Introduction The aim of this study was to examine health-related quality of life (HRQoL) as measured by EQ-5D and to investigate the influence of chronic conditions and other risk factors on HRQoL based on a distributed sample located in Shaanxi Province, China. Methods A multi-stage stratified cluster sampling method was performed to select subjects. EQ-5D was employed to measure the HRQoL. The likelihood that individuals with selected chronic diseases would report any problem in the EQ-5D dimensions was calculated and tested relative to that of each of the two reference groups. Multivariable linear regression models were used to investigate factors associated with EQ VAS. Results The most frequently reported problems involved pain/discomfort (8.8%) and anxiety/depression (7.6%). Nearly half of the respondents who reported problems in any of the five dimensions were chronic patients. Higher EQ VAS scores were associated with the male gender, higher level of education, employment, younger age, an urban area of residence, access to free medical service and higher levels of physical activity. Except for anemia, all the selected chronic diseases were indicative of a negative EQ VAS score. The three leading risk factors were cerebrovascular disease, cancer and mental disease. Increases in age, number of chronic conditions and frequency of physical activity were found to have a gradient effect. Conclusion The results of the present work add to the volume of knowledge regarding population health status in this area, apart from the known health status using mortality and morbidity data. Medical, policy, social and individual attention should be given to the management of chronic diseases and improvement of HRQoL. Longitudinal studies must be performed to monitor changes in HRQoL and to permit evaluation of the outcomes of chronic disease intervention programs.

The similarity comparison of binding sites based on amino acid between different proteins can facilitate protein function identification. However, Binding site usually consists of several crucial amino acids which are frequently dispersed among different regions of a protein and consequently make the comparison of binding sites difficult. In this study, we introduce a new method, named as chemical and geometric similarity of binding site (CGS-BSite), to compute the ligand binding site similarity based on discrete amino acids with maximum-weight bipartite matching algorithm. The principle of computing the similarity is to find a Euclidean Transformation which makes the similar amino acids approximate to each other in a geometry space, and vice versa. CGS-BSite permits site and ligand flexibilities, provides a stable prediction performance on the flexible ligand binding sites. Binding site prediction on three test datasets with CGS-BSite method has similar performance to Patch-Surfer method but outperforms other five tested methods, reaching to 0.80, 0.71 and 0.85 based on the area under the receiver operating characteristic curve, respectively. It performs a marginally better than Patch-Surfer on the binding sites with small volume and higher hydrophobicity, and presents good robustness to the variance of the volume and hydrophobicity of ligand binding sites. Overall, our method provides an alternative approach to compute the ligand binding site similarity and predict potential special ligand binding sites from the existing ligand targets based on the target similarity.

Objective: To understand reality applications of health data platform for hospital information in the region to provide a reference for promoting information construction.Methods: Selected 30 health system(third-grade class-6 hospitals and second-grade class-24 hospitals) for the survey,the questionnaire includes four parts-hospitals situation,information technology department,planning of funding and hospital data platform application.Results: 18 hospitals had the information technology planning,and 4 hospitals had no planning.The hospital information construction funds were put into the hardware,two grade of hospitals were unreasonable(P 0.05).The efficiency of the medical data using the platform were not the same,the inpatient access control system,outpatient and emergency plan flat rate system,outpatient and emergency pharmacy management system were the three most using systems,the lowest using system was outpatient and emergency department.Conclusion: The majority of the platform for the construction of the city hospital medical data os still stuck in the first phase,but also a complex systems engineering,we should to strengthen the information work of the organization and leadership and to develop appropriate information technology standards,the establishment of the CIO system,large construction funding that can truly serve for patients.

Healthcare cost management is an important part of hospital management,and has positive effect on hospital's scientific development.The main barriers in cost management include measurements are not standard,costs data are coarse,data collection methods are behindhand,and informatization level of management is not enough.The paper analyzed the difficulties faced cost management in hospital and proposed effective countermeasures,such as normative measurement,fine management,and improving management informatization which made the obvious effect.

Medical price management is an important part of economic management in hospital.The management and inspection methods of medical prices are lagged behind which is difficult to meet the requirement of new situation.Price automated audits and publicity can be achieved by relying on information systems,which can enhance the management level.

