25 December 2025, Volume 32 Issue 6

    

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  Research Progress on Adult Chronic Diseases and Their Comorbidity Trajectories

  RuanYao, LiuYang, LiChunxia, XueTong, ZhangTao

  Chinese Journal of Hospital Statistics. 2025, 32(6): 401-406. https://doi.org/10.3969/j.issn.1006-5253.2025.06.001

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  Objective To evaluate the research status of chronic disease comorbidity trajectories, and systematically sort out the influence mechanisms of health behavioral factors on the development trajectories of chronic diseases and their comorbidities. Methods By retrieving relevant literatures published from 2000 to 2024 in databases such as CNKI, PubMed and Web of Science, we systematically sorted out the methodological progress of chronic disease comorbidity trajectory modeling at home and abroad, and focused on analyzing the impacts of health behavioral factors (smoking, physical activity, sleep quality, dietary patterns, and body weight management) on the accumulation of chronic diseases and the evolution of comorbidity trajectories. We comprehensively used evidence from cross-sectional studies and longitudinal cohort studies to explore the dynamic process of transition from single disease to multi-morbidity. Results Trajectory modeling studies showed that 4–6 types of comorbidity progression trajectories with significant heterogeneity could be identified based on advanced methods such as latent class growth models. Health behavior interventions had significant effects on the prevention and control of chronic disease comorbidities. Regular physical activity could serve as a primary prevention measure for 35 types of chronic diseases, significantly reducing the cumulative risk of chronic diseases; smoking cessation interventions effectively blocked the progression of cancers and cardiovascular diseases; adequate sleep (≥7 h/night) and high-quality dietary patterns were both significantly associated with a reduced risk of an increase in the number of chronic diseases. Longitudinal cohort studies further confirmed that individuals with low-level physical activity had a 2–3 times higher risk of being classified into the rapid progression trajectory group, and smoking combined with high-risk drinking significantly increased the probability of transitioning to a high-risk comorbidity state. Conclusion Health behaviors play a crucial regulatory role in the whole-course evolution of chronic diseases. Future prevention and control strategies should shift from single-behavior interventions to dynamic management of aggregated behavior patterns, so as to promote the construction of an individualized prevention and intervention system oriented by comorbidity trajectories.
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  Analysis of Nursing Demand Attributes in Stroke Patients with Aphasia during the Rehabilitation Period Based on the KANO Model

  GanKena, ZhongYan, FuYanrui, DongQin

  Chinese Journal of Hospital Statistics. 2025, 32(6): 407-412. https://doi.org/10.3969/j.issn.1006-5253.2025.06.002

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  Objective To analyze the nursing demands of stroke patients with aphasia during the rehabilitation period based on the KANO model. Methods A questionnaire was designed by combining the KANO model with the Delphi expert consultation method. A total of 200 stroke patients with aphasia who were in the rehabilitation period in the Department of Neurology of a municipal people's hospital from January 2023 to January 2024 were randomly selected as the research subjects. The attributes of patients' nursing demands were determined through KANO model demand attribute classification, better-worse coefficient analysis and two-dimensional matrix analysis. The most sensitive and need-to-improve elements were identified via demand element screening. Results After the classification of demand attributes by the KANO model, combined with better-worse coefficient analysis and two-dimensional matrix analysis, the index classification results showed that the expected demands accounted for 50.00% (8/16), attractive demands accounted for 18.75% (3/16), and must-be demands accounted for 31.25% (5/15). Through the KANO model factor selection line, the top 5 key factors affecting the nursing demands of stroke patients with aphasia during the rehabilitation period were screened out, which were post-discharge speech medical referral service, breaking the daily routine, relatives' companionship, adjustment of negative psychological state, and doctor-patient communication channels. Conclusion For the nursing service of stroke patients with aphasia during the rehabilitation period, on the basis of meeting the must-be attributes, efforts should be made to improve the expected attributes and strive to satisfy the attractive attributes. Hospitals can invest resources in these items to provide better medical services for patients.
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  The Chain Mediating Effect of Rumination on Post-traumatic Stress Disorder and Post-traumatic Growth in Young and Middle-aged Patients with Acute Myocardial Infarction

