The purpose of evidence-based healthcare management is to prevent the overuse, underuse or misuse of some management measures, and to eliminate the gap between research and practice or the difference between best practices and conventional practices. Evidence-based healthcare management is still in an early stage of development. It also faces many challenges, which have aroused some criticism and even suspicion. This is closely related to the complexity of the management field itself and the lack of empirical research in the field. Considering the scarcity of high-quality health and medical resources in China, in order to improve the scientificalness of healthcare decision-making, we strongly appeal that promoting evidence-based healthcare management requires government-led, universal education, intensified research, scientific evaluation, technological innovation and integration.
ObjectiveTo identify primary osteoporosis patients’ function and environment status based on International Classification of Functioning, Disability and Health (ICF) and provide evidence to clinical treatment, rehabilitation therapy and rehabilitation nursing.MethodsA questionnaire survey was conducted among osteoporosis patients hospitalized in the Center of rehabilitation Medicine of West China Hospital of SiChuan University, from May 2017 to December 2019. The research design was based on a cross-sectional survey. ICF was applied to simplify the core classification set, and a convenient sampling method was adopted.ResultsA total of 240 patients were investigated. All of the patients’ function showed limitation but different level. Meanwhile, including Walking (D450), Sensation of pain(B280), Structure of trunk (S760), Lifting and carrying objects (D430), Mobility of joint function (B710), the proportion of injuries were more than 90%, most of which the limitation level were light and moderate injuries indicating 5%-49% injuries; more than 50% pointed the three parts of environment factors were facilitative factors including Products or substances for personal consumption (E110), Health professionals (E355), Health services, systems and policies (E580), of which the proportion of Health services, systems and policies (E580) were highest.ConclusionOsteoporosis has a significant effect on patients’ function, we should develop clinical treatment, rehabilitation therapy, rehabilitation nursing based on the current evaluation of function.
Interpretation of the complete scientific connotation of functional foods accurately prior to approval and registration based on animal tests and small sample size human food tests is challenging. Further technical evaluation after market introduction should be carried out on safety, health function and other aspects of those widely used commercial scale production products. According to the analysis report on the consumption situation of post-marketing population submitted when applying for product registration extension since the implementation of the functional food registration and filing management measures more than 3 years ago, the post-marketing evaluation report of functional food still lacks systematic and perfect evidence support. Based on the successful experience of evidence-based medicine and post-marketing evaluation evidence, this paper analyzes the post-marketing evaluation content, evidence source construction, evidence classification and classification of functional food, and puts forward the preliminary idea of constructing post-marketing evaluation evidence body of functional food safety and health function technology from multiple view points, so as to provide insights into evidence system research in this field in the future.
Objective To explore the evaluation index and appointment mechanism of healthy professional titles. Methods We collected the data of people evaluated and appointed as advanced professional titles, and the evaluation and appointment documents in West China Hospital. We analyzed the evaluation index and appointment mechanism. Results A total of 400 people gained senior title promotion. The evaluation indexes focused on academic degrees, papers, research projects, patents, as well as awards and honors. The research achievements reduced of 80% people who had gained senior titles. Conclusion Current evaluation indexes prefer to inflexible index and ignore flexible index. The appointment mechanism lacks outcome evaluation, and the professional title will not be eliminated once appointed. In the future, we should improve the evaluation index and appointment mechanism focusing on the specific characteristics of healthy professional titles.
The study investigates the current status of corporate governance structures in medical insurance agencies in typical cities and provinces in China, highlighting the challenges faced by corporate governance in these institutions. It advocates for the continued comprehensive promotion of the nationwide establishment of a unified corporate governance framework for medical insurance agencies. Furthermore, it recommends enhancing the legislative support system for corporate governance in medical insurance agencies to ensure the effective implementation of decision-making powers within these organizations. Additionally, the study proposes actively establishing social evaluation and supervision mechanisms for corporate governance to further enhance the corporate governance structure of medical insurance agencies in China.
