ObjectivesTo survey the features of reservation bed and investigate the factors of hospital operation which may affect the patient loyalty of reservation bed in large general hospital. MethodsAll patients who reserved bed before July 2013 in hospital service center of a large general hospital were investigated by questionnaire in telephone and collected the basic data. Measurement index was designed to conclude the characteristics of patient loyalty of reservation bed in different departments. Multivariate statistical analysis was used to analyze the influence factors of patient loyalty. ResultsIn the large general hospital, significant difference was found in patient loyalty of reservation bed in different departments. The diversity was mainly impacted by average waiting time of admission, cancelling waiting length, loyalty of patient inside the province, average length of stay, readmission rate on the day of discharge. ConclusionLarge general hospital should pay more attention to dynamic monitoring and disclosure of supply and demand information of bed resources, to improve the management of beds resources and optimize reservation system, to elevate patient's loyalty of reservation bed in hospital.
Objective To analyze the hospitalization expenses and structure of day surgery diseases between general hospital and traditional Chinese medicine hospital, so as to provide a basis for the reform policy formulation of the payment mode of traditional Chinese medicine medical insurance and the optimization of hospital management. Methods Relevant data such as hospitalization expenses and expenses structure of day surgery of one general hospital and one traditional Chinese medicine hospital in Shanghai between January 1, 2019 and June 30, 2022 were selected. The hospitalization expenses and expenses structure of day surgery in traditional Chinese medicine hospital and general hospital were analyzed. Results A total of 95232 day surgery cases were selected in the case hospitals, including 1389 cases in traditional Chinese medicine hospital and 93843 cases in general hospital. The age of day surgery patients in traditional Chinese medicine hospital was smaller than that in general hospital (P<0.001). The total hospitalization expenses [4379.6 (2293.2, 7563.4) vs. 7629.5 (4467.5, 14154.0) yuan], drug expenses [343.0 (65.0, 1107.0) vs. 749.0 (64.0, 1419.0) yuan], consumables expenses [858.8 (162.2, 1630.1) vs. 1951.0 (620.1, 5720.7) yuan], technical labor expenses [1994.8 (1116.8, 3252.4) vs. 3943.3 (2510.8, 6123.4) yuan] of day surgery patients in traditional Chinese medicine hospital were lower than those of patients in general hospital (P<0.001), and the examination expenses were higher than those of patients in general hospital [432.0 (0.0, 898.5) vs. 40.0 (0.0, 418.0) yuan, P<0.001]. In terms of the total hospitalization expenses structure of patients undergoing day surgery, the proportion of technical labor expenses in traditional Chinese medicine hospital was the highest (42.5%), and the proportion of consumables expenses in general hospital was the highest (43.7%). The specialty of day surgery in the traditional Chinese medicine hospital mainly focused on gynecology, general surgery, anorectal surgery and pain medicine, with the highest average expenses in ophthalmology. The specialty of day surgery in the general hospital mainly focused on urology, biliary, pancreatic and gastrointestinal surgery, ophthalmology and gynecolog, with the highest average expenses in orthopedics. There was no statistically significant difference between the age of patients undergoing hemorrhoidectomy in traditional Chinese medicine hospital and that in general hospital (P>0.05). The total hospitalization expenses [7177.4 (6057.5, 8225.7) vs. 10730.3 (8895.7, 14291.4) yuan], drug expenses [838.0 (441.0, 1342.0) vs. 1532.0 (1335.0, 1698.0) yuan], consumables expenses [4518.7 (4268.3, 5084.9) vs. 5550.9 (4066.6, 8340.7) yuan], technical labor expenses [1138.8 (911.3, 1414.2) vs. 3793.9 (2997.1, 4410.3) yuan] of day surgery patients undergoing hemorrhoidectomy in traditional Chinese medicine hospital were lower than those of patients in general hospital (P<0.05), and the examination expenses were higher than those of patients in general hospital [329.0 (0.0, 598.0) vs. 40.0 (40.0, 40.0) yuan, P<0.05]. In terms of the total hospitalization expenses structure of day surgery patients undergoing hemorrhoidectomy, the highest proportion was consumables expenses both in traditional Chinese medicine hospital and general hospital (63.8% and 53.6%, respectively). Conclusions There are differences between the hospitalization expenses of day surgery in traditional Chinese medicine hospital and general hospital. The dominant disease types of day surgery in traditional Chinese medicine hospitals need to be further cultivated. In the future, when the traditional Chinese medicine medical institutions implement the payment according to the diagnosis-related group/diagnosis-intervention packet, they should fully combine the actual situation of the medical institutions and the characteristics of the disease type, and at the same time, they need to further establish the medical fine management based on the disease type quality evaluation.