  HuangLijuan, ZhanFang, LiuYanfang, LiuXiaolan

  Chinese Journal of Hospital Statistics. 2025, 32(6): 413-418. https://doi.org/10.3969/j.issn.1006-5253.2025.06.003

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  Objective To explore the chain mediating effect of rumination on post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) in young and middle-aged patients with acute myocardial infarction.Methods A total of 256 young and middle-aged patients with acute myocardial infarction who received treatment in a hospital from February 2021 to May 2024 were enrolled by convenience sampling. All patients were investigated using the General Information Questionnaire, Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Simplified Chinese version of the Event-Related Rumination Inventory (CERRI), and Post-traumatic Growth Inventory (PTGI). Univariate analysis of patient data was performed using the t-test or chi-square X² test. Pearson correlation analysis was adopted to analyze the correlations among PTSD, rumination and PTG in young and middle-aged patients with acute myocardial infarction. Multivariate linear regression analysis was conducted for the univariate variables with statistical differences and the correlated scale data. Based on the results of relevant literature and multivariate linear regression analysis, AMOS 24.0 software was used to construct a structural equation model for mediating effect analysis.Results A total of 256 questionnaires were distributed, and 238 valid ones were recovered, with an effective recovery rate of 92.97%. The total score of PCL-C was (43.06±6.22), the score of intrusive rumination was (16.13±3.73), the score of deliberate rumination was (15.46±3.12), and the total score of PTGI was (60.07±10.35). Correlation analysis results showed that there was a positive correlation between PTSD and intrusive rumination in patients (r=0.535, P<0.01), while a negative correlation was found between PTSD and deliberate rumination (r=-0.334, P<0.01). PTG level was negatively correlated with intrusive rumination (r=-0.591, P<0.01) and positively correlated with deliberate rumination (r=0.771, P<0.01). Multivariate linear regression analysis indicated that PCL-C score, intrusive rumination and deliberate rumination were independent influencing factors of PTGI score in young and middle-aged patients with acute myocardial infarction (P<0.05). Structural equation model analysis revealed that the 95% confidence interval (95% CI) of the path coefficient of PTSD→deliberate rumination→PTG was (-0.410 to -0.047) with an effect size of -0.155; the 95% CI of the path coefficient of PTSD→intrusive rumination→deliberate rumination→PTG was (-0.335 to -0.077) with an effect size of -0.173.Conclusion PTSD in young and middle-aged patients with acute myocardial infarction can not only directly affect PTG, but also indirectly influence PTG through the independent mediating effect of deliberate rumination and the chain mediating effect of intrusive rumination-deliberate rumination.
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  Analysis of Influencing Factors and Construction of Risk Model for Acute-on-Chronic Liver Failure in Patients with Liver Cirrhosis

  YiTingting, ChenShuhua, LiLinhui

  Chinese Journal of Hospital Statistics. 2025, 32(6): 419-424. https://doi.org/10.3969/j.issn.1006-5253.2025.06.004

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  Objective To analyze the relevant risk factors for acute-on-chronic liver failure (ACLF) in patients with liver cirrhosis and construct an early warning model.Methods A total of 153 cirrhotic patients who were hospitalized and treated in a municipal hospital from May 2020 to July 2023 were retrospectively selected as the research subjects. They were randomly divided into a model set (102 cases) and a validation set (51 cases) at a ratio of 2:1. According to whether ACLF developed during the follow-up period, the model set was further divided into an ACLF group and a non-ACLF group. Multivariate logistic regression analysis was used to identify the influencing factors of ACLF occurrence, and a risk prediction model for ACLF in cirrhotic patients was constructed. The accuracy of the model was evaluated using the receiver operating characteristic (ROC) curve, and the goodness-of-fit of the model was assessed via the Hosmer-Lemeshow test.Results In the model set, there were 16 cases in the ACLF group (15.69%) and 86 cases in the non-ACLF group (84.31%). Multivariate analysis results showed that albumin (A_H) (OR=0.739, 95% CI: 0.576–0.949, P=0.018), prothrombin time (T_P) (OR=1.310, 95% CI: 1.015–1.691, P=0.038), and activated partial thromboplastin time (T_APT) (OR=1.177, 95% CI: 1.044–1.327, P=0.008) were all independent influencing factors for ACLF occurrence in the patients (P<0.05). On this basis, the risk prediction model was established with the equation: logitP＝-9.925-0.302×A_H+0.270×T_P+0.163×T_APT. The area under the ROC curve (AUC) of the model was 0.980 (95% CI: 0.958–1.000), with a sensitivity of 1.000, a specificity of 0.907, and a Youden index of 0.907. The Hosmer-Lemeshow test of the combined model showed that (X²=1.61)and P=0.991.Conclusion The risk prediction model for ACLF in cirrhotic patients has good predictive efficacy. Medical staff can use indicators such as A_H, T_P and T_APT to identify high-risk patients and take timely intervention measures.
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  Construction of a Nomogram Prediction Model for Catheter-Related Bloodstream Infections in Children with Acute Lymphoblastic Leukemia

