ObjectiveThis study aimed to explore the influencing factors and structural changes in hospitalization expenses for heart failure (HF) patients under the Diagnosis-Related Group (DRG) payment system reform, providing a scientific basis for hospitals to control the hospitalization costs of HF patients.MethodsA total of 4,791 hospitalized HF patients from a secondary Grade-A hospital in Liuzhou City between January 1, 2015, and July 31, 2025, were selected as the study subjects. Factors such as the timing of DRG implementation were grouped and included in the analysis. Univariate analysis and multiple linear regression were employed to analyze the influencing factors of total hospitalization expenses and out-of-pocket payments. The degree of structural change and novel gray relational analysis were used to examine the trends and correlations in the structure of hospitalization expenses for HF patients.ResultsThe total hospitalization expenses of HF patients were mainly influenced by the type of medical insurance, number of visits, gender, age, length of stay, number of other diagnosed diseases, diabetes, surgery level, and discharge method (P < 0.05). Out-of-pocket payments were primarily affected by the payment method group, type of medical insurance, number of visits, gender, marital status, admission route, length of stay, and surgery level (P < 0.05). From 2015 to 2025, the treatment fee had the largest Variation of Structural Value (VSV) at 0.1663, showing a positive change, while the drug fee contributed the most to the structural change at 34.06%. The novel gray relational analysis indicated that the top two associated items were diagnosis fees (0.8797) and drug fees (0.7647), meaning that treatment, diagnosis, and drug fees were the main factors affecting the structural changes in hospitalization expenses.ConclusionThe DRG payment system can effectively reduce the hospitalization expenses of HF patients, alleviating their disease burden. When controlling costs under the DRG payment system, comprehensive consideration should be given to influencing factors such as the patient's number of visits, length of stay, surgery level, gender, age, and number of other diagnosed diseases to effectively reduce hospitalization expenses. By utilizing DRG payments and medical insurance policies to manage and control diagnosis and drug fees of heart failure, hospitalization costs can be controlled, and the cost structure optimized.

Objective To investigate the current status of insured residents' awareness of basic medical insurance policies and its influencing factors, reveal the correlation between awareness and insurance participation stability, and provide empirical references for optimizing policy publicity, curbing insurance withdrawal, and consolidating a long-term insurance participation mechanism. Methods A cross-sectional survey was conducted among 1,173 insured residents from 14 prefecture-level cities in Guangxi Zhuang Autonomous Region between July and September 2023 using multi-stage random sampling. Descriptive statistics, univariate analysis (t-test/ANOVA), and linear regression models were applied to systematically analyze the impacts of demographic characteristics and policy information channels on awareness levels. Results The overall awareness of medical insurance policies was low, with only 4.0% of residents reporting "very high awareness". Specifically, awareness rates of procurement policies (7.7%) and dual-channel policies (3.7%) were extremely low. Community medical insurance workstations (50.9%) served as the core communication channel, while television, the internet, and leaflets were important supplementary channels. Linear regression analysis showed that education level (high school/vocational school or above: β = 0.253–0.307, P < 0.01), agricultural employment status (β=-0.252, P < 0.001), and obtaining policy information through community medical insurance workstations (β = 0.177, P < 0.001), the internet (β = 0.206, P < 0.001), and leaflets (β = 0.209, P < 0.001) significantly improved awareness. In contrast, obtaining information through relatives and friends had a negative impact (β=-0.200, P < 0.001). Conclusion Insured residents' awareness of medical insurance policies is generally low, with weak understanding of specific provisions. Education level, employment status, and information channels are key influencing factors.

Lung cancer poses a serious threat to human health. The direct medical expense and indirect social economic burden caused by high morbidity and poor prognosis rate of malignant tumor are higher than other diseases around the world, especially in some developing countries such as China. Guangxi is one of the less developed provinces in China and it is more essential to control the pressure on medical costs. We intend to explore influential factors of hospitalization expense for lung cancer and provide policy recommendations for the control of hospitalization expense. This study was divided into two aspects: internal and external analysis. Degree of structure variation (DSV) was used to explore internal factors. Generalized linear model (GLM) was used to explore external factor. Based on International Classification Diseases, 2,335 lung cancer patients were selected as studying objects. The total hospitalization expense in 2012 was the lowest, and then in increased from 2012 to 2015 year by year. Western medicine expense occupy the highest proportion in total hospitalization expense. Through the analysis of internal influencing factors, the medicine expense and examination expense have large contribution of structure variation from 2012 to 2016 based on DSV. For external factor, OR of occupation, medical insurance type, hospitalization frequency, and length of stay are statistically significant in GLM equation. The hospitalization expense is increasing and the effect of cost control is not significant. The study found that medicine expense and examination expense play an important role in controlling the total hospitalization expense. Therefore we can control the overall hospitalization expense increase by controlling these two expense items. Occupation, medical insurance type, hospitalization frequency, and length of stay have influence on hospitalization expense for lung cancer patients. Therefore we can also develop different cost control measures for different types of patients.

