25 August 2015, Volume 22 Issue 4

    

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Orignal Article
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  Change of outpatients′ visits of health institutions and the causes

  Cai Min, Qian Juncheng

  journal1. 2015, 22(4): 241-244. https://doi.org/10.3969/j.issn.1006-5253.2015.04.001

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  Objective To learn about the change of outpatients′ visit behavior status, to analyze the reason, and to provide reference for guiding patients′ visit behavior around HSR. Methods Using the data of the 4th China National Health Services Survey in 2008 and Health System Reform evaluation survey in 2011, we analyzed the change and influencing factors associated with outpatients′ visit behavior. Results Three years after HSR, more outpatients saw doctors at basic institutions. Conclusion The policy of HSR is good for more outpatients visit at basic institutions, but further consideration about how to make outpatients stay in basic institutions should be considered.
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  Influencing factors on psychosomatic mental health of the medical college students

  Meng Weijing, Gao Peng, Wang Suzhen

  journal1. 2015, 22(4): 245-248. https://doi.org/10.3969/j.issn.1006-5253.2015.04.002

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  Objective To analyze the condition and influence factors of the psychosomatic health in medical college students and supply the support to conduct the targeted mental health education. Methods A total of 669 students from a medical college were measured by using self-designed question-naire and Symptom Checklist 90. Results Symptom Checklist 90 had good reliability and validity indicators. About 26.61% of medical college students had compulsion symptom, which was the biggest proportion. The proportion from high to low was interpersonal sensitivity, depression, psychotieism, paranoididefition, anxiety, hostility, somatization, photic anxiety. Mean scores of compulsion, depression, anxiety, phobia anxiety, psychoticism were higher than Chinese youth norm. The differences were statistically significant. Mean scores of female depression, anxiety, phobia anxiety were higher than those of male. The differences of hostility, phobia anxiety, paranoid ideation were statistically significant among different grades. Through POSTHOC multiple comparison by SNK-q test, the results showed the score of hostility factor for grade 3 was higher than those of grade 1, 2 and 4. At the same time, the score of phobia anxiety factor for grade 1 was higher than that of grade 4 and the score of paranoid ideation factor for grade 3 was higher than that of grade 1. The results of logistic regression analysis showed that family residence, physical exercise, breakfast times per week, fruits and vegetables per day, staying up late per week, surfing the Internet per day were Influencing factors. Conclusion More attention should be paid to mental health of medical college students. Mental health promotion activities should be developed according to mental health status of medical college students.
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  Investigation analysis on psychological status and somnipathy of irritable bowel syndrome patients

  Lu Qunfang

  journal1. 2015, 22(4): 249-250. https://doi.org/10.3969/j.issn.1006-5253.2015.04.003

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  Objective To explore the characteristics of anxiety, depression and sleep of irritable bowel syndrome (IBS) patients, and reveal its intrinsic relationship. Methods 45 IBS patients were chose as case group and 45 healthy people were chosen through health examination as control group. With self rating anxiety scale (SAS), self-rating depressive scale (SDS) and pittsburgh sleep quality index scale (PSQI), we investigated the two subjects, and then compared the incidence rates of anxiety, depression and somnipathy, and scores of sleep quality between the two groups. Results The incidence rates of anxiety, depression and somnipathy in the IBS group were respectively 28.9%, 40.0% and 48.9%, all much bigger than those of the control group (respectively 8.9%, 11.1% and 17.8%, all P<0.05). Scores of sleep quality, daytime dysfunction, somnipathy and sleeping pills in the IBS group were much higher than those of the control group (P<0.01), but there were no statistical significance about the time falling asleep, bed time and sleep efficiency between the two groups (P>0.05). Conclusion IBS patients had fairly severe anxiety, depression and somnipathy, and their total sleep quality was worse than healthy population. So we should carry out comprehensive intervention measures in clinical treatment.
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  Investigation on correlated risk factors of the incidence of vascular dementia of old patients

  Zhang Yingzhong

  journal1. 2015, 22(4): 251-253. https://doi.org/10.3969/j.issn.1006-5253.2015.04.004

