Objectives: To evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methods: Obtaining data from regula...Objectives: To evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methods: Obtaining data from regular reports from public medical institutions in Shanghai, comparing patients who seek doctors from out-of-Shanghai residence and local patients with insurance in terms of the quantity of service, types of diseases, medical expenses, etc. Results: External-care-seeking has a large quantity, especially in hospitalization. In 2012, the number of discharged population from out-of-Shanghai accounted for 22.74% of the total discharged number, the proportion even higher than 30% in tertiary hospitals. Tertiary hospitals have a significant attraction effect, concentrating 59.42% of the outpatient and emergency visits and 71.82% of the amount of hospitalization, with corresponding cost of 75.86% and 82.56%. The top three divisions in tertiary hospitals for external-care-seeking were surgical, obstetrics and gynecology, internal medicine. Based on the interview, admitting out-of-shanghai patients is conducive to the improvement of the technical level of hospitals, and to the enhancement of the utilization efficiency of health resource. However, the local residents may have less accessibility of high quality of medical service. The average expense of external-care-seeking is higher than that of local patients happened in the same level of hospitals. Conclusions: External-care-seeking will have a more far-reaching impact on the health care system in Shanghai;some interventions might be necessary, such as rationally allocating medical resources based on the estimates of external-care-seeking and establishing a medical service supervision mechanism.展开更多
Corrosion behavior of a Ni-16Mo-7Cr base superalloy was systematically investigated under a selenium(Se)atmosphere at 700°C.It shows that Se can react with the alloy elements such as Ni,Mo,Cr et al.to form a reac...Corrosion behavior of a Ni-16Mo-7Cr base superalloy was systematically investigated under a selenium(Se)atmosphere at 700°C.It shows that Se can react with the alloy elements such as Ni,Mo,Cr et al.to form a reaction layer at the surface of alloy,which is mainly composed of Ni_(2)Se_(3),MoSe_(2),and Cr_(3)Se_(4).The tensile properties of the alloy are not greatly affected by changes of Se content.The slight decrease in the tensile strength is attributed to the formation of the reaction layer,which leads to the decrease in the effective undertaking area of the alloy.No intergranular diffusion characteristic of Se elements was observed,and the Se effect of embrittlement on grain boundaries is weaker than that of tellurium(Te).展开更多
文摘Objectives: To evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methods: Obtaining data from regular reports from public medical institutions in Shanghai, comparing patients who seek doctors from out-of-Shanghai residence and local patients with insurance in terms of the quantity of service, types of diseases, medical expenses, etc. Results: External-care-seeking has a large quantity, especially in hospitalization. In 2012, the number of discharged population from out-of-Shanghai accounted for 22.74% of the total discharged number, the proportion even higher than 30% in tertiary hospitals. Tertiary hospitals have a significant attraction effect, concentrating 59.42% of the outpatient and emergency visits and 71.82% of the amount of hospitalization, with corresponding cost of 75.86% and 82.56%. The top three divisions in tertiary hospitals for external-care-seeking were surgical, obstetrics and gynecology, internal medicine. Based on the interview, admitting out-of-shanghai patients is conducive to the improvement of the technical level of hospitals, and to the enhancement of the utilization efficiency of health resource. However, the local residents may have less accessibility of high quality of medical service. The average expense of external-care-seeking is higher than that of local patients happened in the same level of hospitals. Conclusions: External-care-seeking will have a more far-reaching impact on the health care system in Shanghai;some interventions might be necessary, such as rationally allocating medical resources based on the estimates of external-care-seeking and establishing a medical service supervision mechanism.
基金This work was financially supported by the National Natural Science Foundation of China(Grant Nos.52071331,51901241,52001322).
文摘Corrosion behavior of a Ni-16Mo-7Cr base superalloy was systematically investigated under a selenium(Se)atmosphere at 700°C.It shows that Se can react with the alloy elements such as Ni,Mo,Cr et al.to form a reaction layer at the surface of alloy,which is mainly composed of Ni_(2)Se_(3),MoSe_(2),and Cr_(3)Se_(4).The tensile properties of the alloy are not greatly affected by changes of Se content.The slight decrease in the tensile strength is attributed to the formation of the reaction layer,which leads to the decrease in the effective undertaking area of the alloy.No intergranular diffusion characteristic of Se elements was observed,and the Se effect of embrittlement on grain boundaries is weaker than that of tellurium(Te).
