ObjectiveTo explore the practice effect of the combination management of tertiary hospital and community hospital for home peritoneal dialysis patients. MethodsA total of 50 patients of end-stage renal disease from December 2012 to May 2013 were involved in this study, including 26 males, and 24 females with the average age of 47.1±13.9. The patients were randomly divided into hospital group (30 patients) and combination group (20 patients). For the patients in the hospital group, the specialists take care of them with regular outpatient service and follow-up; for the patients in the combination group, they were taken care by doctors from both tertiary hospital and community hospital, while the community general practitioners were trained by the tertiary hospital regularly with peritoneal dialysis basic treatment and standardization management and communication. All the patients were managed for 9 months. ResultsAt the end of the observation,the dialysis adequacy success rate, hemoglobin, blood potassium, phosphorus, calcium, albumin, CO2CP, blood pressure success rate, the incidence of peritonitis, and average monthly medical treatment expense between the two groups were not statistically different (P>0.05); the difference in cost of transportation was statistically significant (P<0.05). ConclusionThe standardization manage of combination of tertiary hospital and community for patients with home peritoneal dialysis may reduces the patients' expense in transportation, and improve the community general practitioners' level of basic knowledge and indication of peritoneal dialysis.
ObjectiveTo investigate old (the no less than 60-year-old) inpatient's diseases and cost constitution of a tertiary hospital in West China from 2008 to 2012, so as to provide baseline data for further research. MethodsThe case records of no less than 60-year-old inpatients in the tertiary hospital were collected from 2008 to 2012, and based on the first diagnose, the diseases were classified according to the International Classification of Diseases (ICD-10). The data including general information of the inpatients, discharge diagnosis, length of hospital stay and hospitalization costs, were analyzed using Stata10.0 software. Resultsa) The total number of old inpatients was 109 585, and male (59.57%) was more than female (40.43%). The disease spectrum included 18 categories. The percentage of old inpatients increased from 31.57% (2008) to 34.25% (2010). b) The top three systematic diseases were neoplasms, diseases of the circulatory system and diseases of the digestive; the male inpatients were more than the female; the number of inpatients who suffered from the top three systematic diseases got decreased with age increasing; neoplasm was the most common disease, there were 34 944 malignant neoplasm inpatients. c) The cumulative constituent ratio of the top five malignant neoplasms in male and female inpatients were respectively 62.51% and 49.44%; and the top five malignant neoplasms of male inpatients were malignant neoplasm of bronchus and lung, other medical care for neoplasm, malignant neoplasm of esophagus, malignant neoplasm of stomach and malignant neoplasm of prostate. The top five malignant neoplasms of female inpatients were other medical care for neoplasm, malignant neoplasm of bronchus and lung, malignant neoplasm of breast, malignant neoplasm of stomach and malignant neoplasm of cervix uteri. d) The average length of hospital stay decreased from 14.12 days to 11.00 days since 2008, and the average cost per capita increased from ￥14 044.79 yuan to ￥18 932.81 yuan since 2008. The proportion of drug cost of inpatients hospitalization cost decreased from 47.21% to 42.16% since 2008. ConclusionThe male inpatients are more than female in the tertiary hospital from 2008 to 2012. The most common systematic disease is neoplasm, especially the malignant neoplasms with higher constituent ratio. The top five malignant neoplasms of male inpatients and female are different. The average length of stay in hospitals has declined in five years, however the average cost per capita has increased.
ObjectivesTo systematically review the training needs of managing staffs in tertiary hospitals in China, to understand the requirements of in-service training for hospital managing staffs, and to provide references for the target and content of tertiary hospital managing staff training.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cross-sectional studies on the training needs of managing staffs in tertiary hospitals in China. The retrieval time was from inception to July 29th, 2018. Two reviewers independently screened literature, extracted the data and descriptive analysis was conducted on the training needs of managing staffs in tertiary hospitals.ResultsA total of 11 studies were included. The results of systematic review suggested that: as for the requirements of training content, hospital management, leadership, personnel training, human resource management and innovation awareness were the most demanding training contents. As for the training methods, experience exchange, case study and topic teaching were the most popular. As for the training time, 2 to 3 days of quarterly training was the most acceptable training time.ConclusionsThere are great training requirements for managing staffs in tertiary hospitals in China, with a large amount of training content and diversity methods. In future, training objectives and methods should be designed to meet the requirements of managing staffs, so as to enhance training quality and achieve training goals.
Objective To explore the present situation of the efficiency about public tertiary general hospitals in Shandong province, measure and compare the efficiency and the state of returns to scale of hospitals under different bed scales. Methods Based on the input and output data of 137 public tertiary general hospitals in Shandong province in 2017, two input indicators (the number of employees and the number of actual beds) and two output indicators (the total number of outpatients and emergent patients, and the number of discharges) were selected. The technical efficiency, pure technical efficiency and scale efficiency of sample hospitals were calculated by using data envelopment analysis, and a comparative analysis was carried out under different bed scales. Results Of the 137 public tertiary general hospitals, the mean of technical efficiency value was 0.666, the medians of pure technical efficiency value and scale efficiency value in 2017 were 0.817 and 0.919, respectively. In the 137 sample hospitals, there were 132 hospitals (96.4%) in ineffective status; there were 90 hospitals (65.7%) exhibiting increasing returns to scale, 11 hospitals (8.0%) exhibiting constant returns to scale, and 36 hospitals (26.3%) exhibiting decreasing returns to scale. There were significant differences in hospital efficiency and returns to scale under different bed sizes (P<0.001), and the scale efficiency was the highest when the bed size was 1001-2000. Conclusions The overall operating efficiency of the public tertiary general hospitals in the province was not high yet. Most hospitals were in ineffective status and most of them were in the state of increasing returns to scale. The optimal scale of actual beds is between 1001 and 2000 beds from the perspective of scale efficiency.