This study aimed to develop a comprehensive evaluation indicator system for assessing the teaching quality (TQ) of graduate students majoring in Health Management. The evaluation indicator system was built using the Delphi Method with 20 senior experts who have extensive experience in health management education and research. The final evaluation system was applied in a case study at Guangxi Medical University. The weight of Teaching Staff (0.381) and Teaching Target (0.381) is higher than that of the Teaching Process (0.237). In the Teaching Staff dimension, experts emphasize that Professional Qualities (0.057) play a key role in TQ, especially Teaching Reflection (0.255) and Political Literacy (0.255). In the Teaching Target dimension, Student Research Output (0.072) and Assessment Criteria (0.065) are the core factors. In the Teaching Process dimension, the weight of Teaching Methods (0.565) is higher than that of Teaching Content (0.435). For the Teaching Staff, experts and students agree that the weight of Professional Expertise is the lowest. In summary, the Professional Qualities in Teaching Staff dimension, especially Teaching Reflection and Political Literacy, are the key factors affecting TQ. Student Research Output and Assessment Criteria are the core factors in the evaluation of Teaching Target.

目的 对2010～2020年广西孕产妇保健服务质量进行综合评价,为进一步提高孕产妇保健服务质量提供依据.方法 以2010～2020年广西孕产妇保健服务相关指标(建卡率、系统管理率、产前检查率、产后访视率、住院分娩率、孕产妇死亡率)为基础,运用TOPSIS法和RSR法对各年度的孕产妇保健服务质量进行综合评价.结果 2010～2020年,孕产妇的系统管理率、产前检查率和产后访视率呈现逐年上升趋势;建卡率和住院分娩率保持在99％以上.广西孕产妇死亡率逐年下降,从2010年的18.88/10万下降到2020年的8.37/10万,年均降幅7.81％.TOPSIS法排序结果显示,2016～2020年名列前列,2010～2015年排名靠后.RSR法分档评价结果显示,2010年孕产妇保健服务质量评定为"差";2016年和2020年评定为"好";其他年份评定为"中".结论 广西孕产妇保健服务质量逐年提高,但仍有进一步提升空间.孕产妇死亡率下降呈现波动反复,进一步下降遇到瓶颈.在"十四五"期间,进一步降低孕产妇死亡率,持续改善孕产妇保健服务质量是广西妇幼卫生工作的难点和重点.

目的 综合评价2010—2020年广西儿童保健服务质量.方法 收集2010—2020年广西5岁以下儿童死亡率、婴儿死亡率、新生儿死亡率、围生儿死亡率、新生儿访视率、3岁以下儿童系统管理率、7岁以下儿童保健管理率作为评价指标,联合应用TOPSIS法和秩和比(RSR)法对广西儿童保健服务质量进行综合评价.结果 (1)与2010年相比,2020年广西5岁以下儿童死亡率、婴儿死亡率、新生儿死亡率、围生儿死亡率分别下降了65.35％、67.19％、65.09％和36.11％,年均降幅分别为10.06％、10.55％、9.99％和4.38％.5岁以下儿童死亡率和婴儿死亡率的城乡之比分别从1:4.89和1:4.28,缩小到2020年的1:1.14和1:1.10.(2)与2010年相比,2020年广西新生儿访视率、3岁以下儿童系统管理率和7岁以下儿童保健管理率提高了0.52％、19.48％和16.38％.(3)基于TOPSIS法的排序结果显示,儿童保健服务质量排名前三的年份为2020年、2016年和2018年;排名倒数三位的年份为2010年、2011年和2012年.RSR法分档评价结果显示,评定为"优"的年份为2016年和2020年,被评定为"差"的年份为2010年.结论 广西儿童保健服务质量总体呈持续向好,但仍需要进一步改善.应持续提高妇幼卫生资源的投入,进一步改善儿童保健服务质量,全面促进儿童健康水平的提升.

