Health poverty alleviation is an important practice in implementing the basic strategy of precision poverty alleviation. It is also an important measure to win the battle against poverty in rural areas. Through the investigation of local medical and health conditions, West China Hospital of Sichuan University built a demand-oriented framework for medical poverty alleviation in Ganzi Prefecture, and gradually carried out precision top-level design, discipline construction, technical training, talent training, endemic disease prevention and control; through establishinga regional medical cooperation network, built featured specialies, built the backbone of medical and health forces, achieved the prevention of endemic diseases throughout life cycle, and improved the overall medical and health service capacity of Ganzi Prefecture. This article introduces the exploration and practice of the demand-oriented model in Ganzi Prefecture by West China Hospital of Sichuan University, aiming at providing a guide for the precision health poverty alleviation in China.
Objective To understand the changing patterns and characteristics of the number of patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) before, during, and in the post-epidemic period of the COVID-19 pandemic and the Association between acute respiratory infections and hospitalization of patients with AECOPD. Methods A retrospective analysis was conducted to count the patients hospitalized for AECOPD in the Department of Respiratory Medicine of the Third Affiliated Hospital of Chongqing Medical University from July 2017 to June 2024. The pattern of change in the number of AECOPD hospitalizations and the associations with patients with respiratory tract infections in outpatient emergency departments were analyzed. Results During the COVID-19 epidemic, the number of hospitalizations of patients with AECOPD did not increase compared with the pre-epidemic period. Instead, it significantly decreased, especially in the winter and spring peaks (P<0.05). The only exception was a peak AECOPD hospitalization in the summer of 2022. COPD inpatient mortality and non-medical discharge rates tended to increase during the epidemic compared with the pre-epidemic period. Analysis of the curve of change in the number of patients with respiratory infections in our outpatient emergency departments during the same period revealed a downward trend in the number of patients with respiratory infections during the epidemic and an explosive increase in the number of patients with respiratory infections in the post epidemic period, whose average monthly number was more than twice as high as that during the epidemic. Correlation analysis of the number of patients with respiratory infections between AECOPD hospitalizations and outpatient emergency departments showed that there was a good correlation between the two in the pre-epidemic and post-epidemic periods, and the correlation between the two in the post-epidemic period was more significant in particular (r=0.84-0.91, P<0.001).In contrast, there was no significant correlation in 2021 and 2022 during the epidemic (r=0.24 and 0.50, P>0.05 ). The most common respiratory infection pathogens among AECOPD hospitalized patients during the post-epidemic period were influenza virus, COVID-19 virus, and human rhinovirus, respectively. Conclusions The pandemic period of COVID-19 infection did not show an increase in the number of AECOPD hospitalizations but rather a trend towards fewer hospitalizations. Respiratory infections were strongly associated with the number of AECOPD hospitalizations in the pre- and post-pandemic periods, while the correlation between the two was poorer during the pandemic period. Influenza virus was the most important respiratory infection pathogen for AECOPD during the post-epidemic period.
ObjectiveTo construct the terminology standard of hospital quality and safety. MethodsThe draft terminology standard was constructed through group discussions, and the final draft terminology standard was formed after one round of Delphi expert consultation and two rounds of expert consensus meetings. ResultsThe recovery rate of the questionnaire was 100%, and the authority coefficient of experts was 0.87. A total of 15 experts were invited to two rounds of expert consensus meetings. The terminology standard for hospital quality and safety (TCHAS 10-1-1-4—2022) was finally released, including 4 first-level categories, 20 second-level categories, and 370 terms in total. ConclusionThe terminology standard of hospital quality and safety developed in this study is scientific and reliable, which can be used as a tool to assist medical institutions in carrying out standardized management.
ObjectiveTo investigate the psychological status and its influencing factors of hospital staff during the outbreak of coronavirus disease 2019 (COVID-19), and provide a reference for psychological intervention strategies for hospital staff in public health emergencies.MethodsIn this cross-sectional study, we investigated the staff of Mianzhu People’s Hospital through an anonymous questionnaire survey sent through WeChat group from February 13th to 18th, 2020, to analyze the psychological situation and influencing factors of the on-the-job staff. SPSS 22.0 software was used for statistical analysis.ResultsAmong the 1 115 staff members who met the inclusion criteria, 951 completed the questionnaire, with a response rate of 85.3%. There were 945 valid questionnaires, with an effective response rate of 84.8%. A total of 224 staff members (23.7%) had mental health problems. Multivariate logistic regression analysis showed that the total scores of social support [odds ratio (OR)=0.869, 95% confidence interval (CI) (0.805, 0.938), P<0.001] and the total scores of stress coping strategies [OR=0.685, 95%CI (0.607, 0.772), P<0.001] were protective factors of psychological status, while having kids [OR=1.607, 95%CI (1.084, 2.382), P=0.018] and the position being logistic worker [OR=2.229, 95%CI (1.326, 3.746), P=0.002] were risk factors of psychological status.ConclusionsDuring the outbreak of COVID-19, mental health problems emerged among the staff of designated medical treatment hospital. When a public health emergency occurs, hospitals and relevant departments should take psychological intervention measures as soon as possible to ensure the work of epidemic prevention and control.
