The study investigates the current status of corporate governance structures in medical insurance agencies in typical cities and provinces in China, highlighting the challenges faced by corporate governance in these institutions. It advocates for the continued comprehensive promotion of the nationwide establishment of a unified corporate governance framework for medical insurance agencies. Furthermore, it recommends enhancing the legislative support system for corporate governance in medical insurance agencies to ensure the effective implementation of decision-making powers within these organizations. Additionally, the study proposes actively establishing social evaluation and supervision mechanisms for corporate governance to further enhance the corporate governance structure of medical insurance agencies in China.
Objective To explore the impact of community healthcare workers’ (CHWs) knowledge, attitude and practice (KAP) on the influenza vaccination among elderly people. Methods By means of simple random sampling, 1 residential quarter of each communities, 2 communities of each districts, 5 districts of Chengdu city were randomly selected, and the elderly equal to or more than 60-year-old were on-site investigated. Meanwhile, the questionnaire survey was conducted among healthcare workers in the selected communities. Results There were 4 KAP factors played a positive role in influenza vaccination among elderly people: CHWs’ affirmation of the effectiveness of influenza vaccine, explicitly knowing the focus groups for influenza vaccination, recommendation of vaccination in flu season when the elderly visits, and participation in flu-related education activities. When the accuracy rate of each factor got improved by 1%, the influenza vaccination rate would improve by 2.747%, 1.299%, 0.864%, 0.602%, respectively. Conclusion The knowledge, attitude and practice of HCWs have impacts on the influenza vaccination rates of elderly people. They are significant to improve the influenza vaccination rates of the elderly.
The purpose of evidence-based healthcare management is to prevent the overuse, underuse or misuse of some management measures, and to eliminate the gap between research and practice or the difference between best practices and conventional practices. Evidence-based healthcare management is still in an early stage of development. It also faces many challenges, which have aroused some criticism and even suspicion. This is closely related to the complexity of the management field itself and the lack of empirical research in the field. Considering the scarcity of high-quality health and medical resources in China, in order to improve the scientificalness of healthcare decision-making, we strongly appeal that promoting evidence-based healthcare management requires government-led, universal education, intensified research, scientific evaluation, technological innovation and integration.
Objective To investigate the situation and related factors of influenza vaccination among healthcare workers in Sichuan, and provide a basis for the formulation of the strategy of influenza vaccination. Methods From August 1st to August 6th, 2022, healthcare workers from 21 prefectures and cities in Sichuan province were selected by the hospital infection quality control centers to conduct an online questionnaire survey for status and related factors of influenza vaccination. Single factor analysis of vaccination rate was carried out by χ2 test, and the related factors of influenza vaccination were analyzed by binary multiple logistic regression model. Results A total of 3264 copies of questionnaires were distributed, and 3244 valid copies were recovered, with an effective recovery rate of 99.4%. The vaccination rate of influenza vaccine in the surveyed healthcare workers was 56.9% (1846/3244). The gender, age, professional title, position, department, hospital type, hospital nature, hospital level, influenza awareness, and influenza vaccination willingness were the factors resulting in statistically significant differences in influenza vaccination rate among healthcare workers (P<0.05). Binary multiple logistic regression indicated that age≥35 years old [odds ratio (OR)=0.799, 95% confidence interval (CI) (0.681, 0.937), P=0.006], the educational background being bachelor degree or above [OR=1.221, 95%CI (1.036, 1.439), P=0.017], position [nurses vs. doctors: OR=1.339, 95%CI (1.112, 1.612), P=0.002; technicians vs. doctors: OR=1.849, 95%CI (1.278, 2.676), P=0.001], the hospital type being specialized hospital [OR=1.804, 95%CI (1.446, 2.251), P<0.001], hospital level [secondary vs. primary hospitals: OR=0.344, 95%CI (0.271, 0.437), P<0.001; tertiary vs. primary hospitals: OR=0.526, 95%CI (0.413, 0.671), P<0.001], influenza awareness [fair vs. poor: OR=1.262, 95%CI (1.057, 1.508), P=0.010; good vs. poor: OR=1.489, 95%CI (1.142, 1.940), P=0.003], vaccination willingness [OR=4.725, 95%CI (4.009, 5.569), P<0.001] were related factors of influenza vaccination in healthcare workers. The influenza awareness was good in 416 healthcare workers (12.8%), fair in 1989 (61.3%), and poor in 839 (25.9%). The correct rate of influenza vaccination frequency was the highest (82.7%), while the correct rate of influenza contraindication was the lowest (3.2%). Among the healthcare workers, 2206 (68.0%) were willing to be vaccinated, of whom 1548 (70.2%) believed that they could protect people with weak immune function around them after vaccination; 1038 were unwilling to be vaccinated with influenza vaccine in the near future, of whom 335 (32.3%) believed that they had strong immunity and did not need to be vaccinated. Conclusions The influenza vaccination rate of medical staff is related to a variety of factors. Strengthening the publicity and education, and encouraging hospitals to provide free influenza vaccination, especially the correct understanding of contraindications, may be helpful to improve the vaccination rate.
