目的 通过应用数据包络分析（DEA）方法对医院科室运营效率进行评价，分析DEA方法在医院临床科室相对效率评价中的价值。 方法 采用聚类分析等确定投入产出指标，采用DEA方法中C2R和BC2模型对2004年1月－2008年12月各科室相对效率进行评价和分析。 结果 70个被评价单元中有41个被评价单元的总体有效值为1，属于相对有效单元；29个被评价单元的C2R模型总体有效值＜1，属于相对无效单元。 结论 DEA方法适用临床科室相对效率评价多投入、多产出的特点，能够有效识别被评价单位中的无效单元，并且对于投入产出值能够指明导致无效的方向和需调整的程度，指导相关管理部门对科室的调整和资源投入方向。
At present, the rapid integration and development of internet technology and medical services have made internet diagnosis and treatment an important part of medical services, and it is also an inevitable development trend of future diagnosis and treatment services. In order to meet the needs of patients for more timely, accurate and convenient medical treatment, West China Hospital of Sichuan University has innovated the internet diagnosis and treatment mode, adopted the innovative mode of diversified online services, pre-treatment mode, expert team mode, specialized medical consortium platform and whole process management, optimized medical resources and structure, promoted regional medical association linkage, and improved patients’ medical experience. The West China Internet Hospital of Sichuan University takes the whole process ecological closed-loop of “medical+health” as the goal, has greatly improved the efficiency and quality of diagnosis and treatment, which is of great significance for the positioning and development of internet hospital. This article will share the construction experience of West China Internet Hospital of Sichuan University.
ObjectiveTo understand the inpatient classification and influence factors of hospitalization expenses, so as to provide basis for hospital management. MethodsThe diagnosis and treatment data of inpatients in a grade A tertiary hospital in 2013 were collected, the percentile method were used to describe the expenses distribution, the K-means clustering method was applied to classify the inpatients, the rank-sum test was utilized to analyze the differences of the costs among different groups, ICD-10 was applied to analyze the diseases distribution, and the median regression was used to analyze the influence factors. ResultsThere were 175 333 inpatients in total. The median of the expenses was 10 016.31 yuan RMB. The inpatients might be classified into seven groups with different expenses (P=0.0001). For inpatients who had no "blood transfusion cost", the top three factors of cost category were operation, laboratory test, examination; for who had "blood transfusion cost", the top three factors of cost category were blood transfusion, laboratory test, examination. There were 2 147, 2 182, 1 499, 1 301, 2 059, 22 and 14 kinds of diseases (ICD-10 four-digit code) respectively among the seven groups. The influence factors could be summarized into patient-related and diagnosis & treatment-related ones. ConclusionThe costs of operation, blood transfusion, laboratory test, and examination affect the inpatients classification greatly. The results could be of help to inform the admission of patients, the expense control and the disease management.
It's common that general rules exist in a certain classification. The general rules of expense classification enable us to judge the category of a patient as soon as possible and to curb the expense. Theory of rough set helps us reach the best reduction of attributes. Based on the core attributes, classification rules are put forward by value reduction. The results show that 10 core attributes remain in 21 attributes of 1527 inpatients' information and 76 classification rules are founded. All of 76 rules guide classification of the patients. 44 of the 76 rules define the only category of a patient, the other 32 rules defines the potential catagories of a patient. Meanwhile, equal attributes of the same category are summerized to guide the cost control of patients. The results indicate that the theory of rough set is effective in attributes reduction and rule generalization of patient expense classification, and it has important significance on medical practice.
With the fast advancement of information technology and artificial intelligence, the conventional medical service model has been presented with new growth potential. Internet-based health care has become one of the unavoidable future delivery methods for diagnostic and therapeutic services. Internet-based hospitals are being deployed in medical facilities throughout. The extension of offline to online diagnosis and treatment will need new standards for the personal competency of physicians as well as new requirements for medical education and staff training. In the context of universal Internet diagnosis and treatment, research on the full-cycle training of medical talent will play a clear guiding role in the development of physicians’ skills. By evaluating the relevant literature on competence model and interviewing the behavior events of working physicians in e-hospitals, together with the real situation of current medical students and doctor training barriers, this article aims to improve the quality of remote healthcare via provide related path for enhancing the periodic medical education based on the competency variables.
ObjectiveTo summarize the experience of earthquake rescue with the help of wise information technology.MethodsThe Jiuzhaigou earthquake of magnitude 7.0 occurred at 21:19 on August 8th 2017. Three hours and 38 minutes after the earthquake, a triad model of remote consultation, mobile video consultation and mobile text consultation was established to assist the earthquake rescue based on the mobile on-line medical consultation application and telemedicine center in West China Hospital. Patients classification, primary diagnosis, psychological counseling, victims searching were done by this novel rescue model.ResultWithin 72 hours after the earthquake, there were 114 doctors taking part in the earthquake rescue, including 4 remote consultations (hospital to hospital), 7 video consultations (doctor to victim), 487 mobile text consultations (doctor to victim), and 32 cases of which were highly relative to earthquake rescue, including one case of positioning for victim-searching.ConclusionThe triad model of earhquake rescue which was first initiated by West China Hospital played an important role in assisting earthquake rescue and achieved good results.