs and ventilator therapy, the higher the hospitalization costs. Compared to medical insurance patients, public medical care was positively correlated with hospitalization costs (P<0.05).Conclusion Health education should be strengthened, early screening and intervention for elderly patients and COPD patients with a history of cardiovascular disease should be carried out, and multidisciplinary diagnostic and treatment modes and improved clinical pathways should be utilized to standardize the diagnostic and treatment processes, logically shorten the average number of hospitalization days, reduce the waste of medical resources and alleviate the patients′ economic burden.

Objective To take 57 tertiary general hospitals in Shandong Province as study samples, to evaluate the medical quality and operation efficiency, and to provide references for strengthening connotation construction and improving the refined management level.Methods Entropy weighted technique for order preference by similarity to ideal solution (TOPSIS) and data envelopment analysis (DEA) were respectively used to evaluate the medical quality and operation efficiency in sample hospitals, by constructing the evaluation index system.Results In terms of medical quality, there was significant difference in highlevel surgical proportion and CMI among sample hospitals, with the maximum weight of both. The top ranked hospitals were A1, A2, A3, A4 and A29, all of which were tertiary and mostly provincial hospitals. In terms of operation efficiency, the overall efficiency of 57 sample hospitals was relatively high, but imbalance development still existed, with 22 hospitals DEA effectiveness, 12 hospitals DEA weakly effectiveness, and 23 hospitals DEA ineffectiveness. There was a positive correlation between medical quality and  technical efficiency.Conclusion There is a big space for improvement of the medical quality and operation efficiency in some sample hospitals. They should focus on functional orientation, continuously enhance medical technology level and internal management capability, optimize resources allocation, and transform from scale expansion to quality and efficiency improvement, in order to promote the high-quality development of hospitals. 

Objective To analyze the operation index data of public hospitals in Jiangsu Province, in order to provide insights for optimizing resource allocation and management of medical resources in public hospitals in Jiangsu Province.Methods Data envelopment analysis (DEA) was employed to assess the operational efficiency of second-level and above public hospitals in sub-cities of Jiangsu from 2015 to 2022.Results From 2015 to 2019, the technical efficiency, scale efficiency and comprehensive efficiency of public hospitals in Jiangsu Province were all 1, indicating that DEA was strong and effective, while the return to scale remained unchanged. From 2020 to 2022, except for 2021, when the technical efficiency was 1, the scores of technical efficiency, scale efficiency and comprehensive efficiency were less than 1, and in 3 years, the scale efficiency and comprehensive efficiency were not effective. Notably, Suzhou, Zhenjiang, and Suqian maintained a scale compensation coefficient of 1 from 2015 to 2022, while other areas experienced fluctuations in scale compensation.Conclusion The operational efficiency of public hospitals in Jiangsu Province varies over time and across regions, indicating uneven development. There is still room for optimizing the allocation of medical resources and scale among public hospitals in many cities.

Metabolomics is a disciplinary field that investigates all small-molecule metabolites within the biological organism. Utilizing advanced technological platforms such as mass spectrometry and nuclear magnetic resonance, comprehensive and high-throughput detection of metabolites can offer new avenues for early disease diagnosis, elucidation of pathogenic mechanisms, and personalized therapeutic approaches. Due to the diversity, high dimensionality, dynamics, noise, and variability inherent in metabolomics data, it poses formidable challenges for the research and development of data analysis methods. This paper aims to provide a comprehensive overview of recent advancements of machine learning methods for statistical analysis on metabolomics data, with particular focus on improved approaches. By synthesizing these methodologies, the intention is to offer a crucial foundation for effective data analysis and to fully harness the potential of metabolomics in medical research.

Objective  Accurate and standardised data form the foundation for reliable research findings. Taking lung surgery as a case study, we analyse the data traits of an anesthesia information system and undertake preprocessing such as encompassing cleaning, conversion, integration and imputation to build a researchready dataset.Methods Relevant data from the anesthesia information system of patients undergoing lung surgery at Sichuan Cancer Hospital between April 2021 and November 2022 were collected. The characteristics of the source data were analysed, and the Python and SAS software were proposed for data preprocessing. Text data were transformed into numerical values for the ease of data mining using Python's SPLIT statements, SAS macros, and functions. Missing values were filled, and anomalies, inconsistencies, and redundant data were corrected through data cleaning and data reduction. Data integration was achieved through NOUNIQUEKEY, SQL and LAG statements to expand the data volume.Results Two Excel sheets were extracted from the anaesthesia information system and the hospital information system, comprising a total of 1 835 anesthesia records and 46 612 medical records. Analysis of the source data revealed that the anaesthesia information system had idiosyncratic medical lexicon, varied semantic expressions, multiple outlines for identical drugs, and certain drugs ending in "alternate". Based on the given data characteristics and semi-structured data structure, we compiled three macros to clean and validate all drug names, standardise medical terminology, and unify outlines. This process led to the extraction of 12 drugs for pre-anaesthesia, 24 drugs for intraoperative use, and 12 drugs for analgesic pumps. Secondary completion of missing data was performed, as well as noise reduction and cleaning of inconsistent data. Forty-eight anesthesia records (2.62%) of non-pulmonary were excluded and 10 irrelevant fields for the mining task were removed. After data integration, 1 748 cases of anesthesia data (97.82%) were matched with medical prescription data. After the data preprocessing described above, the final structured dataset consisted of 1 748 patients and 99 variables.Conclusion The anaesthesia data preprocessing process developed through the analysis of source data achieves data cleaning, data integration, data transformation and data reduction, and thus obtains standardised and precise drugs data. It provides a methodological reference for data cleaning and structuring of anaesthesia information in other institutions and at the same time provides a reliable data base for research that needs to use high quality anaesthesia medication data, which will contribute to the depth and advancement of related research.

