Summary:Throughout the duration of the New Cooperative Medical Scheme(NCMS),it was found that an increasing number of rural patients were seeking out-of^county medical treatment,which posed a great burden on the NCMS ...Summary:Throughout the duration of the New Cooperative Medical Scheme(NCMS),it was found that an increasing number of rural patients were seeking out-of^county medical treatment,which posed a great burden on the NCMS fund.Our study was conducted to examine the prevalence of out-of^county hospitalizations and its related factors,and to provide a scientific basis for follow?up health insurance policies.A total of 215 counties in central and western China from 2008 to 2016 were selected.The total out-of-county hospitalization rate in nine years was 16.95%,which increased from 12.37%in 2008 to 19.21%in 2016 with an average annual growth rate of 5.66%.Its related expenses and compensations were shown to increase each year,with those in the central region being higher than those in the western region.Stepwise logistic regression reveals that the increase in out-of-county hospitalization rate was associated with region(XI),rural population(X2),per capita per year net income(X3),per capita gross domestic product(GDP)(X4),per capita funding amount of NCMS(X5),compensation ratio of out-of^county hospitalization cost(X6),per time average in-county(X7)and out-of-county hospitalization cost(X8).According to Bayesian network(BN),the marginal probability of high out-of^county hospitalization rate was as high as 81.7%.Out-of^county hospitalizations were directly related to X8,X3,X4 and X6.The probability of high out-of-county hospitalization obtained based on hospitalization expenses factors,economy factors,regional characteristics and NCMS policy factors was 95.7%,91.1%,93.0% and 88.8%,respectively.And how these factors affect out-of-county hospitalization and their interrelationships were found out.Our findings suggest that more attention should be paid to the influence mechanism of these factors on out-of-county hospitalizations,and the increase of hospitalizations outside the county should be reasonably supervised and controlled and our results will be used to help guide the formulation of proper intervention policies.展开更多
The public power and the private enterprise, the main agents of national economic and social development, when cooperating strategically, promote increased functional efficiency of their activities. In order to highli...The public power and the private enterprise, the main agents of national economic and social development, when cooperating strategically, promote increased functional efficiency of their activities. In order to highlight the relevance of such partnership, this article aims to analyze the potential of actions jointly developed by private organizations and Brazilian universities. The research problem is lined in the field of health, which hosted actions developed between the Federal University of Rio Grande do Norte （UFRN） and the Hospital Maternity Guiomar Fernandes （HMGF）, located in the city of Alexandria, in Rio Grande do Norte. The study emphasizes the shortcomings of this organization, the resolving power of the university in this scenario, and performs the analysis of the effects of this cooperation. The methodology used in this research was the case study in HMGF. With emphasis on fundraising and improving the informational management system, funding sources for projects of restructuring and expansion of the hospital were sought, as well as initiatives for developing hospital management softwares for small- and medium-sized organizations. As a result, the articulation between the university and the hospital provided the elaboration of a project for software development and the production of a project for physical restructuring and technological investment, aiming to expand the supply and quality of the hospital＇s services. The implementation of information systems, associated with investments in hospital infrastructure, providing increased efficiency in public assistance to the population, bringing both local and regional benefits, besides, providing the authorities with relevant data on the development of public policies.展开更多
基金This work was supported by the National Natural Science Foundation of China(No.71573192 and No.81573262)the Fundamental Research Funds for the Central Universities,HUST(No.2016YXZD042).
文摘Summary:Throughout the duration of the New Cooperative Medical Scheme(NCMS),it was found that an increasing number of rural patients were seeking out-of^county medical treatment,which posed a great burden on the NCMS fund.Our study was conducted to examine the prevalence of out-of^county hospitalizations and its related factors,and to provide a scientific basis for follow?up health insurance policies.A total of 215 counties in central and western China from 2008 to 2016 were selected.The total out-of-county hospitalization rate in nine years was 16.95%,which increased from 12.37%in 2008 to 19.21%in 2016 with an average annual growth rate of 5.66%.Its related expenses and compensations were shown to increase each year,with those in the central region being higher than those in the western region.Stepwise logistic regression reveals that the increase in out-of-county hospitalization rate was associated with region(XI),rural population(X2),per capita per year net income(X3),per capita gross domestic product(GDP)(X4),per capita funding amount of NCMS(X5),compensation ratio of out-of^county hospitalization cost(X6),per time average in-county(X7)and out-of-county hospitalization cost(X8).According to Bayesian network(BN),the marginal probability of high out-of^county hospitalization rate was as high as 81.7%.Out-of^county hospitalizations were directly related to X8,X3,X4 and X6.The probability of high out-of-county hospitalization obtained based on hospitalization expenses factors,economy factors,regional characteristics and NCMS policy factors was 95.7%,91.1%,93.0% and 88.8%,respectively.And how these factors affect out-of-county hospitalization and their interrelationships were found out.Our findings suggest that more attention should be paid to the influence mechanism of these factors on out-of-county hospitalizations,and the increase of hospitalizations outside the county should be reasonably supervised and controlled and our results will be used to help guide the formulation of proper intervention policies.
文摘The public power and the private enterprise, the main agents of national economic and social development, when cooperating strategically, promote increased functional efficiency of their activities. In order to highlight the relevance of such partnership, this article aims to analyze the potential of actions jointly developed by private organizations and Brazilian universities. The research problem is lined in the field of health, which hosted actions developed between the Federal University of Rio Grande do Norte （UFRN） and the Hospital Maternity Guiomar Fernandes （HMGF）, located in the city of Alexandria, in Rio Grande do Norte. The study emphasizes the shortcomings of this organization, the resolving power of the university in this scenario, and performs the analysis of the effects of this cooperation. The methodology used in this research was the case study in HMGF. With emphasis on fundraising and improving the informational management system, funding sources for projects of restructuring and expansion of the hospital were sought, as well as initiatives for developing hospital management softwares for small- and medium-sized organizations. As a result, the articulation between the university and the hospital provided the elaboration of a project for software development and the production of a project for physical restructuring and technological investment, aiming to expand the supply and quality of the hospital＇s services. The implementation of information systems, associated with investments in hospital infrastructure, providing increased efficiency in public assistance to the population, bringing both local and regional benefits, besides, providing the authorities with relevant data on the development of public policies.
