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1.
J Huazhong Univ Sci Technolog Med Sci ; 33(2): 309-314, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23592149

RESUMEN

Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to physician's average work load and massive responsibilities. This paper reviewed the constitution of the PPS in China, and further discussed the problems and issues to be addressed with respect to pay for performance. Our study indicated that the lower basic salary and bonus distribution tied to "profits" was the major contributor to the physician's profit-driven incentive and the potential cause for the speedy growth of health expenditures. We recommend that government funding to hospitals should be increased to fully cover physicians' basic salary, a flexible human resource and talent management mechanism needs to be established that severs personal interest between physicians and hospitals, and modern performance assessment and multiplexed payment systems should be piloted to encourage physicians to get the more legitimate compensation.


Asunto(s)
Programas Nacionales de Salud/economía , Planes de Incentivos para los Médicos/economía , Médicos/economía , Salarios y Beneficios/economía , China , Modelos Económicos
2.
DNA Cell Biol ; 33(6): 345-54, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24592969

RESUMEN

Many existing studies have demonstrated that genetic variants in interleukin (IL) genes might have an impact on an individual's susceptibility to IgA nephropathy (IgAN); but individually published results are inconclusive. This meta-analysis aimed to derive a more precise estimation of the relationships between IL genetic variants and IgAN risk. We searched CISCOM, CINAHL, Web of Science, PubMed, Google Scholar, EBSCO, Cochrane Library, and China BioMedicine (CBM) and China National Knowledge Infrastructure (CNKI) databases from inception through August 1, 2013. Meta-analysis was performed using the STATA 12.0 software. Seven case-control studies were included with a total of 1135 IgAN patients and 1603 healthy controls. Our meta-analysis results revealed that genetic variants in IL-1 and IL-1RN genes were associated with an increased risk of IgAN. However, similar associations were not observed in IL-6, IL-10, and IL-22R genes. Subgroup analysis by ethnicity suggested that there were significant associations between IL genetic variants and an increased risk of IgAN among both Asian and Caucasian populations. Meta-regression analyses showed that gene types may be a major source of heterogeneity. No publication bias was detected in this meta-analysis. The present meta-analysis suggests that IL genetic variants may contribute to the risk of IgAN, especially in IL-1 and IL-1RN genes.


Asunto(s)
Predisposición Genética a la Enfermedad , Glomerulonefritis por IGA/genética , Glomerulonefritis por IGA/inmunología , Proteína Antagonista del Receptor de Interleucina 1/genética , Interleucina-1/genética , Interleucinas/genética , Estudios de Casos y Controles , Glomerulonefritis por IGA/metabolismo , Humanos
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