ObjectiveTo explore the appropriate intervention measures to reduce the influence of drug repercussion by pediatric hospital inpatients on nursing work. MethodBetween March 1st and 28th, 2014, statistical analysis on the characteristics of pediatric drug-return by drug repercussion questionnaires was carried out. ResultsEach drug repercussion took much time of the nurses (median of 5.00 minutes per time). The frequency of drug repercussion in the internal medicine department was more than that in the surgical department; the most drug repercussions were found in the respiratory medicine department, reaching 26.84%. The main category of drug repercussion was aerosolized medication (39.32%). The drug repercussion mainly resulted from lack of patients' education and doctor-related administration, which had a proportion of 31.44% and 27.19%, respectively. ConclusionsThe wards which have more drug repercussions should be under the supervision according to the analysis of drug repercussion. Meanwhile, improving patients' education and training of medical staff can reduce the pediatric hospital inpatients' drug repercussion and also may reduce the bad effects on nursing work.
ObjectiveTo explore the influence factors on inpatients' satisfaction, in order to identify influence factors for improving inpatients' satisfaction. MethodsA sampling survey was conducted in hospitals at different levels in Sichuan province. The satisfaction of inpatients in these hospitals was investigated by self-designed questionnaire. Then, a structural equation model on influence factors of satisfaction was constructed. ResultsA total of 1 237 inpatients from 12 hospitals were surveyed. The total satisfaction of these patients was 82.14%. The patients' satisfaction of grade A tertiary hospital in Chengdu city was obviously lower than that of the prefecture- and county-level hospitals (all P values <0.05). The fitting degree of structural equation model was good; Inpatients' satisfaction was mainly influenced by 5 factors including hospital values (HV), service quality of doctors and nurses (SQ), service process (SP), convenience of resources (CR) and comfort of facilities (CF). Of the 5 factors, the HV and SQ respectively ranked the 1st and 2nd to the influence degree on satisfaction. ConclusionThis study identifies the key influence factors on inpatients' satisfaction. Specific measures should be taken by hospital administrators to improve the quality of medical services and the satisfaction of inpatients.
Objective To investigate the situation of MRI examination in children in outpatient and inpatient departments of the Sichuan Provincial People’s Hospital from 2010 to 2012, so as to provide favourable basis for the choice of imaging examination in children. Methods The materials of electronic reports of MRI examination in paediatric inpatient and outpatient departments from 2010 to 2012 were collected, categorized, and analyzed. Results a) 2 148 children underwent MRI examination in the Sichuan Provincial People’s Hospital from 2010 to 2012. The total number of patients increased with year. Boys were more than girls. The positive incidence was slightly decreased. The number of outpatients was more than inpatients, but the positive incidence was lower in outpatients. b) The total numbers of examination position were increased with year and the number of single position examination was the most (accounted for than 85% of the total numbers). The main examination positions included: head, MRA of the head, cervical column, knees, lumbar column, pituitary gland, thoracic column, and abdomen. The examination positions diversified gradually. The application of examination technique also increased gradually. c) The systemic disease spectrum of positive cases in MRI examination included 9 categories, which accounted for 42.86% of ICD-10. The nervous systematic disease, muscle, skeleton and connective tissue disease were the categories. The major disease types were stable during the recent 3 years. The increase was obvious in injuries of the knees, malacosis and atrophy of the brain, the deformity of the brain. Conclusion The total numbers of the patients and positions examined increased gradually with year in the Sichuan Provincial People’s Hospital from 2010 to 2012. The applications of MRI in the head, limbs and joints, and soft tissues were more extensive. Children diagnosed as positive results had diseases of the central nervous system, limbs and joints, and connective tissue disease.
