Objective To systematically review the impact of Beijing's comprehensive reform of medical consumption linkage on medical expenses, hospital services, and hospital income. Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, and Web of Science were searched to collect empirical research on evaluating the impact of Beijing's comprehensive reform of medical consumption linkage on patient medical expenses and hospital operation (service volume and income structure) from June 15th, 2019 to August 15th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature and extracted data. Results A total of 23 studies were included, and most of them found a relatively small change in the average outpatient and emergency medical expenses after the reform. However, the average inpatient expenses in some hospitals showed an increasing trend; the service volume of most hospitals increased slightly, and the income structure was optimized (e.g., surgery and other medical technology services revenue and its proportion increased). Conclusion The comprehensive reform of the medical consumption linkage in Beijing is the practice of deepening the reform of the medical service price mechanism. Based on the summary of the reform effect, it is recommended to further improve the price mechanism, improve service quality, and promote hierarchical diagnosis and treatment.
Objective To investigate a suspected outbreak of hospital-acquired infections caused by Mycobacterium chelonae related to flexible bronchoscope (hereinafter referred to as “bronchofibroscope”) and apply targeted high-throughput sequencing (tNGS) technology for etiological analysis, providing references for controlling hospital infection outbreaks. Methods A retrospective survey of patients who were detected with Mycobacterium chelonae through tNGS testing of bronchoalveolar lavage fluid (BALF) after bronchofibroscopy at the Zhengdong District, People’s Hospital of Henan University of Chinese Medicine, People’s Hospital of Zhengzhou between May 1, 2018 and March 18, 2024. The causes were investigated through comprehensive measures including on-site epidemiological surveys and environmental health assessments, and intervention measures were developed and evaluated for effectiveness. Results A total of 52 patients were included. Mycobacterium chelonae was detected in 30 patients, nosocomial infection was excluded in all cases. The suspicious contaminated bronchofibroscope lavage fluid and its cleaning and disinfection equipment, environment and other samples were collected. The traditional microbial culture results were negative. The tNGS results showed that Mycobacterium chelonae was detected in bronchofibroscope lavage fluid (sequence number 156), and all the patients with Mycobacterium chelonae detected in BALF used the bronchofibroscope. It was judged that this event was a pseudo-outbreak of nosocomial infection caused by the contamination of bronchofibroscope with the patient’s BALF. After three months of continuous follow-up after the comprehensive control measures were taken, Mycobacterium chelonae was not detected by tNGS in bronchofibroscope lavage fluid or patients’ BALF. All patients in the hospital improved and discharged without any new cases. The pseudo-outbreak of nosocomial infection was effectively controlled. Conclusions There are many links in the reprocessing of bronchofibroscope, which is easy to cause pollution, and the management needs to be strengthened. tNGS detection has the characteristics of high efficiency, few background bacteria and clear pathogen spectrum, which can be used as a supplementary means for the investigation of nosocomial infection outbreaks, and is of great significance for identifying the source of infection and determining the transmission route.
ObjectiveTo study the current situation of WeChat public platforms in 15 provincial hospitals in Hubei Province.MethodsWe searched the website of National Health Commission of the People’s Republic of China, website of Health Commission of Hubei Province, and the official website of each hospital. The WeChat public platforms of 15 provincial hospitals in Hubei Province was determined as the research object. Samples were taken in July, 2019 and the observation cut-off point was on October 30, 2019. All the contents released by the WeChat public platforms in July were counted. Literature research, descriptive statistics, content analysis, WeChat transmission index analysis, observation indicators and other methods were used for analysis and research.ResultsAmong the 15 hospitals, 14 hospitals (93.3%) had established 20 WeChat public platforms, and 5 hospitals (33.3%) simultaneously opened service accounts and subscription accounts. The functions of serving the patients’ medical experience mainly included identity registration, appointment registration, information inquiry, patient feedback, intelligent medical guidance, etc. WeChat tweets were mainly divided into 38.0% of popular medical science, 11.4% of hospital news, 15.8% of medical service, 13.6% of party and government construction, and 21.2% of patient interaction. The monthly push times of 6 WeChat public platforms (30.0%) were less than 4 times. The monthly original rate of WeChat public platform tweets was 16.3%. Among the top 10 WeChat public platforms in the WeChat communication index, 8 (80.0%) were service accounts. There was a big gap in the dissemination effect of tweets.ConclusionsThe WeChat public platform of provincial hospitals in Hubei Province has problems such as single type of WeChat public platform, imperfect service functions, unreasonable tweets frequency, insufficient originality of tweets, and uneven communication effects. It is necessary to enrich platform types, improve platform functions, ameliorate the frequency of tweets, improve the originality of tweets, and pay attention to communication effects.
