Intermediate Service Research Articles

Validation of Diagnostic Coding for Diabetes Mellitus in Hospitalized Patients

ObjectiveSome studies have shown that there is an undercoding of diabetes mellitus among hospitalized patients, which can have adverse clinical and financial implications for health systems. We aimed to validate the discharge diagnostic coding of diabetes mellitus in hospitalized patients using clinical and laboratory-based diagnostic indicators as the reference. MethodsThis was a retrospective cohort study of 83 690 discharges of 48 615 unique adult patients who were hospitalized in an academic medical center over 4.5 years and had at least 4 blood glucose measurements during admission. A missing diabetes code (MDC) was defined using 2 criteria. MDC1 was defined as the presence of any of the following: blood glucose ≥200 (x2), A1C ≥6.5%, home antihyperglycemic medication, or preadmission code for diabetes, whereas MDC2 was defined as preadmission diabetes or at least 2 other criteria in MDC1. Multivariable logistic regression was used to identify factors associated with MDC compared to the present diabetes code. ResultsMDC1 and MDC2 were present in 12 186 (14.6%) and 3542 (4.7%) discharges, respectively. Factors associated with both MDC1 and MDC2 were medium-dose steroid use [adjusted odds ratio (aOR) 2.11, 2.01], high-dose steroid use (aOR 4.70, 2.50), intermediate medical care service (aOR 1.65, 1.55), infection (aOR 1.21, 1.34), and hepatic disease (aOR 1.93, 1.92). ConclusionIn this retrospective study, MDC ranged from 5% to 15% and was associated with various clinical factors. Further prospective studies are needed to validate these findings, explore the mechanisms behind these associations, and understand the clinical and financial implications.

PENGARUH PENGAWASAN, PENDIDIKAN DAN PELATIHAN SERTA PENILAIAN KINERJA TERHADAP PENGEMBANGAN KARIR PEGAWAI DI KANTOR PELAYANAN PAJAK MADYA BATAM

The problems in this research are: How is the influence of supervision, education and training and performance appraisal partially and simultaneously on the career development of employees at the Batam Madya Tax Service Office? Research objectives: To determine the effect of supervision, education and training and performance appraisal partially and simultaneously on the career development of employees at the Batam Intermediate Tax Office. The proposed hypothesis is: There is a significant effect of supervision, education and training and performance appraisal partially and jointly on the career development of employees at the Batam Madya Tax Service Office. The research was conducted at the Batam Intermediate Tax Service Office, Jalan Kuda Laut Number 1 Batu Ampar Batam 29432, with a population of 99 people, and the research sample as many as 97 people. Based on the results of the analysis, it was found that supervision had no effect on career development of the Batam Intermediate Tax Office employees, this was supported by the results of the analysis of t count t-table (0.742 1.986) at n = 97 at 95% significance level. Education and training have a positive and significant effect on the career development of Batam Middle Tax Office employees, this is supported by the analysis of t count t-table (2,920 1,986) at n = 97 at 95% significance level. Performance appraisal has an effect on career development of Batam Intermediate Tax Office employees, this is supported by the analysis of t count t-table (5.862 1.986) at n = 97 with a significant level of 95%. The value of F-count F table (31.660 2.70) this means that together (multiple) there is a positive and significant influence on supervision, education and training and performance assessment on career development of Batam Middle Tax Office employees. Thus, the proposed hypothesis is accepted as true.

64 MANAGING FRAILTY IN AN IRISH PRIMARY CARE SETTING: A QUALITATIVE STUDY

Abstract Background Frailty is a complex, age-related condition which confers a risk of adverse outcomes. Evidence supports the effectiveness of screening and Comprehensive Geriatric Assessment (CGA) to meet the needs of frail older people. Little is known about the views of key stakeholders on frailty in a Primary Care context. This study explored the views of healthcare professionals and patients on frailty management in Primary Care in Ireland. Methods A qualitative descriptive study using semi-structured interviews was conducted. Healthcare professionals and patients were recruited using purposive sampling. Patients were recruited through the Frailty Intervention Team at the local acute hospital. Patients with cognitive impairment were excluded. Written informed consent was provided. Data were audio-recorded, transcribed and analysed using thematic analysis. The research was approved by the local Ethics Committee. Results Three patients and 17 healthcare professionals from general practice, public health nursing, physiotherapy, occupational therapy and social work participated. Three themes emerged. (i) Perceptions of Frailty (ii) Current Management of Frailty and (iii) CGA in Primary Care. Results demonstrated variability of perspectives on the concept of frailty, with limited knowledge of screening and CGA. Healthcare professionals described a fragmented service with sub-standard care for frail older patients. Critical weaknesses were: absence of essential services, uni-disciplinary working, inadequate IT systems and integration. Support for screening and CGA in Primary Care was evident. The general consensus was that frailty management required an adequately resourced Primary Care and the suitability of the current pathway for patients requiring CGA should be reviewed. Conclusion This study highlights an absence of a complete understanding of frailty among healthcare professionals. Inter-professional training and education is advocated. Further development of a frailty pathway and investment in Primary Care is required to improve care for frail older people. An intermediate interface service with a dedicated frailty management team is suggested.