目的 了解广西某医学院校卫生事业管理专业本科生专业认可度现状,探讨提升学生专业认可度的策略.方法 以广西某医学院校卫生事业管理专业本科生为调查对象,采用自编问卷对其进行调查,运用主成分分析法确定影响专业认可度各指标的权重.结果 专业认知、专业情感、专业行为、专业匹配程度的权重分别为 0.187、0.389、0.273、0.151;来自城市、自己喜欢该专业的学生专业认可度高于来自乡镇、农村及非自主选择的学生(P＜0.05).结论 增强学生对专业的情感有利于提高其专业认可度.

目的 了解我国基于疾病诊断相关分组(DRGs)开展医院医疗绩效评价的研究进展情况,总结研究热点及存在的问题.方法 在中国知网数据库检索应用DRGs评价医疗服务绩效的文献.通过中国知网数据库的可视化分析功能分析文献量随年份的变化情况,并运用CiteSpace 5.7.R5 W软件共现作者、机构和关键词知识图谱.结果 随着年份的增长,国内应用DRGs评价医疗服务绩效的文献逐年增多,以2019年产出文献量最多.在应用DRGs开展医院绩效评价的相关研究上,我国学者已形成了两个比较大的聚类,较有影响力的文献主要来源于北京市的相关单位和部门.基于DRGs的医院绩效评价的相关研究热点已经从早期的运用基本条件的研究,逐步发展到基于DRGs评价三级医院医疗服务绩效、基于DRGs结合多种手段进行评价.结论 随着相关政策的出台,应用DRGs评价医疗服务绩效已经成为并将持续成为研究热点.但在我国不同地区该方面的研究发展程度不一致,不同机构、学者还应该加强该研究问题的学术交流,分享前沿学术成果,促进该领域研究和实践的发展.

目的 对广西各地市妇幼保健服务质量进行评价,了解广西不同地区妇幼保健服务水平,为"十四五"广西相关部门进一步精准施策、改善孕产妇保健服务质量提供循证依据.方法 以2020年广西及各地市的孕产妇保健服务相关指标(系统管理率、建卡率、孕产妇死亡率、住院分娩率、产后访视率和产前检查率)为基础,运用TOPSIS法和RSR法对广西各地区的孕产妇保健服务状况进行综合评价.结果 2020年,广西孕产妇死亡率为8.37/10万,孕产妇的系统管理率、建卡率、产后访视率、产前检查率和住院分娩率等指标均超过90％,其中,住院分娩率超过99％,部分地市达到100％.依据TOPSIS法计算所得的Ci值对广西各地市妇幼保健服务质量进行排序,前三位是梧州市、钦州市和北海市;末三位是是南宁市、防城港市和贺州市.TOPSIS法和RSR法相结合进行分档,梧州市、北海市、钦州市被评定为"好";南宁市、防城港市被评定为"差";其他地市被评定"中".结论 广西不同地区之间孕产妇保健服务质量存在明显差异;进一步降低孕产妇死亡率,将是广西今后妇幼卫生保健工作的难点与重点.

目的 综合评价广西村卫生室服务能力,为提高村卫生室服务提供参考依据.方法 从人力、财力、物力、服务功能四个维度构建广西村卫生室服务能力评价指标体系,采用TOPSIS法、RSR法以及两者模糊联合法对2020年广西各地市村卫生室服务能力进行综合评价并分档.结果 评价指标由4个一级指标和16个二级指标构成,有10个指标数据呈上升趋势.在TOPSIS法和RSR法两者模糊联合法的分析中,计算出的南宁市Ci值、RSRi值、0.1Ci+0.9RSRi值、0.5Ci+0.5RSRi值和 0.9Ci+0.1RSRi值分别为 0.5587、0.7500、0.7309、0.6543 和 0.5778,排名均在第一位.结论 广西村卫生室卫生服务趋势向好,地市间村卫生室服务能力不均衡,综合评价方法的科学性较强.

