Effects of a Diagnosis-Related Group Payment Reform on Length and Costs of Hospitalization in Sichuan, China: A Synthetic Control Study.

Background: Diagnosis-related group (DRG) payment policies are increasingly recognized as crucial instruments for addressing health care overprovision and escalating health care costs. The synthetic control method (SCM) has emerged as a robust tool for evaluating the efficacy of health policies worldwide. Methods: This study focused on Panzhihua city in Sichuan Province, a pilot city for DRG payment reform implementation, serving as the treatment group. In contrast, 20 nonpilot cities within the province were utilized as potential control units. A counterfactual control group was constructed to evaluate the changes in average inpatient stay duration and health care organization costs following the DRG payment reform initiated in 2018. Results: Focusing on Panzhihua, Sichuan Province, the analysis reveals that following the reform in March 2018, the average length of hospital stay in Panzhihua decreased by 1.35 days during 2019-2021. Additionally, the average cost per hospitalization dropped by 855.48 RMB, the average cost of medication per hospitalization decreased by 68.51 RMB, and the average cost of diagnostic and therapeutic procedures per hospitalization declined by 136.37 RMB. While global evidence backs DRGs for efficiency and cost reduction, challenges persist in addressing emerging issues like new conditions. Conclusion: Since its introduction in 2018, the DRG payment reform in Sichuan Province has effectively reduced both the duration of hospital stays and the operational costs of health care facilities. However, potential drawbacks include compromised service quality and an elevated risk of patient readmission, indicating a need for further refinement in the implementation of DRG payment reforms in China.

Dimethylsiloxanes in dust from nine indoor microenvironments of Henan Province: Occurrence and human exposure assessment.

Dimethylsiloxanes (MSs) are widely used in daily life and industry, with indoors being the main release site. Detecting the levels of MSs in indoor dust is essential for assessing the risks of human exposure. In this study, the content of MSs (D3-D8 and L3-L16) was quantified in indoor dust samples from nine microenvironments of Henan Province. The detection frequency of the targets ranged from 5.00 % to 100 %. The sum concentration of dimethylsiloxanes (TSi) was in a range of 463-3.32 × 104 ng·g-1 (median: 1.92 × 103 ng·g-1). The sum concentration of linear dimethylsiloxanes (TLSi) from all microenvironments was higher than the sum concentration of cyclic dimethylsiloxanes (TCSi), which was consistent with previously reported results. D7 and D8 were the main cyclic dimethylsiloxane, which had similar sources based on Spearman correlation analysis (p < 0.001). Moreover, D8 was detected with high levels in indoor dust for the first time, which warrants further exploration. L8-L16 were the main linear dimethylsiloxanes, which may have been due to their widespread use in electronic equipment and office equipment. The Spearman analysis found that total organic carbon (TOC) in indoor dust had weak effect on MSs. Additionally, relatively high MS levels were recorded in high people-flow working microenvironments. Accordingly, the exposure doses of MSs via indoor dust intake were estimated for different age groups using the model of worst-case exposure and median concentration. Toddlers had the highest EDIs (95th percentile concentration, 90.7 ng·kg-1-bw·d-1) to MSs.

Flexible Wireless Passive LC Pressure Sensor with Design Methodology and Cost-Effective Preparation.

Continuous monitoring of physical motion, which can be successfully achieved via a wireless flexible wearable electronic device, is essential for people to ensure the appropriate level of exercise. Currently, most of the flexible LC pressure sensors have low sensitivity because of the high Young's modulus of the dielectric properties (such as PDMS) and the inflexible polymer films (as the substrate of the sensors), which don't have excellent stretchability to conform to arbitrarily curved and moving surfaces such as joints. In the LC sensing system, the metal rings, as the traditional readout device, are difficult to meet the needs of the portable readout device for the integrated and planar readout antenna. In order to improve the pressure sensitivity of the sensor, the Ecoflex microcolumn used as the dielectric of the capacitive pressure sensor was prepared by using a metal mold copying method. The Ecoflex elastomer substrates enhanced the levels of conformability, which offered improved capabilities to establish intimate contact with the curved and moving surfaces of the skin. The pressure was applied to the sensor by weights, and the resonance frequency curves of the sensor under different pressures were obtained by the readout device connected to the vector network analyzer. The experimental results show that resonant frequency decreases linearly with the increase of applied pressure in a range of 0-23,760 Pa with a high sensitivity of -2.2 MHz/KPa. We designed a coplanar waveguide-fed monopole antenna used to read the information of the LC sensor, which has the potential to be integrated with RF signal processing circuits as a portable readout device and a higher vertical readout distance (up to 4 cm) than the copper ring. The flexible LC pressure sensor can be attached to the skin conformally and is sensitive to limb bending and facial muscle movements. Therefore, it has the potential to be integrated as a body sensor network that can be used to monitor physical motion.