Effects of formal credit on pastoral household expense: Evidence from the Qinghai-Xizang Plateau of China

Formal credit is critical in agricultural production,allowing more expenditure and productive input,thereby improving farmers'welfare.In pastoral China,formal financial institutions are gradually increasing.However,a limited understanding remains of how formal credit affects herders'household expenses.Based on a survey of 544 herders from the Qinghai-Xizang Plateau of China,this study adopted the propensity score matching approach to identify the effect of formal credit on herders'total household expenses,daily expenses,and productive expenses.The results found that average age,grassland mortgage,and other variables significantly affected herders'participation in formal credit.Formal credit could significantly improve household expenses,especially productive expenses.A heterogeneity analysis showed that formal credit had a greater impact on the household total expense for those at higher levels of wealth;however,it significantly affected the productive expense of herders at lower wealth levels.Moreover,the mediating effect indicated that formal credit could affect herders'household income,thus influencing their household expenses.Finally,this study suggests that policies should improve herders'accessibility to formal credit.

Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

Differences in insomnia-related self-reported outcomes among elderly hospitalized patients

Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.

Comparison of Oral Manifestations in Hospitalized COVID-19 Positive Patients and COVID-19 Negative Dental Outpatients. A Case Series Study and Literature Review

Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that pose a threat to human life. Oral lesions in patients with COVID-19 may appear during or after the illness and may or may not be a consequence of the viral infection. Objective: In this case series we compare the oral manifestations in hospitalized COVID-19 positive patients and COVID-19 negative dental outpatients. Methods: 60 hospitalized COVID-19 patients and 41 control patients, were examined for oral signs and symptoms. The controls were dental patients who visited the hospital for dental care without complaining of any problems related to the oral cavity itself. Results: We have observed a strong association between certain clinical findings and COVID-19, including alterations in taste (ageusia, dysgeusia, and hypogeusia), anosmia, hairy tongue, tongue imprints, red tongue, erythematous candidiasis, pseudomembranous candidiasis, and exfoliative cheilitis. A trend but not statistically significant association at the level of 5% was also noted for colored tongue, linea alba, and pale mucosa. On the contrary, fissured tongue and oral mucosa pigmentation were more frequent in the controls, statistically significant at the level of 5%. Conclusion: COVID-19 has been found to impact the oral cavity, resulting in various oral lesions that can be attributed to either the direct action of the virus or the patient’s immune response.

Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Recent Advances in Glycemic Management for Hospitalized Diabetic Patients

With the increase in the number of diabetic patients,hospitalized diabetes management has become very important.During hospitalization,diabetic patients are prone to high or low blood glucose levels,which pose significant risks and challenges for treatment and recovery.Therefore,glycemic management of diabetic patients during hospitalization is critical.This article reviews the latest research progress in glycemic management of hospitalized diabetic patients from several aspects,develops individualized treatment plans,and uses various methods to manage and control blood glucose in hospitalized diabetic patients.

Education of Hospitalized Diabetic Patients: Analysis of Training Needs among Nurses in a Lebanese Hospital - A Secondary Publication

The design of diabetes inpatient educational preparation should be based on the needs of the nurses involved in terms of skills in this area. The objective of this qualitative study is to identify the preparatory needs of nurses working in the medical and surgical units of a Lebanese hospital in terms of Survival Skills Education for Hospitalized Diabetic Patients (SSEHDP). Method: The focus group method is used for data collection using a semi-structured interview guide. The needs expressed by the thirty-two participating nurses were classified into categories of the competency framework for providing self-management education to diabetic patients proposed by the American Diabetes Association. Results: By focusing on the themes of an SSEHDP, a list of preparatory needs was drawn up. The needs identified and analyzed are then translated into general and specific learning objectives for educational preparation. Conclusion: The needs analysis is only the first step in a work that will ideally continue into the implementation and eventual evaluation of an educational program developed to help nurses acquire skills in the education of diabetic patients.