An analysis of the impact of service inputs in manufacturing industries on eco-efficiency: evidence from China.

The eco-efficiency of manufacturing industries has been a concern for decades in China. However, less attention has been paid to the growing service inputs in manufacturing industries and their eco-efficiency impact. Based on China's input-output tables in consecutive years collected from the structural analysis database issued by the OECD, this study describes service inputs in manufacturing industries with the direct and total consumption coefficients and then primarily discusses its environmental impacts as measured by the green total factor productivity. It finds that a significant nonlinear U-shaped relationship exists between service inputs in manufacturing industries and eco-efficiency in which the expected positive impact only emerges when a critical level of service inputs is achieved. The findings exhibit significant robustness under various measures of outcome variables and explanatory variables, as well as subsample checks and instrumental variable estimation. Environmental technical progress, rather than environmental technical efficiency, plays a decisive role in the U-shaped relationship and contributes to improvement in eco-efficiency. Furthermore, this study reveals that service inputs in the form of direct consumption of intermediate service in manufacturing industries have a significant positive impact on eco-efficiency.

From Street to Road: An Innovative Approach to Explore Discarded Chewing Gum as a Performance-Enhancing Modifier for Road Pavement Applications.

To uncover the potential benefits of discarded chewing gum (DCG) as a performance-enhancing modifier for road pavement applications, its influence on the asphalt binder’s attributes was profoundly examined. The base AP-5 asphalt along with its specimens dosed with various fractions of DCG (e.g., 3, 6, and 9 wt%) were analyzed by Fourier transform-infrared spectroscopy (FT-IR), X-ray diffraction (XRD), thin-layer chromatography-flame ionization detection (TLC-FID), scanning electron microscopy (SEM), atomic force microscopy (AFM), thermogravimetric analysis (TGA), and differential scanning calorimetry (DSC). Brookfield viscometer, ring and ball softening point, needle penetration, and dynamic shear rheometer (DSR) tests were adopted to inspect the physical and rheological changes of asphalt cement after DCG incorporation. FT-IR disclosed that the asphalt-gum interaction was not chemical but physical in nature, whilst XRD demonstrated the existence of talc filler in DCG, which may confer the bituminous mixes with exceptional engineering properties. Iatroscan analysis evinced that the gum treatment particularly altered the aromatic and resin fractions; meanwhile, the content of saturates and asphaltenes remained relatively unchanged. SEM divulged that the DCG has a complete dissolution within the bitumen matrix, which becomes rougher due to higher dose administration. AFM revealed that the steady gum introduction amplified the size of bee-like structures, shrunk their peri-phase domains, and wiped out the para-phase domains entirely. TGA/DTGA/DSC data highlighted that the high-temperature-stable additive slightly affected the thermal properties of blends. DSR and empirical rheological tests showed that the waste gum made the bitumen less vulnerable to heat and tender, thereby boosting its resistance against fatigue cracking at intermediate service temperatures. On top of that, DCG widened the thermal window of bitumen performance grade (PG), and preserved its viscosity at standard temperatures, leading to maintaining an appropriate workability for asphalt mix. In brief, the use of discarded chewing gum as an asphalt modifier is feasible and could mitigate plastic pollution and provide durable roadways by delivering superior performance.