Objective To use Power BI Desktop for multidimensional comparative analysis and data visualization of hospital DIP subgroup details, in order to identify the causes of DIP losses in hospitals.Methods The data were extracted from the DIP subgroup discharge settlement details of a tertiary oncology hospital in 2022. Methods such as data import, data type conversion, data relationship establishment, data modeling, and data visualization were used to build dynamic analysis reports for different dimensions such as the entire hospital, departments, and disease categories.Results Power BI Desktop can effectively enhance the level of fine management for DIP, improve work efficiency, accurately analyze the causes of losses, guide departments in making improvements, and effectively reduce the DIP insurance fund losses for the hospital.Conclusion Power BI Desktop is characterized by its low cost, customization, high level of visualization and automation, as well as a user-friendly interface, making it suitable for promotion in hospitals, especially those with low levels of informatization, insufficient specialized operational personnel, and limited budget for DIP fine management.

Objective To analyze the disease characteristics of inpatient deaths in a tertiary general hospital from 2018 to 2022, and provide reference for the rational allocation of medical resources and the strengthening of medical quality management.Methods All inpatient information from the hospital information system from January 1, 2018 to December 31, 2022 were extracted for statistical analysis from the aspects of gender，age，death disease，case fatality rate, and death disease composition of hospitalized deaths with the use of Excel 2007 and SPSS 18.Results The mortality rate of inpatients was 0.64%. There were 443 male cases (65.63%) and 232 female cases(34.37%)  among the 675 deaths. The top three causes of death were circulatory system diseases, respiratory system diseases, and tumors accounting for 28.44%，28.30%，and 27.56% of total deaths, respectively. The gender ratio of male to female deaths was 1.91∶1, the fatality rate was higher in males than in females, and the difference was statistically significant (χ2=46.068， P<0.001). The higher the age, the higher the fatality rate. The mortality rate rapidly increased after the age of 50.Conclusion The mortality rate of inpatients in the hospital is generally low, and the elderly are at high risk of death. Circulatory system diseases, malignant tumors and respiratory system diseases were the main causes of death．In medical work, medical resources should be scientifically and reasonably allocated based on patient gender, age, high incidence of mortality, and department characteristics to reduce case fatality rate.

Objective To analyze the coupling coordination of medical resources supply and utilization in Guangdong Province in the past five years, and to provide theoretical support for optimizing resources supply and spatial distribution and promoting the coordinated development of supply and utilization in Guangdong Province.Methods The supply and utilization level of medical resources in 21 cities in Guangdong Province in 2018 and 2022 were analyzed by coupling coordination model and GIS spatial analysis.Results The comprehensive level of medical resource supply in Guangdong Province increased from 0.37 to 0.45, and the comprehensive level of utilization decreased from 0.48 to 0.39. In 2018 and 2022, the medical resources supply subsystem and utilization subsystem were in a high-level coupling state, with the mean values of 0.97 and 0.96, respectively. However, the mean values of the coupling coordination degree did not change much in the past five years, 0.64 and 0.63 respectively, and were in a moderate coordination state, showing a trend of high in the west and low in the east, and high in the north and low in the south, with spatial aggregation.Conclusion The coupling coordination degree between medical resource supply and utilization is not high, and the regional differences are obvious. In formulating policies to optimize the distribution of medical resources, attention should be paid to the coordinated development of the two subsystems, and corresponding strategies should be proposed according to the different coupling coordination degrees and lagging types of different cities and regional heterogeneity. At the same time, the advantages of the Guangdong-Hong Kong-Macao Greater Bay Area should be taken into account to strengthen inter-regional cooperation and realize the optimal allocation of resources in different regions.