Efficient disciplinary management in hospitals plays an important role in improving the level of medical services, promoting talent development, elevating research levels, and enhancing the overall strength of hospitals. At present, large comprehensive hospitals are facing increasingly complex challenges and problems in disciplinary construction and management. Bibliometrics, as a tool for literature analysis and evaluation, can assist hospitals in carrying out disciplinary management. This article explores the application and value of bibliometrics in hospital disciplinary management from the perspectives of disciplinary planning, optimizing resource allocation, evaluating disciplinary level, and exploring hot topics and development trends in disciplinary fields, and hopes to provide reference and ideas for peers.
Objective To explore the present situation of the efficiency about public tertiary general hospitals in Shandong province, measure and compare the efficiency and the state of returns to scale of hospitals under different bed scales. Methods Based on the input and output data of 137 public tertiary general hospitals in Shandong province in 2017, two input indicators (the number of employees and the number of actual beds) and two output indicators (the total number of outpatients and emergent patients, and the number of discharges) were selected. The technical efficiency, pure technical efficiency and scale efficiency of sample hospitals were calculated by using data envelopment analysis, and a comparative analysis was carried out under different bed scales. Results Of the 137 public tertiary general hospitals, the mean of technical efficiency value was 0.666, the medians of pure technical efficiency value and scale efficiency value in 2017 were 0.817 and 0.919, respectively. In the 137 sample hospitals, there were 132 hospitals (96.4%) in ineffective status; there were 90 hospitals (65.7%) exhibiting increasing returns to scale, 11 hospitals (8.0%) exhibiting constant returns to scale, and 36 hospitals (26.3%) exhibiting decreasing returns to scale. There were significant differences in hospital efficiency and returns to scale under different bed sizes (P<0.001), and the scale efficiency was the highest when the bed size was 1001-2000. Conclusions The overall operating efficiency of the public tertiary general hospitals in the province was not high yet. Most hospitals were in ineffective status and most of them were in the state of increasing returns to scale. The optimal scale of actual beds is between 1001 and 2000 beds from the perspective of scale efficiency.
Objective To analyze the drug resistance of Mycobacterium tuberculosis complex (MTBC) in West China Hospital of Sichuan University in recent years to provide reference for drug resistance monitoring and prevention strategies of tuberculosis in general hospitals. Methods The clinical strains of MTBC that performed drug susceptibility tests in West China Hospital of Sichuan University between January 2019 and December 2022 were collected. The drug susceptibility information of 13 anti-tuberculosis drugs, namely rifampicin, isoniazid, ethambutol, streptomycin, rifabutin, amikacin, kanamycin, ofloxacin, levofloxacin, moxifloxacin, para-aminosalicylic acid, ethionamide, and capreomycin, was collected and retrospectively analyzed. Results A total of 502 clinical strains of MTBC were included, and 366 of them were isolated from newly-treated patients while 136 form re-treated patients. The resistance rates of MTBC strains to the first-line anti-tuberculosis drugs in descending order were 28.69% (isoniazid), 19.72% (ethambutol), and 14.94% (rifampicin). Among the second-line drugs, the resistance rates to ofloxacin, levofloxacin, and moxifloxacin were 13.55%, 12.15%, and 11.95%, respectively. The resistance rates to amikacin, kanamycin, para-aminosalicylic acid, and ethionamide were all less than 10%. The resistance rates to streptomycin, capreomycin, and rifabutin were 17.53%, 13.55%, and 12.15%, respectively. The resistance rates to the remaining 12 anti-tuberculosis drugs except capreomycin of MTBC strains isolated from re-treated patients were higher than those of MTBC strains isolated from newly-treated patients, and the differences were statistically significant (P<0.05). The isolation rates of monodrug-resistant, polydrug-resistant, multidrug-resistant (MDR) and pre-extensively drug-resistant (pre-XDR) strains were 9.36%, 7.37%, 7.17%, and 7.77%, respectively. The isolation rates of strains with the four drug-resistant phenotypes generally showed a downward trend during the four years, and the changing trends were statistically significant (P<0.05). The isolation rates of MDR and pre-XDR strains from re-treated patients were higher than those from newly-treated patients, and the differences were statistically significant (P<0.001). Conclusion Tuberculosis drug resistance in West China Hospital of Sichuan University, which is a comprehensive tuberculosis-designated hospital, remained severe during the four years from 2019 to 2022, and the prevention of tuberculosis and the monitoring of drug resistance should be further strengthened.