  LuYuzhen, ZhuXuemei, WangCaixia, OuyangMeijun

  Chinese Journal of Hospital Statistics. 2025, 32(6): 425-429. https://doi.org/10.3969/j.issn.1006-5253.2025.06.005

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  Objective To explore the risk factors for catheter-related bloodstream infections (CRBSI) in children with acute lymphoblastic leukemia (ALL) and construct a nomogram prediction model.Methods A retrospective analysis was performed on the clinical data of 230 children with ALL admitted to a hospital from July 2021 to June 2024. According to the occurrence of CRBSI during treatment, the children were divided into an infection group (n=58) and a non-infection group (n=172). The clinical data of the two groups were compared. LASSO regression analysis was used to initially screen the potential early warning indicators for CRBSI in children with ALL. Multivariate binary logistic regression analysis was adopted to identify the risk factors for CRBSI in the children. The R software 4.3.3 package was used to construct a nomogram prediction model. The Hosmer-Lemeshow test, calibration curve, and decision curve were applied to evaluate the goodness-of-fit, calibration degree, and clinical applicability of the nomogram prediction model. The receiver operating characteristic (ROC) curve of the model was plotted.Results There were statistically significant differences between the two groups in white blood cell count, duration of neutropenia, number of chemotherapy cycles, number of punctures, and catheter indwelling time (P<0.05). White blood cell count, duration of neutropenia, number of chemotherapy cycles, number of punctures, and catheter indwelling time were potential early warning indicators for CRBSI in children with ALL. Duration of neutropenia, number of chemotherapy cycles, number of punctures, and catheter indwelling time were identified as the risk factors for CRBSI in children with ALL. The results of the Hosmer-Lemeshow test (X²=9.138, P=0.331) indicated that the nomogram prediction model had a high goodness-of-fit. The prediction results of the nomogram model for CRBSI in children with ALL were highly consistent with the actual outcomes. When the risk threshold was between 0.10 and 0.97, the nomogram model yielded a higher clinical net benefit in predicting CRBSI in children with ALL compared with any single predictor. The area under the ROC curve (AUC) was 0.967 (95% confidence interval [95% CI]: 0.935–0.986), with a sensitivity of 89.66% and a specificity of 93.60%, suggesting that the nomogram model had high predictive efficacy.Conclusion The nomogram prediction model constructed based on the duration of neutropenia, number of chemotherapy cycles, number of punctures, and catheter indwelling time can help clinicians better identify high-risk children during treatment, take corresponding preventive measures, and improve the prognosis.
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  Construction and Validation of a Prediction Model for Intraoperative Hypothermia in Elderly Patients Undergoing Total Knee Arthroplasty

  HuShanshan, LiuTing, PengXiaoqing

  Chinese Journal of Hospital Statistics. 2025, 32(6): 430-436. https://doi.org/10.3969/j.issn.1006-5253.2025.06.006