Retrospective analysis of referrals to the North East of England intermediate oral surgery service

AbstractIntroductionThe intermediate oral surgery service in North East England was introduced in 2009 following changes in the primary care contract in 2005 allowing primary care organisations to locally commission services to meet population need. The aim of this service introduction was to reduce pressures on secondary care and improve efficiency and costs of oral surgery service provision. Where there are geographical variations in the number of referrals received to intermediate oral surgery services in North East England, this study aimed to identify the reasons for these.Materials and methodsA retrospective analysis of referrals to the National Health Service (NHS) Intermediate North East of England Oral Surgery Service was completed. Analysis of 48,286 referrals from 2009 to 2019 was assessed from two NHS specialist oral surgery providers. Primary care practice referrals were located to practice postcode; the sum of referrals from each postcode accumulated over this period. Referral variations were compared with NHS primary care contract sizes, distance to specialist provider and Index of Multiple Deprivation of provider location to identify correlations.ResultsData indicate a significant range in primary care referral frequency over the 10‐year period. Referrals from primary care providers ranged from 1 to 2334 over the 10‐year period. No correlation is seen between distance to provider (r2 = 0.058), contract size (r2 = 0.087), deprivation levels (r2 = 0.01) and the referral rate.ConclusionThe large variation in referral rate provides data for commissioners of dental services including managed clinical networks (MCNs) to outline high referring primary care practices and plan for future service development.

Ways to diversify enterprises in the space sphere: Challenges, problems, and solutions

Subject. The article addresses the efficiency of commercialization through enterprise diversification in the rocket and space sphere. Objectives. The study aims to assess the condition of the space market, find ways of diversification, identify opportunities for commercialization and diversification of business in this area to generate profit, and highlight urgent problems in the space market. Methods. We employ econometric methods, like correlation and regression analysis, and methods of mathematical statistics. Results. We propose a large-scale structure of the space market, enabling to examine and explore the relationship between its segments. The paper provides an assessment of the space market and opportunities for commercialization and diversification of business in this area for generating profit. It includes a profit-making model based on intermediate segments and post-sale service, which can serve as a basis for business diversification in this sphere. It also presents recommendations for further investigation. Conclusions. The lack of communication between the space market segments makes it difficult to develop the production of launchers, and therefore, in the long run, will lead to a reduction in the number of launches and degradation of the industry.

Laboratory evaluation of cracking resistance for asphalt mixtures modified with nanoclay and nanocellulose

Cracking failure is one of the major distress modes associated with asphalt pavement. Asphalt modification has been identified as an effective method to improve pavement performance. In this study, nanomaterials including bentonite and halloysite nanoclays and nanocellulose are added to PG 64-28 straight run asphalt binder for modification. The potential of these nanomaterials for improving the cracking performance of asphalt pavements at intermediate pavement service temperatures is investigated. Rheological evaluation is conducted using a dynamic shear rheometer (DSR), and the cracking resistance of the asphalt mixtures is determined through indirect tension asphalt cracking test (IDEAL-CT). A high-shear mixer is used to disperse the nanomaterial in the asphalt and the field emission scanning electron microscope (FESEM) analysis shows a relatively good dispersion of the nanomaterials. Furthermore, the results of the IDEAL-CT show an improvement in cracking test index by as much as 47%–114% through nanomaterial modification.

Factors associated with success in transition care services among older people in Australia

BackgroundThe Australian Transition Care Program (TCP) is a national intermediate care service aiming to optimise functional independence and delay entry to permanent care for older people leaving hospital. The aim of this study was to describe the outcomes of TCP and identify demographic and clinical factors associated with TCP ‘success’, to assist with clinical judgements about suitable candidates for the program.MethodWe conducted a descriptive cohort study of all older Australians accessing TCP for the first time between 2007 and 2015. Logistic regression models assessed demographic and clinical factors associated with change in performance on a modified Barthel Index from TCP entry to discharge and on discharge to community. Fine-Gray regression models estimated factors associated with transition to permanent care within 6 months of TCP discharge, with death as a competing event.ResultsFunctional independence improved from entry to discharge for 46,712 (38.4%) of 124,301 TCP users. Improvement was more common with younger age, less frailty, shorter hospital stay prior to TCP, and among women, those without a carer, living outside a major city, and without dementia. People who received TCP in a residential setting were far less likely to record improved functional impairment and more likely to be discharged to permanent care than those in a community setting. Discharge to community was more common with younger age and among women and those without dementia. Nearly 12% of community TCP and 63% of residential TCP users had transitioned to permanent care 6 months after discharge. Entry to permanent care was more common with older age, higher levels of frailty, and among those with dementia.ConclusionsMore than half of TCP users are discharged to home and remain at home after 6 months. However, residential-based TCP may have limited efficacy. Age, frailty, carer status, and dementia are key factors to consider when assessing program suitability. Future studies comparing users to a suitably matched control group will be very helpful for confirming whether the TCP program is meeting its aims.