To explore the influencing factors causing the change of hospitalization cost (HC) in patients with kidney stone disease (KSD), control the increase of HC and reduce the economic burden of patients. Data were derived from one provincial general public hospital in Guangxi, China. Model of Artificial Neural Networks and Multiple Linear Regression were used in analyze the external factors from 2012 to 2016. From 2012 to 2016, the total cost increased year by year without the influence of prices. In perspective of Artificial Neural Networks model, influencing importance of length of stay (LoS) and year and hospitalization frequency rank the first three places. With the processing of multiple linear regression model, it was found that the factors of LoS and year were positively correlated with HC, while the hospitalization frequency factor was negatively correlated. Due to the two models, LoS and year and hospitalization frequency affect HC. So decreasing LoS and increasing medical service efficiency are meaningful for controlling HC. By comparison of the two methods, Artificial Neural model is more suitable for information of this study, but much information still can not be explained and further study will be made.

目的:调查广西医科大学在新型冠状病毒肺炎疫情下的本科生心理健康状况,为更好地进行学生心理健康教育提供依据.方法:使用广泛性焦虑量表和抑郁症状群量表,对485名本科生进行电子问卷调查,分析比较不同人口学背景及基本情况下焦虑情绪和抑郁情绪的发生率.结果:焦虑情绪发生率是40.7％,其中轻度、中度和重度焦虑发生率分别是36.2％、4.3％和0.2％;抑郁情绪发生率是46.0％,其中轻度、中度、中重度和重度抑郁情绪发生率分别是33.3％、10.1％、2.0％和0.6％.专业因素、盼望开学程度及学生身体健康状况与焦虑情绪具有显著相关性.学生身体健康状况与抑郁情绪具有显著相关性.结论:大学生在新冠肺炎疫情应激影响下,出现不同程度的焦虑和抑郁,专业因素及盼望开学程度(社交倾向)与学生焦虑情绪的产生有一定的关联性,学生的身体健康状况与焦虑情绪及抑郁情绪均有一定关联性,学校应该对学生进行心理干预或相关的教育疏导.

目的 了解广西某市医联体内患者对医疗服务的满意情况及对医联体相关政策的知晓情况.方法 采用方便抽样法,选取在广西L市医联体内就诊的199例患者(就诊于L市某三甲医院97例,就诊于S县人民医院102例)作为研究对象.采用自制问卷调查患者的基本情况,患者对医疗服务的满意情况,患者对医联体、基层首诊、分级诊疗相关政策的了解情况、态度和评价,以及住院患者对回基层医疗机构康复的意愿.结果 (1)S县人民医院的患者中,59.8％(61/102)为外地居民.L市某三甲医院、S县人民医院患者的满意率分别为99.0％(96/97)、83.3％(85/102);L市某三甲医院患者最满意之处是医院服务态度好,其次为技术水平高,S县人民医院患者最满意之处是医院服务态度好.(2)L市某三甲医院、S县人民医院分别有60.8％(59/97)、44.1％(45/102)的患者不了解医联体,S县人民医院中了解医联体的患者比例相对高于L市某三甲医院(分别34.3％、8.2％).L市某三甲医院、S县人民医院患者了解医联体政策的最主要途径分别是"听周围人诉说"(39.5％)、"医务人员告知"(45.6％).(3)L市某三甲医院、S县人民医院中愿意接受基层首诊的患者比例分别为67.0％(65/97)、79.4％(81/102),主要原因为"离家较近"和"习惯使然".L市某三甲医院中不愿意接受基层首诊的患者比例相对高于S县人民医院(分别为32.0％、20.6％),其中L市某三甲医院患者不愿意接受基层首诊的原因主要为基层医疗机构的医生能力不高和数量不足、药品品种数量不足.(4)L市某三甲医院、S县人民医院仅分别有24例、5例患者曾有过转诊经验,且多数患者是通过"医生口头建议"的方式进行转诊.多数患者对转诊服务较满意,造成少数患者不满意的原因主要是"不清楚转诊流程和标准".(5)S县人民医院、L市某三甲医院分别有53.7％(22/41)、31.6％(12/38)住院患者愿意在病情稳定后转回基层医疗机构继续康复.不愿意接受回基层医疗机构康复的原因主要为患者不信任卫生院/社区中心的医疗技术水平.结论 医联体对周边患者具有一定的吸引作用,医联体内患者对医疗服务的满意率整体较高,大部分患者均表示愿意接受基层首诊,但大部分患者对医联体不了解.今后需进一步规范医联体内双向转诊的流程,提升基层医疗机构的诊疗水平,加强对医联体的宣传,以进一步提高医联体内患者的满意度和对医联体政策的知晓率,推动分级诊疗模式的有效实施,促进资源的合理利用.

