RESUMEN
Strengthening the supervision of medical insurance funds is an important measure to promote the healthy and sustainable development of the medical security system. In January 2022, a tertiary general hospital in Beijing carried out risk identification and prevention and control practices for the use of medical insurance funds. By using such methods as fault tree analysis and risk matrix, the probability and impact of events were quantitatively evaluated, high-risk events during the use of medical insurance funds were identified, and corresponding risk prevention and control measures were developed, relying on intelligent regulatory systems. From January to November 2022, the hospital outpatient medical insurance refusal amount(20 080 yuan) caused by such high-risk events as exceeding drug instructions, exceeding medical insurance indications, and exceeding age limits decreased by 42.30% compared to the same period in 2021(11 585 yuan). The discharge and settlement time of medical insurance patients decreased from 3 working days to 1 working day. This practice had effectively improved the quality and efficiency of hospital medical insurance fund supervision, improved patients′ medical experience, and provided reference for strengthening the safe and standardized use of medical insurance funds by medical institutions.
RESUMEN
Objective:To investigate whether adjuvant skin-marker positioning can decrease the set-up errors in overweight patients with thoracic and abdominal tumors.Methods:A total of 60 overweight patients with thoracic and abdominal tumors treated with radiotherapy in the First Affiliated of Fujian Medical University between January 2018 and December 2018 were randomly divided into two groups. In group A, conventional skin-marker positioning was adopted. In group B, conventional skin-marker positioning combined with adjuvant skin-marker position was employed. All patients were immobilized with thermoplastic positioning body membrane with head-body plate fixation. The set-up errors in the right-left, head-foot and dorsoventral directions were obtained from cone-beam CT (CBCT) scan system before radiation delivery. The set-up errors were statistically compared between two groups by using t-test. Results:In group A, the set-up errors in the right-left, head-foot and dorsoventral directions were (4.47±2.91) mm, (5.43±2.61) mm and (3.87±2.40) mm, significantly higher compared with (2.97±1.68) mm, (3.21±1.62) mm and (2.59±1.57) mm, respectively (all P<0.001). Conclusion:Adjuvant skin-marker positioning method can reduce the set-up errors and enhance the positioning repeatability in overweight patients with thoracic and abdominal tumors receiving radiotherapy.
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Objective To investigate perceptions of patient safety culture(PSC) among nurses in tertiary hospitals in Kunming. Methods Totally 2629 nurses were recruited by convenience sampling method from 7 tertiary hospi-tals in Kunming between July 2015 to January 2016. Hospital Survey on Patient Safety Culture (HSOPS) was used to assess PSC. Results The top three superior dimensions of PSC were Organizational Learning-Continuous Im-provement(86.60%),Teamwork within Hospital Units(83.34%) and Feedback and Communication about Error(75.98%). The last three inferior dimensions of PSC wereNonpunitive response to error(23.74%),Staffing(33.71%) and Teamwork across hospital units(49.45%). There were significant differences in certain items among nurses with different educational level,academic title,working hour per week(P<0.05). Conclusion Establishing nonpunitive re-sponse culture,reasonably arranging staffing and working hours,and encouraging nurses with high educational level and title to play their full role,are critical measures to improve patient safety culture in hospital.