42,149 research outputs found
Sanming Model of Medical Service Integration: Impact on Medical Expenditures, Service Provision, and Resource Allocation in China
No full textKunhe Lin,1,* Xiao Liu,2,* Li Xiang,1 Fei Luo3 1Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Medical Affairs, Wuhan No. 1 Hospital, Wuhan, People’s Republic of China; 3Department of Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fei Luo, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, People’s Republic of China, Email [email protected]: Fragmentation of healthcare services has been a central issue, contributing to escalating medical expenditures and service provision, thereby exacerbating the waste of limited medical resources. In response, China has introduced the Sanming Mode, a medical service integration model designed to address these challenges. This study evaluates the model’s impact on medical expenditures, service provision, and resource allocation.Methods: We conducted an interrupted time series analysis on outcome variables related to medical expenditures, service provision, and resource allocation in Sanming City. The dataset encompassed operational data from all public hospitals and community health service institutions in Sanming from January 2016 to November 2019.Results: Post-reform, the monthly medical expenditures, outpatient visits, and inpatient admissions in Sanming City shifted from a rapid growth trend to a slower growth trend, with slopes decreasing by 0.1%, 1.4%, and 0.5%, respectively. Heterogeneity analysis between hospitals and community health service institutions revealed a more pronounced slowdown in the growth rate of monthly medical expenses in community health service institutions. However, the growth rates for outpatient and inpatient visits in hospitals significantly decreased post-reform, while there was no significant change observed in community health service institutions.Conclusion: The Sanming Model represents a significant localized attempt to integrate hospital and community health services in China. It effectively curbs the rapid growth of medical expenditures and service provision, thereby reducing the consumption of basic medical insurance funds. The Model enhances the efficiency of medical resource utilization and promotes a shift in service provision from hospitals to community health service institutions, reflecting a trend in resource allocation that concentrates serious illnesses in hospitals while directing minor health issues to community health service institutions. This positive impact promotes the effective integration and rational allocation of medical resources.Keywords: medical service integration, Sanming model, health expenditures, resource allocation, healthcare efficiency, Community Health Service Institution
y An evaluation of systemic reforms of public hospitals: the Sanming model in China
No full textLow- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives. By employing the difference-in-difference (DID) method and using the hospital-level data from 187 public hospitals in Fujian province, we find that the Sanming model has reduced medical costs significantly without measurably sacrificing clinical quality and productive efficiency. The systemic reform, on average, has reduced the medical care cost per outpatient visit and per inpatient admission by 6.1% (P-value = 0.0445) and 15.4% (P-value < 0.001), respectively. It is largely accomplished through a decrease in drug expenditures per outpatient visit and per inpatient admission of about 29% (P-value < 0.001) and 53% (P-value < 0.001). These results show that the Sanming model has achieved at least a short-term success in improving the performance of the public hospitals. These findings suggest that such a systemic transformation of public hospitals, where the governance structure, payment system and physician compensation methods are aligned, are crucial to improving their performance; it holds critical lessons for China and other LMICs.SCI(E)SSCIARTICLE81135-11453
Assessment of Self-Archiving in Institutional Repositories: Depositorship and Full-Text Availability
No full textThis research evaluates the success of open access self-archiving in several well-known institutional repositories. Two assessment factors have been applied to examine the current practice of self-archiving: depositorship and the availability of full text. This research discovers that the rate of author self-archiving is low and that the majority of documents have been deposited by a librarian or administrative staff. Similarly, the rate of full-text availability is relatively low, except for Australian repositories. By identifying different practices of self-archiving, repository managers can create new strategies for the operation of their repositories and the development of archiving policies
Information Literacy and Librarian-Faculty Collaboration: A Model for Success:
No full textIn the age of information explosion and technological advancement, issues of information storage, organization, access, and evaluation have become necessarily important in our societies. Addressing issues of information literacy and designing how they can be best integrated in students' learning process are of critical importance. Library professionals in the United States, particularly in the academia, have realized the importance of information literacy and have attempted in various ways to address these issues. The ultimate goal is to make information literacy an integral part of the academic curriculum, thus helping students to succeed not only during their years in college but also for their lifelong career choices. This article will look at ways of how information literacy can best be incorporated into students' academic experience, and how this process can make students' learning meaningful and successful. Specifically, the author will examine the model of librarian-faculty collaboration in integrating information literacy into the curriculum, as demonstrated in the Ohio Five Colleges' Information Literacy Program.Publisher version of this article is available at: http://www.white-clouds.com/iclc/cliej/cl24.ht
Table_1_The Impact of Sanming Healthcare Reform on Antibiotic Appropriate Use in County Hospitals in China.DOCX
