ObjectiveTo understand the current situation of outpatient service, strengthen outpatient physicians management, maintain outpatient clinical order, and improve the credibility and service quality of public hospitals.MethodsThe measures such as deepening the supply-side reform of outpatient service, strengthening the awareness of integrity service, regulating suspending or substituting diagnosis service management, and optimizing doctors’ scheduling were performed to improve the outpatient service plan management since 2012. The data of outpatient diagnosis and treatment and doctor appraisals from 2013 to 2016 were retrospectively collected from hospital information system, combined with the third party satisfaction data; and the rates of suspending and substituting of outpatient service, clinical service time distribution for doctors at all levels, proportion of appointment register, and the average satisfaction index were analyzed.ResultsThe rates of suspending and substituting of clinical service reduced from 5.8% and 6.4% in 2013 to 2.5% and 4.1% in 2016, respectively, and the differences were statistically significant (P<0.05); the proportion of outpatient physicians with vice-senior title or above from 2014 to 2016 was lower than that in 2013, with the decrease from 81.0% in the morning and 73.0% in the afternoon to 75.9% and 69.1%, respectively; the proportion of appointment register increased from 54.7% in 2013 to 68.2% in 2016; the patients’ satisfaction was higher in 2016 than that in 2015.ConclusionThe outpatient service management of large general hospitals should be patients’ needs-oriented; with the awareness of integrity service, regulating the approval system of suspending or substituting of outpatient service, improving the pre-arranged planning for suspending service, optimizing the qualification admittance system, and improving the regular appraisal system, may effectively solve the problems of unbalanced outpatient physicians resources and service, maintain the good order of medical service, improve medical care quality, and raise patients satisfaction.
ObjectiveTo evaluate the efficacy, safety, and feasibility of fecal drainage technique on rectal anastomosis for preventing anastomotic leakage after operation for middle-low rectal cancer.MethodsThe retrospective analysis was used to collect the middle-low rectal cancer which completed operation in this hospital from 2014 to 2019. According to the way of preventing annstomotic leakage, the patients were divided into two groups: fecal drainage on rectal anastomosis group (Abbreviation: fecal drainage group) and end ileum prophylactic stoma group (Abbreviation: ileostomy group). The incidence of anastomotic leakage after operation and the different treatment methods following leakage were compared between the two groups.ResultsA total of 231 cases were recorded, including 84 cases in the fecal drainage group, 147 cases in the ileostomy group. There were no significant differences in the baseline data such as the gender, age, preoperative complications, operation mode, etc. between the two groups (P>0.050). There were no significant differences in the operation time, intraoperative blood loss, incision infection, postoperative intestinal obstruction, total hospitalization cost, death, anastomotic leakage (overall, each grade, treatment, and outcome) between the two groups (P>0.050). Although the length of hospital stay except the patients with anastomotic leakage in the fecal drainage group was significantly longer than that in the ileostomy group (P<0.001), there was no significant difference in the total length of hospital stay between the two groups (P>0.050), and the incidence of anastomotic stenosis in the fecal drainage group was significantly lower than that in the ileostomy group (P=0.029).ConclusionAccording to the results of this study, fecal drainage technique on rectal anastomosis is effective, safe, and feasible in preventing anastomotic leakage after operation for middle-low rectal cancer.
With the rapid development of information science and technology, the development of internet medical service is irresistible, forming a new situation of digital ecological environment of medical cloud service. However, reform and innovation of medical service mode have brought many problems and challenges to the elderly with low level of information literacy and difficult operation of information and intelligent applications on mobile phones, forming a “digital gap” with intelligent medicine. This paper analyzes the status quo of the digital divide in the elderly group, and classifies the elderly according to the pain and difficulty of the elderly wisdom, and then implements a series of online and offline aging adaptation to build a harmonious and humanistic care Internet plus medical service ecosystem for the elderly. The project is closely related to the physical and psychological transformation of the elderly, and can be used for reference.