Objective Healthcare risk has become a popular topic in medical research field all over the world. With the increasing of healthcare safety adverse events and medical conflict cases every year, publications about this topic have been rapidly increased in China, but research on the essentials and categories of healthcare risk are still lacked. This paper aims to summarize the essentials and categories of healthcare risk research systematically through analyzing domestic studies in healthcare risk over the past decade, so as to provide decision-making evidences and policy suggenstions on healthcare risk management in China. Methods We searched the China Academic Journal Network Publishing Database of CNKI (1999-2010), in which those papers’ title containing the phrase of healthcare risk had been brought into our research, then we summerized the domestic concepts and contents in healthcare risk by essential analysis and frequency statistics. Results 255 papers were included, including 26 Class B papers (accounting for 10.20%), six Class C papers (accounting for 2.35%) and 223 Class D papers (accounting for 87.45%); but there were only 79 papers (accounting for 35.11% ) which had a clear definition of healthcare risk. From these papers, we found the essentials of healthcare risk included object, consequences, process and causes, and the research category of healthcare risk included prevention and treatment of risk, causes and effects of factors, risk sharing mechanisms, healthcare risk of special diseases, concept and characteristics, education and training, management method, risks of medical appliances, the species and object of healthcare risk, the category of healthcare risk, the research methods of healthcare risk etc. Conclusion At present, the study of healthcare risk focuses on the risk control and how to release risks from the results, besides, systematic studies are lacked, and the unified definition of healthcare risk has not been formed, Therefore, we recommend that systematic study of the healthcare risks should be strengthened, the definition of healthcare risk should be unified, and the early warning, monitoring, evaluating, and identifying methods should be positively developed, providing decision-making evidences to establish healthcare risk management system in China.
Objective To analyze the complaint characteristics of emergency department of women and children’s specialized hospital, and to provide a basis for improving medical service quality, enhancing hospital management, increasing satisfaction, and reducing complaint rates in specialized hospitals. Methods Using the Healthcare Complaint Analysis Tool classification framework, a retrospective analysis was conducted on complaints from the Emergency Department of West China Second University Hospital of Sichuan University. Results The total number of complaints from 2020 to 2022 was 525, and the number of complaints had been increasing year by year. There were 196 complaints against personnel and 329 complaints against regions. There were 320 complaints related to management issues (61.0%), 143 complaints related to doctor-patient relationship issues (27.2%), and 62 complaints related to clinical issues (11.8%). The complained areas were mainly fever clinics (193 cases), and the complained personnel were mainly nurses (82 cases). Conclusion The emergency department of women and children’s specialized hospitals is different from comprehensive hospitals, and active optimization should be carried out to address the main issues. While continuously improving the level of medical technology, it is also necessary to strengthen information technology construction, optimize medical procedures, improve environmental facilities, and provide psychological support for patients and their caregivers.
Objective Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. Methods?We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. Results?A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province/district, hospital, and non-governmental organization. Conclusion?The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an “NGO-led mode” represented by the United States and Canada and a “government-led mode” represented by the United Kingdom, Australia, and Taiwan.
Based on the situation of healthcare reform, new cooperative hospitals with private assets invested came into being. Our hospital carried out such practice and established the first new type hospital in the southwest of China in 2012. In the new cooperative mode, a new neurology ward was established. A series of unique and innovative means of operation and quality control were applied, including introduction of brand marketing strategy, promoting advantageous sub-professions, and pay special attention on talents and quality control. This article is aimed to share the management experiences.
With the continuous development of medical technology, ambulatory surgery or day surgery is becoming a new and very efficient medical service model in China. However, infection prevention and control in ambulatory surgery center has not yet attracted the attention of infection control practitioners. This paper analyzes the necessity, status quo, and entry point of infection prevention and control work in ambulatory surgery centers. Recommendations in the field of risk assessment, engineering control, behavior management, surveillance, and antimicrobial stewardship are provided to infection control practitioners as well.
Objective To investigate the values of pneumonia severity index ( PSI) , CURB-65,plasma procalcitonin ( PCT) , C-reactive protein ( CRP) measurements for evaluation the severity of healthcare-associated pneumonia ( HCAP) .Methods A retrospective observational study was conducted on 92 hospitalized patients with HCAP admitted between June 2010 and December 2011. They were divided into different groups according to different severity assessment criteria. The variance and correlation of PCT,CRP,WBC and percent of neutrophil ( Neu% ) levels were compared among different groups. ROC curvewas established to analyze PSI, CURB-65, PCT and CRP levels for predicting the motality of HCAP patients.Results In the severe HCAP group, PSI and CURB-65 scoring and serum PCT, CRP, WBC, Neu% levels were significantly higher than those in the non-severe HCAP group( P lt; 0. 05) . In the high-risk HCAP group, PCT, CRP, WBC and Neu% levels were significantly higher than those in the low-risk HCAP group according to the PSI and CURB-65 scoring criteria( P lt;0. 05) .WBC and Neu% levels were also significantly higher than those in the moderate-risk group. PSI and CURB-65 scoring were positively correlated with PCT and CRP levels. PSI scoring gt;120 points or CURB-65 scoring gt;2 points on admission were predictors of mortality. Conclusions PSI and CURB-65 scoring are correlated with severity of HCAP. Combining serum PCT and CRP levels can improve the predictive accuracy of the severity of HCAP.