山西省2000-2004年住院川崎病病例流行病学分析

川崎病（KD）是一种病因尚未明确的以全身血管炎性病变为主的小儿发热出疹性疾病。自1967年日本川崎富作医师首次报道以来，世界各地相继有病例报道，我国部分省市也做了KD的流行病学调查，发现该病的发病率逐年上升。为此我们对山西省部分医院的住院病例进行回顾分析，以了解山西省KD的流行病学特征。     

662例住院患者的用药分析

目的 分析住院患者的药物利用情况和药品费用。方法 对2004年9月1～7日我院出院的662例患者的药物利用情况和住院期间的药品费用进行统计分析。结果 662名患者在住院期间共使用药物901种，人均用药24．15种。使用最多的药物分别是抗感染药物、抗肿瘤药物、血液系统用药和消化系统药物。给药方式以口服和注射给药为主，其中注射药品的消耗金额占了药品总金额的90％。患者在住院期间的用药金额平均为7234元。结论 住院患者的用药品种数较多，药品费用负担较重。减少用药品种、采取口服用药方式、选择合适的治疗药物可望促进药物利用水平的提高，减轻患者的经济负担。     

住院病人药品消耗因子分析

目的通过对住院病人药品分类消耗的研究,探讨药品消耗潜在的支配因子,以及控制药品费用增长的主要途径。方法从医院信息系统数据库中提取某年度住院病人消耗的药品明细数据进行因子分析。结果住院病人的药品消耗可以构建6个公因子模型,6个因子模型对医院整体药品消耗与各个专业科室构建的因子模型对科室药品消耗的解释是不同的。抗感染类药品的消耗在药品总消耗中居第一位。结论控制药品消耗费用,医院和科室应采取不同的措施。提高医生对疾病的认识程度和用药干预治疗的应用水平可以提高医疗服务水平,降低医疗成本。     

The rate of outpatient cataract surgery in ten European countries: An analysis using data from the SHARE survey

Background The aim of this study was to determine the rates of outpatient cataract surgery (ROCS) in ten European countries and to find country-specific health indicators explaining the differences. Methods Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE), 251 eligible respondents were identified for which cataract surgery was the last surgical procedure. The ROCS of ten countries were compared using logistic regression. The influence of the public expenditure on health as per cent of the total expenditure on health, of the number of acute care beds per 1,000 population, and of the number of practicing physicians per 1,000 population, was studied by multiple logistic regression. Additional information was obtained from country-specific opinion leaders in the field of cataract surgery. Results The ROCS differed significantly between the ten analysed European countries where Denmark had the highest (100%) and Austria the lowest (0%) rate of day care surgery. A decrease in the density of acute care beds (p < 0.0000001) and in the density of practicing physicians (p < 0.05) and an increase in the public expenditure on health as per cent of the total health expenditure (p < 0.01) lead to an increase in the ROCS. According to the opinion leaders, regulations and financial incentives also have a strong influence on the ROCS. Conclusions The outpatient rate of cataract surgery in the ten European countries was mainly influenced by the acute-care beds density, but also by the density of practicing physicians, and by the public expenditure on health.     

我院住院药房摆药模式探讨

目的探索住院药房摆药新模式。方法介绍我院住院药房摆药系统的流程,并将其与传统模式进行比较。结果与结论采用VERSION2·21管理信息系统,不仅可减轻住院药房的负担,提高工作效率,还可减少药品损失,适宜在中等规模医院住院药房推广。     

住院患者护理需求及满意度相关因素分析

目的分析住院患者护理需求及满意度的相关影响因素。方法选取住院患者200例，发放调查问卷，回收有效问卷191份，对相关数据进行分析。结果住院患者的需求范围广泛；年龄与所在科室对住院患者对生理舒适方面的需求有影响；住院患者对护理工作的总体满意度较高；不同科室的住院患者对家属陪伴需求方面的满意度不同；自理程度与住院患者多方面的满意度有关；住院患者的满意度与护理需求的排序基本一致。结论护理工作需要满足患者各方面的需求，以促进其全面康复。     