Objective To assess the causal effect of schizophrenia on substance abuse and alcohol use disorder, to clarify the causal associations between diseases and behaviors, and to provide new ideas and protocols for improving clinical treatment and prognosis.
Methods Summary statistics from genome - wide association studies of schizophrenia, substance abuse, and alcohol
use disorder were used to exclude instrumental variables with confounding factors and directionally harmonize the data, provided that the three major assumptions of Mendelian randomization of instrumental variables were met. Two - sample Mendelian randomization of the data was performed using the inverse variance weighted method as the main analytical method, with the weighted median method, MR Egger method, simple mode and weighted mode as supplementary analytical methods. Sensitivity analyses were performed using Cochran Q test, MR - Egger intercept analysis and leave - one - out method to test for heterogeneity and pleiotropy and to assess the stability and reliability of the results.
Results In order to exclude the effect of weak instrumental variables and to make instrumental variables strongly correlated with exposure, a more stringent threshold than that of previous studies was used, and a total of 64 single nucleotide polymorphism loci were included as instrumental variables with the P - value threshold set at 5×10⁻¹⁰. The inverse variance weighted method estimated that the risk (OR) of developing substance abuse in schizophrenia was 1.19 times higher than that of the general population (95% CI: 1.126 - 1.261, P = 1.499×10⁻⁹), and the results of the other four analyses also indicated that schizophrenia increased the risk of substance abuse. For the data on
schizophrenia and two groups of alcohol use disorder, the inverse variance weighted method estimated that the risk (OR) of alcohol use disorder in patients with schizophrenia was 1.17 times (95% CI: 1.105 - 1.239, P = 7.398×10⁻⁸) and 1.13 times (95% CI:1.072 - 1.187, P = 3.124×10⁻⁶) that of the general population, respectively. The evaluation results of the weighted median method, simple mode and weighted mode also provided evidence that schizophrenia increased the risk of alcohol use disorder.
Conclusion The existence of a positive causal effect of schizophrenia with substance abuse and alcohol use disorders provides an important idea and basis for subsequent clinical research.

Objective To understand the current status of willingness to stay of in pre-examination and triage nurses in tertiary hospitals, and to explore the relationship between willingness to stay, self-disclosur and professional happiness, so as to provide reference for reducing the turnover rate of nurses in pre-examination and triage.Methods A total of 230 pre-examination and triage nurses from 5 tertiary hospitals in a province were selected by convenience sampling method in September 2022. General data questionnaire, nurse willingness to stay scale, distress disclosure index scale and professional happiness scale of medical workers were used for online investigation.Results The total score of willingness to stay of pre-examination and triage nurses was (22.56±4.38). There was a positive correlation between nurses′ willingness to stay and self-disclosure and professional happiness (r¹=0.206, r²=0.679, P<0.001). Multiple linear regression analysis showed that professional affection, nurse-patient relationship and professional happiness were the main influencing factors of nurses′ willingness to stay (R²=0.557, P<0.001).Conclusion The willingness to stay of pre-examination and triage nurses was at a medium level, and there is a lot of room for improvement. Hospital managers can enhance their willingness to stay in pre-examination and triage nurses by improving their professional affection and professional happiness.

Objective To compare the changes in hospitalization expenses before and after the implementation of DIP payment reform measures in hospitals, and further analyze and evaluate the performance of medical services.Methods The data of the first quarter of 2023 before DIP payment reform and the data of the first quarter of 2024 after DIP payment implementation in a hospital were collected in this research to analyze the the changes in hospitalization expenses and medical service performance.Results After DIP payment reform, the total hospitalization expense and the out-of-pocket expense for patients were significantly reduced, and the difference was statistically significant (P<0.05). The ratio of medical expenses was significantly increased, and medical service performance indicators such as CMI, total DRG, time consumption index, cost consumption index, and low-risk mortality rate were improved.Conclusion DIP payment reform is effective in controlling hospitalization expenses, reducing patients′ out-of-pocket expenses, building acceptable hospitalization expense structure, and significantly improving medical services performance.

Objective To investigate the composition and change of respiratory diseases in a tertiary hospital in Hainan Province, and to provide reference for scientific prevention and control of diseases, dynamic allocation of medical resources and discipline development planning.Methods The home page information of respiratory patients in a tertiary hospital in Hainan Province from 2019 to 2023 was selected, and the diseases were classified according to ICD-10 classification standard, and the gender, age, disease distribution and seasonal distribution of inpatients were retrospectively analyzed.Results A total of 25 003 inpatients were hospitalized from 2019 to 2023, with a male/female ratio of 1.60∶1; the majority of inpatients were middle-aged and the elderly, the least were children and adolescents, but the proportion of both increased year by year; the most patients were hospitalized in winter and the least in autumn; the rank change of inpatient diseases was statistically significant (P<0.001), influenza and pneumonia always ranked first, chronic lower respiratory diseases showed a downward trend year by year, and other diseases of respiratory system showed an upward trend year by year; the inpatient diseases were mainly influenza and pneumonia (48.2%), the proportion of inpatient diseases in infants (0-3 years old) was the highest (81.9%), and the proportion of inpatient diseases in adolescents (7-17 years old) was the lowest (37.3%).Conclusion It is necessary to strengthen health education, improve disease cognition, dynamically allocate medical resources according to the distribution of diseases, and strengthen the discipline construction and special disease management of pediatrics, geriatrics and respiratory medicine.