Sustainability assessment of the Liaohe Estuary wetland based on emergy analysis

The sustainability of wetlands, as an ecological system, is a key indicator of its system stability. The sustainability evaluation of wetlands is the basis of management and research. In this study, the ecosystem value and sustainability of the Liaohe Estuary Wetland were evaluated by using emergy analysis and emergy indicators. The results showed that the total input emergy of the Liaohe Estuary Wetland was 307.12 × 1018 sej, included renewable resources 74.83 × 1018 sej, nonrenewable resources 103.02 × 1018 sej and purchased resources 129.27 × 1018 sej. The final emergy value was 332.9 × 1018 sej, and the main part was the outputs of 290.28 × 1018 sej, accounting for 87.19% of the total emergy export. The intermediate service value emergy was 1980.99 × 1018 sej, of which 90.72% was occupied by biodiversity maintenance value. For the sustainability evaluation of the Liaohe Estuary Wetland, the emergy yield ratio (EYR) was 2.38, the environment loading ratio (ELR) was 3.10, and the emergy sustainability indicator (ESI) was 0.77, the development of the study area was in an unsustainable state. A new index of intermediate-final conversion ratio (EIFC) was established to evaluate the conversion proportion from the intermediate value to the final value. EIFC was 1.18%, which showed that the service potential of wetlands was huge.

Evaluation and sensitivity analysis of the ecosystem service functions of haze absorption by green space based on its quality in China

Evaluation of the ecosystem service functions of haze absorption by green space is important for controlling haze. In this study, the ecosystem service functions of haze absorption by green space in China in 2001, 2004, 2007, 2010, 2013, 2016 and 2018 are analyzed based on green space quality and sensitivity using a geographic information system (GIS) and Moderate Resolution Imaging Spectroradiometer (MODIS) imagery. The results showed that the benchmark ecosystem service functions of haze absorption by green space when considering only the area of green space showed a trend that increases first and then decreases in 2001–2018, with 9000458.55 million Kg, 9145110.75 million Kg and 7734526.75 million Kg in 2001, 2013 and 2018, respectively. However, the corrected functions based on green space quality were 7724215.34 million Kg, 8320301.79 million Kg and 6510132.55 million Kg in the corresponding years. This indicated large differences between ecosystem service functions of haze absorption based on the quality and area of green space; only considering the area of green space to evaluate ecosystem service functions will result in overestimation. In terms of the spatial distribution of the ecosystem service functions of haze absorption by green space, there were greater differences in the benchmark and corrected functions, and the spatial distributions of the maximum, intermediate and minimum ecosystem service functions were notably different. However, the benchmark and corrected functions all showed a consistent trend in the rank of their contribution rates and ecosystem service functions as well as consistent distribution trends: the spatial distribution of ecosystem service functions of haze absorption by green space was very different in the same year, but there was little difference among different years. The change coefficients for the ecosystem service functions of haze absorption by arable land and grass land remained stable, whereas the coefficient of sensitivity for forest cover was elastic. Patch density (PD) and the ecosystem service functions of SO2 absorption, NOx absorption, dust retention and total ecosystem services showed a significant negative correlation, with correlation coefficients of -0.407, -0.511, -.330 and -0.332, respectively. In contrast, the area-weighted mean shape index (SAPE_AM) and ecosystem service functions exhibited significant positive relationships with correlation coefficients of 0.650, 0.634, 0.568 and 0.570, respectively. The results provide an improved method for evaluating the ecosystem service functions of haze absorption by green space as well as a reference for the prevention and control of haze and the coordinated development of regional societies, the economy and the environment.

