ObjectiveTo compare the intraoperative, postoperative indicators and economic costs of varicose veins patients between day surgery and inpatient surgery, and to explore the safety and benefit of large-scale varicose veins day surgery in China.MethodsA retrospective study was conducted to collect varicose veins patients in West China Hospital of Sichuan University from January 2016 to January 2019. Patients were divided into the day surgery group and the inpatient surgery group, and the subjects were matched by the propensity score matching (PSM) method according to the basic characteristic data. Intraoperative and postoperative indicators and economic costs were compared between the two groups.ResultsA total of 1 806 varicose vein patients were enrolled in the study, and 502 patients were enrolled in each of the two groups after PSM matching. After matching, there were no statistically significant differences in gender, age, nationality, marriage status, working status, residence, number of operative legs, medical insurance type, grade of American Society of Anesthesiologists, and complications (including hypertension, diabetes, coronary heart disease, and respiratory system diseases) between the two groups (P>0.05), which were comparable and the differences were not statistically significant. Compared with the inpatient surgery group, the day surgery group had shorter hospital stay, less intraoperative infusion volume, lower total cost, bed cost, nursing cost, drug cost, examination cost, medical insurance, and out-of-pocket (P<0.05). ConclusionThe varicose veins day surgery is not only safe and effective, but also can reduce the medication insurance payment.
ObjectiveTo investigate the factors that influence Chinese residents, self-rated health and the effects of the multilevel health insurance system and neighborhood social capital on self-rated health. MethodsBased on the 2018 China labor-force dynamics survey data, and Stata 15.0 software was used to conduct χ2 test, univariate analysis and multiple logistic regression model were used to analyze the influencing factors of self-rated health of Chinese residents. An interaction model was used to analyze the interactive effects of the multilevel health insurance system and the social capital of the neighborhood on self-rated health. ResultsA total of 10 201 people were investigated in this study, and 39.20% of them were self-rated unhealthy. After adjusting for confounders, the results of the multivariate logistic regression model showed that having social health insurance (OR=0.8, 95%CI 0.7 to 1.0) and having neighborhood social capital (OR=0.7, 95%CI 0.6 to 0.8) were more inclined to self-rated health. In addition, the results showed that being male, having a college degree or higher, having a job, and drinking alcohol increased the risk of self-rated unhealthy (P<0.05); whereas being 45-59 years of age, 60 years of age or older, in the central and western regions, exercising regularly, and having a disease or injury within two weeks decreased the risk of self-rated unhealthy (P<0.05). There was a positive multiplicative interaction effect between health insurance and neighborhood social capital on residents’ self-rated health (univariate: OR=1.5, 95%CI 1.1 to 3.7, P<0.05; multivariate: OR=1.7, 95%CI 1.2 to 2.4, P<0.05), and negative additive interactions (RERI=−0.8, 95%CI −1.4 to −0.1; AP=−0.3, 95%CI −0.6 to −0.1; SI=0.6, 95%CI 0.5 to 0.8). ConclusionAttention should be paid to the self-rated health status of key populations through means such as health promotion and education, and healthy behavior lifestyles should be promoted. The health insurance system should be further improved, and attention should be paid to the role of social capital in the neighborhood, encouraging residents to actively build a good social neighborhood, and realizing the coordinated development of the multilevel health insurance system and the social capital in the neighborhood.