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  Objective To explore the influencing factors of intraoperative hypothermia in elderly patients undergoing total knee arthroplasty, construct and validate a nomogram model, and provide a basis for the intervention of intraoperative hypothermia in elderly patients undergoing total knee arthroplasty. Methods A total of 196 elderly patients who underwent total knee arthroplasty in a municipal hospital of traditional Chinese medicine from November 2021 to November 2023 were selected as the modeling group. According to the occurrence of intraoperative hypothermia, they were divided into the hypothermia group (93 cases) and the non-hypothermia group (103 cases). In addition, 84 elderly patients who underwent total knee arthroplasty in the same hospital from December 2023 to June 2024 were selected as the validation group at a ratio of 7:3, and divided into the hypothermia group (40 cases) and the non-hypothermia group (44 cases) based on the presence of intraoperative hypothermia. Multivariate logistic regression analysis was performed on the potential influencing factors of intraoperative hypothermia in elderly patients undergoing total knee arthroplasty. A nomogram model for risk prediction was constructed and externally validated. Results Logistic regression analysis showed that age, body mass index (BMI), intraoperative blood loss, operation duration, total volume of fluid infusion, and intraoperative admission temperature were the influencing factors of hypothermia. The area under the curve (AUC) of the prediction model was 0.824 (95% confidence interval [95% CI]: 0.767–0.881), with a sensitivity of 0.720 and a specificity of 0.796, indicating good discriminative ability. The AUC of external validation was 0.735, showing favorable validation efficacy. The overall trend of the calibration curves of the prediction model and external validation was close to the ideal curve. Conclusion The early warning model for intraoperative hypothermia in elderly patients undergoing total knee arthroplasty has good predictive value. Targeted intervention measures can be formulated according to the actual conditions of patients.
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  Risk Factor Analysis and Risk Nomogram Model Construction and Validation of Medical Adhesive-related Skin Injury in Elderly ICU Patients

  QiuMeifang, ChenJinhua, XiePinglan

  Chinese Journal of Hospital Statistics. 2025, 32(6): 437-442. https://doi.org/10.3969/j.issn.1006-5253.2025.06.007

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  Objective To explore the risk factors of medical adhesive-related skin injury (MARSI) in elderly patients in the intensive care unit (ICU), and to construct and validate a risk nomogram model.Methods A total of 140 elderly patients admitted to the ICU of a hospital from January 2022 to September 2023 were selected as the training set. They were divided into the injury group and the non-injury group according to the occurrence of MARSI. Relevant data before and after treatment were collected for risk factor analysis, and a risk nomogram model was constructed. In addition, 60 elderly patients admitted to the ICU of the same hospital from October 2023 to June 2024 were selected as the validation set for external validation of the constructed risk nomogram model.Results In this study, there were 18 cases in the injury group (12.86%) and 122 cases in the non-injury group (87.14%). Multivariate analysis showed that body mass index, skin edema, complicated with diabetes mellitus, mechanical ventilation and Braden score were the influencing factors for the occurrence of MARSI in elderly ICU patients (P<0.05). A risk nomogram model was constructed based on these influencing factors. The area under the receiver operating characteristic (ROC) curve of the model was 0.935 (95% confidence interval [95% CI]: 0.877–0.992), with a sensitivity of 88.9% and a specificity of 86.9%. The maximum Youden index was 0.758. The overall trend of the model calibration curve was close to the ideal curve. The Hosmer-Lemeshow test showed that X²=8.945 and P=0.347. The AUC of external validation was 0.973, indicating good calibration consistency. The decision curve analysis (DCA) diagram suggested that the model had good clinical benefit.Conclusion The risk nomogram model constructed in this study can effectively identify the risk factors of MARSI in elderly ICU patients and help clinically prevent the occurrence of MARSI in elderly ICU patients.
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  The Mediating Role of Personal Sense of Control Between Self-efficacy and Diabetes Distress Among Patients with Type 2 Diabetes

  Guobin Sun, Junfang Shou, Shuxia Xuan

  Chinese Journal of Hospital Statistics. 2025, 32(6): 443-447. https://doi.org/10.3969/j.issn.1006-5253.2025.06.008

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  Objective To explore the mediating effect of personal sense of control on self-efficacy and diabetes distress in patients with type 2 diabetes. Methods A total of 180 patients with type 2 diabetes who were treated from June 2022 to June 2023 were enrolled as the research subjects. General data of the patients were collected. Scales were used to evaluate the levels of personal sense of control, diabetes distress and self-efficacy. Pearson correlation analysis was adopted for correlation analysis, and the Process macro plug-in was applied for mediating effect analysis. Results The total scores of personal sense of control, diabetes distress and self-efficacy of the patients were 25.00 (22.00, 29.00) points, (38.42±11.54) points and (29.03±6.50) points, respectively, with the average item scores of 3.57 (3.14, 4.14) points, (2.26±0.68) points and (3.23±0.72) points, respectively. Diabetes distress was negatively correlated with self-efficacy and personal sense of control at different levels (P＜0.05). Personal sense of control played a partial mediating role between self-efficacy and diabetes distress. According to the personal sense of control from low to high, the mediating effect values were -0.010, -0.017 and -0.001, respectively, with the mediating effect being the strongest when the personal sense of control was at the moderate level. Conclusion Personal sense of control has a mediating effect between self-efficacy and diabetes distress in patients with type 2 diabetes, and the mediating effect is the strongest when the level of personal sense of control is moderate.
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  Effects of the Rehabilitation Shift-forward Model on Negative Emotions and Self-care Competence in Patients With Hysteromyomectomy