Objective To provide a disaster triage method by analyzing the data of the hospital transferring casualties after Wenchuan earthquake. Method The data of the patients’ admission and hospital transferring in the West China Hospital were collected after the earthquake in two weeks. Moreover, the reason and the method of the hospital transferring were analyzed. Result In the first two weeks since the earthquake struck Wenchuan, the number of the available bed for earthquake patients in West China Hospital was 124 per day, but in the 2 227 earthquake patients treated, 1 181 patients were admitted. Comparing with the number of the total hospitalized, the percentage is 53.03%. The hospital was overloaded. After a reasonable hospital transference, the daily number of inpatients was stable and all the patients were treated sufficiently. Conclusion After a natural disaster, an effective administration transferring patients to suitable medical recourse should be performed, so that more right treatments should be given to more right patients in the right time and right place.
Hospital-based health technology assessment (HB-HTA) is an indispensable method and measure to improve the level of fine management and establish a value-based medical service system. This paper introduces the differences between HB-HTA and HTA, four organizational management models, assessment process, assessment steps and HB-HTA reporting standardization, which provides a reference for evaluating organizations.
West China Hospital of Sichuan University as a national-level regional medical center in the western part of the country, focused on the actual situation in Tibet and actively carried out precision health poverty alleviation work. Guided by " precision”, the hospital has built a close-knit medical association – Hospital of Tibet People’s Government in Chengdu Office, and through the comprehensive improvement of medical care, teaching, scientific research, and management, creates a medical and health service system with Tibet characteristics. Combining " blood transfusion” and " hematopoietic” to build a " West China Model” for precision health poverty alleviation, West China Hospital of Sichuan University fully demonstrates the public welfare and responsibility of a national-level regional medical center, and constantly exerts regional radiation and leading role, promotes the medical and health service system continuous improvement in Tibet.
Objective To review the research hotspots and cutting-edge dynamics in the field of hospital operations management, providing references for relevant research in our country. Methods Using CiteSpace 6.1.R6 software, we conducted a visual analysis of English literature in the field of hospital operations management collected from the Web of Science database Core Collection from the establishment of the database to December 31st 2022. Result A total of 808 articles were included, with the first article in the field of hospital operations management published in 1980 since the establishment of the Web of Science database. Over the 42-year period, annual publications had shown an increasing trend. Research outcomes were concentrated in institutions and researchers from Europe and the United States, but academic collaboration among institutions and authors was not particularly close. The hotspots in related fields mainly focused on aspects of care quality, management, and performance. Conclusions Studies on hospital operations management in China are in the early stage, and the international influence of research outcomes needs to be further strengthened. The research frontier has shifted from healthcare quality and safety to internal financial performance, human resource management, and resource allocation. Research on the application of technological methods in hospital operations management will continue to emerge.
Objective To summarize primary clinical data from Xiao Tang Shan Hospital (XTSH) Information System, to provide evidence for clinical data of emerging diseases. Method The primary data were extracted from XTSH information system, which related to demographic and background information, case history, prescriptions, laboratory tests, physical examination, vital sign, surgery, diagnostics and expenditures. The software for data verification was developed by Delphi language program. The information of SARS management was developed by Oracle Developer. Results XTSH information system for SARS management collected 1.09 million pieces of information covering 680 SARS cases. The database was functionally divided into inquiry window, conditional case list window and case details spread window, which provided information of SARS management and shaped a platform for further investigation. Quality control of clinical data was done by the software of SARS Information Real Control.Conclusions XTSH information system collected complete data of SARS management, which made healthcare, research and policy-making on SARS accessible, and made it possible to share resources and train the professionals.
Objective
To discuss the running effect of the modified hospital-community integrated two-way-referral service mode in day surgery.
Methods
The hospital-community integrated two-way-referral service mode in day surgery was built in May 2014 by our center, and applied in the communities’ health service network in Chenghua District, Wuhou District, and Jinjiang District. From March 2017 some improvements of the mode were made, such as assigning specific person for the management of two-way-referral, conducting lectures in communities to train the community medical staff, and carrying out gratuitous treatment. The community acceptance rate and patients satisfaction were retrospectively analyzed between March of 2016 and March of 2017, and the number of upward referral (from community to hospital) was retrospectively analyzed between March to June of 2016 and March to June of 2017.
Results
The community acceptance rate was elevated from 81.3% to 99.1% and the patients satisfaction was improved from 95.4% to 100.0%, and the differences between the two periods were statistically significant (P<0.05). The number of upward referral increased from 0 to 23.
Conclusions
The modified hospital-community integrated service mode could optimize the course of surgery appointment, and make it convenient for patients. Furthermore, it also adjusts the reasonable allocation of medical resource effectively and promotes the implementation of national hierarchical medical system.
