25 April 2025, Volume 32 Issue 2

    

• Select all
  |

• Select
  Application of comprehensive model of ensemble interpolation in study of spatial distribution pattern of diseases

  Cen Honglei, Zhao Yayie, Ye Junjie, Ma Xiaohong, Wang Rui, Qin Zezhen, Mo Zhiyang, Li Qiao, Tang Xianyan

  Chinese Journal of Hospital Statistics. 2025, 32(2): 81-85. https://doi.org/10.3969/j.issn.1006-5253.2025.02.001

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To linearly weight the results of inverse distance weighted interpolation (IDW), ordinary Kriging interpolation (OK) and thin plate spline interpolation (TPS), and fit a comprehensive model of ensemble interpolation to objectively and comprehensively reveal the spatial pattern of diseases. Methods Taking the mortality rate of liver cancer at county level in Guangxi for example, we revealed the death risk via IDW, OK and TPS interpolation models, and compared the mean prediction error (MPE), root - mean - square prediction error (RMSE), R - square (R2) value and the fitting smoothness of spatial interpolation maps between the IDW model, the OK model and the TPS model. Then, we used the RMSE of above specific models to generate weights to linearly weight single interpolation models, and estimated the death risk of liver cancer across Guangxi by a comprehensive model of ensemble interpolation.
  Results The fitting indicators of IDW, OK and TPS models were somewhat inconsistent, and each model had its advantages and disadvantages. Specifically, from small to large, the MPE was TPS (0.002), OK (0.004) and IDW (0.020), respectively, and the accuracy of TPS was better than that of OK. From small to large, RMSE was OK (0.349), TPS (0.362) and IDW (0.390), respectively, and the variability of OK was better than that of TPS. From small to large, R2 was OK (0.47), TPS (0.44) and IDW (0.37), respectively, and OK was better than TPS in fitting accuracy. The comprehensive model of ensemble interpolation integrated the advantages of above three models and overcame the instability of specific models, with MPE, RMSE and R2 being 0.005, 0.352 and 0.43, respectively. Conclusion IDW, OK and TPS interpolation models have their own advantages in estimating the spatial patterns of diseases, but findings of different models are inconsistent to some extent. The comprehensive model of ensemble interpolation reduces the uncertainty of each single model, balances the advantages and disadvantages of each single model and generated a comprehensive evidence to reveal the spatial pattern of diseases, via weighting above three single models.
  

  
  
• Select
  Nomogram prediction model establishment of 30-day survival after cardiac arrest and return of spontaneous circulation in emergency department

  Su Bingingqiang, Zhang Bingwen, Wu Sunying, Ma Xucan, Jiang Jie, Lou Xiaohua

  Chinese Journal of Hospital Statistics. 2025, 32(2): 86-92. https://doi.org/10.3969/j.issn.1006-5253.2025.02.002

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  To explore the risk factors of 30-day survival after cardiac arrest (CA) and return of spontaneous circulation (ROSC) in the emergency department and to establish a nomogram prediction model. Methods  A dual center retrospectively observational study was conducted. The patients with CA admitted to the emergency departments of two hospitals were enrolled, including Affiliated Jinhua Hospital, Zhejiang University School of Medicine and Wucheng District of Jinhua Municipal Central Hospital. A modified Utstein template was applied to collect information about these patients, including general data, CA related data, arterial blood gas analysis after ROSC, and the 30-days survival rate. The influence factors of 30-days survival rate were screened with logistic regression analysis. A nomogram prediction model was established to evaluate the value in predicting 30 days survival after CA and ROSC.Results  A total of 150 patients with ROSC were enrolled, 40 cases survived within 30 days (26.7%), and only 22 cases survived to hospital discharge with good neurological prognosis (14.7%). The survival group patients were younger, with higher ratio of in-hospital cardiac arrest (IHCA), cardiogenic cardiac arrest, initial shockable rhythm and higher pH value than the death group (P < 0.025). The ROC curve showed that the cut-off value of age was 60.5 years old, and pH was 7.05. Multivariate logistic regression analysis showed that patients′ age < 60 years old (OR = 11.30, 95% CI 1.76-72.63, P = 0.011), cardiogenic cardiac arrest (OR = 10.78, 95% CI 1.55-75.16, P = 0.016) and pH > 7.05 (OR = 15.25, 95% CI 2.46-94.49, P = 0.003) were independent influencing factors of 30-day survival. The negative predictive value of pH > 7.05 for 30 day survival was 91.1%. The AUC of nomogram prediction model was 0.929 (95% CI 0.874-0.985), the sensitivity was 0.95, and the specificity was 0.75. The calibration curve showed that the predicted probability was basically consistent with the actual probability. The analysis of the decision curve confirmed that the nomogram prediction model had good clinical usability. Conclusion  The nomogram model based on age, cardiogenic cardiac arrest, location of CA, initial shockable rhythm and pH could predict the 30-day survival of patients after ROSC in the emergency department rapidly, and pH was the most significant prognostic factor.
• Select
  Time-series analysis of the number of radiological examinations in the radiology department of a children′s hospital in Hangzhou from 2021 to 2023