[目的]了解医务人员对医联体政策的了解和看法,为政策决定者提供参考.[方法]以自编式调查问卷,对L市医院和S县医院的医务人员进行调查,并采用卡方检验对调查结果进行分析.[结果]S县医院医务人员工作满意率为42.0％,收入满意率为13.1％,低于L市医院;两家医院均约有30％的医务人员不了解医联体内双向转诊标准;S县医院医务人员从未参与过患者上转的占30％以上;两家医院的医务人员均认为"病人病情严重,县医院无条件诊治"是患者上转的主要原因;S县医院中30％以上医务人员认为目前双向转诊效果一般,两家医院医务人员普遍认为"提高基层医疗机构医疗卫生服务能力"才能促进分级诊疗制度的进一步完善.[结论]S县医院医务人员工作满意度较低,收入满意度不高;医务人员对医联体的知晓情况欠佳,内部宣传和教育工作有待深入;S县医院医联体工作参与率较高,但下转难问题依然存在.

Background: By collecting the medical record information of hospitalization cost (HC) of the elderly over 60 years, to comprehensively analyze the influencing factors of the rise of HC from the internal and external dimensions, so as to put forward targeted measures and suggestions to control the excessive growth of HC. Objectives: to assess the hospitalization cost of elderly patients with lung cancer in the Western region of China Methods: Taking a tertiary hospital in Guangxi Zhuang Autonomous Region of China, herein after referred to as Guangxi Xi as a sample, the medical record home page data of lung cancer patients over 60 years old from 2012 to 2016 were collected, and the influencing factors of HC were analyzed. Grey Relation Analysis and Structural Variation Degree were used in the analysis of internal influencing factors. Structural Equation Model was used in the analysis of external influencing factors. Results: The HC of elderly patients with lung cancer was found to be increased year by year from 2012 to 2016. The structural variation degree of HC from 2015 to 2016 was the largest, which was 12.81%. The Grey Relation analysis results showed that the correlation degrees of medicine cost, examination cost and consumables cost were 1.000, 0.8606 and 0.7559 respectively, which were the main internal factors affecting HC. The structural equation model showed that the length of stay, whether to operate, re-hospitalization plan, the number of complications, occupation and hospitalization frequency had an impact on the HC and their total impact effects were 0.688, 0.428, 0.221, 0.184, 054 and 0.044 respectively. Conclusion: The HC of elderly patients with lung cancer are increasing year by year, but the increase rate is reasonable. The cost of medicine and consumable have been solved to a certain extent, while the examination cost still needs to be further controlled. The length of stay is still the main influencing factor, and other factors will indirectly affect the hospitalization cost through this factor.

目的 了解广西壮族自治区上林县某乡镇卫生院2014—2017年基本公共卫生服务提供状况,为提高乡镇卫生院的基本公共卫生服务能力提供参考.方法 自编问卷,调查广西壮族自治区上林县某乡镇卫生院2014—2017年基本公共卫生服务提供状况,内容包括居民健康档案管理、重性精神疾病患者管理等.结果 2014—2017年该卫生院的重性精神疾病患者管理率、按要求进行规范管理的儿童数比例呈上升趋势;居民健康规范化累计建档率、按要求进行系统管理的糖尿病患者人数比例和有效控制人数比例、高血压有效控制人数比例、孕产妇系统管理率、老年人健康管理率呈下降趋势.结论 该卫生院在部分基本公共卫生服务上取得一定成效,但在健康管理、人群服务和疾病管理方面存在不足.

卫生政策学作为融合了多门学科知识和方法的一门综合学科,包含了经济学、管理学、社会学、政治学等众多领域的知识.内容抽样且深奥,理论体系非常庞杂.在日常的教学实践中,学生普遍反映卫生政策学内容较枯燥、乏味,学习兴趣不高,传统的教学形式无法满足授课的需要,更无法帮助学生深入理解卫生政策的实质.针对传统教学法在卫生政策学教学中的诸多弊端,该文结合教学实践,从问题教学法、案例教学法和雨课堂3个方面探讨教学形式,以实现加深学生对卫生政策学内容的理解,调动学习积极性,全方位了解学生学习情况的目的.

