Objective To construct an information hospital service system and discuss the application effect of information construction in the hospital service center. Methods Patients admitted to West China Hospital of Sichuan University between June 2022 and January 2023 were selected. We innovatively practiced intelligent safety gate, self-appointment admission registration, pre-hospital examination and advance migration, pre-hospital health education, an age-appropriate transformation of information service, and other information service measures to investigate the medical experience of patients, and compared patients’ satisfaction with medical treatment under four admission management methods (Huayitong APP, WeChat, self-service machine, and manual management). Results A total of 1452 patients were surveyed. The overall satisfaction score for medical treatment of patients was (4.98±0.04) points. Among them, Huayitong APP was (4.99±0.03) points, WeChat was (4.98±0.13) points, self-service machine was (4.97±0.05) points, and manual treatment was (4.92±0.11) points. There was a statistically significant difference between groups in overall satisfaction with different admission procedures (F=68.582, P<0.001). Since the information construction of the hospital admission service center was carried out, the average time of admission was (12.4±2.3) minutes, and 89.4% (1 298/1 452) of patients thought the time of admission was ideal. Conclusions The information construction of a hospital admission service center can effectively improve patients’ medical experience and enhance patient satisfaction. In the future, it is necessary to explore the influencing factors of patients’ satisfaction with information construction, and constantly improve and upgrade the information construction of hospital admission service centers.
Objective To report our experience in living donor liver harvesting of right lobe grafts. MethodsThe data of 76 living donors of right lobe grafts hepatectomy between August 2007 and December 2008 were studied. Before operation, the graft size, remnant liver volume rate, fatty liver, middle hepatic vein type, and the level of portal hypertension of recipient were comprehensive assessed to determine whether harvested middle hepatic vein. The graft was harvested depending on the port vein and hepatic artery ischemia-line. B-ultrasound was used to definite the structure and branch of middle hepatic vein, and intraoperative cholangiography was performed to definite the structure and variation of bile duct. Donor operative time, intraoperative blood loss, postoperative hospital stay, levels of bilirubin, international normalized ratio （INR）, and ALT, and complications after operation were recorded. Results All the operations were successful. The operative time was (8.3±1.3) h, the blood loss was (325±127) ml without blood transfusion in operation. The ALT, INR, and bilirubin recovered on the 12th day. The most common complication in early post-operation was wound infection in 5 cases, 4 cases had cholestasis, 4 cases occurred cross-section bile leakage, and 11 cases occurred varying degrees of delayed gastric emptying in 4～7 d after operation, who were all alleviated by corresponding treatments. The hospital stay was 9～21 d (median: 14 d) after operation. Conclusion Preoperative evaluation of the hepatic anatomy and precise surgical procedure are crucial, which will help the development of graft harvesting and rehabilitation of donor.
To understand the current situation of community epilepsy management in China, summarize the experience of international community epilepsy management, and provide reference for strengthening community epilepsy management in China. Summarize the current situation of epilepsy development in China, summarize and analyze the international experience of community epilepsy management in the United States, Australia, Britain and other countries, as well as the reference significance for domestic community epilepsy management. According to the evaluation criteria of community epilepsy management, it is suggested that the Chinese government should increase its support, formulate various strategic objectives, strengthen publicity and health education, improve patients' self-management support, explore the prevention and control mode of promoting epilepsy management in urban and rural communities, strengthen the training of medical service teams and design a reasonable referral system.
This article outlined the background and the concept of health decision support system (HDSS), discussed its application status in medical service, hospital management, public health management and other fields in the following four developed countries: United States, UK, Canada and Australia. It also introduced the main functions of MYCIN, CPOE, DHCP, Panorama etc., and summarized the above four countries’ successful experiences, including, actively promoting the application of decision support technology in health field through closely combining with the practical needs, valuing evidenced-based resources development and repository research, making scientific health policy to guide the orderly development of decision support systems, and strengthening the construction of E-health infrastructure and core systems, in hopes of providing reference for the development of health decision support system in China.
Objective To systematically evaluate the qualitative research on disease experience of breast cancer patients. Methods China National Knowledge Infrastructure, WanFang Data, and Web of Science were searched for qualitative research on disease experience of breast cancer patients till April 15, 2022. JBI was used to evaluate the quality of the literatures, and meta-integration was used to systematic evaluation. Results A total of 36 literatures were included. Among them, there were 177 clear research results, and a total of 14 complete research results were extracted, including positive experience and negative experience, which were summarized into 7 categories. 7 categories included physical experience, psychological experience, family and social support, disease knowledge needs, medical humanistic care, medical treatment process, coping. Two integrated results were synthesized, including disease experience and medical treatment experience. Conclusions In the whole process of breast cancer patients’ illness and medical treatment, they need not only guidance and support, but also medical humanistic care to help them respond to their own changes in a timely manner. The quality of life of patients can be improved by providing them with sufficient disease related information, striving to improve the medical treatment process, establishing and improving their all-round support system.
Objective To report the experiences using orthotopic heart transplantation （HTX） to treat a patient with primary cardiac pheochromocytoma （PCT）. Methods On June 2, 2005, a 48-year-old woman received orthotopic HTX because she suffered from cardiac PCT which can not be resected. The procedure for the recipient was uneventful. The aortic crossclamp time was 95 min, assist circulation time 64 min. Results Twenty days after the operation, the patient was discharged without any events, and serum norepinepherine dropped to 1. 339 ng/ml, and urinary norepinepherine 108μg/24h. Conclusion Orthotopic HTX is an effective treatment for cardiac PCT when it cannot be resected.