Objectives This study is aimed at developing a set of data groups (DGs) to be employed as reusable building blocks for the construction of the eight most common clinical documents used in China's general hospitals in order to achieve their structural and semantic standardization. Methods The Diagnostics knowledge framework, the related approaches taken from the Health Level Seven (HL7), the Integrating the Healthcare Enterprise (IHE), and the Healthcare Information Technology Standards Panel (HITSP) and 1,487 original clinical records were considered together to form the DG architecture and data sets. The internal structure, content, and semantics of each DG were then defined by mapping each DG data set to a corresponding Clinical Document Architecture data element and matching each DG data set to the metadata in the Chinese National Health Data Dictionary. By using the DGs as reusable building blocks, standardized structures and semantics regarding the clinical documents for semantic interoperability were able to be constructed. Results Altogether, 5 header DGs, 48 section DGs, and 17 entry DGs were developed. Several issues regarding the DGs, including their internal structure, identifiers, data set names, definitions, length and format, data types, and value sets, were further defined. Standardized structures and semantics regarding the eight clinical documents were structured by the DGs. Conclusions This approach of constructing clinical document standards using DGs is a feasible standard-driven solution useful in preparing documents possessing semantic interoperability among the disparate information systems in China. These standards need to be validated and refined through further study.

Objective To estimate the prevalence of depressive symptoms and to determine the impact of socio-demographic variables, chronic diseases and health-related events on depression in a community sample of older adults in Xi'an, Shaanxi Province.Methods: Cross sectional, multistage community survey. A semi-structured questionnaire including socio-demographic characteristics, physical health, chronic diseases and health-related events was administered to 1587 older adults from eight communities. Depression was assessed using the 30-item Geriatric Depression Scale (GDS) with a threshold of < 11/11+. Analysis was conducted using SPSS16.0 Complex Samples Logistic analysis procedure.Results: The prevalence of depression was 27.0% (95% CI 24.7-29.2%). In a univariate analysis, the following variables were significantly associated with depression: female gender, low max income, coronary heart disease, suffering 3 or above chronic diseases and functional impairments, 4 adverse life events (financial problems, death of closely related person, unpleasantness experience and horrifying experience) and suffering 1 or above adverse life events. After adjustment for age and gender, odds ratios for depression were significantly higher for coronary heart disease, suffering 3 or above chronic diseases and functional impairments, adverse life event (financial problems, unpleasantness experience) and suffering 3 or above adverse life events.Conclusions: According to GDS estimates, 27.0% Chinese urban older adult had depression symptoms. In designing prevention programs, detection and management of older patients with depression should be a high priority in developing countries. Copyright (C) 2011 John Wiley & Sons, Ltd.

Background Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Methods Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. Results A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8%) completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time ( P < 0.001). However, gender, urban residence, and valid waiting time showed no significant differences ( P > 0.05). Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day ( P < 0.001). Conclusion Compared to the usual queuing method, the web-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However, further improvements are needed for broad use of the system.

医院经济管理部门主要职责之一是对医疗经济运行进行分析,经济运行分析质量成为经济管理部门工作水平和能力的重要标志,医疗经济运行分析办法成为经济管理者必须掌握的技能,笔者结合多年经济运行分析经验,从分析对象、内容、方法及分析手段四个方面入手,阐述如何做好医疗经济运行分析工作.

This article aims at building clinical data groups for Electronic Medical Records (EMR) in China. These data groups can be reused as basic information units in building the medical sheets of Electronic Medical Record Systems (EMRS) and serve as part of its implementation guideline. The results were based on medical sheets, the forms that are used in hospitals, which were collected from hospitals. To categorize the information in these sheets into data groups, we adopted the Health Level 7 Clinical Document Architecture Release 2 Model (HL7 CDA R2 Model). The regulations and legal documents concerning health informatics and related standards in China were implemented. A set of 75 data groups with 452 data elements was created. These data elements were atomic items that comprised the data groups. Medical sheet items contained clinical records information and could be described by standard data elements that exist in current health document protocols. These data groups match different units of the CDA model. Twelve data groups with 87 standardized data elements described EMR headers, and 63 data groups with 405 standardized data elements constituted the body. The later 63 data groups in fact formed the sections of the model. The data groups had two levels. Those at the first level contained both the second level data groups and the standardized data elements. The data groups were basically reusable information units that served as guidelines for building EMRS and that were used to rebuild a medical sheet and serve as templates for the clinical records. As a pilot study of health information standards in China, the development of EMR data groups combined international standards with Chinese national regulations and standards, and this was the most critical part of the research. The original medical sheets from hospitals contain first hand medical information, and some of their items reveal the data types characteristic of the Chinese socialist national health system. It is possible and critical to localize and stabilize the adopted international health standards through abstracting and categorizing those items for future sharing and for the implementation of EMRS in China.