Decentralization of Services Through Three Tiers in Wireless Body Area Networks

The Wireless Body Area Network (WBAN) contains a set of sensors, placed in the patient’s environment, to detect the vital signs and transmit the results towards the relevant services that interact in urgent cases. The present work exposes a functional WBAN architecture formed by three layers: closest, intermediate and farthest. The closest layer senses the chemical and biological signs. If the case is normal, or it can be locally regulated, the service stops there; else the intermediate service, namely the local hospital, is consulted to make treatments. Therefore, the patient will be transported into the hospital for examinations. If this condition is established the processus stopped there, otherwise, the request of help from an outside hospital becomes necessary. This request passes through a manager that supervises a network of hospitals and looks for a free place to welcome the patient. After the localization of a hospital, its coordinates will be forwarded into the customer hospital, for transporting the patient. The simulation results show that this design increases the patient’s probability of healing and maximizes the use of the available resources, relative to the centralization of services at a single layer or at two layers.

Integrated Computational Materials Engineering of Gamma Titanium Aluminides for Aerospace Applications

Although the benefits of titanium aluminides for intermediate service temperature applications were well conceived and significant research and development activities were conducted in the past four decades, they remained as developmental materials due to barriers associated with melting, processing, scale-up, and cost. Demanding requirements of efficient aero-engines and extensive risk reduction demonstrations paved the path for commercial introduction of gamma titanium aluminides. The single most attractive current application is for low pressure turbine blades (LPTBs) in advanced aero-engines replacing conventionally cast nickel superalloys. This paper provides an overview of recent progress, producibility challenges, and opportunities. The successful journey of gamma (γ) TiAl LPTB development from laboratory demonstrations to production insertions in mass-produced commercial jet engines will be described. Collaboration and integrated product development were identified as the most critical needs for rapid maturation and implementation of γ-TiAl into aerospace applications. An integrated computational materials engineering modeling framework and toolsets developed under a collaborative US Air Force Metals Affordability Initiative project between industry, government, and academia will be illustrated. Model-based optimization of material and processing for achieving desired performance goals will be highlighted.

A system approach to designing intermediate tier service improvements

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)

Pengaruh Keadlilan, Sistem Perpajakan dan Kualitas Pelayanan Terhadap Penggelapan Pajak

This research aims to analyze the effect of justice, taxation system and service quality on tax evasion. Data collection techniques carried out through the Makassar Intermediate Tax Service Office. Methods of data analysis using descriptive statistics, data quality tests, classic assumption tests and hypothesis tests. This study uses a data processing program that is SPSS version 23. Furthermore, testing the hypothesis using multiple linear regression equations. And using the F test and t test. the results of this study found a positive and significant influence of the Justice and taxation variables on tax evasion. The quality of tax authorities has a negative and significant effect on tax evasion. This shows that the better quality of services provided by the tax authorities can reduce tax evasion actions carried out by taxpayers. The higher the attitude of the taxpayer towards the tax authorities, the higher the taxpayer compliance

Analysis of 4-mm DSR tests: calibration, sample preparation, and evaluation of repeatability and reproducibility

Rheological characterisation methods are important when it comes to a performance-based selection system for bituminous binders for road applications. Standardised methods exist for the determination of bitumen rheological behaviour based on a dynamic shear rheometer (DSR) at intermediate and high service temperatures and a bending beam rheometer (BBR) at low temperatures. Recently, a dynamic shear rheometer with 4 mm parallel plates (4-mm DSR), has been proposed by Western Research Institute (WRI), as a promising method to determine the rheological behaviour at low temperatures. Clear advantages of the 4-mm DSR are related to the small sample size, especially important for recovered and aged binders, and the ability to work with adequate stresses at very low temperatures. Furthermore, if 4-mm DSR can be used to assess the low temperature behaviour of bitumen, then the performance of a binder in the whole range of service temperatures, could be assessed by just one equipment, a DSR. This paper focuses on the challenges related to 4-mm DSR tests regarding equipment preparation, with a specific attention to the temperature assessment and calibration. Furthermore, a sample preparation method, assuring good adhesion to both plates is proposed and the repeatability and reproducibility of 4-mm DSR tests is evaluated.