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  Objective To explore the correlated risk factors of the incidence of vascular dementia (VD) of old patients, and to provide basis for early preventing, diagnosing and treating of this disease. Methods With case control study method, 84 cases of VD patients and 84 cases of non-VD patients respectively accepted questionnaire investigation. Single factor analysis and multiple factors analysis were used to screen risk factors of VD. Results Single factor analysis results showed that the indexes of these factors such as age, physical fitness, hypertension, heart disease, diabetes mellitus, hyperlipoidemia, hyperhomocystinemia, atherosclerosis, chronic cardiopulmonary disease, anaemia and depression in the case group were much higher than the those of the control group (P<0.05). Multiple factor analysis results showed that the risk factors of VD included hypertension (OR=3.346), heart disease (OR=6.263), diabetes mellitus (OR=4.890), hyperhomocystinemia (OR=2.946), chronic cardiopulmonary disease (OR=3.421) and depression (OR=2.520). Conclusion The independent risk factors of VD contain hypertension, heart disease, diabetes mellitus, hyperhomocystinemia, chronic cardiopulmonary disease and depression. We should early prevent and treat VD in case of the changeable risk factors.
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  Assessment and analysis on the equalization of hospitalization costs in 11 city of Shanxi in 2011

  Wu Fei, Niu Lina, Meng Pan, Tan Kai, Han Ying, Yan Fengru

  journal1. 2015, 22(4): 254-257. https://doi.org/10.3969/j.issn.1006-5253.2015.04.005

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  Objective To evaluate the equalization of hospitalization cost in 11 city in Shanxi, to provide the theoretical basis for promoting the equalization of basic and public health services in steps, and to put forward suggestions on how to effectively control the rapid increase of medical expenses. Methods Based on the data provided by the Information Management Center of Health Department in Shanxi, 7 indicators related to the hospitalization costs of 11 cities of Shanxi were selected. Microsoft Excel was used for data analysis. Results In 5 types of hospitalization expenses of the 11 cities in Shanxi Province in 2011, the average medical cost was higher in Taiyuan and Yangquan than the average level of Shanxi and this cost was lower in Shuozhou, Xinzhou, Lvliang and other cities. The average operation cost per inpatient was higher in Taiyuan, Changzhi, Jincheng than the average level of Shanxi, but it was lower in Shuozhou and Xinzhou. The average hospital bed charge was higher in Taiyuan and Datong than the average level, but it was lower in Xinzhou and Lvliang. Medicine cost accounted for about 43% in the constituents of the hospitalization expenses of Shanxi between 2008 and 2011, but the proportion of examination cost was increasing and treatment and operation cost were decreasing since 2009. Conclusion In general, the hospitalization cost is unequal among 11 cities in Shanxi. We should take effective measures to promote the equalization for rural and urban residents, therefore, to meet the current needs of deepening the reform of the health system, and to improve the fairness of the basic public health services.
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  Application research of diagnosis related groups in performance management system of a hospital

  Miao Liqiong, Shan Desheng, Li Li, Zhu Hongyuan, Ke Jiang, Li Xiaocui, Yang Qing

  journal1. 2015, 22(4): 258-260. https://doi.org/10.3969/j.issn.1006-5253.2015.04.006

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  Objective The Diagnosis Related Groups (DRGs) were studied to explore it′s application in performance management system of a hospital. Methods We built the performance evaluation system based on medical business index, efficiency indicator, cost control index, drug control index, medical quality and medical safety index by the way of extracting the home page of hospital discharge record from 2009 to 2013 and grouping automatically with the ″BJ-DRGs″ grouping machine. Results Since the introduction of DGRs for performance management, the evaluation index of the hospital′s business has been improved. The quantity, quality, efficiency indicators and so on of the medical service in the hospital have been perfected. The work efficiency has been improved. The DGRs has effective control of the growth rate of the medical expense. It promoted the orientation of the medical service and made it change from the economic type to the social pattern, to achieve the central targets of the hospital, which was better quality and the higher efficiency. Conclusion The introduction of DRGs achieved great effect in the hospital performance appraisal system.
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  Comparative analysis for outpatient waiting time based on logistic regression model

  Zhong Jianliang, Chen Caier, Pei Jingbo, Cao Lijun, Lu Youchuan, Wang Gang

  journal1. 2015, 22(4): 261-264. https://doi.org/10.3969/j.issn.1006-5253.2015.04.007

