Surgical treatment of liver cancer and pancreatic cancer under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.

Hospice and Palliative Care in China's Mainland:History,Current Status and Challenges

The concept of End-of-Life Care(EOLC)came into China in the late1980s.However,hospice and palliative care in medical practice develope slowly.In recent years,profesionals,patients and their families,as well as government begin to attach importance to it.There is a hospice and palliative care movement now in China.This article gives an overview of the progress and the current status in multiple aspects of hospice and palliative care in China's Mainland,and points out the barriers and challenges for its further development in the future.

Availability and Quality of Emergency Obstetric Care, an Alternative Strategy to Reduce Maternal Mortality: Experience of Tongji Hospital, Wuhan, China

The burden of maternal mortality (MM) and morbidity is especially high in Asia.However,China has made significant progress in reducing MM over the past two decades,and hence maternal death rate has declined considerably in last decade,To analyze availability and quality of emergency obstetric care (EmOC) received by women at Tongji Hospital,Wuhan,China,this study retrospectively analyzed various pregnancy-related complications at the hospital from 2000 to 2009.Two baseline periods of equal length were used for the comparison of variables.A total of 11 223 obstetric complications leading to MM were identified on a total of 15 730 hospitalizations,either 71.35％ of all activities.No maternal death was recorded.Mean age of women was 29.31 years with a wide range of 14-52 years.About 96.26％ of women had higher levels of schooling,university degrees and above and received the education of secondary school or college.About 3.74％ received primary education at period two (P2) from 2005 to 2009,which was significantly higher than that of period one (P1) from 2000 to 2004 (P＜0.05) (OR:0.586; 95％ CI:0.442 to 0.776).About 65.69％ were employed as skilled or professional workers at P2,which was significantly higher than that of P1 (P＜0.05).About 34.31％ were unskilled workers at P2,which was significantly higher than that of P1 (P＜0.05).Caesarean section was performed for 9,930 women (88.48％) and the percentage of the procedure increased significantly from 19.25％ at P1 to 69.23％ at P2 (P＜0.05).We were led to conclude that,despite the progress,significant gaps in the performance of maternal health services between rural and urban areas remain.However,MM reduction can be achieved in China.Priorities must include,but not limited to the following:secondary healthcare development,health policy and management,strengthening primary healthcare services.

Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China:a Cross-sectional Survey 3 Years after the Healthcare Reform

The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.

Development of the Transitional Care Model for nursing care in China's Mainland:A literature review

Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing care;in 2010,the Chinese government has acknowledged the need to implement the TCM in China.Objective:This study has the following objectives:(1)perform a thorough review of the literature regarding the development and implementation of the TCM in China's Mainland within the past 5 years;(2)provide a comprehensive discussion of the current status,problems,and strategies related to the implementation of the TCM in China's Mainland;and(3)suggest strategies pertaining to the future of the TCM in China.Design:The current pertinent literature is systematically reviewed.Data sources:Systematic and manual searches in computerized databases for relevant studies regarding the TCM led to the inclusion of 26 papers in this review.Review methods:Abstracts that satisfied the inclusion criteria were reviewed independently by the two authors of this manuscript,and discrepancies were resolved through discussion.The same reviewers independently assessed the paper in its entirety for selected abstracts.Results:The present English literature reviewrevealed a paucity of updated information about the development and implementation of the TCM in China's Mainland.Nevertheless,the dramatic growth of the TCM in the past 5 years has had a vital impact within the society and in nursing development.This review also revealed numerous issues regarding the focus of the TCM.Overall implications for practiceandrecommendations for future researchare discussed.Conclusion:Despite the potential of this nursing model to have a successful and beneficial impact in China's Mainland,it remains an under-researched topic.Further research on education and training as well as premium policies for nurses under the TCM are needed.

Care of HIV-infected patients in China

Compared with high infection areas of the world, the total HIV infection rate in China is relatively low. Nonetheless, because of China’s vast territory and large population, the potential infection risk must be taken seriously. In the next few years, needle sharing among injection drug users will remain the most common route of transmission for the HIV/ AIDS epidemic in China. Unprotected sex is gradually becoming a major route of transmission. China began to imple- ment HAART in 1999 according to international standards. Prior to 2003, there were only about 150 HIV/AIDS patients were treated with HAART in some clinical trials and about 100 HIV/AIDS patients were treated by private sources. Results of those treatments are the scientific basis for development of the therapeutic strategies in China. In March of 2003, the Chinese government initiated China CARES program. In November of 2003, the Chinese Ministry of Health announced a national policy of free ARV treatment to all HIV+ Chinese citizens who were in poverty and required ARV therapy. There are total of 19,456 HIV/AIDS patients received free ARV drugs to date in 159 regions and 441 towns. Current challenges are how to follow-up and evaluate those patients in the clinical settings. The longer the therapy is postponed, the more side effects and the higher probability of drug resistance are going to occur. It remains unclear, therefore, when HAART regimen should be started in the HIV/AIDS population in China.

The Current Status and Challenges Regarding Tuberculosis Infection Control in Health Care Facilities in China

Health care facilities are a high-risk environment for generating and spreading respiratory infectious diseases such as tuberculosis （TB）. The TB prevention and treatment staff in health care facilities are responsible for the identification, diagnosis, treatment, supervision, and management of TB patients .

Variations in non-ST-elevation myocardial infarction care across three levels of hospitals in China:analysis from the China Acute Myocardial Infarction Registry

Objective To explore the variation of treatment and outcomes for NSTEMI across different-level hospitals, which potentially influenced by unbalanced economy and disparate medical care.Methods The China AMI registry consists of 108 hospitals across three levels (province, prefecture and county) throughout China.