目的:了解广西壮族自治区乡镇卫生院医务人员对精神疾病态度现状及相关因素.方法:于2018年1-6月,采取分层整群随机抽样方法抽取广西45所乡镇卫生院888名医务人员,调查其对精神疾病的态度.调查工具采用原卫生部办公厅下发的《精神疾病态度问卷》.采用多元线性回归法分析医务人员对精神疾病态度的相关因素.结果:34.1％的医务人员对精神疾病持负性态度.本科及以上者和副高职称者的负性态度比例较低(P＜0.05);医生的负性态度比例较低,护士则较高(P＜0.05);参加精神卫生服务培训者负性态度比例低于未参加者(P＜0.05).多元线性回归显示,知识得分高、医生和参与培训的乡镇医务人员的态度得分较高;护士的态度得分较低.结论:部分乡镇卫生院医务人员对精神疾病及患者存在歧视.护士对精神疾病的态度比医生较负面.提高医务人员的精神卫生知识水平有助于改善其对精神疾病及患者的歧视态度.

目的 分析江西省2015～2018年卫生资源配置的现状和公平性.方法 收集2015～2018年江西省11个地级市的卫生机构数、床位数、卫生技术人员数、执业(助理)医师数、注册护士数等基本卫生资源配置指标,以及常住人口数、各地区生产总值、地理面积等数据.运用基尼系数、泰尔指数,分别从人口、地理面积、经济维度分析江西省卫生资源配置公平性,并与全国平均水平进行比较.结果(1)2015～2018年,江西省床位数、卫生技术人员数、执业(助理)医师数、注册护士数等卫生资源配置总量及每千人口和每平方公里配置数均呈增长的趋势,但卫生机构数方面无论是总量还是每千人口和每平方公里配置数均呈下降趋势;2018年江西省每千人口卫生机构数高于全国平均水平,而每千常住人口床位数、卫生技术人员数、执业(助理)医师数、注册护士数均低于全国平均水平.(2)除卫生机构数外其他四项卫生资源基尼系数均为地理面积维度最高,经济维度次之,人口维度最低、公平性最好;泰尔指数分析结果表明,卫生资源按人口配置的公平性总体上优于按地理面积配置和按经济发展状况配置的公平性.(3)2018年江西省每千常住人口床位数、卫生技术人员数、执业(助理)医师数和注册护士数在赣北地区最高,赣东地区最低;每千人口卫生机构数在赣北地区最低,赣南地区最高,地区间卫生资源配置存在较大差异.结论 2015～2018年江西省卫生资源配置总量增加,但增长速度不足;卫生资源配置人口公平性优于地理面积和经济公平性;地区内卫生资源分布不均衡,地区间差异大.

目的 了解广西乡镇卫生院医务人员精神卫生知识知晓情况及其影响因素.方法 于2018年6月,采取分层整群随机抽样方法抽取广西45所乡镇卫生院888名医务人员,开展精神卫生知识知晓状况调查,调查工具采用原卫生部办公厅下发的《心理健康知识和精神障碍预防知识问卷》.结果 广西乡镇卫生院医务人员精神卫生知识总体知晓率为75.8％,其中反映精神障碍病因与预防知识的知晓率为66.1％,精神卫生节日-“世界自杀预防日”知晓率为27.4％.不同年龄、学历、职称、职业类型、精防工作和培训等因素之间知晓率差异有统计学意义(x2值分别为12.049、185.897、41.145、37.297、108.006和88.153,P均＜0.05).精防人员知晓率(83.9％)高于非精防人员(74.4％);参加精神卫生培训者知晓率(81.3％)高于非参加者(74.2％).多元逐步回归分析显示,学历、职称、参加精防工作和培训与精神卫生知识得分呈正相关(P＜0.05);参加精防工作和培训是影响知识得分的主要因素.结论 广西乡镇卫生院医务人员精神卫生知识的知晓率仍需进一步提高.影响精神卫生知识知晓水平的主要因素包括参加精防工作、参加精神卫生培训、学历和职称.