ObjectiveTo explore the epidemiological characteristics and analyze the related diagnosis and treatment information of wound outpatient cases in a tertiay hospital in Leshan City.MethodsThe data of cases admitted to the wound clinic in a tertiary hospital of Leshan City between January 1st, 2017 and December 31st, 2019 were retrospectively collected. The SPSS software was used for statistical analyses in terms of basic patient information, wound type and dressing use, number of visits and expenses.ResultsA total of 10 880 cases were enrolled. The average age of the patients treated was (45.23±13.45) years old. Patients from the Central District, where the hospital was located in, accounted for the highest proportion (38.63%). The proportion of acute skin and soft tissue injuries was higher than that of chronic skin and soft tissue injuries (62.51% vs. 37.49%). According to the proportions from high to low, the top three chronic skin and soft tissue injuries were postoperative refractory wounds (19.63%), skin and soft tissue infections (3.90%), and stoma complications (3.04%), respectively. A total of 22 937 functional wound dressings were used, of which non-woven outer dressings accounted for 47.52%. Patients with acute skin and soft tissue injuries had a higher healing rate compared with those with chronic skin and soft tissue injuries (96.65% vs. 43.03%, P<0.05). The type of skin and soft tissue injuries with the most visits was cancerous wound [the median (lower quartile, upper quartile) was 68 (35, 121) visits], and the one with the least visits was acute skin and soft tissue injuries [the median (lower quartile, upper quartile) was 2 (1, 7) visits].ConclusionsAs the distance between residence and hospital grows, the number of patients decreases, suggesting that the specialized nursing assistance has achieved initial results in remote areas, but the task of assistance in surrounding areas is still heavy. The type of skin and soft tissue injuries is changing under the concept of enhanced recovery after surgery, and wound care plays an important role in the recovery of patients after surgery. The concept of wet healing and new dressings to promote wound healing are widely used, but still need to be further popularized among patients and medical staff. For chronic wounds that are more expensive to treat, it is necessary to formulate comprehensive treatment plans such as wound treatment, psychological support, and systemic nutrition to promote healing.
ObjectiveTo assess the feasibility and safety of percutaneous transcatheter closure of atrial septal defect (ASD) guided by transthoracic echocardiography (TTE) in outpatients.MethodsFrom December 2016 to June 2018, 50 simple ASD patients underwent TTE-guided transcatheter closure in the outpatient operating room of our hospital (a TTE group) including 22 males and 28 females at the age of 16-48 (27.40±6.95) years. Fifty patients with simple ASD treated with the guidance of conventional fluoroscopy during the same period were treated as a control group, including 22 males and 28 females at the age of 15-48 (28.58±6.96) years. Both groups were re-examined by TTE during follow-up at 1 month, 3 months, 6 months and 1 year.ResultsThe mean age, body weight, the size of ASD and occluder and success rate had no statistical difference between the two groups (P>0.05). Compared with the control group, the TTE group had significantly lower mean operation time (P<0.01) and less cost (P<0.01) since patients need not to be hospitalized. No related complications were found in the TTE group during follow-up.ConclusionPercutaneous transcatheter closure of ASD guided by TTE appears safe and effective for outpatients, and can significantly reduce the cost.
ObjectiveTo understand the experiences of out-patient services of the elderly patients, and to analyze the impact factors of the satisfaction of elderly patients, so as to produce evidence for healthcare quality improvement. MethodsBased on the data collected from the out-patient survey of the 2015 Evaluation of the National Healthcare Improvement Initiative, we compared the disparities of patient satisfaction among different age-groups, between different geographic regions and different types of hospitals. We conducted multivariate binary logistic regression analysis to identify factors, associated with the satisfaction of the elderly outpatients. We also compared satisfaction of the Chinese elderly patients with healthcare services with other countries. ResultsSatisfaction scores of the Chinese elderly out-patients were statistically significant higher than that of the young and middle aged out-patients in the domains of hospital environment (satisfaction score=4.42), process efficiency (satisfaction score=4.20), and overall satisfaction (satisfaction score=4.47) (P < 0.001). On the contrary, the elderly out-patients were less satisfied in the domain of hospital informationization experience (satisfaction score=4.25) than the young and middle aged out-patients. This was also the case for the three indicators under this domain, including convenient appointment (satisfaction score=4.27), diversified payment methods (satisfaction score=4.24) and self-service devices (satisfaction score=4.26) (P < 0.001). Western region and traditional Chinese hospitals had significantly lower elderly outpatient satisfaction comparing with eastern and central regions, and general & specialist hospitals (P < 0.05). Trustful doctor-patient relationship (OR=3.45), respected and comfortable care (OR=1.45), clear and reliable mechanism and channel for praise and complain (OR=1.39), length of communication time with doctors (OR=1.35) and length of waiting time until consultation is acceptable (OR=1.29) were the major factors associated with the overall satisfaction of the elderly out-patients. The overall satisfaction of the Chinese elderly out-patients is a bit lower than that in our neighboring country Japan. The satisfaction towards length of communication with doctors of the Chinese elderly patients is lower than that in most of the industrialized countries. ConclusionSpecial demands of the elderly patients should be carefully considered by hospitals in the process of developing new appointment methods and hospital informationization with the aim of healthcare improvement. Longer communication time with doctors, shorter waiting time until consultation, improving human care and building efficiency mechanism and channel for praise and complain are the priorities for future healthcare improvement.