  Wang Qidi, Lao Qun, Weng Ting, Weng Mengling, Liu Kan, Xia Xiaolian, Feng Changfeng

  Chinese Journal of Hospital Statistics. 2025, 32(2): 93-97. https://doi.org/10.3969/j.issn.1006-5253.2025.02.003

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  To analyze the change trend on the number of radiological examinations with time-series in a children′s hospital in Hangzhou from 2021 to 2023, and to provide data support for strengthening the management level and service quality of the radiology department in the hospital. Methods  A retrospective study was conducted on 374303 radiological examinations in the radiology department of the hospital, from January 1, 2021 to December 31, 2023. The seasonal index analysis with time series was used to analyze the change trend of the number of radiological examinations in three years.Results  The total number of radiological examinations in the radiology department of the hospital was 374303 times from 2021 to 2023. The average highest peak on the number of radiological examinations was the fourth quarter (autumn, 37105 times), and the lowest was the first quarter (winter, 25166 times). The peak months of radiological examinations were July, August, October, November and December (total of 5 months), and the average highest peak month was October, with 13225 times, accounting for 10.6% of the radiological examinations during the year. The minimun number of the radiological examinations occurred from January to May (total of 5 months), and the number of the radiological examinations was the least in February, with 6487 times, accounting for 5.2% of the radiological examinations during the year. The peak periods in daytime on the number of radiological examinations were from 10∶00 to 12∶00 and from 13∶30 to 15∶30. The number of the radiological examinations in the night-time from 17∶30 to 1∶30 was 10.1 times that in the night-time from 1∶30 to 8∶00. Conclusion  The number of radiological examinations in the radiology department of the hospital varies seasonally. Analyzing the peak and low periods of the radiological examinations can provide a basis for allocating medical resources reasonably, which can effectively improve the diagnostic capabilities and the level of medical service in the radiology department of the hospital.
  

  
  
• Select
  Construction of a Nomogram prediction model for type 2 diabetes mellitus complicated with nephropathy based on bio-chemical indicators

  Ye Xueqing, Li Weiping, Ye Buyun

  Chinese Journal of Hospital Statistics. 2025, 32(2): 98-103. https://doi.org/10.3969/j.issn.1006-5253.2025.02.004

