Analysis on the influencing factors of 31-day unplanned readmission in obstetrics department of public hospitals / 中华医院管理杂志

Objective:To explore the influencing factors of 31-day unplanned readmission in obstetrics.Methods:The medical records and relevant clinical data of 29 public hospitals in a province in 2017 were collected to construct a two-level logistic regression model on the influencing factors of 31-day unplanned readmission.Results:In 2017, there were 71 330 obstetric patients discharged from 29 public hospitals, 690 of whom were unplanned readmitted in 31 days, accounting for 0.97%. The type of medical insurance payment, number of previous hospitalization, condition of previous hospitalization, age, history of cesarean section, pregnancy complications and complications during delivery were all the factors influencing the 31-day unplanned readmission of obstetrics.Conclusions:The condition of 31-day unplanned readmission could be influenced by the factors of sociology, previous visit and clinical. These factors should be considered reasonably in the evaluation and management of obstetric quality.

Evaluation application of death indicators and unplanned return indicators based on provincial diagnosis-related groups platform / 中华医院管理杂志

Objective:To explore the relationship between death indicators and unplanned return indicators on healthcare quality evaluation.Methods:A total of 836 976 medical record data were collected from 31 tertiary public general hospitals in a diagnosis-related groups(DRG) data platform in 2017. Multiple death indices(low and low-risk risk group mortality, high-risk group mortality, crude mortality, and risk adjusted mortality) and unplanned return indices(31-day unplanned readmission rate and 31-day unplanned return to surgery rate) were calculated. Pearson′s correlation coefficient was used to examine the relationships among those indices.Results:Death indicators were correlated with each other, but the unplanned readmission rate was not correlated with the unplanned reoperation rate( r=0.305). There was no correlation between unplanned re-entry rate and death rate. The correlation coefficients were as follows: unplanned readmission rate versus low and low-risk group mortality( r=-0.227), versus high-risk group mortality( r=-0.098), versus actual mortality( r=-0.130), versus risk adjusted mortality( r=0.010); unplanned reoperation rate versus low and low-risk group mortality( r=0.105), versus high-risk group mortality( r=0.030), versus actual mortality( r=-0.004), versus risk adjusted mortality( r=-0.141). Conclusions:The indicators of death and the indicators of unplanned return are not the same in terms of actual management technology and evaluation effect. They are complementary to each other and can form an ideal combination of quality evaluation indicators.

Clinical application of combined detection of HE4 and CA125 in patients with endometriosis / 国际检验医学杂志

Objective To investigate the application value of single or combined detection of HE4 and CA125 in the differentia‐tion diagnosis of endometriosis .Methods The detection results of serum HE4 and CA125 levels in 105 cases of patients with ovari‐an endometriosis (endometriosis group) ,53 cases of patients with (ovarian malignant group) tumor and 64 healthy women undergo‐ing the healthy physical examination(control group) were performed the retrospective and statistical analysis .Results The positive rates of serum HE4 in the endometriosis group ,ovarian malignant tumor group and control group were 57 .1% ,90 .6% and 12 .5%respectively with statistically significant difference among them (P< 0 .05) .The positive rates of serum CA125 in the above 3 groups were 44 .8% ,92 .5% and 14 .0% respectively ,and the differences were statistically significant(P<0 .05) .(3)The sensitivity and specificity of 70 pmol/L≤ HE4<150 pmol/L for diagnosing endometriosis were 57 .14% and 53 .86% respectively ,which of 35 U/mL≤CA125<150 U/mL for diagnosing endometriosis were 44 .76% and 61 .24% .But the sensitivity and specificity of their combined detection were 70 .32% and 60 .38% .There were statistically significant differences of sensitivity and specificity among single and combined detecion of HE4 and CA125(P<0 .05) .Conclusion Serum HE4 and CA125 levels are significantly elevated in the patients with endometriosis ,their combined detection could further raise the sensitivity for diagnosing endometriosis .