Tibial transverse transport (TTT) was firstly applied to treat thromboangiitis obliterans successfully by Professor QU Long in China in 2000. Based on this, the team of Professor HUA Qikai in the First Affiliated Hospital of Guangxi Medical University applied this technique to treat diabetic foot since 2013, and until now, more than 500 patients underwent this treatment with excellent effectiveness including a salvage rate as high as 96.1%. Our team also improved this technique in many aspects, and developed a TTT-based classification system and treatment for diabetic foot. We also explored the underlying mechanism of TTT treatment using imaging, histology, and other basic research methods. To further promote the application of this technique in clinic, we reported the findings from our cases and reviewed our previous findings in this study.
ObjectiveTo explore the efficacy and safety of hybrid surgery in the treatment of thoracoabdominal aortic aneurysm (TAAA). MethodsTwenty patients who were diagnosed with TAAA (including chronic thoracoabdominal aortic dissection aneurysm) and underwent hybrid surgery in Vascular Surgery, West China Hospital, Sichuan University were enrolled between January 2015 and December 2022. All the patients underwent retrograde reconstruction for visceral arteries in the open surgery. Additionally, one-stage or two-stage endovascular aortic repair with covered stents was performed. The patients’ clinical baseline information was collected. Moreover, the patients received clinical follow-up and imaging examinations postoperatively, whose informationwas collected. ResultsOne patient developed paraplegia and acute renal failure 16 days postoperatively in the hospital, and subsequently died in the hospital due to septic shock. Another patient underwent exploratory laparotomy for hemostasis due to anastomotic bleeding in the hospital. The other patients did not experience serious complications perioperatively. Nineteen patients were discharged from the hospital with long-term follow-up ranging from 10 to 144 months (median time: 48 months), and all of them had a long-term survival. No patients were observed with paraplegia, myocardial infarction, stroke, or rupture of aneurysm. None of the patients received reintervention during the follow-up, except for one patient who underwent ultrasound-guided puncture and suctionin the aneurysmallumen. ConclusionHybrid surgery is an effective treatment for TAAA with favorable short- and long-term safety and efficacy.
Objective To explore the impact of quarantine experiences on the public’s perceived infection risk and expectations following the shift in coronavirus disease 2019 (COVID-19) policy. Methods From December 7 to 10, 2022, an online questionnaire survey was conducted to collect data on respondents’ past quarantine experiences and their perceived infection risk and expectations after the relaxation of COVID-19 restrictions. Independent-samples t-tests and multiple linear regression analysis were used to examine the effect of quarantine experience on the public’s perceived infection risk and expectations. Results A total of 570 valid questionnaires were collected. Among the 570 respondents, 377 had quarantine experience. Those who had experienced quarantine reported a significantly higher perceived risk of COVID-19 infection than those who had not (3.07±1.28 vs. 2.77±1.23, P=0.007). Multiple linear regression analysis showed that quarantine experience [unstandardized partial regression coefficient (b)=0.278, 95% confidence interval (CI) (0.069, 0.487), P=0.009] and attitude change [b=0.319, 95%CI (0.251, 0.388), P<0.001] were significant influencing factors of perceived infection risk. Conclusions After the shift in COVID-19 policy, quarantine experience has a significant impact on the public’s perceived infection risk and expectations. Respondents with quarantine experiences have a higher perceived risk of contracting the virus and more pessimistic expectations.
ObjectiveTo understand the experiences of out-patient services of the elderly patients, and to analyze the impact factors of the satisfaction of elderly patients, so as to produce evidence for healthcare quality improvement. MethodsBased on the data collected from the out-patient survey of the 2015 Evaluation of the National Healthcare Improvement Initiative, we compared the disparities of patient satisfaction among different age-groups, between different geographic regions and different types of hospitals. We conducted multivariate binary logistic regression analysis to identify factors, associated with the satisfaction of the elderly outpatients. We also compared satisfaction of the Chinese elderly patients with healthcare services with other countries. ResultsSatisfaction scores of the Chinese elderly out-patients were statistically significant higher than that of the young and middle aged out-patients in the domains of hospital environment (satisfaction score=4.42), process efficiency (satisfaction score=4.20), and overall satisfaction (satisfaction score=4.47) (P < 0.001). On the contrary, the elderly out-patients were less satisfied in the domain of hospital informationization experience (satisfaction score=4.25) than the young and middle aged out-patients. This was also the case for the three indicators under this domain, including convenient appointment (satisfaction score=4.27), diversified payment methods (satisfaction score=4.24) and self-service devices (satisfaction score=4.26) (P < 0.001). Western region and traditional Chinese hospitals had significantly lower elderly outpatient satisfaction comparing with eastern and central regions, and general & specialist hospitals (P < 0.05). Trustful doctor-patient relationship (OR=3.45), respected and comfortable care (OR=1.45), clear and reliable mechanism and channel for praise and complain (OR=1.39), length of communication time with doctors (OR=1.35) and length of waiting time until consultation is acceptable (OR=1.29) were the major factors associated with the overall satisfaction of the elderly out-patients. The overall satisfaction of the Chinese elderly out-patients is a bit lower than that in our neighboring country Japan. The satisfaction towards length of communication with doctors of the Chinese elderly patients is lower than that in most of the industrialized countries. ConclusionSpecial demands of the elderly patients should be carefully considered by hospitals in the process of developing new appointment methods and hospital informationization with the aim of healthcare improvement. Longer communication time with doctors, shorter waiting time until consultation, improving human care and building efficiency mechanism and channel for praise and complain are the priorities for future healthcare improvement.