Implementing a step down intermediate care service

PurposeThe purpose of this paper is to explore implementation and development of step-down intermediate care (IC) in Glasgow City from the perspective of staff.Design/methodology/approachThe study used qualitative methods. Nine key members of staff were interviewed and three focus groups were run for social work, rehabilitation and care home staff. Framework analysis was used to identify common themes.FindingsThe proposed benefits of IC were supported anecdotally by staff. Perceived enablers included: having a range of engaged stakeholders, strong leadership and a risk management system in place, good relationships, trust and communication between agencies, a discharge target, training of staff, changing perception of risk and risk aversion, the right infrastructure and staffing, an accommodation-based strategy for patients discharged from IC, the right context of political priorities, funding and ongoing adaptation of the model in discussion with frontline staff. Potential improvements included a common recording system shared across all agencies, improving transition of patients from hospital to IC, development of a tool for identifying suitable candidates for IC, overcoming placement issues on discharge from IC, ensuring appropriate rehabilitation facilities within IC units, attachment of social work staff to IC units and finding solutions to issues related to variation in health and social care systems between sectors and hospitals.Originality/valueThe findings of this study help the ongoing refinement of the IC service. Some of the recommendations have already been implemented and will be of value to similar services being developed elsewhere.

Assessing the technical efficiency of intermodal freight transport chains using a modified network DEA approach

This paper presents a modified Network DEA model (NDEA) to measure the performance of intermodal freight transport (IFT) chains and to find the sources of inefficiencies. The model addresses two challenges in the application of NDEA to the IFT domain: first, the chains may differ in the number of divisions (i.e., transshipment/transportation activities); and second, one needs to define a relevant intermediate service. For purposes of illustration, the model is applied to a particular European IFT network for which the inefficient transport/transshipment segments are identified and discussed.

An assessment of child passenger safety levels of service in Michigan

Objective: The purpose of this article was to assess the match between child passenger safety resources (child passenger safety technicians [CPSTs], car seat checks, and child restraint system [CRS] distribution programs) and the child population in Michigan by utilizing geographic information systems approaches and to analyze the impact of Michigan’s CPSTs on child passenger safety behaviors on departure from a seat check.Methods: Data were collected from administrative sources and a survey of CPSTs to determine the number and location of child passenger safety resources and children in Michigan. The main analyses used data from 2014. The child population ≤4 years old per county and per traffic safety region was determined from census data. CPST and car seat check locations were determined from a list from the Michigan Office of Highway Safety Planning (Mi-OHSP) and a survey of CPSTs who coordinate seat checks. Summary sheets from Mi-OHSP served as the data source for CRSs distributed through their occupant protection program. Data from child passenger safety checklists completed with seat checks were obtained from Safe Kids Michigan. Addresses were geocoded using Google Maps Geocoding API and then mapped at the county level using ArcGIS Desktop 10.3.1. Descriptive statistics were calculated and levels of service were determined at the county and regional levels.Results: In 2014, there were 570,929 children ≤4 years old in Michigan and 979 CPSTs who worked at 209 known seat check locations. An average of 6,854 seats was checked per year through Safe Kids Michigan Coalitions. All but 3 regions met an intermediate service level for seat check locations by offering one or more per 5,000 children ≤4 years old. There was at least one CPST in 80 of 83 counties (median 5; interquartile range, 2, 10.5). Assuming that an average Michigan CPST provides 10 h of service each year, all but 2 regions reached an intermediate service level of at least one technician hour per 90 children ≤4 years old. Fewer regions reached a basic level of service for the number of seat checks. Almost half (49.5%) of Safe Kids Michigan seat checks resulted in a change in child passenger safety behaviors.Conclusions: Child passenger safety resources in Michigan are not evenly distributed yet most regions and counties meet intermediate levels of service. Reallocating resources to areas that are providing basic levels of service could help reduce disparities in child passenger safety behaviors.

Assessment of Ecosystem Service Value of the Liaohe Estuarine Wetland

The functions and services of wetland ecosystems to human society have been generally recognized. Currently, most evaluations of wetlands are a comprehensive evaluation of their ultimate value. It is rare to discuss for energy and matter lost and transferred. In this study, emergy theory was used to assess the ultimate and intermediate service values of the Liaohe estuarine wetland ecosystem. Results show that its ultimate service value was $28.2 million, and its intermediate service value was $35,614.03 million. The 1263 time difference between intermediate and ultimate value shows that much server value was dissipated in the form of energy. In the ultimate service value, the value of adjusting the atmosphere was $8.02 million, accounting for 28.45% of the total value, and flood diversion and storage value was $6.98 million, accounting for 24.75%. These results illustrate that the most important service value of the Liaohe estuarine wetland ecosystem is to adjust the atmosphere and divert and store floods. In intermediate service value, maintaining-biodiversity value was $34,182 million, accounting for 95.98% of total value, showing that the Liaohe estuarine wetland plays an important role in species resources and regional seed banks.