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  To analyze the influencing factors of type 2 diabetes mellitus complicated with nephropathy based on biochemical indexes and construct Nomogram prediction model. Methods The data of patients in the complication group and non-complication group were observed to analyze the relevant factors affecting type 2 diabetes mellitus complicating nephropathy; Nomogram prediction model was constructed and validated. Results Compared with patients in the non-complicated group, the patients in the complicated group had higher levels of BMI, disease duration, CysC, HbA1c, BUN, Cr, hs-CRP, UA, lower levels of FCP, HDL-C, UA, and a higher percentage of the presence of insulin resistance (P < 0.05); the AUC of BMI, disease duration, FCPCysC, HDL-C, HbA1c, BUN, Cr, and hs-CRP were 0.702, 0.696, 0.609, 0.690, 0.626, 0.806, 0.647, 0.607, 0.689, 0.655, respectively (P < 0.05); BMI, disease duration, HbA1c, UA, and insulin resistance were the patients with co-morbid nephropathy (P < 0.05); Nomogram model was constructed based on risk variables to predict the risk of comorbid ne-phropathy in patients with type 2 diabetes mellitus with a C-index of 0.753 (95% CI: 0.712-0.769), and the risk threshold of this model was > 0.15; Analysis of the ROC curve based on the validation set showed an AUC of 0.902 (0.844-0.960); H-L goodness-of-fit test showed: χ² = 14.918, P = 0.061 (P > 0.05). Conclusion BMI, disease duration, HbA1c, UA, insulin re-sistance are the influencing factors of type 2 diabetes mellitus patients with comorbid nephropathy, and the constructed Nomogram model has good predictive ability and clinical practical value. It helps to individualize and quantify the assessment of patients with comorbid nephropathy.
• Select
  Meta-analysis of the effect of dapagliflozin on glucose and lipid metabolism in patients with stage Ⅲ of diabetic nephropathy

  Yao Lili, Xu Jinlong, Ren Liufen, Ma Weicheng, Li Jiao, Tang Ziliang

  Chinese Journal of Hospital Statistics. 2025, 32(2): 104-111. https://doi.org/10.3969/j.issn.1006-5253.2025.02.005

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  To systematically evaluate the effect of dapagliflozin on glucose and lipid metabolism in patients with stage Ⅲ of diabetic nephropathy (DN-Ⅲ). Methods  Randomized controlled studies (RCTs) on the effect of dapagliflozin on glucose and lipid metabolism in patients with DN-Ⅲ were retrieved. Literature was screened, the data were extracted, and RevMan 5.4.1. was used for quality evaluation. Results  A total of 2107 patients were included in 23 studies. Meta results showed that compared with the control group, dapagliflozin significantly reduced HbA1c, FBG, PBG, HOME-IR and significantly increased HOME-β in patients with DN-Ⅲ, but it had little impact on ΔFIns; compared with the control group, dapagliflozin significantly reduced TC, TG, LDL-c and significantly increased HDL-c in patients with DN-Ⅲ; compared with the control group, dapagliflozin significantly reduced SBP and DBP in patients with DN-Ⅲ. In addition, compared with the control group, dapagliflozin could significantly reduce BMI, but there was no significant difference in the incidence of ADR. Conclusion  Dapagliflozin can improve the glucose and lipid metabolism in patients with DN-Ⅲ, and it is safe and effective. However, in view of the limitations of the inclusion study, it still needs to be verified by a well-designed large-scale clinical randomized controlled study.
• Select
  Current status and mode exploration of internet medical service charge in China

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

  Chinese Journal of Hospital Statistics. 2025, 32(2): 112-117. https://doi.org/10.3969/j.issn.1006-5253.2025.02.006

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  To understand the current status and mode of Internet medical service charge in China. Methods  An online questionnaire survey on Internet medical service charge was conducted in Internet hospitals established by physical medical institutions in 8 provinces in China from October to November 2023. Descriptive analysis methods were used to analyze data of charging basis and standards of Internet hospitals. Results  The charges for Internet medical services in the 54 hospitals investigated were primarily determined by the type of consultation, hospital classification, and doctors' professional levels. In 78.4% of the hospitals, the online subsequent visit cost was 10 yuan or less per case. The costs of graphic, voice, and video health consultation for doctors of different ranks in various levels of hospitals primarily were less than 20 yuan. Approximately 44.4% of hospitals supported online medical insurance payment. Conclusion  It is imperative to establish a multi-tiered and comprehensive pricing mechanism for Internet medical services in China, enhance supervision over Internet medical charges, and comprehensively promote online payment for medical insurance to ensure the provision of high-quality and sustainable development of Internet medical services.
• Select
  Analysis of effect of reform of a public hospital in Binzhou on changes of medical cost structure

