目的探究疾病诊断相关分组(diagnosis related groups,DRGs)在胃肠肿瘤外科医疗服务绩效管理中的运用。方法依托新疆某医院绩效评价平台,调取在线上报的病案首页的数据,比较某院胃肠肿瘤外科2017年1月-2020年12月住院患者DRGs组数、病...目的探究疾病诊断相关分组(diagnosis related groups,DRGs)在胃肠肿瘤外科医疗服务绩效管理中的运用。方法依托新疆某医院绩效评价平台,调取在线上报的病案首页的数据,比较某院胃肠肿瘤外科2017年1月-2020年12月住院患者DRGs组数、病例组合指数(case-mix index,CMI)、费用消耗指数、时间消耗指数等指标,从服务能力、服务效率、医疗安全3个维度进行分析。结果2017—2020年该科DRGs组数增长了13个、CMI值提高了0.5192、总权重提高了658.93,平均住院日上升了5.03 d、平均总费用增加了24584.29元,平均耗材费增加了10935.22元,耗材费占比上升了9.89个百分点,时间消耗指数和费用消耗指数均呈上升的趋势;三四级手术率提高了37.51个百分点,微创手术率提高了11.71个百分点;但术后死亡率上升了0.06%,非计划再手术率上升了0.6%。结论胃肠肿瘤外科在提高外科服务能力的同时,要以DRGs评价为抓手,进一步加强患者的精细化管理,提高科室医疗服务能力和服务效率,保障患者安全。展开更多
Cyber physical system(CPS)provides more powerful service by cyber and physical features through the wireless communication.As a kind of social organized network system,a fundamental question of CPS is to achieve servi...Cyber physical system(CPS)provides more powerful service by cyber and physical features through the wireless communication.As a kind of social organized network system,a fundamental question of CPS is to achieve service self-organization with its nodes autonomously working in both physical and cyber environments.To solve the problem,the social nature of nodes in CPS is firstly addressed,and then a formal social semantic descriptions is presented for physical environment,node service and task in order to make the nodes communicate automatically and physical environment sensibly.Further,the Horn clause is introduced to represent the reasoning rules of service organizing.Based on the match function,which is defined for measurement between semantics,the semantic aware measurement is presented to evaluate whether environment around a node can satisfy the task requirement or not.Moreover,the service capacity evaluation method for nodes is addressed to find out the competent service from both cyber and physical features of nodes.According to aforementioned two measurements,the task semantic decomposition algorithm and the organizing matrix are defined and the service self-organizing mechanism for CPS is proposed.Finally,examinations are given to further verify the efficiency and feasibility of the proposed mechanism.展开更多
文摘目的探究疾病诊断相关分组(diagnosis related groups,DRGs)在胃肠肿瘤外科医疗服务绩效管理中的运用。方法依托新疆某医院绩效评价平台,调取在线上报的病案首页的数据,比较某院胃肠肿瘤外科2017年1月-2020年12月住院患者DRGs组数、病例组合指数(case-mix index,CMI)、费用消耗指数、时间消耗指数等指标,从服务能力、服务效率、医疗安全3个维度进行分析。结果2017—2020年该科DRGs组数增长了13个、CMI值提高了0.5192、总权重提高了658.93,平均住院日上升了5.03 d、平均总费用增加了24584.29元,平均耗材费增加了10935.22元,耗材费占比上升了9.89个百分点,时间消耗指数和费用消耗指数均呈上升的趋势;三四级手术率提高了37.51个百分点,微创手术率提高了11.71个百分点;但术后死亡率上升了0.06%,非计划再手术率上升了0.6%。结论胃肠肿瘤外科在提高外科服务能力的同时,要以DRGs评价为抓手,进一步加强患者的精细化管理,提高科室医疗服务能力和服务效率,保障患者安全。
基金Supported by the National Natural Science Foundation of China(61103069,71171148)the National High-Tech Research and Development Plan of China(″863″ Plan)(2012BAD35B01)+2 种基金the Innovation Program of Shanghai Municipal Education Commission(13YZ052)the Shanghai Committee of Science and Technology(11DZ1501703,11dz12106001)the Program of Shanghai Normal University(DXL125,DCL201302)
文摘Cyber physical system(CPS)provides more powerful service by cyber and physical features through the wireless communication.As a kind of social organized network system,a fundamental question of CPS is to achieve service self-organization with its nodes autonomously working in both physical and cyber environments.To solve the problem,the social nature of nodes in CPS is firstly addressed,and then a formal social semantic descriptions is presented for physical environment,node service and task in order to make the nodes communicate automatically and physical environment sensibly.Further,the Horn clause is introduced to represent the reasoning rules of service organizing.Based on the match function,which is defined for measurement between semantics,the semantic aware measurement is presented to evaluate whether environment around a node can satisfy the task requirement or not.Moreover,the service capacity evaluation method for nodes is addressed to find out the competent service from both cyber and physical features of nodes.According to aforementioned two measurements,the task semantic decomposition algorithm and the organizing matrix are defined and the service self-organizing mechanism for CPS is proposed.Finally,examinations are given to further verify the efficiency and feasibility of the proposed mechanism.
