Objective To systematically review the issues and countermeasures in supervising medical insurance funds under the DRG/DIP payment model. Methods The CNKI, WanFang Data, CBM, VIP, PubMed, Web of Science, and Embase databases were electronically searched to collect studies related to objectives from inception to March 15, 2024. Two reviewers independently screened the literature, extracted data, and assessed the quality of the included studies using the Critical Appraisal Skills Programme (CASP). Excel 2019 was used for data extraction and organization, and a thematic synthesis approach was employed for analysis. Results Nineteen qualitative studies were included. Nine studies identified key issues in fund supervision under the DRG/DIP model: inadequate regulatory mechanisms, weak regulatory capacity, low informatization, and traditional regulatory concepts. Fourteen studies proposed optimization strategies, including establishing a regulatory system, customizing regulatory indicators, creating a performance evaluation mechanism, developing talent, promoting multi-party regulation, enhancing intelligent supervision systems, and improving stakeholder collaboration and communication. Conclusion The DRG/DIP payment model faces challenges in medical insurance fund supervision, including weak mechanisms and capacity. Improving regulatory efficiency and ensuring medical service quality requires strengthening the regulatory system, customizing indicator systems, and enhancing talent development.
ObjectiveTo systematically review the efficacy of different non-pharmacological interventions for smoking cessation. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, VIP and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of different non-pharmacological interventions for smoking cessation from inception to November, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using Stata 15.1 software. ResultsA total of 27 RCTs involving 14 interventions were included. The results of the network meta-analysis showed that compared with conventional advice, video counseling (OR=2.34, 95%CI 1.32 to 4.15), mobile phone text message (OR=1.82, 95%CI 1.03 to 3.20), motivational interview (OR=2.00, 95%CI 1.11 to 3.59) and health education (OR=3.40, 95%CI 1.52 to 7.57) were higher in quitting rate (P<0.05). The sort results showed that health education was the most likely to be the best intervention (86.20%), followed by video consultation (74.10%). ConclusionCurrent evidence shows that the smoking cessation effects of health education, video counseling, telephone counseling, mobile phone text message and motivational interview. Among them, health education may be the best. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
In response to the specific requirements of nutrition research, Schwingshackl’s research group developed the NutriGrade grading system, which independently assessed the quality of evidence in randomized controlled trials and cohort studies in nutrition, aiming to summarize the associations or effects between different nutritional factors and outcomes and meet the specific needs of evidence users. It has the advantages of novel classification, quantifiability, independence and pertinence, and it has better consistency, fairness, reliability and feasibility. Well-designed prospective cohort studies are more feasible in the field of nutrition than randomized controlled trials. The grading of the evidence quality for cohort studies included the following eight items: a) risk of bias, study quality, and study limitations; b) precision; c) heterogeneity; d) directness; e) publication bias; f) funding bias; g) effect size; and h) dose-response. Based on the evaluation results of the above items, the evidence quality could be divided into four grades: high (8-10), moderate (<8), low (<6), and very low (<4). The purpose of this paper was to introduce the basic principles, specific contents, and application methods of the NutriGrade grading system for cohort studies and cite examples to provide references for relevant researchers.
ObjectiveTo construct rapid health technology assessment (RHTA) reporting norms, with a view to providing methodological references for RHTA research and reporting. MethodsBased on the preliminary pool of entries constructed by the literature research results, and taking into account the characteristics of RHTA, a Delphi expert correspondence questionnaire was designed, and 25 experts in the field of HTA were selected to conduct multiple rounds of expert correspondence. By calculating the expert authority coefficient and opinion coordination coefficient, combined with the average value of the entry score, coefficient of variation and full score ratio, the entries were selected to form the list of RHTA report specifications. ResultsThe positive coefficient of experts in both rounds of investigation was 100%, the expert authority coefficient in the first round was 0.858, and the expert authority coefficient in the second round was 0.838. The Kendall coordination coefficient in the first round was 0.169, and in the second round it was 0.081. According to the correspondence of 2 rounds of investigation, the final formation included 8 aspects, 26 first-level entries and 18 second-level entries in the list of RHTA report specifications. ConclusionThis study constructed the RHTA report specification, which is both scientific and operable, providing a reference for RHTA report writing.