No full textBackgroundThe excessive use of resources and poor quality of care are great concerns worldwide, particularly in China. In 2013, a model of systematic reforms was developed in Sanming to address the inefficiency and waste in public hospitals. However, limited empirical studies have evaluated the effect of Sanming healthcare reform on antibiotic appropriate use. This study aims to evaluate the impact of the healthcare reform on the appropriate use of antibiotics in county-level public hospitals in Sanming, China.MethodsWe conducted a retrospective observational study exploring trends in antibiotic use with an interrupted time series design. We selected three county-level hospitals in Sanming and extracted outpatient prescriptions of the Departments of Internal Medicine and the Department of Pediatrics between January 2011 and December 2017. Acute Upper Respiratory Tract Infection (AURI), Acute Bronchitis (AB) and Community Acquired Pneumonia (CAP) were selected as the sample diseases for our analysis. The primary outcome was the percentage of prescriptions conformed with standard treatment guidelines (STGs).ResultsA total of 142,180 prescriptions were included in the analysis. During the study period, the percentage of antibiotics prescriptions conformed with STGs boosted from 32.4% in 2011 to 82.3% in 2017. Moreover, after the reform, the rate of prescriptions that conformed with STGs showed significant increasing trends in children with AURI (β = 1.624, p ConclusionOur study confirmed that the Sanming healthcare reform helped to promote the appropriate use of antibiotics in county-level hospitals. This systematic approach to healthcare reform, characterized by an effective governance structure, dynamic financial compensation mechanisms, and specialized drug stewardship, is promising for future public hospital reforms.</p
Metiochodes minor Li, He & Liu 2010
No full textMetiochodes minor Li, He & Liu, 2010 Figs. 2D, 3D, 4D, 5D, 6D, 7D Metiochodes minor Li et al. 2010; He 2018. Material examined. 1 male, CHINA, Fujiang Prov., Sanming, Mingxi, Longkeng, 8-viii-2008, coll. He Zhu-Qing; 2 females, CHINA, Zhejiang Prov., Tianmushan, 17-viii-2018, coll. He Zhu-Qing; 3 males, CHINA, Zhejiang Prov., Tianmushan, 11-viii-2019, coll. He Zhu-Qing; 1 male, CHINA, Zhejiang Prov., Tianmushan, 6-ix-2019, coll. He Zhu-Qing. Measurements (in mm). Male: SZ 9.75–9.79, PR 0.70–0.78, HF 4.10–4.23; females: SZ 10.19–11.81, PR 0.75–0.85, HF 4.55–4.82, OV 3.27–3.58. Distribution. China (Fujian, Zhejiang).Published as part of Li, Shi-Yu, Liu, Yi-Jiao & He, Zhu-Qing, 2022, New and little-known mute Trigonidiinae species from China (Orthoptera: Grylloidea: Trigonidiidae), pp. 210-220 in Zootaxa 5115 (2) on page 214, DOI: 10.11646/zootaxa.5115.2.2, http://zenodo.org/record/635226
Characterization of the complete chloroplast genome of Sanming wild banana (Musa itinerans) and phylogenetic relationships
No full textSanming wild banana (Musa itinerans) is a cold resistant wild banana found in Fujian province of China. In this study, we characterized its complete chloroplast genome using BGISEQ-500 sequencing. The chloroplast genome is 171,815 bp in size, containing a pair of IR regions (35,142 bp), a large single copy region (89,995 bp), and a small single copy region (11,464 bp). The whole chloroplast genome contains 111 unique genes, including 78 protein-coding genes, 29 tRNAs, and 4 rRNAs. Phylogenetic maximum likelihood analysis revealed that Sanming wild banana showed the closest relationship with Musa itinerans that collected from Yunnan Province of China
Effects of medical consortium policy on health services: an interrupted time-series analysis in Sanming, China
No full textObjectivesChina has implemented reforms to enhance the operational efficiency of three-level medical services through medical consortiums (MCs). This study evaluated the impact of MCs reform on health services in Sanming, China.MethodsAn interrupted time-series analysis (ITSA) was conducted to assess the impact of MCs on changes in health service levels and trends across the overall situation of MCs and different institutional types within MCs, including county hospitals and grassroots medical institutions. The evaluation focused on various indicators such as outpatient and emergency visits, inpatients, average length of stay, occupancy rate of hospital beds, and hospital bed turnover times. Monthly data were collected from April 2015 to June 2019 through reports on the Sanming Municipal Health Commission website and the Sanming public hospital management monitoring platform.ResultsAfter the intervention of MCs reform, a significant increase was observed in the total number of inpatients (β3 = 174.28, p < 0.05). However, no statistically significant change was observed in the total number of outpatient and emergency visits (β3 = 155.82, p = 0.91). Additionally, the implementation of MCs reform led to an amplification in service volumes provided by county hospitals, with significant increases in the number of outpatient and emergency visits (β3 = 1376.54, p < 0.05) and an upward trend in the number of inpatients (β3 = 98.87, p < 0.01). However, no significant changes were observed under the MCs policy for grassroots medical institutions regarding the number of outpatient and emergency visits (β3 = −1220.72, p = 0.22) and number of inpatients (β3 = 75.42, p = 0.09).ConclusionThe Sanming MCs reform has achieved some progress in augmenting service volumes. Nevertheless, it has not led to an increase in service volumes at the grassroots medical institutions. There persists an insufficiency in the efficiency of services and a need for further improvement in primary healthcare. To address these concerns, it is imperative for county hospitals to offer targeted assistance that can enhance motivation among grassroots medical institutions. Besides the MCs should explore initiatives, including improved management of medical equipment, allocation of funding, and personnel resources
Factors to Assess Self-Archiving in Institutional Repositories
No full textThis paper proposes a group of factors that may be used to assess the success of open access self-archiving. It concentrates on self-archiving in institutional repositories. The authors emphasize the importance of examining content materials, particularly the availability of full text versus abstracts and the deposits archived by authors versus by others.Peer reviewe
Applying the NISO Metasearch Initiative Scheme to Enhance E-Resources Management at Rutgers University Library
No full textThis paper discusses problems in the management of library e-resources and attempts to identify potential solutions to the problems. By describing an e-resources enhancement project taken by Rutgers University Libraries, this paper points to the importance of providing contextually-rich metadata and reorganizing the accessibility of e-resources on a library’s website. It introduces how this Rutgers project adopted the National Information Standards Organization Metasearch Initiative to support the identification of appropriate e-collections for metaseaching. The outcomes of the project have facilitated a dynamic display of relevant e-resources to library users as an effective way of automatic access to library e-collections.Peer reviewe
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