  Xi Zhu, Wenhua Zhao

  Chinese Journal of Hospital Statistics. 2025, 32(6): 448-451. https://doi.org/10.3969/j.issn.1006-5253.2025.06.009

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  Objective To explore the effects of the rehabilitation shift-forward model on negative emotions and self-care ability in patients undergoing hysteromyomectomy. Methods A total of 80 patients who underwent hysteromyomectomy in a TCM hospital in Leping City, Jiangxi Province from January 2021 to June 2024 were prospectively selected, and divided into a control group and an observation group with 40 cases each using the random number table method. The control group received routine nursing care, while the observation group was given nursing care based on the rehabilitation shift-forward model. The negative emotions [Self-Rating Anxiety Scale (SAS) scores, Self-Rating Depression Scale (SDS) scores], self-care ability and postoperative rehabilitation indicators were compared between the two groups. Results Before nursing intervention, there were no statistically significant differences between the two groups (P＞0.05). After nursing intervention, the SAS and SDS scores of the observation group were lower than those of the control group; the scores of each dimension of self-care ability in the observation group were higher than those in the control group; the time to get out of bed, first exhaust time and hospital stay of the observation group were shorter than those of the control group, with statistically significant differences (P＜0.05). Conclusion The rehabilitation shift-forward model for patients undergoing hysteromyomectomy can alleviate negative emotions such as anxiety and depression, improve their self-care ability, shorten the length of hospital stay, and thus accelerate the postoperative rehabilitation process.
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  Establishment of Prediction Model and Nursing Strategies for Lower Extremity Venous Thrombosis in Patients After Knee Joint Cruciate Ligament Reconstruction

  Xiong Jing, Zhou Yumei, Liu Yinghui, Wang Hui

  Chinese Journal of Hospital Statistics. 2025, 32(6): 452-456. https://doi.org/10.3969/j.issn.1006-5253.2025.06.010

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  Objective To analyze the influencing factors of lower extremity venous thrombosis (LEVT) in patients after knee joint cruciate ligament reconstruction, and to construct a prediction model. Methods A total of 200 patients with knee cruciate ligament injury who underwent cruciate ligament reconstruction in a hospital from August 2022 to February 2024 were selected as the research objects. According to the occurrence of LEVT, they were divided into the thrombosis group (n=42) and the non-thrombosis group (n=158). The data of the two groups were collected to analyze the related influencing factors of LEVT after knee cruciate ligament reconstruction. R language was used to construct a nomogram prediction model. Calibration curves and decision curves were used to evaluate the model, and the related nursing intervention measures were analyzed. Results Compared with the non-thrombosis group, the patients in the thrombosis group had higher body mass index (BMI), tourniquet time and D-dimer level, and a higher proportion of combined reconstruction (P<0.05). BMI, tourniquet time and D-dimer had certain predictive value for postoperative LEVT, with their area under the curve (AUC) being 0.763, 0.790 and 0.734 respectively (P<0.05). BMI, surgical type, tourniquet time and D-dimer were the influencing factors of postoperative LEVT (P<0.05). The nomogram model showed good performance in predicting the risk of postoperative LEVT, with a concordance index (C-index) of 0.942 (0.912-0.973). When the risk threshold was greater than 0.16, the model could bring benefits to patients by influencing clinical decisions. Conclusion BMI, surgical type, tourniquet time and D-dimer are the influencing factors of postoperative LEVT in patients after knee cruciate ligament reconstruction, and the constructed nomogram model has good predictive ability. 
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  A Survey on the Psychological Detachment Status and Its Influencing Factors of Caregivers of Maintenance Hemodialysis Patients