Clinical and Epidemiological Aspects of Severe Acute Malnourished Children from 6 to 59 Months Hospitalized in a Secondary Hospital in Mali

Introduction: Malnutrition acts on the immune system and thus increases susceptibility to infections. Infections can weaken the body and cause malnutrition, so we speak of a vicious circle between malnutrition and infection. Objective: To study the clinical and epidemiological aspects of severe acute malnutrition in children aged 6 to 59 months. Methodology: This was a prospective and descriptive study extending from July 1, 2018 to June 30, 2019. All severely acute malnourished children aged 6 to 59 months were hospitalized at URENI whose parents or careers accepted their participation in the study. Results: Severe acute malnutrition was diagnosed in 398 of the 671 hospitalized children, i.e. 59.3%. The median age was 15.33 months (2 months - 59 months). The sex ratio was 1.03 (M = 50.8 F = 49.2). Eighty-seven percent of mothers were housewives. Parents were uneducated in 49.3% for mothers and 51.8% for fathers. Marasmus represented 93.5% of cases, children diagnosed with HIV+ represented 6.3% with exclusively HIV1 (100%). Pneumopathy was most frequently associated pathology with 33.4%. The duration of hospitalization was less than 7 days in 67.6% of cases and 93.3% of children had been successfully treated. The mortality rate was 4%. Conclusion: Malnutrition still remains a public health problem affecting mainly children aged 13 to 24 months, mainly from low-income families.

Experiences of Social Isolation in Older Hospitalized Patients with COVID-19 and Their Close Relatives: A Qualitative Study

Background: Proximity between older patients and their close relatives is essential during hospitalisation. During the first wave of the pandemic, the Danish Patient Safety Authority restricted no hospital visitors. Aim: To explore how older patients with COVID-19 and their close relatives experienced physical separation during hospitalization. Method: A qualitative study using semi-structured interviews and thematic analysis was employed. Findings: Six interviews were conducted: three patients with a mean age of 81 years and three close relatives—two daughters and one spouse. The patients felt boredom, loneliness, and a sense of imprisonment, yet they felt safe and satisfied. Isolation was known beforehand from the media. Close relatives emphasised that information, involvement, and collaboration with hospital staff were crucial. Conclusion: Although older patients with COVID-19 and their close relatives widely accept their situation during hospitalization, they experience negative consequences from social isolation.

Etiological and Evolutionary Profile of Anemia in Patients Hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes

Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all anemic patients hospitalized during the study period. Results: We identified 91 cases of anemia out of 200 patients admitted to the Unit that is a hospital prevalence of 45.5%. The age group of 26 to 35 years was the most represented, that is to say 29 cases (31.87%) with an average age of 43.55 years ± 17.48 years, the female sex predominated, 51 cases (56.04%) with a sex ratio of 0.78. Housewives represented 41 cases (45.05%). The majority of patients resided in rural areas 48 cases (52.75%). The main manifestations were: asthenia 75 cases (78.02%), vertigo 68 cases (74.72%), dyspnea 62 cases (68.13%), headaches 59 cases (64.83%), palpitations 55 cases (60.44%), conjunctival pallor 53 cases (58.24%), tachycardia 43 cases (47.25%), systolic murmur 18 cases (19.78%) and IMO 11 cases (12.09%). The associated pathologies were: infected diabetic wounds 25.27%, followed by bacterial pleuro-pneumopathy 18.68%. Biologically, microcytic anemia was the most frequent 49 cases (53.84%), followed by normocytic anemia 35 cases (38.46%) and macrocytic anemia 7 cases (7.7%). Anemia was hypochromic, 53 cases (58.24%) were more encountered compared to normochromic anemia 38 cases (41.76%). The anemia was: severe in 43 cases (47.25%), moderate 29 cases (31.87%) and mild 19 cases (20.88%). Inflammatory anemia is the most common etiological diagnosis in 60% of cases, followed by vitamin B12 deficiency anemia observed in 21% of patients and then blood diseases in 7.33% of cases. The main causes of death were HIV (50%) and kidney failure (33.33%). Conclusion: Anemia is a frequent symptom in internal medicine. It constitutes a real diagnostic challenge for the internist and this sometimes in an emergency context. The use of specialized examinations and labile blood products is essential in our hospital.

Comparison of Mortality, Length of Stay, and Hospitalization Costs of Hospitalized COVID-19 Patients with Cardiac and Non-Cardiac Disease

Background: The COVID-19 pandemic has presented unprecedented challenges to global healthcare systems. As the pandemic unfolded, it became evident that certain groups of individuals were at an elevated risk of experiencing severe disease outcomes. Among these high-risk groups, individuals with pre-existing cardiac conditions emerged as particularly vulnerable. Objective: This study aimed to investigate the relationship between the length of stay, mortality, and costs of COVID-19 patients with and without a history of cardiac disease. Design: This retrospective study was conducted in Jam Hospital in Tehran, Iran, from March 21, 2021, to March 21, 2022. All patients with laboratory-confirmed COVID-19 who were hospitalized during this period were included. Results: A total of 500 COVID-19 patients were hospitalized, with 31.6% having a history of cardiac disease and 68.4% without any cardiac disease. Patients with cardiac disease were significantly older (median [range] age, 69.35 [37 - 94] years) compared to non-cardiac patients (54.95 [13 - 97] years) (p Conclusion: Patients with cardiac disease who are hospitalized with COVID-19 have a higher mortality rate, longer hospital stays, greater disease severity, ICU admission, and higher costs. Therefore, improved prevention and management strategies are crucial for these patients.