  Sun Xiaowei, Wang Zhiting, Zhai Yuxia, Zhang Nana, Song Fengfeng, Zhao Suqing

  Chinese Journal of Hospital Statistics. 2025, 32(2): 118-123. https://doi.org/10.3969/j.issn.1006-5253.2025.02.007

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  To analyze the changes in the structure of outpatient and inpatient costs in a public hospital in Binzhou under the background of new medical reform, and provide references and theoretical basis for further implementing healthcare reform policies in Binzhou. Methods  Outpatient and inpatient cost data from a public hospital in Binzhou City from 2013 to 2022 were collected, and grey correlation method and structural change degree were used to analyze the indicators. Results  Grey relational analysis revealed that, from 2013 to 2022, the top three correlated factors in outpatient expenses were medication expenses, examination fees, and laboratory fees; in inpatient expenses, medication expenses, health material fees, and examination fees were the top three expenses. The results of the structural correlation analysis showed that in both outpatient and inpatient expenses, the change in medication expenses was the largest contributor with a negative change. Conclusion  Under the background of the new medical reform, there have been initial achievements in controlling medication expenses. However, examination fees and health material fees have shown an upward trend and accounted for a relatively high proportion, which requires attention. Technical service fees have been increasing annually but still have a relatively low proportion.
• Select
  Analysis of the Disease Spectrum of Discharged Patients in a Psychiatric Specialized Hospital from 2013 to 2022

  Li Jiarui, Liang Jiancong, Mo Xin

  Chinese Journal of Hospital Statistics. 2025, 32(2): 124-129. https://doi.org/10.3969/j.issn.1006-5253.2025.02.008

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the changes in the disease spectrum of discharged patients in a psychiatric specialized hospital from 2013 to 2022, with a focus on exploring the impact of the COVID-19 pandemic on a specific mental disorder, F98, which usually onset during childhood and adolescence, so as to provide a reference for the prevention and treatment of mental diseases and the management of the hospital. Methods The information on the front pages of inpatient medical records of discharged patients from the psychiatry department of a psychiatric specialized hospital from January 1, 2013 to December 31, 2022 was exported through the medical record statistical management system of medical institutions in Guangdong Province. The constituent ratios, changing trends of the main discharge diagnoses of patients in each year, and the differential changes related to the pandemic were analyzed. Results Schizophrenia (F20) ranked first in the disease spectrum for 10 consecutive years. The number of male patients with schizophrenia reached its peak in the age group of 26-35 years old. It is particularly noteworthy that since the pandemic, the number of cases of F98, which usually onset during childhood and adolescence, has significantly increased, especially among female patients, and this increase is statistically significant. Conclusion The hospital should adjust its specialty settings according to the changes in the disease spectrum and the growth of the number of inpatients, and focus on strengthening the construction of the departments of mental disorders, affective disorders, clinical psychology, and the adolescent sub-specialty. At the same time, targeted mental health support should be provided for female adolescents, and public health policies and the education system should be promoted to strengthen mental health education and early intervention to alleviate the long-term impact of the pandemic.
• Select
  The Impact of DRG Payment Reform on the Hospitalization Costs of Diabetic Patients

  LinZhan, MaYueshen, YangFengkun, ZhangJunfeng, XianYidan, LiuXuan, HuangHuijie, ZhangXiaoyan, DongJingran, CuiZhuang, SongZhen, LiChangping, GaoTingzhi

  Chinese Journal of Hospital Statistics. 2025, 32(2): 130-135. https://doi.org/10.3969/j.issn.1006-5253.2025.02.009