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  Objective To explore the methods of comparative analysis for outpatient waiting time. Methods We collected outpatient waiting time data from the HIS system database, with the use of SPSS software established the regression model between waiting time and waiting success rate, then according to the regression model, plotted the regression curve, and on the basis of the regression model and the regression curves, combined with the conventional statistical index, average, median etc, evaluated outpatient waiting time. Results For evaluating outpatient waiting time, the regression model index was consistent with the conventional statistical index, so the regression model was effective, the evaluation was reasonable. Conclusion Both the regression model index and the conventional statistical index can evaluate outpatient waiting time. They are complementary and can confirm each other, and the evaluation results are comprehensive and intuitionistic. So it is a new method for evaluating outpatient waiting time.
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  Using weighted TOPSIS method to evaluate job performance of hospital clinical departments

  Qi Aiqin, Peng Kai, Gao Yong,Shi Dewen

  journal1. 2015, 22(4): 264-266. https://doi.org/10.3969/j.issn.1006-5253.2015.04.008

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  Objective Using weighted TOPSIS method to evaluate job performance of hospital clinical departments, to provide a reliable basis for decision-making of the hospital management. Methods Having a comprehensive evaluation and horizontal comparison of 27 clinical departments′ job performance of a hospital in 2012,using weighted TOPSIS method from three aspects, the working efficiency, quality of medical work and economic denefit. Results Evaluation results consistent with the actual situation of the hospital, in the 27 departments, ICU have the best job performance evaluation, Obstetrics secondly, Respiratory Medicine worst. Conclusion Weighted TOPSIS method is simple, reasonable, flexible and suitable to promote and apply in job performance evaluation of clinical departments in hospitals.
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  Case control study on correlated risk factors of operation on urinary system complicated with urinary tract infection

  Pan Diqing, Shao Faming

  journal1. 2015, 22(4): 267-269. https://doi.org/10.3969/j.issn.1006-5253.2015.04.009

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  Objective To explore the correlated risk factors of operation on Urinary System complicated with Urinary Tract Infection, and to provide basis for preventing and treating the infection. Methods We retrospectively chose 345 cases of operation on urinary system, according to the happening of urinary tract infection after 6 weeks of operation, divided them into infection group and non-infection group. Correlated risk factors possibly causing urinary tract infection after operation were collected, and risk factors were screened by single factor and multiple factors analysis methods. Results The incidence rate of operation on urinary system complicated with urinary tract infection was 11.9% (40/345). Single factor analysis showed that age, combined with diabetes mellitus, urinary tract infection of anamnesis, use of antibiotic before operation, diagnosis and treatment of traumatic, trauma score, time of catheter indwelling, length of stay and residual urine of leaving hospital influenced the incidence of urinary tract infection. Multiple factor analysis results showed that urinary tract infection of anamnesis (OR=2.878), diagnosis and treatment of traumatic (OR=3.019), trauma score (OR=2.631) and time of catheter indwelling (OR=3.367) were the risk factors of urinary tract infection, while the use of antibiotic before operation (OR=0.268) was the protective factor of urinary tract infection. Conclusion The incidence rate of operation on urinary system complicated with urinary tract infection is a little high, and we should control infection before and after operation, decrease traumatic diagnosis and treatment, and reduce the incidence of urinary tract infection after operation.
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  Correlation between serum vitamin D level and disease severity and disease control in children with asthmatic

  Zhu Bijun, Zhang Chengwei

  journal1. 2015, 22(4): 270-273. https://doi.org/10.3969/j.issn.1006-5253.2015.04.010