随着医疗领域信息化的发展,信息的标准化日益显现出其重要性.要打破信息孤岛,实现医疗卫生信息跨机构真正的共享,信息不仅要能够被接收,更要能被接收方正确地理解和使用.HL7 V3的数据类型标准就是要达到使信息接收者能正确理解和使用信息的目的.本文介绍了HL7 V3数据类型的基本内容,举例说明了HL7 V3数据类型XML表达规范及其在信息共享实现过程中所扮演的角色和重要性.同时指出,由于文化和医疗体制不同,我国在采用该标准时还需根据实际需要有所改进.

Hospital Information System,called HIS,has become more and more popular and provide a potential platform of hardware and software for improving medical quality management.This article proposed the idea and approach of building a Medical Quality Management Platform that take HIS as the groundwork.

我国医院 20 世纪 90 年代初逐步开始实行成本核算工作,虽然经历了 10 多年的发展,但核算于段仍普遍比较落后,很多医院计算机网络自动化程序较低,有的医院虽有计算机,许多信息需要人工处理,计算机只能起到打印机和计算器的作用;

Objective To construct a safe,stable and credible system for the running of network system and improve its application effect.Method Starting with the information system construction in Xijing hospital,the existent network system was programmed and rebuilt by establishing a assistant switch core and constructing multi-center redundancy link.Conclusion The rebuilt information system of Xijing hospital attains the anticipated effect,and shows rationality and practicability in use.What's more,combined with actual experience,the rebuild of hospital network system was summarized and suggestions were given.

总后勤部卫生部从1995年开始启动"金卫工程'军字一号'工程",投入了上百人年,研制开发出医院信息系统的网络版软件,并于1997年开始在全军20多所医院开始试运行,到2001年底,全军几百所医院已经全部采用了军队医院信息系统.经过近10年的应用,业务部门已经熟练掌握了各功能模块的使用,完成了从手工操作向信息化的转变.

随着计算机技术的发展,医院统计室工作模式发生了革命性变化,由过去手工统计方式转变为现在使用计算机软件统计方式,医院统计软件的使用,大大提高了统计工作效率,方便了对统计数据的分析与调用.但由于医院性质、医院级别不同等原因,全国目前有多个版本的统计软件在使用,这些软件都能完成医院常用统计工作,产生需要的统计报表与统计指标,但在对统计数据、指标常规分析上存在不小的差异,笔者结合多年医院统计软件开发经验,提出了医院统计软件数据分析模块应具备的功能.

随着医院信息系统的逐渐普及,医院统计工作方式也发生了根本变化,由以前手工统计或单机统计逐步转变为网络环境下的统计[1].统计中使用、产生的大量数据资料由以前纸张存储或单机磁盘存储转变为服务器存储.虽然服务器存储有许多优点,但对统计人员来说又产生了新的矛盾,统计人员不能有效方便地操作、处理服务器数据,这是目前局域网环境下统计工作面临的新问题之一.我在此方面做了不少尝试,摸索出服务器数据本地化的实现方式.

随着医院信息系统(HIS)的发展,医疗过程中产生的大量数据记录在HIS中,医院基础数据登记也随之发生了革命性变化,由过去手工登记转变为计算机登记,这为医院统计工作的广泛化、深入化、细致化奠定了基础.虽然HIS数据库管理系统多样,但基础数据均可存储成EXCEL格式,医院统计人员可使用Excel对基础数据进行统计处理,产生医疗统计指标.笔者在多年统计工作中发现Exeel中的数据透视表统计功能强大,医院统计人员可借助于此功能快速完成很多统计任务,本文就其在医院统计中的应用做一阐述.