  Zheng Huanhuan, Nian Sujuan, Deng Huili, Yan Mingxia

  Chinese Journal of Hospital Statistics. 2025, 32(6): 457-461. https://doi.org/10.3969/j.issn.1006-5253.2025.06.011

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  Objective To investigate and analyze the status of psychological detachment and its influencing factors among caregivers of maintenance hemodialysis (MHD) patients. Methods Patients undergoing MHD and their caregivers in an MHD center of a hospital from November 2019 to July 2023 were selected as the research subjects. A self-designed questionnaire was used to collect the general data of MHD patients and their caregivers. Univariate analysis and multivariate logistic regression analysis were performed to identify the influencing factors of psychological detachment in caregivers of MHD patients. Results In this study, the average score of psychological detachment among 185 caregivers of MHD patients was (12.08±3.55) points, the average score of caregiver burden was (28.12±6.08) points, the average score of personal burden was (9.93±2.48) points, and the average score of caregiver social burden was (19.11±6.24) points. Correlation analysis showed that the psychological detachment score of caregivers was negatively correlated with the total score of caregiver burden (r=-0.412, P<0.05) and the score of caregiver social burden (r=-0.267, P<0.05), while no correlation was found with the score of personal burden (r=-0.137, P>0.05). Univariate analysis indicated that the level of psychological detachment in caregivers of MHD patients was associated with educational level, monthly per capita household income, joint care with others, daily care time for patients, personality type, employment status, duration of patient dialysis, dialysis-related complications of patients, and caregiver social burden score (P<0.05). Multivariate logistic regression analysis revealed that caregiver social burden score, educational level below senior high school, no joint care with others, daily care time ≥6 hours, intermediate or introverted personality type, patient dialysis duration ≥1 year, and presence of dialysis-related complications in patients were independent risk factors affecting the psychological detachment level of caregivers of MHD patients (P<0.05). Conclusion The psychological detachment level of caregivers of MHD patients is moderate. Caregiver social burden score, educational level below senior high school, no joint care with others, daily care time ≥6 hours, intermediate or introverted personality type, patient dialysis duration ≥1 year, and presence of dialysis-related complications in patients are independent risk factors for the psychological detachment level of caregivers of MHD patients.
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  Analysis of Vascular Calcification Status and Its Influencing Factors in Uremic Patients Undergoing Hemodialysis

  Zheng Chenglie, Gong Lijia

  Chinese Journal of Hospital Statistics. 2025, 32(6): 462-465. https://doi.org/10.3969/j.issn.1006-5253.2025.06.012

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  Objective To investigate the status of vascular calcification and analyze its influencing factors in uremic patients undergoing maintenance hemodialysis. Methods A total of 130 uremic patients who received maintenance hemodialysis in a hospital from January 2023 to January 2024 were enrolled. Vascular calcification was evaluated by echocardiography, and the patients were divided into a calcification group (n=52) and a non-calcification group (n=78). Clinical indicators were compared between the two groups. Factors with statistical differences in univariate analysis were included in binary logistic regression analysis to screen for risk factors. Receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of continuous variables for vascular calcification. Results Compared with the non-calcification group, the calcification group had significantly higher levels of age, dialysis duration, serum phosphorus, serum calcium, high-sensitivity C-reactive protein (hs-CRP) and parathyroid hormone (all P<0.05). Binary logistic regression analysis showed that age, dialysis duration, serum phosphorus, serum calcium, hs-CRP and parathyroid hormone were independent influencing factors for vascular calcification in uremic patients undergoing hemodialysis (all P<0.05). Conclusion Age, dialysis duration, serum phosphorus, serum calcium, hs-CRP and parathyroid hormone are the main influencing factors for vascular calcification in uremic patients undergoing hemodialysis. Clinical attention should be paid to these factors, and early prevention and treatment measures should be taken when necessary to improve the quality of life of uremic patients undergoing hemodialysis.
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  Analysis of Health Examination Results of Primary and Secondary School Students in Xuyi County during the 2019-2020 Academic Year

  Zhang Lei, Jin Xiaoxiang, Wang Xiaoyue

  Chinese Journal of Hospital Statistics. 2025, 32(6): 466-470. https://doi.org/10.3969/j.issn.1006-5253.2025.06.013