Objective To analyze the effect of nitrogen dioxide (NO₂) on hospital visits for respiratory diseases in Jiaxing.Methods We collected daily air NO₂ monitoring data, meteorological factors and hospital visits for respiratory diseases in Jiaxing from 2019 to 2021．We used Wilcoxon rank sum test and generalized addition model (GAM) to analyze the acute effects of air NO₂ on hospital visits for respiratory diseases.Results The average daily concentration of NO₂ exceeded the standard for 9 days. The daily hospital visits for respiratory diseases and childhood respiratory diseases on days when air NO₂ exceeded the national standard were higher than those on qualified days. In the single-day lag effect analysis, the excess risk (ER) of daily hospital visits for respiratory diseases and adult respiratory diseases both reached the maximum on lag4, while the ER of daily hospital visits for childhood respiratory diseases reached the maximum on lag3 with ER(95%CI) being 2.23% (1.52%-2.94%), 1.73%(1.06%-2.41%) and 2.73%(1.73%-3.74%) with NO₂ concentration increase per 10 μg/m3, respectively. In the cumulative lag effect analysis, the ER of daily hospital visits for respiratory diseases, adult and childhood respiratory diseases all reached the maximum on lag07, with ER(95%CI) being 5.35%(4.06%6.66%), 3.47%(2.25%-4.70%) and 7.17%(5.31%-9.07%) with NO₂ concentration increase per 10 μg/m³, respectively. The maximum ER of hospital visits for childhood respiratory diseases was higher than that for adults.Conclusion The increase of NO₂ concentration in Jiaxing may lead to an increase in hospital visits for respiratory diseases with a lag effect, and the health protection of children′s respiratory system should be especially strengthened.

Objective To analyze the impact of age and surgical procedures on hospitalization costs for lung cancer patients undergoing surgery.Methods The study focused on surgical patients who were primarily diagnosed with lung cancer (C34.) in a tertiary hospital in Ningbo from January 1, 2022 to December 31, 2022, and analyzed their DRG enrollment status. Differential analysis of patient costs in the DRG group using t-test and analysis of variance based on age and surgical procedures.Results A total of 2 489 lung cancer surgery patients were all assigned to the EB1 chest surgery group. There was no statistically significant difference (P>0.05) in the impact of age and surgical procedures on patient costs between EB11 major chest surgery with severe complications and comorbidities. The hospitalization costs of patients over 60 years old in the group of EB13 major chest surgery with general complications and comorbidities and in the group of EB15 major chest surgery without complications and comorbidities were significantly higher than those of patients under 60 years old (P<0.05). As age increased, hospitalization costs increased, and the amount of medical insurance losses in hospitals increased, with statistical significance (P<0.05). Except for no difference in hospitalization costs between lobectomy and total pneumonectomy, there was a statistically significant difference in hospitalization costs among other surgical procedures in the EB13 group (P<0.05). Except for no difference in hospitalization costs between partial lobectomy, lobectomy and pneumonectomy, all other surgical procedures showed statistically significant differences (P<0.05) in the EB15 group. As the surgical resection range increased, hospitalization costs increased, the medical insurance losses increased in the hospital, and the difference was statistically significant (P<0.05).Conclusion The hospitalization costs of lung cancer patients undergoing surgery are greatly influenced by age and surgical procedures. When optimizing the DRG grouping scheme, it is necessary to improve the compatibility with clinical practice and further refine it with full consideration of the actual clinical situation.

Objective To predict the outpatient volume of a tertiary general hospital in Zhejiang Province by establishing the seasonal ARIMA model, and to provide a basis for the rational allocation of outpatient human resources.Methods Based on the outpatient visits data of a tertiary general hospital in Zhejiang Province from January 2013 to June 2023, the seasonal ARIMA model was constructed by SPSS software to predict the annual outpatient visits from July 2023 to December 2023. By comparing the measured outpatient visits, the accuracy of the seasonal ARIMA model was evaluated.Results The outpatient volume of the general hospital showed an increasing trend year by year, and showed the characteristics of periodic fluctuations. The optimal seasonal ARIMA model fitted was ARIMA(0,1,1)(1,0,1)12, BIC (Bayesian information criterion) was 5.273, MAPE (mean absolute percentage error) was 14.265, R2 (module determination coefficient) was 0.408, and the overall relative error was 1.83%, indicating good prediction results.Conclusion The seasonal ARIMA model can simulate the change trend of the outpatient volume in the time series of the tertiary general hospital well, and provide a theoretical basis for the short-term forecast of the outpatient volume in the hospital.

Objective: To analyze the internal composition and changes of the hospitalization costs of lung cancer surgery patients, explore the main influencing factors of hospitalization costs, predict the trend of hospitalization costs, and provide an empirical basis for reducing the hospitalization medical burden of lung cancer patients. Methods: The information on the front pages of the hospitalization medical records of lung cancer surgery patients in a certain third-level Class-A hospital from 2018 to 2022 was collected. The new grey correlation and structural change degree analysis methods were used to study the internal structural changes of hospitalization costs and the correlation degree among them. Through univariate analysis and multiple linear regression analysis, the main influencing factors of hospitalization costs were explored. The GM(1,1) model was used to predict the hospitalization costs from 2023 to 2025. Results: (1) From 2018 to 2022, the average hospitalization cost per case of lung cancer surgery patients in this hospital decreased year by year, with an average annual decrease of 6.67%. (2) Drug costs, diagnostic costs, and surgical treatment costs were the main factors for the structural changes of hospitalization costs, with a cumulative structural change degree of 33.76% and a cumulative contribution rate of 86.23%. (3) The top three in the correlation degree ranking were material costs (0.952), comprehensive medical service costs (0.843), and diagnostic costs (0.697) in turn. (4) Multiple linear regression analysis showed that higher age, more number of complications/accompanying diseases, the medical payment method of urban employee basic medical insurance, and more hospitalization days were the influencing factors for the increase of hospitalization costs of lung cancer surgery patients (P < 0.05); the marital status of being widowed or divorced and emergency admission were the influencing factors for the decrease of hospitalization costs of lung cancer surgery patients (P < 0.05). (5) The GM(1,1) model predicted that the hospitalization costs would further decrease in the next three years. Conclusion: The control of hospitalization costs for lung cancer surgery in this hospital has achieved certain results, especially in controlling drug costs. The costs of surgical treatment that reflect the labor value of medical staff have increased. Diagnostic costs and material costs are the key points for the hospital to further control hospitalization costs in the next step. Clinically, the hospitalization costs of lung cancer surgery patients can be further reduced by early detection, early diagnosis, early treatment, and scientifically reducing the number of hospitalization days. Comprehensive measures should be taken to optimize the composition of patients' hospitalization costs, strengthen the management of controllable factors, and reduce the hospitalization medical burden of lung cancer surgery patients.

