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 analyze the application status and existing problems of value stream mapping (VSM) in improving medical services at home and abroad, so as to provide decision evidence for hospitals to apply VSM to improve medical services.MethodsUsing “value stream mapping” and “value stream” as search terms, we searched PubMed, Embase, China National Knowledge Infrastructure, CQVIP Journal Database and Wanfang Database (2009-2019), and collected relevant literature on the application of VSM to improve medical services at home and abroad. We conducted bibliometric analysis after confirming the literature according to the inclusion criteria. The standardization of application of VSM was also evaluated.ResultsOf the 299 articles retrieved, 13 studies fulfilled the inclusion criteria. The publication time of the literature was distributed between 2013 and 2019. Of the 8 foreign articles included, the regions to which the first author belonged were 4 in the United States, 1 in Ireland, Norway, Lebanon and Indonesia respectively. Of the 5 included domestic articles, the regions to which the first author belonged were 2 in Zhejiang and Shanghai respectively, and 1 in Guangdong. Of the foreign literature, 5 articles did not clearly state the sample size observed when drawing VSM, 5 articles incomplete drawing elements of VSM, and 3 articles did not show VSM. Of the domestic literature, 2 articles did not clearly state the sample size observed when drawing VSM, 3 articles had incomplete drawing elements of VSM, and 1 article did not show VSM.ConclusionsVSM is relatively more used in high-income and upper-middle income countries. The medical service improvement issues for which VSM is applied are relatively single. The standardization of the application of VSM in domestic and foreign literature needs to be improved overall.
Objective We conducted a questionnaire study who attended the First West China Forum on Chest Enhanced Recovery after Surgery (ERAS) in order to analyze whether it can improve the knowledge of ERAS and how to organize an effective meeting. Methods We analyzed 188 questionnaires from the representatives of the First West China Forum on Chest ERAS after the meeting which included two parts: one was the personal basic information and institution of respondents, and the other was the opinion of the content setting and suggestion for the next forum. Results A percentage of 97.7% of participants believed that this forum contributed to improving their understanding of ERAS and 65.3% of them will put the concept of ERAS into practice after the meeting. The exchange of experience and project communication of ERAS were the most useful agendas approved by representatives while expert lectures should be more appropriate (18.1%). Arrangement for topic discussion and enough time for discussion were supported by 93.1% and 98.9% of the representatives respectively. Multi-center project discussion (80.9%) and interactive sessions especially WeChat interaction (74.0%) should be added on ERAS forum. Conclusion Reasonable agenda settings are beneficial to improve the understanding and compliance of application of ERAS.
The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional cinical data repository (CDR).
Basing on the special geographical environment, population, economic level and medical conditions of the areas along the plateau railway, as well as the policy requirements of primary healthcare institutions in China, combining the reality and early practice of the areas along the plateau railway in China, the High Altitude Medicine Committee of Sichuan Medical Association gathered the experts in the field of high altitude medicine in China, and launched the Expert Consensus on Basic Requirements for Primary Healthcare Institutions in Areas Along the Plateau Railway. Its content covers the scale and layout, infrastructure, personnel allocation and service capacity, material allocation of primary healthcare institutions in areas along the plateau railway, and provides professional guidance for primary healthcare institutions in these areas.
Value-based healthcare (VBHC) is an important guideline for current and future healthcare services. In practice, VBHC should be the best goal of public welfare of healthcare service. Meanwhile, VBHC and cost-effectiveness analysis together provide scientific evidence for healthcare decision-making. Pay by value is inevitable in the next stage of the reform of the payment system of medical insurance, and the health service system should be reconstructed based on VBHC. Finally, the challenges of VBHC implementation are discussed.
Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.
Objective To analyze the current application status of lean healthcare management in hospital pharmacy services domestically and internationally, and provide evidence support for optimizing pharmacy service practices. Methods The literature on the application of lean healthcare management to pharmacy services in domestic and foreign hospitals published in China National Knowledge Infrastructure, Wanfang, PubMed, SinoMed from January 1, 2006 to June 30, 2025 was systematically searched. The characteristics, application scenarios, lean tools, and implementation effects included in the literature were analyzed. Results Finally, 22 articles were included, including 7 English articles and 15 Chinese articles. The publication time of literature in domestic and foreign research showed different trends. Foreign research showed a sustained and stable number of publications, while domestic research showed an overall trend of being flat in the early stage and active in recent times. The application of lean healthcare in pharmacy services mainly involved optimizing outpatient pharmacy service processes (8 articles), managing inpatient pharmacy operations (9 articles), specialized management of ward pharmacies (2 articles), and management of intravenous medication dispensing centers (2 articles). The included literature usually used multidimensional indicators to evaluate the improvement effectiveness of lean healthcare management. In China, it focused highly on patient waiting time for medication retrieval (7 articles) and patient/medical staff satisfaction (6 articles), while in foreign countries, it mainly involved drug dispensing/turnover time. The application of drug dispensing/turnover time was relatively balanced in domestic and foreign literature (5 domestic articles and 3 foreign articles). The included literature covered 11 lean tools, with the most frequently used tools being value stream mapping. More than half of the studies used a combination of multiple tools to improve the model, with foreign applications highly concentrated on value stream maps (6 articles), and domestic tool choices being more diverse. Conclusions There are differences in the development stages and evaluation focuses of lean healthcare management research related to pharmacy services in domestic and foreign hospitals, as well as the application models of lean tools.
ObjectiveTo systematically map the research landscape, hotspots, and evolutionary trends of Chinese-language literature on value-based healthcare (VBHC) in China, and to provide evidence for advancing localized VBHC research and practice. Methods VBHC-related publications published between January 1, 2006 and August 30, 2024 were retrieved from the China National Knowledge Infrastructure, Wanfang Data, and VIP database. CiteSpace was used for visualized bibliometric analyses, including co-authorship, institutional collaboration, keyword co-occurrence, clustering, burst detection, and timeline mapping. Results A total of 237 articles were included. Since 2017, VBHC-related publications in China have increased markedly. Collaboration networks among institutions and authors showed low density, indicating relatively weak and fragmented cooperation. High-frequency keywords included “value co-creation” “public hospitals” and “value orientation”. Burst analysis identified “healthcare costs” “value co-creation” and “medical insurance payment” as major recent research focuses. The timeline map suggested three stages in the evolution of VBHC research: initial exploration, emerging development, and rapid growth of research hotspots. ConclusionsInterest in VBHC research in China continues to grow, yet collaborative research and interdisciplinary integration remain limited. Future efforts should strengthen cross-institutional and cross-disciplinary collaboration, promote the development of shared data platforms, and build VBHC evaluation frameworks tailored to China’s institutional context.
In recent years, the incidence of thyroid cancer has risen significantly, making it the third most common malignant tumor among women in China. With the rapid development of artificial intelligence technology, the diagnosis and treatment models of thyroid nodules are undergoing profound changes. By efficiently processing massive amounts of data, providing precise analysis and personalized suggestions, artificial intelligence has significantly promoted the integrated development of thyroid cancer in preoperative diagnosis, surgical navigation, surgical methods and postoperative management, thus facilitating the realization of “precision medicine and smart medicine” in thyroid surgery. This article focuses on the current development status of the “internet+thyroid” model and looks forward to its future development.