Retroperitoneal and abdominal bleeding in anticoagulated COVID-19 hospitalized patients:Case series and brief literature review

BACKGROUND Hospitalized and severely ill coronavirus disease 2019(COVID-19)patients necessitate prophylactic or therapeutic anticoagulation to minimize the risk of thrombosis at different sites.Life-threatening bleeding complications include spontaneous iliopsoas hematoma,peritoneal bleeding,and extra-abdominal manifestations such as intracranial hemorrhage.CASE SUMMARY Bleeding in the abdominal wall results in less severe complications than seen with iliopsoas hematoma or peritoneal bleeding.In our case series of 9 patients,we present retroperitoneal and abdominal bleeding complications following anticoagulation in hospitalized COVID-19 patients with severe acute respiratory syndrome coronavirus 2 pneumonia.Contrast-enhanced computed tomography(CE-CT)is the best imaging modality for assessing hematoma secondary to anticoagulation and determines the therapeutic approach,whether interventional,surgical,or conservative management.CONCLUSION We present the role of CE-CT for rapid and precise localization of the bleeding site and prognostic counseling.Finally,we provide a brief review of the literature.

Quality of life of hospitalized patients after lung cancer operation and analysis of influencing factors

Objective:To explore the current status and influencing factors of quality of life in patients with lung cancer after surgery in a tertiary hospital in Hainan province.Methods:To investigate the influencing factors of quality of life of lung cancer patients after surgery in a tertiary hospital in Hainan province by cross‑sectional survey method.Results:The scores of insomnia,appetite loss,constipation and pain in 186 lung cancer patients after surgery in a tertiary hospital in Hainan Province were significantly higher than the reference value.Multiple linear regression analysis showed that older patients(>60 years)had lower scores in physical function domain(β=-0.193),and female patients had more appetite loss symptoms(β=0.245).Compared with other minority ethnic groups,Han ethnic group had lower scores in role function domain(β=0.179),more severe fatigue symptoms(β=-0.162),and higher general health level(β=0.166).Patients with employee medical insurance had lower scores of emotional function(β=0.194),cognitive function(β=0.281),the lowest score in social function(β=0.188),and severe pain in other parts(β=-0.227).Smokers had less cough symptoms(β=0.175)and more arm and shoulder pain symptoms(β=-0.21)than non‑smokers.Patients with secondhand smoke exposure had lower cognitive function scores(β=-0.158)and more obvious symptoms of oral ulcer(β=0.185).Patients who drank alcohol frequently(drinking frequency>1 time/day)had more severe cough symptoms(β=0.27).Patients with small number of children(0‑1)had milder cough symptoms(β=0.178).Patients who did not understand the disease had obvious symptoms of arm and shoulder pain(β=0.151).Patients with early pathological stage(stageⅠ‑Ⅱ)had more severe shortness of breath(β=-0.159)and pain(β=-0.181).The symptoms of appetite loss were more obvious in patients living in cities(β=0.192).The symptoms of peripheral neuropathy were more obvious(β=0.174).Patients who often consumed pickulated food had severe pain symptoms(β=-0.219),and pain in other parts was obvious(β=-0.149).Male patients had obvious alopecia symptoms(β=-0.306).Conclusion:Age,ethnicity,residence,type of medical insurance,number of children,pathological stage of lung cancer,smoking,second‑hand smoke exposure,alcohol consumption,and frequent consumption of pickled food were related to the quality of life of lung cancer patients in hospital after surgery.Medical staff and family members should pay attention to the emotional communication of patients during the treatment of lung cancer patients in hospital after surgery.Patients should avoid exposure to smoking,alcohol and second‑hand smoke,and reduce consumption of pickled food.

Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers:A systematic review and meta-analysis

BACKGROUND The definition of diabetic foot syndrome(DFS)varies depending on the location and resources.Few classifications are available according to the indication.DF ulcers and vitamin D deficiency are common diseases among patients with diabetes.Previous literature has shown an association between DF ulcer(DFU)and vitamin D deficiency.However,the available meta-0analysis was limited by substantial bias.AIM To investigate the association between DFUs and vitamin D levels.METHODS We searched PubMed,MEDLINE,and Cochrane Library,EBSCO,and Google Scholar for studies comparing vitamin D levels and DF.The keywords DFU,DFS,diabetic septic foot,vitamin D level,25-hydroxy vitamin D,vitamin D status,and vitamin D deficiency were used.The search engine was set for articles published during the period from inception to October 2022.A predetermined table was used to collect the study information.RESULTS Vitamin D level was lower among patients with DFU compared to their counterparts[odds ratio(OR):-5.77;95%confidence interval(CI):-7.87 to-3.66;χ2 was 84.62,mean difference,9;I2 for heterogeneity,89%;P<0.001 and P for overall effect<0.001].The results remained robust for hospitalized patients(OR:-6.3295%CI:-11.66 to-0.97;χ2 was 19.39;mean difference,2;I2 for heterogeneity,90%;P=0.02).CONCLUSION Vitamin D was lower among outpatients and hospitalized patients with DFUs.Further larger randomized controlled trials are needed.

Research on the Effect of R&D Investment Intensity and Sales Expense on the Performance of Biomedical Enterprises

Objective To explore the influence of new drug R&D investment and sales expense on the performance of biomedical enterprises.Methods The financial statements of 76 listed biomedical enterprises for 5 consecutive years were selected,and the data were modeled to study the effect of R&D investment and sales expense on the performance of biomedical enterprises by using financial indicators as tools and statistical methods of multiple linear regression.Results and Conclusion Under the premise that the weak related factors such as enterprise scale,life cycle and asset-liability ratio are set as unrelated variables,the R&D investment intensity of biomedical enterprises is negatively correlated with the current performance,which also shows that the R&D of biomedical enterprises has the characteristics of high risk.Besides,the influence of early R&D investment is delayed.However,the sales expense of leading biomedical enterprises with large scales have higher proportion.Meanwhile the greater sales expense of the same enterprise in different periods,the better the enterprise performance is.Biomedical enterprises should consider their own development stage to develop more patented drugs.Besides,they must formulate plans for allocating reasonable sales personnel and cost expense to ensure that enterprises can obtain better benefits.

2014—2023年西安市某三甲综合医院AECOPD住院患者的流行病学特征及费用结构研究

目的探讨2014—2023年西安市某三甲综合医院慢性阻塞性肺疾病急性加重(AECOPD)住院患者的流行病学特征及费用结构研究。方法收集某院2014年1月—2023年12月的AECOPD住院患者的病案首页信息(n=6748),回顾性分析其人口学特征、临床特征的分布及住院费用构成情况,并采用结构变动度分析不同年度住院费用的结构变动情况。结果2014—2023年主诊确诊为AECOPD患者占本机构所有住院患者4.81‰,10年间AECOPD住院患者的构成比呈持续下降趋势(χ2=1083.351,P<0.001);不同年度中AECOPD住院患者的性别、职业、医疗付费方式、来源的分布均有统计学差异(P<0.05);不同年度AECOPD住院患者的季节分布有统计学差异(χ2=157.328,P<0.001);不同年度AECOPD住院患者住院天数分布之间有统计学差异(χ2=83.463,P<0.001);不同年度中AECOPD患者的住院次数、入院病情、是否合并症或并发症、是否有药物过敏史以及是否有再次住院计划的构成比之间均有统计学差异(P<0.05);不同年度AECOPD住院患者的结局之间有统计学差异(χ2=153.367,P<0.001);AECOPD患者次均住院费用呈2014—2016年逐步升高,2016—2023年逐步下降的趋势(P<0.01);不同年度AECOPD患者住院费用中均以药品费用和诊断费用为主;2014—2022年AECOPD住院患者次均费用整体住院的结构变动度(DSV)为41.62%,其中2012年与2013年住院费用的DSV最大(22.69%),2017年与2018年的DSV最小(4.23%)。结论近10年AECOPD住院患者的构成比和病死率整体呈下降趋势;AECOPD住院患者中70~79岁组构成比最高,主要分布在冬季;10年间次均住院费用整体呈下降趋势,费用构成主要以药品费和诊断费用为主,药品费用成逐年下降的趋势,诊断费用呈逐年增加的趋势,说明医疗政策改革在优化住院费用结构、控制费用不合理增长中的作用显著。

