Objective To compare administration of incidence reporting systems for healthcare risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, and to provide evidence and recommendations for healthcare 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 (1) A total of 142 documents were included in this study. The United States had the most relevant documents (68). (2) The type of incidents from reporting systems has expanded from medication errors and hospital-acquired infections to near-misses, and now includes all patient safety incidents. (3) The incidence-reporting systems can be grouped into two models: government-led and legal/regulatory/NGO-collaborative. (4) In two cases, reporting systems were established for specific incident types: One for death or serious injury events (the sentinel events database in Britain, SIRL), and one for healthcare-associated infections (NHSN in America). (5) Compared to the four countries, Taiwan’s system put more emphasis on public welfare, confidentiality, and information sharing. The contents of reporting there covered every aspect of risk management to create a more secure environment. Conclusion (1) Britain’s national reporting and learning system was representative of a government-led model; (2) The United States was the earliest country to have a reporting system, which included a limited range of incident types. Management of incidents became more reliable with increased application of laws, regulations, and guidances; (3) Both the Canadian and the Australian systems drew from the American experience and are still developing; (4) The Taiwanese system was comprehensive and is an instructional case.
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.
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.
Medical aid to Xinjiang is an important task for large public hospitals in China. The innovative mode of team aiding in medical aid program for Xinjiang has played an important role in the national aid-Xinjiang program. West China Hospital of Sichuan University is actively exploring an aid-Xinjiang mode which combines medical aid of multi-disciplinary teams collaborated by doctors, nurses, medical technicians, and management teams with scientific and technological aid; based on the reality of Xinjiang medical healthcare, promoting the overall improvement of medical care through multi-disciplinary integration of resources; and relied on big data, promoting the innovative development of scientific and technological aid to Xinjiang. It is of great practical significance to summarize the work of medical aid to Xinjiang in West China Hospital of Sichuan University over the years and to put forward suggestions for the generalization and popularization of the medical aid to Xinjiang mode.
ObjectiveTo explore the continuous changing trend of healthcare-associated infection prevalence rate in a children’s hospital.MethodsFrom July 2012 to November 2018, a cross-sectional survey was conducted to investigate the prevalence of healthcare-associated infections in hospitalized children for seven consecutive years by combining case-checking and bedside survey.ResultsA total of 10 310 hospitalized children were investigated in the past seven years. The incidence of healthcare-associated infections from 2012 to 2018 was 2.08%, 4.84%, 1.59%, 3.76%, 1.63%, 1.74%, and 2.08%, respectively, showing a statistically significant downward trend (LLA=7.631, P=0.006). The departments with higher proportion of healthcare-associated infections were pediatric surgery (50.0%), pediatric medicine (44.8%), neonatal medicine (2.8%), and intensive care units (2.4%) . Viruses (38.8%) were the most common pathogens of healthcare-associated infections, followed by Gram-negative bacteria (34.3%) .ConclusionsThe prevalence of healthcare-associated infections in the children’s hospital showed a downward trend year by year. Pediatric surgery is the most common occurrence department, and viruses are the most common pathogens. It can provide evidence for prevention and control of healthcare-associated infection in children’s hospitals.
ObjectiveTo introduce economic evaluation methods for anticancer-drugs with basket trial design, and to provide references for related research and decision-making. MethodsA case analysis was conducted on economic evaluation methods for anticancer-drugs with basket trial design, which was issued by Canadian Agency for Drugs and Technologies in Health (CADTH) in the Economic Guidance Report. Moreover, both the advantages and disadvantages of the methods were analyzed in accordance with the characteristics of basket trials. ResultsPooled analysis and tumor-specific analysis were two methods frequently employed in the case analysis. However, great uncertainties were available in both of them. The uncertainty of the former was mainly reflected in the heterogeneity of the targeted population, while the uncertainty of the latter was mainly shown in the insufficient sample size of the subgroup. ConclusionCurrently, economic evaluation methods for anticancer-drugs with basket trial design are immature. Thus, researchers are required to explore the methods of innovation evaluation with lower uncertainty; reimbursement decision-makers should fully consider the uncertainty of evaluation results and enterprises should collect the real-world data for the demands of evaluation to promote the reasonable allocation of healthcare resources in China.
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.
ObjectiveTo analyze the main input and output of healthcare reform in China, and to provide references for improving the policies and measures of healthcare reform in China in future. MethodsData from the National Health Services Survey, and the China Statistical Yearbook etc. was collected to compare and analyze the allocation of health resources, health status of residents, health service utilization, and medical burden before and after healthcare reform. ResultsDuring the reform from 2009 to 2013, hospital health and technical personnel increased year by year. In 2013, the proportion of health and technical personnel in hospitals was up to 61.4% of the total national health technical personnel. In 2013, 65.19% of government expenditure on healthcare was used for disease treatment, and only 14.59% was used for disease prevention. Compared with the year of 2008, the two-week prevalence rate of residents increased by 5.2%, the chronic disease prevalence rate increased by 9% in 2013. Compared with the year of 2009, the annually diagnosed and treated patients increased 18.2 billion person-time, the annually discharged patients increased 59.65 million person-time in 2013. The individual residents paid 52.49% of total medical expenses. ConclusionSince the healthcare reform, China's central and local governments have imputed a large number of health resources into hospitals for "disease treatment". That partly improved the utilization of residents' health service, but the two-week prevalence rate and chronic disease prevalence rate are rapidly growing. There is still high burden of medical expenses for the residents. China's healthcare model should be changed from "treatment-centered" to "prevention-centered" in future.
Objective To summarize and analysis the working experience of healthcare performance evaluation and reporting experience in local health administration department of Australia, and provide decision support to China on such work as establishing objective, scientific, effective healthcare performance evaluation system, strengthening government’s supervision over health service and improving healthcare system management efficiency. Methods Searching official networks and databases of Australia, and finding out relevant policy, reports, and documents on healthcare performance evaluation. Results Typical healthcare performance evaluation systems in Australian are as follos: National Health Performance Framework (NHPF), the National Healthcare Agreement（NHA）and Review of Government Service Provision. Conclusions These programs in Australian is enlightening to these work in China that performance evaluation should be the prior tool in health system to management and reform, the performance measurement indicators systems should emphasize the quality safety and health fair.We should set up scientific and flexible index inclusion criteria and open report and compare performance information.
The article summarized the national and international history and current situation of healthcare-associated infection control, and analyzed the tendency of new technique and progress in healthcare-associated infection control according to the experience in research and practice.