Objective To explore the latent profile category of team Cha-xu among clinical nurses and its influence on job withdrawal behavior, and provide some reference for the management of clinical nurses.Methods Clinical nurses were selected from two tertiary hospitals in Wenzhou, Zhejiang Province from January to April 2023 by convenience sampling. The basic data questionnaire, perceived climate of team Cha-xu scale and job withdrawal behavior scale were used in the investigation.Results A total of 392 clinical nurses were included in the study. The score of perceived climate of team Cha-xu in clinical nurses was 41.15±8.07. The model fitting effect of three latent profile categories was best, namely "insider" with low scores, accounting for 28.06%; "intermediate", accounting for 41.07% and "outsider" with higher scores, accounting for 30.87%. Nurses with different professional titles, work relationship and monthly income showed significant differences in perceived climate of team Cha-xu (P<0.05). The score of job withdrawal behavior was 18.13±3.39. The nurses in different perceived climate of team Cha-xu category had different job withdrawal behaviors (F=4.883, P<0.05). The pairwise comparison results showed that there was no significant difference between "insider" and "middleman" (P>0.05), while there was significant difference between "outsider" and "insider", "outsider" and "middleman" (P<0.05).Conclusion Nursing managers should pay attention to the impact of perceived climate of team Cha-xu on job withdrawal behaviors, strive to improve their own management level, create a harmonious working atmosphere, and give clinical nurses full support and care, so as to reduce the perceived climate of team Cha-xu and the job withdrawal behavior.

Objective To analyze the hotspots and trends of Diagnosis-Intervention Packet (DIP) research in China in order to provide reference for the research direction.Methods The CNKI was used to retrieve the DIP-related literature, and descriptive analysis was conducted on the basic information such as the publication time of the literature. The social network method was used to analyze the core authors and high-frequency keywords, and visualize the connection between network nodes.Results From 2011 to 2023, a total of 545 related DIP literatures were published. There were 178 core journal literatures (32.66%) and 367 non-core journal literatures (67.34%). Since 2016, the DIP literature has rapidly increased, with over 200 articles published in 2023. There were 71 core authors in this field, forming 5 multi-person cooperation groups, led by Gao Guangying and Tian Jiashuai, with a total of 278 articles published. The network cograph and centrality analysis of high-frequency keywords showed that "medical insurance payment", "public hospitals", "fine management", "payment methods", and "cost control" ranked at the top of the degree centrality and proximity centrality rankings; while the intermediary centrality of "fine management" and "medical insurance payment" was relatively large.Conclusion The literature in DIP field is showing a continuous growth trend in China, with multiple research teams formed by core authors who have a greater influence and academic leadership role. The hotspots mainly focus on medical insurance payment and fine management in public hospitals. The development trend will go deep into many fine links such as cost control of public hospitals.

Objective To analyze the dynamic change of the number of admissions in the otolaryngology department of a hospital, aiming to provide a reference for the refined management of the department and the scientific allocation of medical and health resources.Methods The dynamic indicators in the time series analysis were used to analyze the annual change of the number of hospital admissions from 2013 to 2022, and the moving average seasonal index method was used to statistically analyze the number of hospital admissions in each month and quarter.Results The number of admissions to the department of otolaryngology in the hospital showed an overall growth trend, with a cumulative increase of 1 721 person-times, with a cumulative increase of 48.33%. The monthly peak period of hospital admissions was in July and August, of which July was the highest, with a seasonal index of 131.66%; and the trough period was in February, June, September, November, and December, of which September was the lowest, with a seasonal index of 79.59%. The quarterly peak was in the third quarter, with a seasonal index of 108.92%; and the trough was in the fourth quarter, with a seasonal index of 93.27%.Conclusion The number of admissions to the department of otolaryngology in the hospital shows obvious cyclical changes with monthly and quarterly changes, and medical and health resources should be scientifically and reasonably allocated according to the law to improve the quality and efficiency of medical services.