Objective To investigate the disease constitution and cost of inpatients in Gaozha Central Township Health Center (GzC) in Wuzhong City of Ningxia Hui Autonomous Region from 2008 to 2010, so as to provide baseline data for further research. Methods A questionnaire combined with a special interview was carried out, and case records and cost information of GzC inpatients in 2008, 2009 and 2010 (from January to November) were collected. The diseases in discharge record were classified according to International Classification of Diseases (ICD-10) based on the first diagnose and the cost was analyzed. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Results a) The total number of the inpatients was 1124, 642 and 747 in 2008, 2009 and 2010, respectively. The female was more than the male in both 2008 (59.34% vs. 40.66%) and 2009 (60.75% vs. 39.25%), and their disease spectrum included 17 categories, which accounted for 81% of ICD-10; b) The top six most commonly seen systematic diseases with a constituent ratio from 86.63% to 92.06% in recent three years were as follows: the respiratory system, digestive system, circulatory system, genitourinary system, injury and toxicosis, skeletal musculature and connective tissue disease. Except the injury and toxicosis, the other five systematic diseases were commonly seen in females rather than in males; c) The top 15 monopathies in recent three years were pulmonary infection, tracheitis or bronchitis, coronary heart disease, soft tissue injury, gastritis or chronic gastritis, upper respiratory infection, hypertension, urinary tract infection, prolapse of lumbar intervertebral disc, pelvic inflammation, fracture, pneumocardial diseases, superficial injury, chronic cholecystitis and arthritis; d) The main burdens of disease for inpatients focused on 35-54 age groups, then followed by the age groups above 55 in 2008 and 2009. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males. Pulmonary infection focused on the age groups above 35; the onset of hypertension increased obviously and a sharp rise of hypertension existed in the 45-54 age groups in 2008, but the hypertention focused on 35-44 age groups in 2009; e) The total inpatients with top 15 monopathies accounted for 64.06% to 71.21%, including 8-9 chronic diseases ranking higher in 2010, and 6-7 acute diseases focusing on infection and injury; and f) The average costs of chronic diseases were higher than those of acute diseases. Conclusion a) There is a big gap between GzC and Yong’an Central Township Health Center (YaC) regarding the level of the regional economic development, the situation of disease burden and cost of inpatients. The former is demonstrated as general Central Township Health Center, while the latter as affluent Central Township Health Center in western China; b) In recent three years, the main systematic diseases are in respiratory, circulatory and digestive system; the inpatients suffer from more chronic diseases rather than acute diseases in their young age; the acute diseases mainly include infection and injury, and the pulmonary infection has ranked as the first during the past three years; c) The inpatients in 2008 and 2009 are mainly in ages of 35 to 54, and then are over 55 years old. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males; d) The patients’ average costs of chronic diseases for hospitalization and drug in 2010 were lower than those of YaC. Consideration on reasonable constitution of the cost for hospitalization should be paid attention to; and e) It is urgent to strengthen the construction of infrastructure and informatization in GzC.
Objective To investigate the health technology assessment reports, analyze publication characteristics and report quality, and explore hot topics in health technology assessment. Methods Web of Science and CNKI databases were searched to collect complete health technology assessment reports from inception to January 2023. SPSS 26.0 software was used to analyze the publication journals, countries, number of authors, assessment types and assessment contents of the assessment reports. The report quality was assessed based on International Network of Agencies for Health Technology Assessment (INAHTA) report criteria (2007 edition). VOSviewer 1.6.11 was used to analyze keywords clustering. Results A total of 216 papers were included, with 158 published by Chinese authors, and a rapid growth trend in the number of reports over past four years. The rate of reports on health technology social adaptability assessment was only 17.13%. Among the Chinese reports, 25 were general health technology assessments, 35 were rapid assessments, and 3 were mini assessments. Among the English reports, 4 were rapid assessments, and 54 were regular healthcare technology assessments. For the 14 items in the INAHTA reporting criteria, the reporting rates were high for the brief summary (98.61%), problem description (94.91%), and results discussion entries (97.69%). However, the reporting rates were low for criteria such as personnel responsibilities, conflict of interest statements, and peer review statements, at 31.94%, 19.44%, and 3.24% respectively. English literature generally exhibited higher report quality. Conclusion In recent years, the volume of health technology assessment reports in China has been increasing, with developments in assessment types and application fields. However, there are also problems with standardization of reporting.
ObjectivesTo analyze the characteristics six types of cross-regional cancer patients and their medical behavior in Beijing.MethodsWe described the characteristics of cross-regional patients, analyzed the differences between cross-regional and local patients, and identified the key factors by analyzing the influencing factors of patient's cross-regional behavior to factors by using binary logistic regression model.ResultsCompared with local patients, cross-regional cancer patients had the following characteristics: consisting primarily of young and middle-aged workforce, simpler disease status and those more inclined to choose special hospital and surgical treatment.ConclusionsPromoting the construction of regional oncology medical center can meet the needs of cross-regional patients and relieve the pressure of medical treatment in large cities caused by cross-regional medical treatment behavior.
ObjectiveTo explore the clinical effect of healthy education on functional constipation caused by unhealthy lifestyle, and to analyze the disadvantages affecting the curative effect. MethodsA total of 167 cases of functional constipation from February 2009 to February 2012 were included. All of the patients were followed up for one year. We collected clinical data of curative effect and influencing factors, determined the clinical value of healthy education, and analyzed the influence of different factors on the curative effect of healthy education. ResultsThe total curative effect after one-year follow-up was 84.4%. The curative effect in elderly patients was significantly higher than that in middle-aged ones (P<0.05). The curative effect in urban patients was remarkably higher than that in rural ones (P<0.05). And the curative effect of patients with college degree wass much higher than that in patients with education background of primary school or below (P<0.05). ConclusionHealthy education has important value on releasing and eliminating functional constipation caused by unhealthy lifestyle. And it needs individual education aimed at patients with different age, education degree, and domicile.
The development and application of health decision support system (HDSS) in clinical service and health management is efficient in controlling health expenditure rising from overlapped examinations, and in reducing medical errors rising from insufficient decision-making support tools. Typical HDSS in America includes CPOE, MYCIN, QMR, NEDSS etc., which are mainly used in disease diagnosis and treatment, public health emergency management, hospital management, and health insurance management. The successful experiences accumulated in the development of the US health decision support system are worth referring to, such as, integration of management system, decision-makers and ICT, meeting the urgent needs of clinical service and health management, effective E-health construction, and rational development pathway from clinical decision support system to health management decision support system.