Abstract Objective To investigate the disease constitution and hospitalization expenses in Songqiao Central Township Health Center (SqC) in Gaoyou City of Jiangsu Province in 2010, so as to provide the baseline data of disease burden for further study. Methods The inpatient records of SqC in 2010 were collected. The first discharge diagnoses were classified according to the International Classification of Disease 10 (ICD-10). The general information of the inpatients, discharge diagnosis, hospitalization expenses, disease category, age, gender, and reimbursement of expenses were described and analyzed by using Microsoft Excel 2003 and SPSS 13.0 software. Results a) The total number of inpatients was 1036 in 2010, and the gender ratio was about 1.0 (50.7% vs. 49.3%); b) The disease spectrum included 17 categories. The cumulative percents of the top 5 systematic diseases were 81.2%, including the respiratory, digestive, neoplasm, circulatory diseases, and injury, poisoning amp; external causes; c) The top 15 diseases were pneumonia, fracture, malignant neoplasm, benign neoplasm, acute bronchitis, cerebral infarction, hypertension, acute appendicitis, emphysema, cholecystolithias accompanied with cholecystitis, inguinal hernia, coronary heart disease, diabetes mellitus, chronic bronchitis and superficial injury; d) The patients suffering from pneumonia and acute bronchitis were mainly over 65 years old and younger than 5; e) The number of chronic diseases significantly increased with age, especially after the age of 35 years old, and reached the peak at the age over 65 years old; while the acute diseases were mainly distributed at the age younger than 15 yeas old and older than 65 years old. The average length of stay, the total hospitalization and out-of-pocket expenses per capita of the chronic diseases were more than those of the acute ones (13.8 days vs. 9.9 days, ? 3 082 vs. ? 2 615; ? 417 vs. ? 371, respectively); f)The length of stay and total hospitalization per capita were quite higher than the other township health centers (11.6 days vs. 5.2 days, ? 3 001.4 vs. ? 1 004.6); and g) Both of the total reimbursement and out-of-pocket expenses per capita accounted for 44%-57% of the total hospitalization expenses. Among the total reimbursement, the payment from New Cooperative Medical Scheme (NCMS) accounted for over 99%, while that from Medical Aid Scheme only accounted for less than 2%. Conclusion a) The top 3 systematic diseases of SqC are seen in respiratory system, digestive system and neoplasm. The acute diseases are mainly pneumonia and fracture; b) The number of acute or chronic diseases increases significantly with age, especially after 35 years old. Both adolescents and the aged suffer from the heaviest burden of diseases; c) The average length of stay and hospitalization expenses pre capita of SqC are much higher than those of the other township health centers; and d) NCMS is the major source of reimbursement. However, the proportion of out-of-pocket expenses and the burden of diseases are still very high and heavy. Thus the policy of NCMS needs to be adjusted step by step in future.
Objective To provide references to control the cost of stroke inpatients by analysing pertinent factors of stroke inpatients. Methods According to the models of Anderson and Newnan, univariable analysis and multivariable statistical analysis were applied to a number of factors including predisposing factors, enabling factors, and needs factors in 1 969 stroke inpatients of two third level first-class hospitals in Chongqing. Results Among the 1 969 stroke inpatients, 64% had a history of hypertension, and 50% exhibited hypertension during their stay in hospital. Expenditure on medication consumed the highest costs (51%). Length of stay was the most important factor affecting inpatient expense, additional factors were number of surgical operation, nurse type, Rankin score, number of complications etc. Conclusions Complex measures focusing on hypertension to prevent and control of stroke are recommended. Reducing unnecessary stay in hospital and appropriate prescribing are important methods to reduce cost of stroke inpatients.
Objective To investigate drug usage and costs of children inpatients with bronchopneumonia in Karamay Central Hospital in 2014 and to provide baseline for evidence-based pharmacy study of single disease in respiratory system. Methods The information of drug use and expenditure of children inpatients with bronchopneumonia were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 890 children inpatients were included, the average age was 1.00±2.17 years old. Among the antibiotics of single therapy, the frequency of amoxicillin and clavulanate potassium for injection was highest. Among the antibiotics of combination therapy, the frequency of macrolides was highest. Conclusion The mainly drugs for treatment of children inpatients with bronchopneumonia in Karamay Central Hospital in 2014 is amoxicillin and clavulanate potassium for injection.