Objective To evaluate the performance of n neonatal inpatient medical services in municipal hospitals based on DRG-indicators.Methods Medical records of neonatal inpatients reported by all municipal medical institutions were collected, and the top 10 hospitals were included in the analysis. The medical service was evaluated from the three dimensions of service ability, service efficiency, and medical quality and safety, and the comprehensive index method was used to compare the medical service with the list of provincial key clinical specialties.Results The kinds of DRG groups were comprehensive, with no death cases in the low-risk group. Hospital A ranked first in terms of capacity index and comprehensive ranking, while hospitals D and H ranked first in efficiency index, and Hospital E ranked first in terms of DRG groups and CMI.Conclusion The coverage of neonatal disease treatment was wide and the medical quality was pretty well in the city. However, there is a need for balanced development between medical service capacity and efficiency, and more attention should be paid to the specify dimensions of indicators, rather than a single comprehensive ranking.

Objective To explore the correlation between psychological capital and study adaptability of male nursing undergraduates.Methods We selected 202 male students majoring in nursing in a university by convenience sampling method, and the learning adjustment scale and psychological capital scale were used for investigation and analysis.Results The average score of psychological capital of male nursing undergraduates was (93.72±10.72). The average score of study adaptability was (113.96±13.65). There was a significant positive correlation between the total score of psychological capital and the total score of study adaptability (r=0.631, P<0.01). Psychological capital of male nursing students has a positive predictive effect on study adaptability.Conclusion Male nursing undergraduate students are in the middle level of study adaptability and psychological capital, and psychological capital has a positive predictive effect on study adaptability.

Objective To analyze the main disease composition of inpatient deaths in a tertiary comprehensive hospital
from 2016 to 2022, and provide a basis for the hospital to further reduce case fatality rates. Methods Medical record data suchas name, gender, age, discharge diagnosis, disease code, etc. were extracted from the electronic medical record system of a tertiary comprehensive hospital from January 1, 2016 to December 31, 2022. According to the International Classification of Diseases (ICD - 10), Excel 2016 and SPSS 25.0 were used to perform statistical analysis on the data. Results From 2016 to 2022,the number of deaths was 3777, with the case fatality rate of 1.14%. Among them, the case fatality rate of male (1.60%) was higher than that of female (0.73%), and the difference was statistically significant (χ² ＝ 564.778, P ＜ 0.001). With the increase of age, the case fatality rate gradually increased, with the highest case fatality rate 5.09% for those aged 90 and above,and the highest number of deaths occurring in the 70 - 79 age group. The top three causes of death were tumors, circulatory system diseases, and respiratory diseases. Conclusion It is necessary to pay attention to the health status of male and elderly groups,and strengthen the promotion of health knowledge. Tumors, circulatory system diseases, and respiratory system diseases are the
main causes of death. It is necessary to strengthen talent development and technological innovation in corresponding departments to reduce case fatality rates.

Objective To investigate the prevalence of osteoporosis among middle-aged and elderly people over 45 years old in Wenzhou, and analyze its influencing factors, so as to provide basis for formulating osteoporosis prevention and control measures.Methods A convenient sampling method was adopted to select 1 064 residents over 45 years old in Wenzhou from July to December 2023. A questionnaire survey was carried out, and the bone density of 1/3 of the distal radius of the study subjects was measured and recorded by ultrasonic bone densitometry.Results Among 1 064 middle-aged and elderly people over 45 years old, 239 cases had osteoporosis, with a prevalence rate of 22.46%. The results of logistic regression analysis showed that age (OR=2.498, 95%CI: 1.0585.901), BMI (OR=1.323, 95%CI: 1.037-1.688) were the risk factors for the prevalence of osteoporosis in middle-aged and older population, and that receiving sunshine hours (OR=0.488, 95%CI: 0.266-0.895), calcium supplementation (OR=0.465, 95% CI: 0.262-0.826), and consumption of milk (OR=0.500, 95% CI: 0.286-0.874) were protective factors for the prevalence of osteoporosis in middle-aged and elderly population.Conclusion The prevalence of osteoporosis in the middle-aged and elderly population over 45 years old is high in Wenzhou community. Weight control, daily exposure to more than 30min of sunlight, calcium supplementation, and milk drinking can help to prevent osteoporosis in the middle-aged and elderly population and improve their quality of life.

Objective To explore the relationship between respectful leadership, psychological security and employee satisfaction, in order to provide reference for hospital managers to improve employee satisfaction.Methods Respectful leadership scale, psychological safety scale and job satisfaction scale were used to conduct a questionnaire survey on employees for descriptive analysis, correlation analysis and a structural equation model was constructed based on the results.Results The total score of respectful leadership was (45.82±10.25), psychological safety was (17.31±3.43) and employee satisfaction was (26.90±5.88). Pearson correlation analysis showed that there was a significant positive correlation between the three variables, and the absolute value of correlation coefficient ranged from 0.335 to 0.583 (P<0.01). Respectful leadership had no direct predictive effect on employee satisfaction (β=0.05, P>0.05), the indirect effect coefficient of respectful leadership on employee satisfaction was 0.35, the total effect coefficient was 0.40, and the mediating effect accounted for 87.5%. This indicates that respectful leadership indirectly affects employee satisfaction through psychological safety.Conclusion Psychological safety plays an mediating role in the relationship between respectful leadership and employee satisfaction. The management departments can evaluate the performance of respect for subordinates by leaders, advocate respectful leadership, and improve the psychological security and satisfaction of employees.

