OBJECTIVE This paper is aimed to observe the long-term result of reconstruction of wrist joint by replacing distal end of radius with vascularized fibular head in patient of giant tumor. METHODS From July 1978 to November 1993, 12 cases of giant tumor of distal end of radius were treated by this procedure and followed up for 6 months to 15 years, and the movement range of wrist, grip strength, and pain were evaluated. RESULTS The painful wrist released in 11 cases, only one case still existed mild pain and felt discomfortable. The average range of movement of wrist joint was 34.05 degree in volar flexion, 52.80 degree in dorsal extension, 26.25 degree in ulnar deviation, and 19.75 degree in radial deviation, and average grip strength was 44.6 kg. Compared with the contralateral side, there were accounted for 46.2%, 72.7%, 76.1%, 80.6%, and 76.7% respectively. CONCLUSION Replacement of distal end of radius with fibular head to reconstruct wrist joint can restore function of carpal joint, which is proved to be a safe and effective method.
Objective Through the analysis of hospital costs of 16 866 cases of patients with lung cancer in Sichuan Province, in oder to find the main influencing factors of hospital costs of patients with lung cancer, and to provide references for reducing the hospital costs of patients with lung cancer. Methods We selected information of in-patients with lung cancer in 6 hospitals in Sichuan province from January 2008 to December 2011 based on full consideration into the local economic levels geographics distribution of different regions in Sichuan province. Then we extracted baseline data, hospitalization data and costs, and then analysis on relevant influencing factors was performed using single factor analysis of variance and multiple stepwise regression analysis. Results A total of 16 918 cases are chosen, of which, 16 866 were effective for further analysis. The results of statistical analysis showed that, the cost of western medicine accounted for the most of the average of the total hospital costs (50.79%) , followed by the cost of diagnosis and treatment (40.79%). The reuslts of multiple stepwise regression analysis showed that, the top three factors influencing hospital costs most included hospital stay, operation, and regions. Conclusion Facing daily increasing costs of hospital costs of lung cancer, effectively reducing drug expenses of patients could be a breakthrough. We could ultimately reduce the hospital costs of patients with lung cancer as well as the the economic burden of patients and society, by strengthening hospital management, shortening hospital stay, and rationally regulating drug use.
ObjectiveTo investigate the distribution, service volume, and medical efficiency of private general hospitals in Sichuan Province to provide references for optimizing the allocation of health resources in Sichuan Province. MethodsUsing the 2020 data from private general hospitals above the second level in 18 cities and states in Sichuan Province, this study calculated the market concentration and competitiveness with the Herfindahl-Hirschman index (HHI). A three-stage data envelopment analysis (DEA) model was employed to eliminate environmental variables and random errors for hospital efficiency analysis. Influencing factors were conducted using a Tobit regression model. ResultsThe HHI indices for the number of licensed (assistant) physicians, beds, and total consultations in each city and state were below 1 000, indicating a low concentration market. The comprehensive technical efficiency, pure technical efficiency, and scale efficiency of private general hospitals above the second level in Sichuan Province were 0.534, 0.661, and 0.806, respectively, after the three-stage DEA analysis. The number of practicing (assistant) physicians was negatively correlated with scale efficiency. the number of beds was negatively correlated with pure technical efficiency. The total number of consultations showed a positive correlation with overall technical efficiency, pure technical efficiency, and scale efficiency. ConclusionThe provincial private hospital market exhibits low concentration competition. Differences in efficiency exist among various regions, grades, and hospital types. Market competition in resource allocation promotes the improvement of pure technological efficiency and scale efficiency. Market share competition hinders the improvement of comprehensive technical efficiency, pure technical efficiency, and scale efficiency.
An experimental study was designed on the treatment of 8 superficial burn wounds and 5 wounds after removing the split-thickness skin grafts with 200GS permanent magnetic flat dressings, and some of the wounds were chosen at random which did not received any treatment and would be served as control. It was noted that the volume of exudate in the treatment group was 11.9 50.7％ less than that of the control group, and the total protein, the albumin and globulin contents in the treatment cases were far less in exudate than those of the control cases. It was concluded that the magnetic therapy not only decresed the exudate, but also diminished the amount of total protein, albumin and globulin in the exudating fluid and it was of benefit to wound recovery.