Comparison of research hotspots and trends in long-term care for the elderly between China and Australia: a bibliometric analysis

Objective:To explore the current status and development of long-term care(LTC)research in terms of publications in China and Australia,to identify the major contributing authors and institutions,and to compare the research hotspots and trends between China and Australia in order to encourage informed collaborations and work in future.Methods:We collected bibliometric data on the LTC of the elderly in China and Australia from 2009 to 2020 using Chinese National Knowledge Infrastructure(CNKI)and Web of Science(WOS).Cite Space software was used to analyze co-authorships,co-institutions,and co-keywords.Results:A total of 826 ar ticles in Chinese and 393 in English were included for analysis.The total number of publications showed an upward trend in both countries.The top 10 productive researchers and institutions in China and Australia were identified,and their collaboration network was revealed.Then,the knowledge maps of cooccurring keywords,respectively,showed the hotspots of"LTC insurance,disabled elderly,combination of medical and health care,nursing home"and"nursing home,dementia,quality of life,intervention"in China and Australia.Strong citation burst keywords illustrated the emerging trends of"combination of medical and health care,healthy aging"in China and"polypharmacy,prevention"in Australia.Conclusions:This article provided an insight into LTC of the elderly in China and Australia,and research in this field is developing rapidly and is being increasingly valued.The findings will be useful for future researchers to facilitate collaboration,identify new topics,and suppor t urgently needed research of LTC in China.

Impact of the New Cooperative Medical Scheme on Health Care Service Utilization in Rural China

Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.

Spiritual care perceptions, spiritual health and their relationships with spiritual care competence among clinical nurses in China: A cross-sectional quantitative study

Objective:To investigate the status quo of spiritual care competence and assocaited influencing factors among clinical nurses in China,and examine the relationships among spiritual care perceptions,spiritual health and spiritual care competence,and the mediating role of spiritual health between spiritual care competence and spiritual care perceptions,in order to provide reference for the construction of spiritual care education intervention program to improve the spiritual care competence of clinical nurses in China.Methods:A total of 1454 clinical nurses from 17 hospitals in Tianjin were selected by convenience sampling method,and were investigated with sociodemographic characteristics questionnaire,the Chinese version of Spiritual Care Competence Scale(C-SCCS),the Chinese Version of the Spiritual Care-Giving Scale(C-SCGS)and the Spiritual Health Scale Short Form(SHS-SF).Results:The scores of spiritual care competence of nurses was(57.52±16.02).The results of multiple linear regression showed that nurses'spiritual care competence was influenced by 9 sociodemographic characteristics such as educational background and nursing age,as well as spiritual care perceptions and spiritual health factors,which accounted for 67.2%of the total variation.And spiritual care competence was positively correlated with spiritual care perceptions(r=0.639,P<0.01)and spiritual health(r=0.596,P<0.01).Besides,spiritual health played a mediating role between between other two variables,accounting for 27.5%of the indirect effect.Conclusions:The scores of spiritual care competence of clinical nurses was in the lower middle level,which needs to be further improved.It is recommended that nurse managers and educators should pay attention to the spiritual care education of nurses,and improve spiritual care perceptions and spiritual health level of nurses in multiple ways,at multiple levels,so as to improve their spiritual care competence and to maximize the satisfy spiritual care needs of patients.

China Elderly Care:A Confucian Legacy

This paper explores the Confucian roots of elderly care expectations and how these expectations may influence the current state of the elderly and elderly care in modem China.This paper posits that the outdated expectations combined with recent urbanization trends has put unrealistic pressures on society to adequately care for a rapidly aging population.Until expectations are adjusted to reflect modem day families and realities,the elderly will continue to struggle with a sense of inadequate care,which can lead to mental health issues and feelings of isolation.Once the shackles of Confucian expectations are removed,families,governments and private institutions will have the freedom to be more creative in the way they imagine solutions for elderly care.

Spiritual health, empathy ability and their relationships with spiritual care perceptions among nursing students in China: A cross-sectional correlational study

Objective:To investigate the status quo of spiritual care perceptions and associated factors among nursing students in China,and explore the relationships among spiritual care perceptions,spiritual health and empathy ability,in order to provide reference for the construction of spiritual care education intervention program to improve the spiritual care perceptions and competence of nursing students in China.Methods:A cross-sectional and correlational design was undertaken and a convenience sample of 3615 nursing students selected from 11 universities and colleges in Hebei Shijiazhuang and Tianjin,China from January to July 2021.Participants provided data on sociodemographic by completing the sociodemographic characteristics questionnaire,the Chinese Version of the Spiritual Care-Giving Scale(C-SCGS),Spiritual Health Scale Short Form(SHS-SF)and Jefferson Scale of Physician Empathy-Nursing Student(JSPE-NS).Results:The scores of spiritual care perceptions and spiritual health were 172.44±26.23 and 97.54±12.37,respectively,both in the middle level.The score of empathy ability was 102.92±19.65,lower than the average.Spiritual care perceptions of nursing students were positively correlated with spiritual health(r=0.635,P<0.01)and empathy ability(r=0.547,P<0.01).Conclusions:The level of spiritual care perceptions of nursing students in China needs to be improved.It is suggested that nurse managers and educators should pay attention to the spiritual care education of nursing students,by perfecting the spiritual care education system to improve their spiritual health level and empathy ability in multiple ways and levels,like clarifying and standardizing educational objectives,breaking through the traditional single evaluation system,and formulating scientific comprehensive evaluation standards and systems.,so as to improve their spiritual care perceptions and competence level.