Objective To analyze the epidemiological characteristics of malignant tumors collected from the monitoring points of China′s cause of death surveillance system in 2021, to grasp the loss of life expectancy due to malignant tumors in China′s population and analyze the factors affecting it, and to estimate the burden of disease due to malignant tumors in China in.Methods The malignant tumour mortality rate and potential years of life lost of Chinese residents were calculated by different age and gender groups by using Excel 2021 and SPSS 26.0 software. Results The mortality rate of malignant neoplasms in our cause of death surveillance system in 2021 was 164.2/100000, and the median rate was 156.7/100000. The top 5 in potential years of life lost and mortality were lung, liver, stomach, colorectal, and esophageal cancers. The potential years of life lost due to cancer deaths in our population in 2021 totaled 4575932 person - years, resulting in a loss of 370.54 billion yuan in GDP for the whole society. Conclusion The burden of malignant tumors in China remains heavy, with obvious regional, age and gender differences in the burden of malignant tumors. Measures such as improving the cancer prevention and treatment system and promoting measures such as cancer screening and early diagnosis and treatment are crucial to reducing the burden of malignant tumors.

Objective The study aimed to sort out the research hotspots and development trend in this field in the past 10 years, and to provide reference for the research of cancer prognosis prediction model, through the econometric statistics and
visual analysis of the related research of cancer prognosis prediction model. Methods Web of Science, PubMed, and CNKI databases were used as the search sources, and the literature on cancer prognosis prediction model published in the Chinese and English search sources from Jan. 1st, 2013 to June 15th, 2024 was analyzed and visualized based on CiteSpace, VOSviewer software, and the bibliometrix package of the R language.Results A total of 1341 Chinese articles were retrieved through the CNKI database, with 1322 valid articles remaining after duplication. From the WOS and PubMed databases, 2069 and 3284 English articles were retrieved, respectively. After merging and duplication, 4908 valid English articles were retained. The overall trend of publications from 2013 to 2024 was upward. The country with the most publications in English literature was China (2270 articles), the institution with the most publications was Fudan University (268 articles), and the institution with the most publications in Chinese literature had only five articles. The authors who have published the most Chinese literatures were Wang Debin (5 articles), Chai Jing (5 articles), and Liu Yang (5 articles), and the author who published the most English literature was Wang Wei (24 articles). The high - strength emerging words in both Chinese and English literature were breast cancer (Chineseemergent strength: 8.95, English emergent strength: 11.06), and the clustering results showed that the related studies of colorectal cancer, bladder cancer, prostate cancer, machine learning were more prominent. Conclusion Cancer prognostic prediction modeling is receiving more and more attention from experts and scholars, covering more cancer types and richer research methods. Machine learning algorithms are being used more often, and the nomogram visualizes the results to better guide clinical practice. The application of genome - wide association analysis in the field of cancer prognosis prediction is expected to be a potentially promising research direction. Universal collaboration among countries, institutions, and authors has not yet been established, and there is a need to further strengthen the cooperation for deeper academic cross - fertilization. The cancer - suppressive mechanisms of
iron death and copper death have received more attention and have a broad clinical research prospect.

Objective To analyze the internal composition and correlation of hospitalization expenses of negative difference cases in gynecological DRG disease group, so as to provide decision - making reference for hospitals to optimize the cost structure and realize the fine management. Methods The medical insurance year - end liquidation data of the DRG group (a total of 13 groups) with more than 100 cases of gynecological diseases in a tertiary hospital in 2023 were collected. The structural change degree method was used to analyze the changes in the internal composition of hospitalization expenses, and the new grey correlation analysis was used to evaluate the correlation between each subdivision cost and the total hospitalization cost.Results The proportion of negative balance in 8951 cases was 50.2%. There were 8 groups with more than 50% negative difference cases in each DRG group. The three groups with the highest degree of structural change were NZ13 (other diseases of female reproductive system with general complications and comorbidities), NB13 (female reproductive system reconstruction surgery with general complications and comorbidities), and RE13 (malignant proliferative diseases chemical and/or targeted, biological treatment with general complications and comorbidities). The contribution rate of inspection fee was higher in each group, followed by

operation fee. The top three of the correlation degree of the subdivision cost and the average cost with hospitalization expenses were operation cost (0.744), inspection cost (0.743) and drug cost (0.712). Conclusion It is necessary to pay attention to the fees of surgical items, carry out reasonable inspections, scientifically control the proportion of drug consumption and rationally adjust the cost structure, standardize the quality of the medical record home page,optimize the clinical pathway, and reduce the occurrence of negative difference cases through various measures.