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To understand the hospitalization situation of diabetic patients in Tianjin and the changing trends of the composition of their hospitalization expenses before and after the implementation of the DRG payment reform policy, and to analyze the effectiveness of the DRG policy reform and the possible existing problems. Methods Based on the medical insurance settlement data in Tianjin before and after the implementation of DRG from 2021 to 2023, the degree of structure variation (DSV), grey correlation analysis (GRA) and interrupted time series (ITS) analysis were used to study the impact of the DRG policy on the hospitalization situation and expenses of diabetic patients. Results Compared with before the reform, the emergency admission rate of hospitalized diabetic patients increased after the reform ($P < 0.001$), while the length of hospital stay, hospitalization expenses, comprehensive medical service fees, drug fees, health material fees and individual out-of-pocket expenses all decreased ($P < 0.001$). The results of DSV and GRA analysis showed that the main factors affecting the hospitalization expenses of diabetic patients were examination fees, laboratory test fees, comprehensive medical service fees and drug fees. The results of ITS analysis showed that after the DRG reform, the average inpatient expense per visit decreased by 281.50 yuan ($P < 0.001$), and the monthly growth rate reversed from 56.15 yuan before the reform to -42.51 yuan ($P < 0.001$), and the reduction rate of individual out-of-pocket expenses increased ($P < 0.001$). Except for the examination fees, the growth trends of the composition of various hospitalization expenses all reversed ($P < 0.001$). Among them, the comprehensive medical service fees had the largest reduction, and the monthly growth rate reversed from 21.68 yuan before the reform to -17.23 yuan ($P < 0.001$), followed by drug fees, laboratory test fees and health material fees. Conclusion The DRG payment method reform in Tianjin has achieved remarkable results, with obvious achievements in reducing costs and increasing efficiency, effectively reducing the economic burden on patients. However, the increase in the emergency admission rate and the still unreasonable expense structure suggest that the DRG reform still needs further optimization.
• Select
  Analysis of 819 Inpatient Death Cases in a Tertiary General Hospital from 2021 to 2023

  ZengTianfu, WuQiaoli, TongXiaoyi, MaGe

  Chinese Journal of Hospital Statistics. 2025, 32(2): 136-139. https://doi.org/10.3969/j.issn.1006-5253.2025.02.010

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To retrospectively analyze the inpatient death cases in a tertiary general hospital, so as to understand and master the death situation and causes of inpatients in the hospital in recent years, and provide a scientific and reasonable management basis for the hospital. Methods The inpatient death cases in a tertiary general hospital from 2021 to 2023 were collected and retrospectively analyzed from the aspects of age, gender, department, and disease diagnosis at death. Results There were 819 death cases in this hospital from 2021 to 2023, with a total inpatient mortality rate of 0.58%. The male-female ratio was 1.96:1, and those aged 60 and above accounted for 82.42%. The departments with the most deaths were mainly ICU, Department of Cardiology, Department of Respiratory Medicine, and Department of Neurosurgery. The top three diseases were tumors, circulatory system diseases, and respiratory system diseases. Conclusion With the aggravation of population aging, tumors, circulatory system diseases, and respiratory system diseases have become the main causes of inpatient death in this hospital, and elderly patients are the key objects that need attention.

• Select
  Case Analysis of Coding for Colonic Polyp Diseases and Surgeries and Their DRG Grouping

  YangNa, YuYan

  Chinese Journal of Hospital Statistics. 2025, 32(2): 140-144. https://doi.org/10.3969/j.issn.1006-5253.2025.02.011

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  This paper analyzes the filling and coding quality of the main diagnosis and main surgery in the medical records of intestinal polyps in the Gastroenterology Department, and explores its impact on DRG grouping. Combining with the DRG grouping results, it analyzes the possible problems in coding and explores the changes in DRG grouping before and after code correction. The study finds that the main reasons for coding errors include that clinical doctors do not pay attention to the selection and filling of the main diagnosis, coders lack clinical knowledge and coding skills, and the return time of pathological reports lags. Therefore, it is recommended to strengthen the standardized training of clinical doctors on filling the front page of medical records, improve the professional level of coders, strengthen the hospital quality control process, and establish a supervision and feedback mechanism, etc., so as to improve the accuracy of coding and the correct rate of DRGs grouping, and provide accurate data information for DRGs payment and the hospital.
• Select
  Research on Strategies for Improving the Professional Identity of Integrated Medical and Elderly Care Talents from the Perspective of Social Interaction

