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.
【摘要】 目的 了解2007年-2008年成都地区17家医院抗肿瘤药物的使用情况。 方法 以销售金额、用药频度（DDDs）对2007年、2008年成都地区17家医院抗肿瘤药物消耗数据进行分类统计、综合分析、对比。 结果 2008年成都地区17家医院抗肿瘤药物用药金额增长幅度较大，各亚类抗肿瘤药物中其它类抗肿瘤药物类、植物来源的抗肿瘤药、抗代谢药金额排序依次占前3位。销售金额前100位药物中，肿瘤药物占据8位，大多数是其它类抗肿瘤药物，且其用药频度也靠前。 结论 抗肿瘤药物用药金额和用药量都将快速增长，其中其它类抗肿瘤药物和植物来源的抗肿瘤药的发展尤被看好。【Abstract】 Objective To evaluate the situation of antineoplastics used in Chengdu area from 2007 to 2008. Methods The consumption data of antineoplastics used in 17 hospitals of Chengdu area in 2007 and 2008 were classified, and the consumption sum and defined daily doses (DDDs) were analyzed. Results The total consumption sum of antineoplastics in 2008 increased sharply. Other antineoplastics, herbal-sourced antineoplastics and antimetabolism drugs ranked in the first three places. Among the top drugs in terms of consumption sum, antineoplastics took 8 places. Conclusion The consumption sum and DDDs of antineoplastics, especially other antineoplastics and herbal-sourced antineoplastics, will increase rapidly.
Objective To summarize the surgical learning curve and preliminary operative experience of dual-robotic navigated minimally invasive treatment on pelvic fractures by TiRobot and Artis Zeego. Methods Between July 2019 and February 2021, 90 patients with pelvic fractures were treated with dual-robotic navigated minimally invasive surgery by TiRobot and Artis Zeego. There were 64 males and 26 females, with an average age of 46.5 years (range, 13-78 years). Body mass index was 14.67-32.66 kg/m2 (mean, 23.61 kg/m2). Causes of injuries included traffic accident in 43 cases, falling from height in 37 cases, low-energy injuries such as flat falls in 10 cases. The interval between injury and surgery was 1-36 days (mean, 7.3 days). According to the location of the implanted screws, the patients were divided into sacroiliac screw group (n=33), acetabular screw group (acetabulum anterior/posterior column, n=24), composite screws group (sacroiliac and acetabulum anterior/posterior column, n=33). According to the screw implantation time and accuracy, the surgical learning curve was plotted, and the differences in the relevant indicators between learning stage and skilled stage were compared. Results All 90 patients successfully completed the operation, the intraoperative bleeding volume was 5-200 mL (median, 20 mL). There was no vascular or nerve injury. All incisions healed by first intention. The screw implantation time ranged from 7.5 to 33.0 minutes (mean, 18.92 minutes), and the screw implantation accuracy ranged from 1.1 to 1.8 mm (mean, 1.56 mm). According to the learning curve, the practice stage of 3 groups was reached after 7, 10, and 11 cases, respectively. With the accumulation of surgical experience, the screw implantation time had a significant downward trend. Compared with the learning stage, the screw implantation time on skilled stage in 3 groups significantly shortened (P<0.05), but the difference in the screw implantation accuracy was not significant (P>0.05). Conclusion TiRobot and Artis Zeego assisted pelvic fracture surgery is safe and efficient, which helps the surgeon to quickly master the pelvic channel screw surgery, and the operation time is significantly shortened on the premise of ensuring the implantation accuracy.