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  Objective To understand the health status of primary and secondary school students in Xuyi County and provide a reference for further improving the prevention and control of school diseases in the county. Methods A health examination was conducted on students from 70 primary and secondary schools in Xuyi County, and the examination data were collected; the conditions of poor eyesight, dental caries, malnutrition, overweight and obesity among the students were analyzed. Results A total of 86,962 students received health examinations in the 2019–2020 academic year. The rate of poor eyesight was 62.57%, with the detection rate in girls (65.56%) higher than that in boys (59.78%), and the detection rate in senior high school students (88.24%) higher than that in primary school students (46.42%) and junior high school students (77.66%), all with statistically significant differences (P<0.05). The detection rate of dental caries was 33.72%, with the detection rate in girls (36.02%) higher than that in boys (31.57%), and the detection rate in primary school students (46.73%) higher than that in junior high school students (20.66%) and senior high school students (14.77%), all with statistically significant differences (P<0.05). The detection rate of malnutrition was 4.20%, with the detection rate in boys (5.12%) higher than that in girls (3.21%), and the detection rate in junior high school students (4.40%) higher than that in primary school students (4.32%) and senior high school students (3.36%), all with statistically significant differences (P<0.05). The detection rate of overweight was 15.34%, with the detection rate in boys (17.31%) higher than that in girls (13.22%), and the detection rate in senior high school students (16.98%) higher than that in primary school students (14.55%) and junior high school students (15.87%), all with statistically significant differences (P<0.05). The detection rate of obesity was 12.66%, with the detection rate in boys (15.54%) higher than that in girls (9.56%), and the detection rate in primary school students (14.30%) higher than that in junior high school students (10.75%) and senior high school students (10.78%), all with statistically significant differences (P<0.05). Conclusion The problem of poor eyesight among primary and secondary school students in Xuyi County is prominent, and the high detection rate of dental caries cannot be ignored. Malnutrition and overnutrition coexist in this group. Society, schools and families should take joint measures to prevent the occurrence and development of common diseases among students.
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  Analysis of the Current Status and Influencing Factors of Social Support Network in Pregnant Women with Hypertensive Disorders in Pregnancy

  Xiao Yanfang

  Chinese Journal of Hospital Statistics. 2025, 32(6): 471-476. https://doi.org/10.3969/j.issn.1006-5253.2025.06.014

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  Objective To explore the current status and influencing factors of social support network in pregnant women with pregnancy-induced hypertension (PIH). Methods Pregnant women with PIH admitted to a hospital from October 2022 to March 2024 were selected by convenience sampling method, and the current status and influencing factors of their social support network were analyzed. Results Among the 230 pregnant women with PIH, the functional network dimension of social support network was (8.94±2.47) person-times, and the structural network dimension was (12.03±2.72) person-times. Univariate analysis showed that age, participation in economic/public welfare activities, educational level, self-management ability and place of residence were all influencing factors of the functional network dimension of PIH pregnant women, with statistically significant differences (P<0.05). Multiple linear regression analysis showed that age, participation in economic/public welfare activities, educational level and self-management ability were all influencing factors of the structural network dimension of PIH pregnant women, with statistically significant differences (P<0.05). Conclusion There are many influencing factors of functional and structural network dimensions in PIH pregnant women. It is necessary to strengthen the construction of social support network and improve the level of social support network of PIH pregnant women, which is helpful to improve their health status. 
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  Current Status and Model Exploration of Internet Medical Service Charging in China

  Ji Meihao, Shi Xiaobing, Cui Fangfang, Zhang Xu, Zhao Jie

  Chinese Journal of Hospital Statistics. 2025, 32(6): 477-482. https://doi.org/10.3969/j.issn.1006-5253.2025.06.015