基于决策树模型HC25病组DRGs细分组及住院费用的影响因素研究

目的构建基于决策树模型HC25病组患者DRGs细分组的研究及住院费用的影响因素。方法收集西安交通大学第一附属医院2020年1月至2022年6月依据CHS-DRG分组方案进入HC25(胆囊切除术,不伴并发症或合并症)病组患者的病案首页数据(n=3844),通过单因素和多因素分析了解影响住院费用的主要因素,通过建立决策树模型进行病例组合,分析分组效果及不同分组的费用标准。结果正态性检验结果显示:住院费用呈偏态分布(χ2=0.197,P<0.001);单因素方差分析结果显示:住院费用在不同年龄、性别、手术方式、患者来源、医疗付费方式、入院病情危重情况、术前时间、住院时间、是否有再住院计划之间,差异有统计学意义(P均<0.05);多重线性逐步回归分析结果显示,影响住院费用显著性差异的因素从大到小依次为:住院时间、手术方式、入院病情危重情况、性别、术前时间、患者来源、再住院计划(P均<0.05);采用CHAID共生成了7个DRGs分组,第一层分类节点变量是手术方式,第二层是术前时间、住院时间,第三层是入院时病情危重情况;不同DRGs组合的住院费用比较,差异有统计学意义(χ2=2474.595,P<0.001),组合DRGs(1)的住院费用最高,权重最高;DRGs(7)的住院费用最低,权重最小;所有DRGs病组中超标费用患者共170例(4.42%),各组超标费用比例均<10%。结论基于决策树模型对HC25病组的细分组效果合理有效,能较客观反映医疗资源消耗水平。

中日友好医院党建引领高质量发展实践与思考

公立医院党建工作是实现高质量发展的重要保障。本文以中日友好医院为例,介绍把党的政治建设、思想建设、组织建设、作风建设、纪律建设、制度建设与医院高质量发展紧密结合的实践探索,逐步形成以高质量党建引领高质量发展的“六提升”工作法,为公立医院党建引领高质量发展提供参考。

“互联网+居家护理”在志愿护理服务中的应用效果

目的探讨"互联网+居家护理"在志愿护理服务中的应用效果。方法选取2020年12月至2021年12月"党群服务365平台"82例需要服务人群作为研究对象,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组实施常规医疗服务,观察组实施"互联网+居家护理"服务,两组均持续护理12个月。比较两组的医院看病次数、医疗花费情况、日常生活能力、精神状态、照护者照护技能水平以及生活满意度。结果观察组医院看病次数、医疗花费情况均少于对照组,差异有统计学意义(P<0.05);观察组护理后日常生活活动能力量表(ADL)评分低于对照组,简易精神状态检查量表(MMSE)评分、照护技能水平评分均高于对照组,差异有统计学意义(P<0.05);观察组护理后生活满意度调查表(LSR)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论通过互联网平台,护理志愿者对服务人群进行居家护理,能够改善服务人群的精神状态,促使其保持身心健康,提高生活自理能力,还能提高照护者的护理技能,一定程度上减少看病次数和医疗花费,从而提升服务人员满意度。

基于疾病诊断相关分组付费对天津市天津医院本地患者住院费用情况及影响因素分析

目的分析疾病诊断相关分组(DRG)付费对天津市天津医院本地住院患者住院费用情况及影响因素。方法选择天津市天津医院2021年1月至12月DRG实施前(对照组)和2022年1月至12月DRG实施后(改革组)的本地住院患者费用结算信息和病案基本信息。比较两组一般资料、人均住院总费用、人均每日住院费用、相对权重(RW);分析人均每日住院费用的影响因素。结果本研究对照组纳入病例24140例;改革组纳入19181例。两组性别、年龄比较,差异有统计学意义(P<0.05);两组住院时间比较,差异无统计学意义(P>0.05)。两组人均住院总费用、人均每日住院费用、RW比较,差异有统计学意义(P<0.05);两组材料费用、药品费用、手术费用中人均住院总费用、人均每日住院费用比较,差异有统计学意义(P<0.05)。不同DRG分类、性别、年龄、RW人均每日住院费用比较,差异有统计学意义(P<0.05)。DRG、DRG分类、性别、年龄、RW为人均每日住院费用的影响因素(P<0.05);多元回归方程为:人均每日住院费用=10408-428.097×DRG改革组-242.224×DRG材料组+1239.124×DRG药品组-576.581×男+1283.163×年龄(60~<80岁)+1732.570×年龄(80~<90岁)+844.677×年龄(≥90岁)-5665.426×RW(<0.5)-5154.877×RW(0.5~<0.8)-1999.976×RW(0.8~<1.2)。结论推行DRG付费后住院患者就医费用降低,而影响人均每日住院费用的主要是DRG、DRG分类、性别、年龄、RW。