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  Objective To investigate the correlation between serum vitamin D₃ level and disease severity and disease control in children with asthmatic. Methods 144 cases of children with asthma were divided into mild intermittent group (n=35 cases), mild group (n=36 cases), moderate group (n=48 cases) and severe group (n=25 cases) according to the degree of the disease, and 50 cases of healthy children were selected as control group. Serum 25-(OH)D₃ level was detected in control children and asthma children and the childhood asthma control test (C-ACT) was used for evaluation of children with asthma control after 4 weeks treatment. All asthma children were divided into not controlled group, partly controlled group and completely controlled group according to the C-ACT, and serum 25-(OH)D₃ levels were compared between groups. Results There were statistically significant differences in serum 25-(OH)D₃ levels among the control group, mild intermittent group, mild group, moderate group, and severe group (P<0.05), and from control group to severe group serum, serum 25-(OH)D₃ levels gradually decreased (P<0.05). There were statistically significant differences in serum 25-(OH)D₃ levels among not controlled group, partly controlled group and completely controlled group (P<0.05), and from completely controlled group to not controlled group, serum 25-(OH)D₃ levels gradually decreased (P<0.05). Spearman correlation analysis showed that serum 25-(OH)D₃ level was negatively correlated with disease severity (r_s=-0.489, P<0.05), and serum 25-(OH)D₃ level was also negatively correlated with C-ACT score (r_s=-0.470, P<0.05). Multivariable logistic regression analysis showed that risk ratio of asthma children with severity and C-ACT score <19 points of value increased gradually when the serum 25-(OH)D₃ level decreased. Conclusion Serum 25-(OH)D₃ level is closely related to asthmatic severity and disease control, and early detection of serum vitamin D level has a certain significance in evaluation asthmatic severity and recent prognosis in children with asthma.
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  Management and countermeasures of health examination report error

  Luo Jia

  journal1. 2015, 22(4): 274-275. https://doi.org/10.3969/j.issn.1006-5253.2015.04.011

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  Objective To analyze the causes of health examination report errors and identify appropriate countermeasures. Methods Selected 1 146 reports in 2013 and 1 468 reports in 2014 in the health management of hospital medical centers for a retrospective analysis, and compared complaints and physical examination report errors before and after strengthening health report management. Results In 2013 the health examination complaints accounted for 1.17% of the total number of medical records, significantly higher than 0.58% of 2014, and the difference was statistically significant (P<0.05). Before strengthening the management of medical reports, the medical examination report errors were significantly more than those after strengthening the medical report management, and the differences were statistically significant (P<0.05). Before strengthening the management of medical reports, the incidences of errors such as illegible report words, writing errors, and incomplete conclusion and incidence of total errors were significantly higher than those after strengthening medical report management, and the differences were statistically significant (P<0.05). Conclusion Increasing the degree of attention of medical personnel, formulating the corresponding perfect rules and regulations, and adopting detailed report template are the main means to reduce medical examination report errors.
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  Epidemiological characteristic analysis of 4 523 patients with psoriasis vulgaris

  Zhao Na, Wu Weizhi, Pan Futang, Wei Baojian , Dong Lu , Yang Ping

  journal1. 2015, 22(4): 276-279. https://doi.org/10.3969/j.issn.1006-5253.2015.04.012

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  Objective To investigate and summarize the epidemiological characteristics of patients with psoriasis vulgaris in the clinic of a hospital for skin diseases. Methods A epidemiology investigation was performed on 4 523 patients with psoriasis vulgaris in a Hospital Information System (HIS) data base of a hospital for skin diseases. SPSS 17. 0 were used for statistical analysis. Results The ratio of male to female in the group was 1.43∶1. The average of the first onset ages was 26.99± 13.74. 83.53% patients had early age onset while 16.47% had late age onset. The average course of all the patients with psoriasis was 7.43±8.65 years. The most common affected parts were lower limbs 89.74%. The most common lesion shape was plaque type 47.29%. 57.42% patients were in the stable stage. 24.23% patients had a family history of psoriasis. 26.18% early-onset patients and 13.83% late-onset patients had a family history. Statistic analysis showed that there was significant differences between the two groups (P＜0.05). The most common inducing factor was biological factor (43.99%). Most patients suffered from the disease in winter (47.88%) or spring(47.31%);14.87% patients had joint symptoms and 5.81% patients were confirmed with psoriasis arthritis. Conclusion Male patients were more than female ones in the group. The number of early-onset patients was more than that of the late-onset patients. Most patients had a long course. The most common affected parts were limbs. Chronic plaques psoriasis was the most common. Most patients were in the stable stage and were mild and moderate. The rate of the family history in the early-onset patients was more than that of late-onset patients. Biological factor and season factor were the most common inducing factors in the group. Patients with joint symptoms may have a probability combined with psoriasis arthritis.