A comparison of two hospitalist models with traditional care in a community teaching hospital

PURPOSE: Many studies have documented significant length of stay reduction and cost savings when hospitalist care is compared with traditional care. However, less is known about the concurrent performance of more than one hospitalist model in a single site. SUBJECTS AND METHODS: This retrospective cohort study of 10595 patients was conducted between July 2001 and June 2002 in a tertiary care community-based teaching hospital. Risk-adjusted length of stay, variable costs, 30-day readmission rates, and in-hospital and 30-day mortality were measured for patients treated by Community Physicians, Private Hospitalists and Academic Hospitalists. RESULTS: There was a 20% reduction in length of stay on the Academic Hospitalist service (p <.0001) and 8% on the Private Hospitalist service (P = .049) compared with Community Physicians. Similarly, total costs were 10% less on the Academic (P <.0001) and 6% less on the Private Hospitalist (P = .02) services compared with Community Physicians. The length of stay of Academic Hospitalists was 13% shorter than that of Private Hospitalists (P = .002); differences in costs between hospitalist groups were not statistically significant. Differences in in-hospital and 30-day mortality and 30-day readmission rates among the 3 physician groups were also not statistically significant. CONCLUSIONS: The impact on patient outcomes and resource utilization may vary with the hospitalist model used. Future studies should examine the specific organizational characteristics of hospitalists that contribute to improved patient care and resource utilization.     

Smoking cessation a byproduct of EEG telemetry monitoring

Smoking is a common problem in epilepsy patients. The inpatient video-EEG monitoring (VEEG) unit provides a unique and conducive environment for epilepsy patients to participate actively in a smoking-cessation program. The restrictions and confinement to the telemetry bed impose a forced abstinence from smoking. It has been suggested that patients who are hospitalized may be more receptive to smoking-cessation advice. We report two patients who were successfully able to quit smoking after admission for VEEG.     

Inpatient treatment for eating disorders: outcome at discharge and 3-month follow-up

There have been few studies of inpatient treatment for eating disorders. Existing studies have mostly examined small samples of either anorexic or bulimic patients. The current study evaluated large samples of anorexic and bulimic inpatients at intake, discharge, and a 3-month follow-up. At discharge, patients in both groups showed substantial and statistically significant improvements on self-report measures of depression and eating disorder symptomatology. Treatment gains were largely maintained at follow-up. Correlational analyses found consistent inverse relationships between degree of change experienced during and after hospitalization. More favorable outcome during treatment was associated with less favorable outcome after treatment. Implications of these findings for the assessment and treatment of eating disorders are discussed.     

上海市蛔虫病住院病例调查

目的了解上海市蛔虫病住院情况及其对患者的危害和经济负担，为防治蛔虫病提供依据。方法采用回顾性调查方法，在全市范围内对各级医疗部门确诊的蛔虫病住院病历资料进行分析。结果上海市19个区县提供1991～2001年间蛔虫病例共1790例，其中肠道蛔虫病、胆道蛔虫病分别占28．38％和69．83％。2001年的住院病例数（94例）较1991年（175例）下降了46．29％，总体呈下降趋势。患者男女之比为1：1、36，平均住院年龄为32、71岁，1～9岁年龄段以肠蛔虫病为主，青壮年以胆道蛔虫病为主。13．35％患者出现并发症，居前三位为胆囊炎（27、10％）、胆管炎（18，25％）、贫血（2．99％）。25、31％患者通过病原学确诊，影像学检查阳性率为76.54％。肠、胆蛔虫病单用药物治疗者占43.65％～47．63％，痊愈占64．49％～78．97％。住院天数平均11.33d，最长98d。平均每例住院费用肠道蛔虫769元，胆道蛔虫2661元。结论蛔虫病多发生于儿童和妇女，1991～2001年间的住院例数呈下降趋势，对高危人群应采取切实可行的防治措施。