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  Objective To understand the current status and charging models of internet medical service fees in China. Methods From September to October 2023, an online questionnaire survey was conducted on the medical service charging status of internet hospitals established based on physical medical institutions in 8 provinces (autonomous regions, municipalities directly under the Central Government) across China. Descriptive analysis was used to analyze the charging basis and standards of internet hospitals. Results Among the 54 surveyed hospitals, the charging of internet medical services was mainly based on the form of consultation, hospital grade and doctor's professional rank. The online follow-up consultation fee of 80.5% of the hospitals was 10 yuan or less per case. The fees for graphic, voice and video health consultations provided by doctors of different professional ranks in hospitals of different grades were mainly below 20 yuan. 44.4% of the hospitals supported online medical insurance payment. Conclusion It is necessary to establish a multi-level and composite pricing mechanism for internet medical services in China, improve the supervision of internet medical service charges, promote online medical insurance payment, and ensure the high-quality and sustainable development of internet medical services.
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  Research on Exploration and Application of the Refined Management Service Platform for Public Hospitals Based on Data Elements

  Sun Jingjie, Xiao Xue, Tan Zhenlei, Li Peilong, Liu Tianzheng, Zhang Yaoguang, Wang Yuehan, Nie Lei

  Chinese Journal of Hospital Statistics. 2025, 32(6): 483-488. https://doi.org/10.3969/j.issn.1006-5253.2025.06.016

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  Focusing on the practical demand of medical refined management driven by data elements, based on multi-source data such as health statistics, traditional Chinese medicine statistics and front page of medical records, a refined management service platform for public hospitals based on data elements was explored and constructed by adopting a multi-level and distributed architecture design combined with the underlying architectures of J2EE and .NET Core. The platform is equipped with 7 major modules, integrates visual display and intelligent models, and supports data horizontal benchmarking and vertical trend analysis services, helping public hospitals achieve scientific management and precise improvement. The application verification in 43 cooperative pilot hospitals has further proved the effectiveness of the platform in breaking data barriers, improving management efficiency and service level, and provided a feasible path for exploring the empowerment of new productive forces by data elements. 
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  Improving the Quality of Inpatient Medical Record Front Pages via the Performance Appraisal Model for Coders

  Song Lina, Zhu Hong

  Chinese Journal of Hospital Statistics. 2025, 32(6): 489-492. https://doi.org/10.3969/j.issn.1006-5253.2025.06.017

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  Objective To analyze the effect of implementing performance appraisal for coders on improving the data quality of inpatient medical record front pages, and explore the mode for the continuous improvement of inpatient medical record front page quality. Methods Since June 2023, the Medical Record Department has set up a coding group, appointed specialized coders, and implemented performance appraisal for coders. Targeted supporting schemes were formulated and implemented for the difficulties encountered in coding work. A total of 1000 inpatient medical record front pages before and after the implementation of performance appraisal (March–May 2023 and March–May 2024) were randomly selected. Quality control of the medical record front pages was conducted in accordance with the Specifications for Completing the Data of Inpatient Medical Record Front Pages (2016 Edition). The changes in the data quality management and control indicators of inpatient medical record front pages and the filling status of major error items before and after the implementation of performance appraisal were compared and analyzed. Results After the implementation of performance appraisal, the average quality control score of inpatient medical record front pages was significantly increased, the excellent rate was raised, and the error rate was lower than that before the implementation, with statistically significant differences (P<0.05). Conclusion Implementing performance appraisal for coders can effectively improve the data quality of inpatient medical record front pages, which is worthy of popularization and application.
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  Implementation of Nonparametric Test Methods in Medical Statistics Based on Python —— Program Development and Application of the Nemenyi Test

  Zhu Zhongxin, Zhang Bingsong

  Chinese Journal of Hospital Statistics. 2025, 32(6): 493-496. https://doi.org/10.3969/j.issn.1006-5253.2025.06.018

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  Objective This study aims to develop a Nemenyi test program for pairwise comparisons following the Kruskal-Wallis test of multiple independent samples using Python, and provide an efficient and reusable nonparametric test tool for medical researchers. Methods Based on Python, a directly callable function program named "kruskal_nemenyi_test" was designed and developed to realize the automated processing of the Kruskal-Wallis test and Nemenyi test. The correctness of the program was verified using the sample data from the textbook Medical Statistics. Results A complete program for the Kruskal-Wallis test and Nemenyi test was successfully developed. Verification tests showed that the test statistics and P-values output by the program were consistent with the standard sample results, and the program code has been open-sourced and shared on the GitHub platform. Conclusion The Python-based Nemenyi test program features high efficiency, accuracy and ease of invocation. It provides a practical tool for nonparametric statistical analysis in medical research and helps improve the scientificity and reliability of statistical results.