目的基于以资源为基础的相对价值系数(resource based relative value scale,RBRVS),核算产妇顺产分娩的护理成本,为制定合理的产房助产分娩收费标准提供科学依据。方法选取2021年11月-12月在山东省某三甲医院采用顺产方式分娩的126例...目的基于以资源为基础的相对价值系数(resource based relative value scale,RBRVS),核算产妇顺产分娩的护理成本,为制定合理的产房助产分娩收费标准提供科学依据。方法选取2021年11月-12月在山东省某三甲医院采用顺产方式分娩的126例产妇作为研究对象,借鉴RBRVS对其顺产护理项目的人力成本进行分析,确定人力成本相对价值比率,采用工时测定法对顺产实际操作时间进行测定,应用项目成本阶梯分摊法核算顺产项目实际护理成本。结果顺产护理操作总时间为(404.10±115.87)min,其中观察产程及宫缩耗费时间最长。顺产分娩服务项目总成本为(1216.61±357.68)元,其中人力成本为(759.92±219.62)元,占主要部分。结论产房顺产护理项目收费标准与实际成本有一定差距,建议顺产护理项目收费适时调整,充分体现助产人员的劳动价值。展开更多
Cerebral blood perfusion and cerebrovascular lesions are important factors that can affect the therapeutic efficacy of thrombolysis.At present,the majority of studies focus on assessing the accuracy of lesion location...Cerebral blood perfusion and cerebrovascular lesions are important factors that can affect the therapeutic efficacy of thrombolysis.At present,the majority of studies focus on assessing the accuracy of lesion location using imaging methods before treatment,with less attention to predictions of outcomes after thrombolysis.Thus,in the present study,we assessed the efficacy of combined computed tomography（CT） perfusion and CT angiography in predicting clinical outcomes after thrombolysis in ischemic stroke patients.The study included 52 patients who received both CT perfusion and CT angiography.Patients were grouped based on the following criteria to compare clinical outcomes：（1） thrombolytic and non-thrombolytic patients,（2） thrombolytic patients with CT angiography showing the presence or absence of a vascular stenosis,（3） thrombolytic patients with CT perfusion showing the presence or absence of hemodynamic mismatch,and（4） different CT angiography and CT perfusion results.Short-term outcome was assessed by the 24-hour National Institution of Health Stroke Scale score change.Long-term outcome was assessed by the 3-month modified Rankin Scale score.Of 52 ischemic stroke patients,29 were treated with thrombolysis and exhibited improved short-term outcomes compared with those without thrombolysis treatment（23 patients）.Patients with both vascular stenosis and blood flow mismatch（13 patients） exhibited the best short-term outcome,while there was no correlation of long-term outcome with CT angiography or CT perfusion findings.These data suggest that combined CT perfusion and CT angiography are useful for predicting short-term outcome,but not long-term outcome,after thrombolysis.展开更多
文摘目的基于以资源为基础的相对价值系数(resource based relative value scale,RBRVS),核算产妇顺产分娩的护理成本,为制定合理的产房助产分娩收费标准提供科学依据。方法选取2021年11月-12月在山东省某三甲医院采用顺产方式分娩的126例产妇作为研究对象,借鉴RBRVS对其顺产护理项目的人力成本进行分析,确定人力成本相对价值比率,采用工时测定法对顺产实际操作时间进行测定,应用项目成本阶梯分摊法核算顺产项目实际护理成本。结果顺产护理操作总时间为(404.10±115.87)min,其中观察产程及宫缩耗费时间最长。顺产分娩服务项目总成本为(1216.61±357.68)元,其中人力成本为(759.92±219.62)元,占主要部分。结论产房顺产护理项目收费标准与实际成本有一定差距,建议顺产护理项目收费适时调整,充分体现助产人员的劳动价值。
基金supported by the Science and Technical Committee of Shanghai Municipality of China,No.16QA1400900the Outstanding Youth Grant from Shanghai Municipal Commission of Health and Family Planning of China,No.XYQ2013107+1 种基金the China Postdoctoral Science Foundation,No.2016M592595the National Key Research and Development Program of China,No.2016YFA0203700
文摘Cerebral blood perfusion and cerebrovascular lesions are important factors that can affect the therapeutic efficacy of thrombolysis.At present,the majority of studies focus on assessing the accuracy of lesion location using imaging methods before treatment,with less attention to predictions of outcomes after thrombolysis.Thus,in the present study,we assessed the efficacy of combined computed tomography（CT） perfusion and CT angiography in predicting clinical outcomes after thrombolysis in ischemic stroke patients.The study included 52 patients who received both CT perfusion and CT angiography.Patients were grouped based on the following criteria to compare clinical outcomes：（1） thrombolytic and non-thrombolytic patients,（2） thrombolytic patients with CT angiography showing the presence or absence of a vascular stenosis,（3） thrombolytic patients with CT perfusion showing the presence or absence of hemodynamic mismatch,and（4） different CT angiography and CT perfusion results.Short-term outcome was assessed by the 24-hour National Institution of Health Stroke Scale score change.Long-term outcome was assessed by the 3-month modified Rankin Scale score.Of 52 ischemic stroke patients,29 were treated with thrombolysis and exhibited improved short-term outcomes compared with those without thrombolysis treatment（23 patients）.Patients with both vascular stenosis and blood flow mismatch（13 patients） exhibited the best short-term outcome,while there was no correlation of long-term outcome with CT angiography or CT perfusion findings.These data suggest that combined CT perfusion and CT angiography are useful for predicting short-term outcome,but not long-term outcome,after thrombolysis.
