Objective To investigate the comprehensive efficacy and cost-effectiveness of early nutritional intervention combined with acupoint electrical stimulation under the enhanced recovery after surgery (ERAS) concept in elderly patients undergoing total hip arthroplasty (THA), and to verify the robustness of the results through Monte Carlo validation. Methods Elderly patients who underwent THA in the Ziyang Central Hospital between January 2022 and December 2024 were retrospectively selected. Patients who did not implement the ERAS protocol between January and December 2022 were included in the control group, while patients who implemented the ERAS protocol between January 2023 and December 2024 were included in the intervention group. Total hospitalization costs, postoperative complication rates, patient satisfaction, and clinical indicators were collected to construct a comprehensive efficacy score. Monte Carlo validation was used to analyze the incremental cost-effectiveness ratio and parameter uncertainty. Results A total of 140 patients were enrolled, with 70 in each group. There were no statistically significant differences in gender, age, and preoperative indicators between the two groups (P>0.05). The Richmond Agitation-Sedation Scale scores [(?0.03±0.87) vs. (0.53±0.85) points; P<0.05] and the incidence of agitation [5.7% (4/70) vs. 34.3% (24/70); P<0.05] were lower in the intervention group compared to the control group. The total incidence of adverse reactions in the postoperative intervention group [5.7% (4/70) vs. 18.6% (13/70); P<0.05] was lower than that in the control group. The comprehensive efficacy score, hospitalization costs, and cost-effectiveness ratio were all superior in the intervention group compared to the control group (P<0.05). Monte Carlo validation results further confirmed the advantages of early nutrition combined with acupoint electrical stimulation in improving cost-effectiveness. Conclusions ERAS-based early nutritional intervention combined with acupoint electrical stimulation can significantly enhance the comprehensive efficacy and reduce medical costs in elderly THA patients. Monte Carlo validation verifies the robustness of its cost-effectiveness, providing health economic evidence for clinical decision-making.
Under the background of a series of national policies, various forms of medical association have been established in recent years. The purpose of the medical association is to promote the coordination and integration of medical services and the rational distribution of medical resources. However, the implementation effect varies greatly. In the process of construction, there are problems such as the unsynchronized coordination and operation between the upper and lower levels, the inadequate integration of resources, the differences and conflicts in information standards and even cultural concepts, which limit the construction effect of the medical association to a certain extent. In order to solve these problems and explore a better path for the construction of medical association, this paper summarizes and analyzes the integrated development and construction measures of “discipline+operation” of the First People’s Hospital of Ziyang under the “government-hospital cooperation”, hoping to provide experience and reference for the construction of medical association to a certain extent through the summary and analysis, thus contributing to the better development of the construction of medical association.
Discipline construction is the core of hospital survival and development, and an important carrier for hospitals to show service ability and play social benefits. The practice of Ziyang Central Hospital shows that the group department operation service model, by bringing together operational, performance, medical, insurance, and clinical department staff into a team, led by a member of the party and government leadership, has a positive impact on the development of the discipline, and has achieved significant results. This paper summarizes and analyzes the group department operation service model at Ziyang Central Hospital, and proposes that this service model is a new pathway to promote discipline development and provides a new perspective and reference experience for the hospital to achieve business and finance integration.