Objective To provide baseline datum for further evidence-based selecting essential health technology or essential medicine by comparing the top 15 inpatient diseases in the three pilot township clinics in western China from 2008 to 2010. Methods With the key words as disease spectrum, constitution of disease, inpatient disease category, inpatient diseases and so on, such databases as CBM, CNKI, VIP, WanFang and official websites of Ministry of Health were searched on computer, and the manual search was also conducted in combination to extract the related datum of provinces where the pilot township health centers were situated. The Excel software was used for data classification and analyses. Results (1) Among the 16 included literatures including 15 journal papers and 1 master thesis, 4 scored from zero to 3.5, 9 scored from 3.5 to 6.75, and the left 3 scored 7 or more than 7; (2) The common inpatient diseases in the township health centers in eastern, central and western regions in China were different. The upper respiratory tract infection, acute/chronic bronchitis, acute/chronic gastritis and appendicitis were the common inpatient diseases in the township health centers throughout China. The pneumonia, emphysema, cholelithiasis, cholecystitis, and acute/chronic gastroenteritis were the common inpatient diseases in the township health centers in southwest and northwest regions. The top 15 inpatient diseases in the three pilot township clinics in this study covered all the common inpatient diseases in the township health centers in southwest and northwest regions in China; (3) The total number of the top 15 inpatient diseases of the three pilot township health centers in western China between 2008 and 2010 was 35, including 20 chronic and 15 acute diseases. The chronic diseases were chronic bronchitis, chronic gastritis, hypertension, lumbar/cervical disease, cholelithiasis or cholecystitis, coronary heart disease, chronic pulmonary heart disease, urinary calculi, pelvic inflammation, vertebrobasilar insufficiency, arthritis, acute exacerbation of chronic bronchitis, Meniere’s disease, chronic obstructive emphysema, myocardial ischemia, prostatitis, etc.. The acute diseases were upper respiratory tract infection, pulmonary infection, fracture, superficial injury, acute appendicitis, acute bronchitis, urinary tract infection, acute gastritis, acute gastroenteritis, delivery amp; cesarean section, soft tissue injury, acute urticaria, etc.; and (4) While the common inpatient disease categories were relatively centralized and stable, but some of them were different in regions, inpatients’ age and sex structure. Conclusion (1) There are some differences in the common inpatient diseases in the township health centers among eastern, central and western regions in China, thus it is necessary to select essential health technology and essential medicine according to local conditions; (2) As a good representation, the common inpatients diseases in the three pilot township health centers in western China can provide the baseline evidence for selecting essential health technology and essential medicine for the township health centers in western China; (3) There are lack of national/regional statistics, survey data and evidence-based research on disease spectrum of the township health centers currently. While the investigation methods or statistics measurements/quality of these included studies are variable without standard regulation; and (4) It suggests that the state and every provinces should implement and improve the statistic analysis of disease spectrum of the township health centers, train staffs and fulfill the construction of information system.
Objective To investigate drug usage and costs of pneumonia inpatients in Karamay Central Hospital in 2014 and to provide baseline for evidence-based pharmacy study of single disease in respiratory system. Methods The information of drug use and expenditure of pneumonia inpatients were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 309 inpatients were included, among the 78.96% were more than 60 years old. Among the antibiotics single therapy, the frequency of cefoperazone and sulbactam was the highest. Among the antibiotics combination therapy, the frequency of β-lactam antibiotics was the highest. Conclusion Pneumonia inpatients in Karamay Central Hospital are mainly older patients. The β-lactam antibiotics is used most in clinical practice.
Objective To investigate drug usage and costs of ischemic stroke inpatients in Karamay Central Hospital in 2014 and to provide evidence and reference for evidence-based pharmacy study of single disease in circulation system. Methods The information of drug use and expenditure of ischemic stroke inpatients were collected from the hspital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results We included 522 ischemic stroke inpatients in Karamay Central Hospital in 2014, the average age was 67.58±13.27 years old. Forty three kinds of drugs were used for ischemic stroke therapy. The total expenditure of drugs was 10.94 million and 1 807.99 yuan per person. The most used drugs were for symptomatic treatment which included 18 kinds of drugs. The using frequency of aspirin, edaravone, oxircetan were the highest. The secondary prevention medicines included 23 kinds of drugs. The anti-hypertensive, lipid-lowering and hypoglycemic agents were prescribed mostly. Traditional Chinese medicines were prescribed 234 times, and the injection Ligustrazine with glucose was the most used drug. Conclusion The mainly drugs for treatment of ischemia stroke inpatients in Karamay Central Hospital in 2014 are aspirin, edaravone and oxircetan; while the expenditure of clopidogrel and oxiracetam were the highest.
Objectives To investigate the disease composition and medical costs of in patients with chronic kidney disease (CKD) in People's Hospital of Xinjiang Uygur Autonomous Region from 2012 to 2017. Methods To retrieve the records of patients with CKD, and to classify the main diagnosis of the first page of the medical record according to the International Classification of Diseases (ICD-10) standard. Data was analyzed using Excel 2010 and SPSS 19.0 software. Results A total of 11 650 CKD patients were included, with a sex ratio of 1.48 to 1. The patients were mainly young and middle-aged, accounting for 75.56%. The top 11 diseases of CKD patients were chronic glomerulonephritis, membranous nephropathy, diabetic nephropathy, IgA nephropathy, hypertensive nephropathy, minimally pathological nephritis, focal segmental glomerulosclerosis, lupus nephritis, Polycystic kidney disease, chronic interstitial nephritis and purpuric nephritis. The per capita hospitalization days of CKD patients was 11.23 days, and the per capita medical expenses was 1.51 million yuan. Significant differences were found in different genders, ethnic groups, age groups, disease composition and CKD staging. The medical expenses of CKD patients were mainly medicine and inspection fees, accounting for 71.35%. Conclusions Inpatients of CKD in the People's Hospital of Xinjiang Uygur Autonomous Region have a heavy disease burden and large difference in their conditions.