ObjectiveTo explore the current situation of nosocomial infection, sample test and use of antibiotics in the in-patients, so as to provide scientific evidence for control and prevention of nosocomial infection. MethodsBedside investigation and medical records checking were adapted to conduct cross-sectional survey among all the in-patients in 2013 and 2014. ResultsOn July 16 th, 2013 (00:00-24:00) and September 10 th, 2014 (00:00-24:00), a total of 1 400 in-patients were investigated in whom 68 with nosocomial infection were diagnosed, with a prevalence rate of 4.86%. No statistical difference were found between the two year's prevalence rate (χ2=1.341, P=0.264). The prevalence rate of Intensive Care Unit, Department of Neurosurgery (including Department of Thoracic Surgery) and Department General Surgery ranked the first three places, and the most common infection position was respiratory tract (61.76%). The usage rate of antibiotics was 48.00% in the two years, and no statistical difference was observed in the usage rate between the two years (χ2=1.309, P=0.261). Therapeutic use (67.86%) and onefold use (90.33%) accounted for most of antibiotics use. Test rate of therapeutic antibiotics use was 49.17% and no statistical difference was observed in the test rates between the two years (χ2=2.023, P=0.170). ConcluslonsThe nosocomial infection rate was stably high in the two years. To prevent and control nosocomial infection effectively, medical personnels knowledge and skills on nosocomial infection should be improved, surveillance and guidance towards key departments should be strengthened and clinicians' diagnosis and treatment behaviors should further be regulated.
Objectives To compare the differences of the medical charity donations between at home and abroad in West China Hospital of Sichuan University, so as to provide the evidence for the management and development of medical charity in West China Hospital and China. Methods A cross-sectional study was conducted to investigate and analyze the current situation and problems of the medical charity donations at home and abroad in West China Hospital from January 2005 to December 2006. Results The total amount of the charity funds at home and abroad was 2.043 mill ion and 14.6 mill ion, respectively. The main target diseases of domestic donation were tumor, hematologic disease, dangerous and severe diseases and congenital heart disease, which accounted for 43.3%, 35.9%, 15.8% and 1.0%, respectivley. While the main targeted interventions and diseases of overseas donation were hearing rehabilitation, prosthetic replacement, cataract and congenital heart disease, which took up 52.1%, 27.4%, 13.7% and 6.8%, respectively. Conclusions There are differences in the amount of charity funds, target diseases, behavioral motivations, organizations, objectives and criteria of the charity donation between the donations at home and abroad. It would probably cause the problems in recruitment, distribution and monitoring of the charity funds. It is suggested that the hospital management committee of charity funds and the related law to regulate the charity behaviors should be developed.
目的 探讨局部麻醉（以下简称局麻）腹股沟疝无张力修补术在基层医院的应用价值。方法 分析内蒙古医学院附属人民医院2010年10月至2011年12月期间242例行局麻腹股沟疝修补手术患者的临床资料。结果 除1例因过度紧张而停止手术外，其余手术顺利。平均手术时间50min，所有患者术后0.5～4h （平均2h） 均能下床活动，切口疼痛时间0.5～1d。无一例发生尿潴留；12例患者术后阴囊轻-中度水肿，切口感染1例。全部病例术后观察1～2d出院。门诊随访2～15个月（平均8个月），复发2例。结论 局麻下腹股沟疝无张力修补术安全、疼痛轻微、禁忌证少、复发率及费用低，值得在基层医院推广。
摘要:目的:探讨基层医院开展急诊经皮冠状动脉支架植入术(PCI)治疗急性心肌梗死(AMI)的可行性、安全性。方法:回顾分析2002年11月~2009年4月我院41例AMI患者的急诊PCI资料。结果:41例AMI患者,急诊开通梗死相关动脉(IRA)39例(即时成功率95.1%),开通IRA者中术后死亡2例(死亡率4.9%),总成功率90.2％。结论:在有条件的基层医院开展急诊PCI安全有效。Abstract: Objective: To explore the feasibility and safety of primary percutaneous coronary intervention in patients with acute myocardial infarction in elementary hospital. Methods: The clinical data of 41 AMI patients who underwent emergent PCI from November 2002 to April 2009 were retrospectively analyzed. Results: Among the 41 AMI patients referred to PCI, infarctrelated arteries were recanalized in 39 cases. The immediate success rate was 95.1%. 2 cases of them died. The total success rate was 90.2%.Conclusion: Emergent PCI is safe and effective in the hospitals which could carry out PCI.