2016-2018年湖南省冠心病患者住院费用结构分析

目的 分析2016-2018年湖南省冠心病患者住院费用结构变动情况,为有效控制住院费用的增长速度,实现医疗资源的优化配置提供依据.方法 采用多阶段分层抽样的方法,获取2016-2018年湖南省44家医疗卫生机构的25 430例冠心病患者住院数据.通过灰色关联分析法对各单项住院费用的关联程度进行分析;采用结构变动度分析法...     

Gain in real-world cardiac resynchronization therapy efficacy with SyncAV dynamic optimization: Heart failure hospitalizations and costs

1. Download : Download high-res image (150KB)
2. Download : Download full-size image

     

Adverse clinical phenotype in inflammatory bowel disease: A cross sectional study identifying factors potentially amenable to change

Background and Aim: A significant proportion with inflammatory bowel disease (IBD) exhibit an adverse clinical phenotype reflected in endpoints like surgery and hospitalizations. We sought to identify clinico‐demographic factors associated with these adverse consequences that may be amenable to change. Methods: Over 6 months IBD patients visiting a metropolitan center were prospectively identified and given a comprehensive survey addressing patient knowledge, mental health and satisfaction with medical care along with other clinical data. Logistic regression analyses assessed for associations between clinico‐demographic variables and adverse clinical endpoints (previous surgery [ever] and/or recent inpatient admission over a 16 month observation period). Results: Of 256 IBD patients, 162 responded (response rate 63%); 95 (59%) had Crohn's disease (CD), 63 (40%) ulcerative colitis (UC), four indeterminate colitis; 53% were female. Factors associated with a greater likelihood of hospitalization included moderate/severe disease activity, psychological co‐morbidity, numbers of medications and outpatient visits (odds ratio [OR] 7.09 [2.83–17.76], 4.13 [1.25–13.61], 1.26 [1.03–1.54], 1.17 [1.00–1.37] respectively; all P < 0.05). Post‐surgical patients were more likely to have CD, more currently active disease and longer disease duration (OR 8.55 [2.43–29.4], 3.52 [1.26, 9.87], 1.14 [1.08, 1.21] respectively; all P < 0.02), yet were less likely to have previously seen a gastroenterologist, OR 0.25 [0.08–0.76] (P = 0.01). Conclusions: ‘At risk’ patients (those previously operated, with ongoing disease activity, dissatisfaction and/or psychological comorbidities) may benefit from early identification and more intensive management. Specialist gastroenterology care appears to be under‐utilized in operated patients yet may reduce future IBD morbidity.     

军队职工住院资料综合统计分析

目的:了解住院军队职工的患病和住院消耗情况,找出影响军队健康和威胁军队职工生命的主要病因及消耗医疗费用较多的主要病种. 方法:收集并分析2002～2005年某部队医院收治的住院军队职工的有关资料,获得住院队职工的主要疾病和住院费用. 结果:循环系统疾病、呼吸系统疾病、消化系统疾病是影响军队职工健康的主要系统病因,恶性肿瘤和心血管病是消耗医疗费用最多的病种. 结论: 加强对军队职工卫生习惯,降低军队职工主要系统疾病的发病率和死亡率,并加强对消耗费用较多的疾病的监管.     

我国医学院校医疗保险专业建设的理性思考

分析了医学院校医疗保险专业兴起的历史背景,同时医学院校应该是医疗保险专业人才培养的最适合载体。科学的课程体系是医疗保险专业人才培养之本,在设计医疗保险专业课程体系时需要处理好以下几个关系:社会医疗保险和商业医疗保险的课程之间的关系,医学和保险课程之间的关系,理论和实际的关系,成绩和素质之间的关系。     

Another outcome of neonatal intensive care: First year mortality and hospital morbidity

Objectives: To determine first year mortality and hospital morbidity after neonatal intensive care.
Methodology: Cohort study of 6077 surviving infants inborn in one regional hospital in 1988. Nine hundred and eighty-eight received neonatal intensive care and 103 were very low birthweight (VLBW).
Results For infants who required care in the neonatal intensive care unit (NICU), the relative risk of dying before their first birthday was 3.6 (95% confidence intervals [Cl] 1.5-8.8). This increased risk was associated with low birthweight (LBW) rather than requirement for NICU care. Of all inborn survivors, 10.4% were readmitted to hospital in the first year and 2.4% more than once. The readmission rate was 20% for NICU survivors and 30% for VLBW infants. The risk of hospitalization was independently associated both with NICU admission (odds ratio 2.3, Cl 1.9-2.9) and with VLBW (OR 1.8, Cl 1.1-3.0). The NICU survivors also had multiple admissions and prolonged hospital stays.
Conclusions Both low birthweight and neonatal illness requiring intensive care are important indicators of continuing medical vulnerability over the first year of life.     

Childhood asthma hospitalization and residential exposure to state route traffic

This study investigated whether pediatric hospitalization for asthma was related to living near a road with heavy traffic. In this case-control study, cases (N=417) consisted of white children aged 0-14 years who were admitted for asthma and who resided in Erie County, New York, excluding the city of Buffalo. Controls (N=461) were children in the same age range admitted during the same time period for nonrespiratory diseases. Subjects' residential addresses were linked to traffic information provided by the New York State Department of Transportation. After adjustments for age and poverty level were made, children hospitalized for asthma were more likely to live on roads with the highest tertile of vehicle miles traveled (VMT) (odds ratio (OR): 1.93, 95% confidence interval (CI): 1.13-3.29) within 200 m and were more likely to have trucks and trailers passing by within 200 m of their residence (OR=1.43, 95% CI: 1.03-1.99) compared to controls. However, childhood asthma hospitalization was not significantly associated with residential distance from state roads, annual VMT within 500 m, or whether trucks or trailers passed by within 500 m. This study suggests that exposure to high volumes of traffic/truck within 200 m of homes contributes to childhood asthma hospitalizations.     

Day hospitalization programs for eating disorders: a systematic review of the literature

OBJECTIVE: Partial day hospitalization programs for the treatment of eating disorders are increasingly being developed worldwide. METHOD: First, a systematic database search of day hospitalization programs for eating disorders, published in either English or German, was conducted. Programs that provided sufficient information on their program structure were summarized and compared across various dimensions. Second, the responsible program directors were contacted to provide additional information regarding outcome data, current trends, challenges, and future directions of their programs. Third, outcome data from day programs presented at international conferences were included to expand the base of the review. DISCUSSION: Although the programs from different countries and health care environments varied in terms of their purpose and operated within very different health care systems, many similarities were found to exist, including the use of a multidisciplinary staff and reliance on group treatment as the primary means of therapy. Marked differences were noted in terms of inclusion criteria and intensity of care.