Objective To classify hospitalized patients' diseases based on cost structure, and to provide data reference for controlling medical costs and optimizing the structure of medical income. Methods The first page information of inpatient cases from January 2023 to June 2024 in a tertiary hospital in Beijing was selected to extract inpatient expense details, and patients were categorized based on the ICD - 10 disease diagnosis codes of their primary discharge diagnoses. K - means clustering analysis was used to classify diseases according to cost structure, so as to analyze the characteristics of each category's cost structure. Results Based on cost structure, patient diseases were classified into four categories. Category 1 included diseases with high consumable costs, mainly comprising pyonephrosis, ureteral stones, and unstable angina pectoris; category 2 had the highest diagnostic fees, including unspecified liver cirrhosis, alcoholic liver cirrhosis, chronic hepatitis B without delta agent, etc.; category 3 featured balanced proportions across all fee types, including installation and adjustment of urinary devices, unspecified liver
malignancies, medical abortion without complications, etc.; category 4 had relatively higher medication costs, including other specified medical care, chronic liver failure, and chemotherapy sessions for tumors, among others.Conclusion Although high consumable or medication costs may be due to treatment requirements of certain diseases, it is still necessary to reduce expenses through multiple links such as procurement, usage, and management to effectively control medical costs and improve the quality of medical services.

Under the backdrop of the ‘Healthy China’ strategy, it is essential to evaluate and analyze health service productivity in China. This study aims to investigate the factors influencing health service productivity by systematically examining
and analyzing literatures from both domestic and international sources. Through a comprehensive review of the current state of measuring health production efficiency, influencing factors, and research methods, this study identifies gaps and obstacles in existing research. The goal of this paper is to offer a robust literature foundation and theoretical framework for a more precise evaluation of health service productivity efficiency, as well as for enhancing healthcare resource allocation and service quality.

Objective To explore the problems and countermeasures of medical staff in public hospitals in dealing with public health emergencies, in order to provide valuable reference for improving the emergency response capacity of public hospitals. Methods A stratified sampling method was used to randomly select 593 medical staff from 33 wards of 7 departments in a public Grade Three general hospital in Shandong Province, which were closely related to public health. In order to improve comparability and assess the overall performance level more accurately, this study converted scores into grades, so as to analyze the current situation and influencing factors of public hospital medical staff in responding to public health emergencies, and put forward improvement measures and suggestio.Results The participation rate of medical staff in emergency drills, emergency training and emergency handling in response to public health emergencies was 45.14%, and the qualified rate was 58.40%, both at a low level. The qualified rate of medical staff who did not participate in such activities was only 40.78%, compared with 79.83% who participated in activities, the difference was statistically significant (P < 0.05). The overall score rate of these three aspects was 56.11%, indicating that the level of emergency ability was low, and the average score was (2.81 ± 0.88), which
was significantly lower than the qualified score (P < 0.001). Among the three dimensions, the score rate of emergency rescue ability was the highest (75.34%), followed by personal emergency attitude (73.52%), and the ability to master emergency knowledge was the lowest (65.23%). Conclusion In response to public health emergencies, medical staff in the public hospital need to improve their participation in emergency practice activities, ability to grasp emergency knowledge, personal monitoring and early warning ability, and mental health. It is suggested to strengthen the training of basic emergency knowledge and practical skills of medical staff, improve the monitoring and early warning system, and improve the psychological intervention ability of medical staff.

Objective To investigate the influencing pathways and effects of spatial partition on doctors' work interruptions and work engagement under the open work environment. Methods From July to September 2021, a convenience sampling

survey was carried out for doctors from 10 clinical departments of a public hospital in Guangzhou. Data about office space partitions, work interruptions and work engagement of participants were collected via an online self - reported questionnaire. Spatial partition patterns were classified as non - partitioned, half - partitioned and full - partitioned according to the number of partitions and architectural features. Descriptive analysis and multivariate analysis were conducted, and the influencing pathways and effects of spatial partition and work interruption, work engagement were examined with the structural equation mode.Results A total of 128 doctors were included, with 58, 40 and 30 respondents worked in non - partitioned, half - partitioned or full - partitioned space,respectively. The mean levels of work interruptions in the full - partitioned group were lower than those in the non - partitioned and half - partitioned groups, but for a higher mean score of work engagement (P < 0.05). Compared with the non - partitioned pattern,

full - partition had a direct positive effect on work engagement (β = 0.583, P = 0.005), as well as an indirect effect on work engagement through work interruptions (β = 0.225, P = 0.020). The mediating effect accounted for 27.8% of the total effect.Conclusion Under an open space work environment, there is an association between physicians' work engagement and spatial partition pattern, work interruptions, and work interruptions plays a partial mediating role among them. The full - partition pattern is beneficial for enhancing doctors' work engagement level.

Objective To explore the reasons for the behavior of uploading minor diagnostics with no resource consumption, analyze the impact of this behavior on medical insurance payment, improve the awareness and attention of medical institutions to this problem, and seek targeted solutions from two aspects of hospital management and medical insurance supervision.Methods By comparing medical record filling information and DRG enrollment results, quality control was carried out on randomly selected medical insurance settlement lists, and theoretical research was carried out on cases that received more medical insurance payments. The process of the behavior of uploading minor diagnostics with no resource consumption was sorted out to analyze the deep causes. Results The behavior of uploading minor diagnostics with no resource consumption is prominent, and the high - score group leads to high medical insurance payment. This problem is even more pronounced in comprehensive medical institutions, but existing regulatory instruments are not working well. Conclusion The key to solving this problem is, on the one hand, to strengthen training management in these hospitals, and on the other hand, to solve the practical problems of medical institutions and steer in the right direction.