ObjectiveTo retrospectively investigate the medication structure and evaluate the rationality among over-60-year outpatients with lung cancer in the West China Hospital of Sichuan University in 2011. MethodsThe data was extracted from the hospital information system (HIS). Excel 2010 software was used for statistical analysis. Resultsa) The total of over-60-year outpatients with lung cancer were 17 296 person-times, of which 12 606 persons-times patients with no medication accounted for 72.88%. The monotherapy in patients with medication accounted for 75.76%. b) There were 5 types of tumour related drugs, including 56 kinds of different drugs, and the total frequency was 6 460 and the average cost was 2 219.38 yuan. The first three drugs classified by 5 types were traditional Chinese drugs (TCM, 28.50%), other therapy (24.91%), and etiological treatment (22.23%). c) For etiological treatment, tyrosine kinase inhibitors (TKI) accounted for 59.96%, and the first three drugs were gefitinib, recombinant human endostatin, and erlotinib. d) For symptomatic treatment, analgesic drugs accounted for 43.65%; and the first three drugs were tramadol hydrochloride sustained-release tablets, sodium zoledronic oxycodone, and acetaminophen. e) For ADR therapy, liver drugs accounted for 40.97%; and the first three drugs were palonosetron hydrochloride, licorice, and diammonium pantoprazole. f) Other treatment involved immunopotentiating drugs and hematopoietic growth factors, the ratios were 62.65% and 37.35%, and the first three drugs were thymalfasin, thymopentin, and recombinant interleukin-11. g) Huisheng, Banao capsule and Bailing capsule were at the first three usage in TCM, the ratios of which were 51.06%, 15.37%, and 13.91%. h) The top ten drugs were Huisheng oral liquid, gefitinib and thymus AFP, thymopentin recombinant interleukin-11, chelating compound spot capsules, recombinant human endostatin, tramadol hydrochloride extended release tablets, sodium, zole dronic, and Bailing capsule. ConclusionThe antitumor therapies were mainly TKI single drug regimen for over-60-year outpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antitussive and skeletal related events prevention drugs. Besides, Chinese patent medicines are in common use as well.
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 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.
Objective To provide baseline date for further research by retrospectively investigating the disease constitution of over-60-year old patients in the West China Hospital of Sichuan University in 2011. Methods The information of over-60-year old outpatients was extracted from HIS and their diagnoses were classified by ICD-10. The data of single disease among top 3 categories of diseases were rearranged and analyzed by Excel software. Results The total of over-60-year old outpatients was 895 123 person-time in 2011, accounting for 19.65%, including 716 826 person-time in specialist outpatient clinics. The specialist diagnoses of 683 491 person-time could be classified by ICD-10, accounting for 95.35% of specialist outpatients. The top 12 diseases were neoplasm, circulatory, digestive, factors influencing health status and contacting with health services, respiratory, musculoskeletal system and connective tissues, nervous, eyes, symptoms/signs and abnormal clinical and laboratory findings, non-classified, mental and behavioral disorders, endocrine, and genitourinary system diseases, and the cumulative constituent ratio was 92.96%. The main pathogenic sites of neoplasm were bronchus and lung (21.98%), esophagus (8.66%), stomach (8.10%), rectum (7.37%), prostate (5.86%), and liver and intrahepatic bile ducts (5.55%), with a cumulative constituent ratio of 57.72%. The main disease burden in circulatory system was hypertension (39.50%), chronic ischaemic heart disease (11.17%), and cerebral infarction (9.70%), and the cumulative constituent ratio was 60.38%. While the main disease burden in digestive system was gastritis and duodenitis (24.98%), other diseases of digestive system (9.26%), and other diseases of liver (8.90%), and the cumulative constituent ratio was 43.13%. There were more female than male among the over-60-year old outpatients (50.67% vs. 49.33%), and male was higher than female only in the incidence of neoplasm, respiratory, factors influencing health status and contacting with health services, and genitourinary system diseases. The disease constitution ratio of 60-69 years old patients was 58.21%. The top 3 neoplasm were the malignant tumors in digestive (38.20%), respiratory and intrathoracic organs (24.70%), and lymphoid, haematopoietic and related tissue (11.97%), with a cumulative constituent ratio of 74.87%. Conclusion The top 3 disease burden of over-60-year old outpatients in West China Hospital were neoplasm, circulatory and digestive diseases, which reflects the trend and law of treatment demands of old patients. It needs to deeply analyze the frequency and flow pattern of patients, and to provide evidence for preventing and treating geriatric diseases.