  He Xiaomin, Pei Mengyi, Liu Jingyu, Wang Yuelei, Zhai Xiangming

  Chinese Journal of Hospital Statistics. 2025, 32(2): 145-150. https://doi.org/10.3969/j.issn.1006-5253.2025.02.012

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective Through a systematic analysis of the current situation of the professional identity of integrated medical and elderly care talents and its influencing factors, to provide social support for enhancing the professional identity of relevant talents in integrated medical and elderly care and promoting their professional development. Methods Based on the social interaction theory, a self-designed questionnaire was combined with relevant literature. The survey was carried out around three dimensions of the research objects, namely professional cognitive evaluation, interaction influence, and future choices. Results Currently, the overall professional identity of integrated medical and elderly care talents is not high. There are statistically significant differences in the dimensions of professional cognitive evaluation and future choices in terms of age, the possession of old-age care worker certificates, and educational attainment. Conclusion It is necessary to improve the professional identity of integrated medical and elderly care talents by further strengthening social interaction, improving the professional development mechanism for integrated medical and elderly care talents, and providing personalized guidance and services.
• Select
  Analysis of Influencing Factors of Compensation Amount for Medical Mental Damage in 830 Cases

  Chen Zhuo, Yang Fengzhu

  Chinese Journal of Hospital Statistics. 2025, 32(2): 151-155. https://doi.org/10.3969/j.issn.1006-5253.2025.02.013

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To construct a medical mental damage compensation model based on Ordinary Least Squares (OLS) regression, so as to analyze the influencing factors of mental damage compensation in medical damage liability dispute cases. Methods Taking 830 medical damage dispute cases as the research objects, relevant factors were included in the OLS regression analysis through analysis of variance, and a linear regression model was constructed. Results The medical mental damage compensation model showed that the western and northeastern regions in the factor of "region" were negatively correlated with mental damage compensation (P < 0.05), while hospital liability, claimed compensation amount, and disability grade were positively correlated with mental damage compensation (P < 0.05). Conclusion The medical mental damage compensation model is simple with simplified indicators, which is convenient for judges to refer to the data. It is helpful for the pre-litigation settlement of medical disputes and further plays the role of people's mediation in doctor-patient disputes.
• Select
  Differential Analysis of the Clinical Manifestations and Influencing Factors of Acne in Adolescents of Different Genders

  Li Jie, Huang Xiaofeng, Xiao Yiying, Zhang Junhua, Ren Na, Li Haiying

  Chinese Journal of Hospital Statistics. 2025, 32(2): 156-160. https://doi.org/10.3969/j.issn.1006-5253.2025.02.014

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To compare the clinical characteristics, skin care habits in the half year before the first visit, and emotional states in the half year before the first visit of adolescent acne patients of different genders, so as to seek clinical evidence and new ideas for the individualized prevention and treatment of acne. Methods A questionnaire survey was conducted on adolescent acne patients in the dermatology outpatient departments of two Class III Grade A general hospitals in Shandong from December 2023 to March 2024. The questionnaire content included general information, clinical data, skin care habits in the half year before the first visit, emotional states in the half year before the first visit, etc., and the differences among adolescent acne patients of different genders were compared. Results There were statistically significant differences in the age of initial onset and skin care habits in the half year before the first visit among adolescent acne patients of different genders (P < 0.05), while there were no statistically significant differences in the acne affected areas, family history of inheritance, and emotional states in the half year before the first visit (P > 0.05). Conclusion The age of the first visit and the age of initial onset of adolescent acne patients are younger in males than in females. In terms of skin care habits in the half year before the first visit, there are significant differences in skin care methods between males and females. There are no obvious gender differences in the emotions of stress, anxiety, and depression in adolescent acne patients in the half year before the first visit.