Through reviewing the implementation of outpatient appointment services around the whole country, the problems of current outpatient appointment services were analyzed, which included imperfect information platform, low rate of medical experts’ visit on schedule, high rate of breaking the appointment by outpatients, and the new inequity caused by opaque information on the outpatient appointment service. The strategies were put forward to address the problems, including the integration of different social resources, cooperation and sharing, enhancing supervision to increase experts’ visit rate, establishing a new model for outpatient appointment service to decrease the breaking of appointment, and opening information to ensure the fair and impartial appointment.
Objective To summarize and analyze the experience of Canadian hospital report, including report contents, indicators system and result application, so as to provide basis for improving Chinese hospital information report and enhancing healthcare regulation. Methods Official networks and databases in Canada were searched, and relative policies, documents, research reports and information reports were included. Results Canadian Hospital Report Project carried out by Canadian Institute for Health Information was effective for gathering and comparing hospitals’ information, and regulating healthcare service. Ontario Hospital Report Project, as a local policy based on national hospital report project, was a good example of local government to improve healthcare service regulation. Conclusion Canadian Hospital Report and Ontario Hospital Report enlighten us that, carrying out the comparison of hospitals in the same type, ensuring the comparability of data, setting comprehensive and scientific report contents and indicators, and emphasizing the self-evaluation function and self-improvement function of the hospital performance evaluation.
ObjectiveTo evaluate changes in operational effectiveness after the implementation of ambulatory surgical management in pars plana vitrectomy (PPV). MethodsA retrospective clinical study. 17 528 surgeries in 10 895 eyes of 10 895 patients who underwent minimally invasive PPV on an ambulatory and/or inpatient basis at Tianjin Medical University Eye Hospital from August 2015 to June 2023 were included in this study. Among them, 5 346 eyes in 5 346 cases were male; 5 549 eyes in 5 549 cases were female. The age ranged from 0 to 95 years, with the mean age of (57.74±13.15) years. 6 381 surgeries in 3 615 eyes from August 2015 to December 2018 (the initial period of day surgery) were used as the control group; 11 147 surgeries in 7 280 eyes from January 2019 to June 2023 (the expanded period of day surgery) were used as the observation group. According to the management mode of ambulatory surgery, the observation group was subdivided into the decentralized management group (January 2019 to December 2020) and the centralized management group (January 2021 to June 2023), with 2 905 and 4 375 eyes and 4 646 and 6 501 surgeries, respectively. Changes in the percentage of day surgery, average hospitalization days, and average unplanned reoperation rate were compared. The Mann-Whitney U test was used to compare numerical variables between groups; the chi-square test or Fisher's exact test was used to compare categorical variables. ResultsThe number of cases of daytime PPV performed in the observation group and control group was 7 852 (70.44%, 7 852/11 147) and 24 (0.38%, 24/6 381) cases, respectively, and the average hospitalization days were 1 (1) and 5 (3) d. Compared with the control group, the observation group had a significantly higher percentage of day surgery (χ2=8 051.01) and a considerably lower mean hospitalization day (Z=4 536 844.50), and the differences were statistically significant (P＜0.000 1). The mean hospitalization days in the decentralized and centralized management groups were 2 (3) and 1 (0) d, respectively, and unplanned reoperations were 34 (0.73%, 34/4 646) and 171 (2.63%, 171/6 501) eyes, respectively. Compared with the decentralized management group, average hospitalization days was significantly lower (Z=1 436.94) and unplanned reoperation rate was significantly higher (χ2=54.10) were significantly lower in the centralized management group, both of which were statistically significant (P＜0.000 1). ConclusionPPV ambulatory management model can significantly reduce the average hospitalization day, but also results in higher rates of unplanned reoperations.
Hospital-based health technology assessment (HB-HTA) refers to the practice of health technology assessment for hospital management decision-making based on the actual situations in hospitals. It includes processes and methods of health technology assessment carried out in and for hospitals. Under the background of comprehensively promoting the reform of public hospitals in China, HB-HTA is undoubtedly an important scientific method to enhance the fine management of public hospitals and implement the policy of medical reform. This paper introduced the concept, the international and domestic development status, the characteristics of HB-HTA, and put forward the scheme of development of HB-HTA macroscopically, so as to promote the popularization and applications of HB-HTA in China.