In 2021, West China Hospital of Sichuan University established a rare disease diagnosis and treatment and research center. The center adopts the rare disease management model of “one cohesion + four integration”, condenses the core of management, integrates clinical resources, regional alliance resources, training resources and research resources, and explores solutions for all-round services for patients with rare diseases. This article aims to explore the rare disease management model of regional central hospitals and introduces the above-mentioned rare disease management model. The purpose of this article is to promote this model, focus on the advantages of clinical departments and research institutes (offices), increase regional integration, give play to the synergy of regional alliances in clinical diagnosis and treatment and personnel training, and use international cooperation as an opportunity to promote breakthroughs in new drugs and technologies for rare diseases to benefit patients with rare diseases in China.
The interrupted time series analysis was used to evaluate the incentive effect of the management methods of the SCI thesis fund for scientific research in West China Hospital of Sichuan University. We found an increase in number of the SCI papers and the growth rate after the adoption of scientific research incentive measures, indicating that the management methods of the SCI thesis fund had the incentive effect of scientific research. The interrupted time series analysis could be used in the incentive analysis of scientific research.
The prevention and control of COVID-19 has entered a critical moment. “Disease control of 2019 novel coronavirus infection in hospital: West China urgent recommendation” based on the best available evidence and expert experience, provided emergency recommendations for key clinical issues in hospital prevention and control during the COVID-19 epidemic. This recommendation with strong reference value and timeliness is worth learning for hospital managers, sensory control personnel and medical staff at all levels. All medical institutions should establish an emergency response mechanism to accelerate the formation of medical teams and strengthen the protection of medical staff and hospital infection control. We should enhance the implementation of policy and reinforce risk assessment. It is essential to strengthen the implementation of various prevention and control measures as well as risk assessment so as to eventually win the battle of coronavirus infection as soon as possible.
Objective To Provide statistical references for disease-based payment reform with Diagnosis Related Groups (DRGs). Methods Based on 1 969 stroke inpatients from two hospitals in Chongqing city, we used classification and regression trees (CART) of decision tree to establish classification regulations of the case-mix model for stroke inpatients, and multivariate statistical model to evaluate whether the case-mix could provide a satisfactory prediction to costs for stroke inpatients in comparison with the foreign model. Results ① The classification nodes of our model were surgical procedure, nursing care degree, and hospital infection respectively by which 1 969 stroke inpatients were divided into 5 groups. The classification nodes in foreign model were surgical procedure, age≥50 years, and whether patients would refer to other institutions after leaving the hospitals by which 1 969 stroke inpatients were also classified into 5 groups. ② For medical institutions and the third payers, we found that the data from our model could explain 80.46% of the total costs and 16.58% for individual inpatient, which were higher than that of foreign model (76.87% for medical institutions and the third payers, 9.13% for individuals ). Conclusions Compared with foreign model, our model is more suitable for the situation in China. The study is only based on 1 969 stroke inpatients from south west part of China, so the conclusion needs further studies to confirm.
Objective To investigate inpatients disease constitution, costs and rational drug use in the Karamay Central Hospital in 2014 and provide baseline data for further evidence-based study. Methods The information of disease classification, single disease drug use and expenditure of inpatients in 2014 were collected from the Hospital Information System (HIS) of Karamay Central Hospital. We classified the diseases according to the international classification of diseases coding (ICD-10), and analyzed the data by Microsoft Excel 2007 software including frequency, proportion, cumulative proportion and sample average. Results ① A total of 24 936 inpatients in 2014 were included, with male to female ratio being 0.96 to 1 and minority rate being 22.95%. The top three systematic diseases were respiratory diseases, diseases concerning pregnancy, child birth and puerperium and circulatory system diseases respectively; ② The top three age groups were 25 to 59, ≥60 and 0 to 4 respectively; ③ The top three costs per capita of single disease were pulmonary infectious, tumor chemotherapy and symptomatic treatment respectively; the top three western medicine costs per capita were tumor chemotherapy, symptomatic treatment and pulmonary infection; the top three Chinese medicine costs per capita were chronic kidney disease (CKD), angina and ischemic stroke. Conclusion The single diseases ranking and percentage of inpatients in 2014 of Karamay Central Hospital were different from the disease burden of Xinjiang Uygur Autonomous Region, the country and even the whole world. Based on the above results, the respiratory diseases and circulatory diseases were selected as the systematic evidence-based pharmacy study goal.
Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.