Objective To systematically review the impact of Beijing's comprehensive reform of medical consumption linkage on medical expenses, hospital services, and hospital income. Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, and Web of Science were searched to collect empirical research on evaluating the impact of Beijing's comprehensive reform of medical consumption linkage on patient medical expenses and hospital operation (service volume and income structure) from June 15th, 2019 to August 15th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature and extracted data. Results A total of 23 studies were included, and most of them found a relatively small change in the average outpatient and emergency medical expenses after the reform. However, the average inpatient expenses in some hospitals showed an increasing trend; the service volume of most hospitals increased slightly, and the income structure was optimized (e.g., surgery and other medical technology services revenue and its proportion increased). Conclusion The comprehensive reform of the medical consumption linkage in Beijing is the practice of deepening the reform of the medical service price mechanism. Based on the summary of the reform effect, it is recommended to further improve the price mechanism, improve service quality, and promote hierarchical diagnosis and treatment.
Global Minimum Essential Requirements (GMER) is focused on training medical students to equip them with the scientific foundation of medicine, clinical techniques, a doctor’s professional ethos, social sciences, health economics, medical information management and communication skills, etc. Based on GMER and its evaluation and through the integration of GMER’s seven requirements into the objectives of the clinical-medicine major, Shanxi Medical University is reforming medical education to carry forward high quality education in a comprehensive way. These reforms include adjustments in the content, methods and means of the teaching in order to improve teaching conditions and optimize the curriculum structure, and to enhance the quality of education. At the same time the management system is being reformed and sustainability-featured mechanisms of management and operation are being created, to make simulated hospital a base wherein GMER is fully followed. Simulated hospital for clinical teaching is built to cultivate the students’ abilities in clinical thinking and clinical education. This takes into full consideration training in professional quality, the cultivation of students’ comprehensive ability and GMER’s aim of reaching the final objective, namely, the following four transformations of the students: from essential knowledge to clinical practice, from single technique to all-round ability, from patterning thought to integrated and innovative thought and from a student of clinical medicine to a professional doctor. The objective is to fulfill the task of teaching clinical medicine in a more favorable way, promoting the reform and development of China’s medical education and keeping pace with changes in medical education elsewhere in the world.
With the development of economic globalization and the complication of enterprise management, the level of internal control has become an important part for measuring the quality of management, risk prevention, competitiveness and operational efficiency of modern enterprises. As a special economic organization, hospitals have some defects in terms of internal control environment, organization of control system, risk management and implementation system, supervision, control and evaluation system. Based on the “Medical Institutions Internal Control Provisions of Finance and Accounting (Trial)” and “A Lecture on Medical Institutions Internal Control of Finance and Accounting”, this article gives some suggestions on how to improve the management of hospital internal control.
ObjectivesTo investigate the utilization of essential medicines and antibiotics in primary healthcare system of Xinjin county of Chengdu city from 2009 to 2011.
MethodsThe data of utilization of all the medicines, essential medicines and antibiotics was collected from 17 hospitals of Xinjin primary healthcare system. Microsoft Excel 2003 was used to analyze the data.
ResultsCompared with 2009, the total costs of medicines and essential medicines increased by 72.27% and 135.4% respectively in 2010. After the implementation of essential medicine policy in 2010, the proportion of essential medicines accounted for more than 90% in community healthcare centers (CHCs) and township hospitals (THs) and over 50% in county-level hospitals in 2011. In 2010, the average cost per prescription among outpatients increased by 3.51% in total, but deceased by 16.23% in CHCs/THs (RMB 15.09 yuan per prescription). In July of 2011, the policy to control the use of antibiotics was implemented in Xinjin county. The use of antibiotics decreased, but still accounted for over 30% in 9 out of 13 CHCs/THs. The use of bigeminy antibiotics and trigeminy antibiotics accounted for 0.42 to 5.56% and 0 to 0.44%, respectively.