ObjectiveTo understand the inpatient classification and influence factors of hospitalization expenses, so as to provide basis for hospital management. MethodsThe diagnosis and treatment data of inpatients in a grade A tertiary hospital in 2013 were collected, the percentile method were used to describe the expenses distribution, the K-means clustering method was applied to classify the inpatients, the rank-sum test was utilized to analyze the differences of the costs among different groups, ICD-10 was applied to analyze the diseases distribution, and the median regression was used to analyze the influence factors. ResultsThere were 175 333 inpatients in total. The median of the expenses was 10 016.31 yuan RMB. The inpatients might be classified into seven groups with different expenses (P=0.0001). For inpatients who had no "blood transfusion cost", the top three factors of cost category were operation, laboratory test, examination; for who had "blood transfusion cost", the top three factors of cost category were blood transfusion, laboratory test, examination. There were 2 147, 2 182, 1 499, 1 301, 2 059, 22 and 14 kinds of diseases (ICD-10 four-digit code) respectively among the seven groups. The influence factors could be summarized into patient-related and diagnosis & treatment-related ones. ConclusionThe costs of operation, blood transfusion, laboratory test, and examination affect the inpatients classification greatly. The results could be of help to inform the admission of patients, the expense control and the disease management.
Hospital hosting has made great success in public hospitals. Small and medium public hospitals have made great progress in management and healing with the help of large comprehensive hospitals. The business model of hospital hosting has been used in private hospitals. This study will introduce the differences among each model of hospital hosting and analysis the efficiency in private hospital area.
Social Evaluation is an important reference to guide the reform and development of a public hospital. In view of the patient, hospital stakeholders and the public, West China Hospital of Sichuan University creatively constructed a social evaluation system, including patient satisfaction degree, expert appraisal and online public comment, in order to maintain a good medical environment. After several years of construction and application, the system has been quite effective in promote the development of the hospital. In the assessment of patients' satisfaction degree toward the hospital, we made a great improvement.
Objective To explore the impact of personal digital assistant (PDA) information system on surgery operations, so as to provide basis for improving the efficiency of surgery operations and building medical research databases. Methods The data of patients undergoing surgical treatment in Northern Jiangsu People’s Hospital between October 1, 2018 and September 30, 2020 were retrospectively analysised. According to whether to operate the PDA information system, the patients who did not use the PDA information system for surgical treatment between October 1, 2018 and September 30, 2019 were taken as the control group (before the operation), and the patients who used the PDA information system for surgical treatment between October 1, 2019 and September 30, 2020 were taken as the intervention group (after the operation). The quality of surgical operation, the time of anesthesia opening, the time of opening operation, the length of operation, and other operation indicators before and after the operation of the PDA information system were analyzed. Results A total of 59 610 patients were enrolled, including 27 726 in the control group and 31 884 in the intervention group. Compared with before the operation of the PDA information system, the total annual operation increased by 4 158 cases (15.00%), and the average turnover of per operation room increased (17.10%). The average anesthesia opening time is 14.52 minutes earlier. The average operation opening time is 18.25 minutes earlier. Except for gastrointestinal center surgery, thoracic surgery, neurology surgery, trauma center surgery, intensive care unit ward surgery, biliary and pancreatic surgery, hepatosplenic surgery, and other types of surgery (P>0.05), other types of surgeries were statistically significant differences in the operation duration before and after other operations (P<0.05). Conclusions The PDA information system developed based on "VariFlight" quantifies the quality of surgical operations more finely. It can effectively improve the operation efficiency and economic benefits of surgery, shorten the operation time, contribute to the construction of medical research databases.
As the development of medical imageology, radioexamination has become one of the main approaches of disease diagnosis. However, the society and hospital have not taken the hidden danger and harmfulness of radiation seriously. Through discussing the following eight aspects of radiation safety culture management, this paper aims to reduce the risk of radiation and ensure the safety of patients and medical staff: a) Improving the awareness of safety culture and the understanding of patients on safety culture; b) Consummating the safety management system of the radiation; c) Attaching importance to implementing the relevant laws and regulations of radiation; d) Mastering the examination indications, and especially the contraindications of radiation; e) Strengthening the clinical cooperation and exchange; f) Improving the staff’s ability to distinguish hidden danger and identify patients in high risk; g) Strengthening the nursing behavior safety management of the radiation department; and h) Strengthening the biological security management of the radiation department.