West China Hospital of Sichuan University has explored and established an intelligent assistant evaluation mechanism for professional titles based on the personnel information system, which makes the evaluation more convenient, more efficient, and the whole process more open and transparent. This paper aimed to introduce it and to provide references for evidence-based decision-making of medical institutions.
Objective To investigate the changes of multidrug-resistant organisms (MDROs) in the First People’s Hospital of Longquanyi District of Chengdu around its overall relocation. Methods The First People’s Hospital of Longquanyi District of Chengdu was overall relocated on December 31st, 2016. The detection rates of MDROs and the changes in nosocomial infections before the relocation (from 2015 to 2016) and after the relocation (from 2017 to 2020) were retrospectively analyzed. Results A total of 83634 qualified specimens were submitted for inspection, 8945 strains of pathogenic bacteria were detected, and the detection rate of pathogenic bacteria was 10.70%, showing an increasing trend in yearly detection rates of pathogenic bacteria (χ2trend=8.722, P=0.003); among them, 1551 MDRO strains were detected, and the detection rate of MDROs was 17.34%, showing an increasing trend in yearly detection rates of MDROs (χ2trend=11.140, P=0.001). The detection rate of pathogenic bacteria before relocation was lower than that after relocation, and the difference was statistically significant (9.64% vs. 11.08%; χ2=35.408, P<0.001); there was no significant difference in the detection rate of MDROs before and after relocation (16.32% vs. 17.66%; χ2=2.050, P=0.152). From 2015 to 2020, the detection rates of pathogenic bacteria from sputum+throat swab specimens (χ2trend=81.764, P<0.001) and secretion+pus specimens (χ2trend=56.311, P<0.001) showed increasing trends, while the detection rates of pathogenic bacteria from blood specimens (χ2trend=110.400, P<0.001), urine specimens (χ2trend=11.919, P=0.001), and sterile body fluid specimens (χ2trend=20.158, P<0.001) showed decreasing trends. The MDRO detection rates of Escherichia coli (χ2trend=21.742, P<0.001), Staphylococcus aureus (χ2trend=47.049, P<0.001), and Pseudomonas aeruginosa (χ2trend=66.625, P<0.001) showed increasing trends, while the MDRO detection rates of Klebsiella pneumoniae (χ2trend=2.929, P=0.087) and Acinetobacter baumannii (χ2trend=0.498, P=0.481) showed no statistically linear trend, but the MDRO detection rate of Acinetobacter baumannii dropped significantly in 2017. In the targeted monitored MDROs, the proportions of nosocomial infections in methicillin-resistant Staphylococcus aureus (χ2trend=4.581, P=0.032), carbapenem-resistant Enterobacteriaceae (χ2trend=8.031, P=0.005), and carbapenem-resistant Pseudomonas aeruginosa (χ2trend=6.692, P=0.010) showed decreasing trends; there was no statistically linear trend in the proportion of nosocomial infections in carbapenem-resistant Acinetobacter baumannii (χ2trend=0.597, P=0.440); only one strain of vancomycin-resistant Enterococcus was detected in 2017, and no nosocomial infection occurred. Conclusions The overall detection rate of pathogenic bacteria and MDROs in this tertiary general hospital around relocation showed increasing trends year by year. The detection rate of pathogenic bacteria after relocation was higher than that before relocation, but the detection rate of MDROs after relocation did not differ from that before relocation. The proportion of nosocomial infections among the targeted monitored MDROs decreased.