ConclusionsThe use of essential medicines increases in Xinjin county and met the national requirements. The average cost per prescription among outpatient decreases in THs and CHCs. After controlling the use of antibiotics, the proportion and cost of antibiotics is still very high, and irrational use of antibiotics probably still exists. The training and guide for evidence-based rational use of medicine should be enhanced in future.
ObjectiveTo explore the feasibility of introducing student-standardized patients in the teaching reform of medical nursing course.
MethodsWe chose four classes of nursing students from grade 2012 between September and December 2014 as the research subjects.Cluster sampling was used to choose two classes of 84 nursing students randomly as trial group, who received student-standardized patients in their practical learning; while the rest 2 classes of 83 students were chosen as control group, who received traditional teaching method.The course scores and the effect evaluation were compared between the two groups.
ResultsThe basic knowledge test score of the trial group 31.28±4.81 was not significantly different from that of the control group 32.10±2.15(P > 0.05).The case analysis test score of the trial group 54.36±3.45 was significantly higher than that of the control group 43.12±1.37(P < 0.05).The communication ability, health education ability, skill operation ability and professional quality score of nursing students in the trial group were also significantly higher than those in the control group (P < 0.05).
ConclusionIntroducing student-standardized patients in practical teaching of medical nursing can improve the teaching effect and students' comprehensive ability.
Objective To explore the impact of diagnosis-related group (DRG) payment method reform under total amount control on neurology and neurosurgery departments. Methods The DRG grouping data of the Department of Neurology and the Department of Neurosurgery of Panzhihua Central Hospital from January 2018 to December 2020 were collected, and the mature DRG evaluation indexes in China were selected. Using the interrupt time series analysis method, the DRG-related indexes of the two departments before and after the introduction of the performance appraisal plan in July 2019 were compared, to evaluate the intervention effects on the two departments. Results Both neurology and neurosurgery departments showed a slow downward trend in the overall medical service capacity under the DRG payment. The efficiency of medical services showed a slow upward trend and the consumption of medical expenses showed a slow downward trend in the Department of Neurology, while the efficiency of medical services showed a slow downward trend and the consumption of medical expenses showed a slow upward trend in the Department of Neurosurgery. According to the results of interrupt time series analysis, in the Department of Neurosurgery, the total weight showed a significant downward trend before intervention (β1=?5.526, P=0.003), and the downward trend became sluggish after intervention, with a statistically significant slope difference before and after intervention (β3=4.546, P=0.047); the case-mix index showed a downward trend before intervention (β1=?0.050, P<0.001), and no obvious trend after intervention, with a statistically significant slope difference before and after intervention (β3=0.052, P=0.001); the cost consumption index showed no obvious downward trend before intervention (β1=?0.006, P=0.258), and an upward trend after intervention, with a statistically significant slope difference before and after intervention (β3=0.027, P=0.032). The impact of this assessment plan on the Department of Neurology was not statistically significant (P>0.05), needing further observation. Conclusions The reform of DRG payment method under total amount control has different effects on the evaluation indicators of clinical departments of different natures. It is recommended to implement classified management and assessment for clinical departments of different natures.
Evidence-based medicine is the methodology of modern clinical research and plays an important role in guiding clinical practice. It has become an integral part of medical education. In the digital age, evidence-based medicine has evolved to incorporate innovative research models that utilize multimodal clinical big data and artificial intelligence methods. These advancements aim to address the challenges posed by diverse research questions, data methods, and evidence sources. However, the current teaching content in medical schools often fails to keep pace with the rapidly evolving disciplines, impeding students' comprehensive understanding of the discipline's knowledge system, cutting-edge theories, and development directions. In this regard, this article takes the opportunity of graduate curriculum reform to incorporate real-world data research, artificial intelligence, and bioinformatics into the existing evidence-based medicine curriculum, and explores the reform of evidence-based medicine teaching in the information age. The aim is to enable students to truly understand the role and value of evidence-based medicine in the development of medicine, while possessing a solid theoretical foundation, a broad international perspective, and a keen research sense, in order to cultivate talents for the development of the evidence-based medicine discipline.
