Types Of Medical Institutions Research Articles

Physicians’ perception toward using telephone consultations during the COVID-19 pandemic in Korea

Background: As the world faced a pandemic caused by the coronavirus disease (COVID-19) outbreak in 2019, telemedicine quickly spread and was widely adopted. This was the first instance where telephone consultations were temporarily allowed in Korea. We used data from the 2020 Korean Physician Survey and analyzed the physicians’ perceptions of telephone consultations, the reasons for providing these consultations, and the level of physician satisfaction after providing it.Current Concepts: A total of 6,342 respondents were selected for the final analysis of the research results. Regardless of the COVID-19 pandemic, the data showed that most physicians had a negative perception (77.1%) toward the introduction of the telemedicine system. A third (31.1%) of physicians surveyed had provided medical treatment via telephone consultation. According to the position the physicians held, professors, fellows, self-employed physicians, and public health physicians had the most experience in this method of consultation. The use of telephone consultation was highest in the field of internal medicine (44.5%) treatment. Data also showed that most physicians (83.5%) who provided such consultations experienced difficulties in making a medical judgment that could ensure their patients’ safety.Discussion and Conclusion: The results of this study verified that physicians’ opinions about the telemedicine system differed according to service, area of specialization, region, and type of medical institution. A closer review and establishment of policy alternatives are required to explore the possible expansion of teleconsultations and related medical treatments in the future.

Systematization of Features and Recommendations Regarding Architectural and Urban Planning and Placement of University Hospitals

The purpose of the article is to identify the architectural features of the university hospitals design, which are based on a comprehensive analysis and systematization of the existing historical and recent global perspective, as well as the study of the latest trends in the development and architectural design of medical institutions in leading countries. The University Hospital is a multifunctional medical complex that combines and synthesizes several functions: multidisciplinary and specialized, educational and training, and research functions, experimental and innovative items production, as well as various auxiliary, secondary services and processes. The main contribution and originality of the study is the systematization of the existing experience in the construction of clinical and university hospitals and on this basis, the punctuation of the main provisions, features, and a number of recommendations (architectural-planning, structural and construction materials, master plan, aesthetic and artistic solutions, and functional components of the blocks) for the architectural design of these types of medical institutions. The main and significant conclusion of the article is the understanding of the individual project approach to the design of university hospitals, as well as the need for their active development as the most promising and effective type of hospital structure. When designing university hospitals, it is also proposed to take into account the principles of sustainable development and apply them within the boundaries of environmental design aimed at reducing the negative impact of urbanization processes.

Changes in diagnosis rate and treatment trends of benign prostatic hyperplasia in Korea: A nationwide population-based cohort study.

PurposeThis study aimed to evaluate benign prostatic hyperplasia (BPH) diagnosis rate and the changing landscape of medical and surgical management of BPH over the last decade using national population data of South Korea.MethodsThe present study analyzed data of patients diagnosed with BPH (N40) who underwent medical treatment or surgery in 3% of the national patient sample of the Health Insurance and Review Assessment database each year between 2012 and 2018. The primary outcome was the proportion of medical and surgical treatment for BPH. It was evaluated each year between 2012 and 2018. Secondary outcomes included total BPH diagnosis rate in each year of the study period. BPH diagnosis rate by age group was evaluated. The proportion of medical and surgical treatment for BPH according to the type of medical institution was investigated.ResultsThe proportion of surgical treatment was 1.2% in 2012, 1.0% in 2013, 1.0% in 2014, 0.9% in 2015, 0.8% in 2016, 0.7% 2018, and 0.8% 2018, showing a progressive overall decrease from 2012 to 2018. The rate of surgical treatment for BPH increased with increasing age during the study period, showing a progressive overall increase (from 9,202 per 100,000 men in 2012 to 11,610 per 100 000 men in 2018). The number of patients with BPH was increased steadily from 2012 to 2018 in all age groups. The rate of surgical treatment in tertiary referral hospitals was the highest during the study period, followed by that in general hospitals, hospitals, and clinics.ConclusionsIn Korea, the diagnosis rate of BPH was steadily increasing during the study period. Overall surgical treatment gradually decreased compared with an increase in medical treatment among all treatments for BPH. Thus, a comprehensive treatment plan for BPH should be established considering this trend.

Incidence and trend of severe postpartum hemorrhage between 2016 and 2019 in China

Objective: To investigate the incidence and trend of severe postpartum hemorrhage (sPPH) in China, and to provide basic data for the development and evaluation of sPPH prevention and control strategy. Methods: Obstetric data was extracted from annual national representative sampling surveys based on the National Clinical Improvement System. From 2016 to 2019, 2 978, 3 400, 4 576 and 4 594 maternity hospitals with sPPH cases were included for statistics. The annual incidence of sPPH was calculated according to province and type of medical institutions and generalized linear model was emplyed to identify the determinants affecting sPPH incidence. Results: In China, sPPH incidence increased from 0.62% in 2016 to 0.93% in 2018, and was 0.92% in 2019. Eighteen provinces had an inverted U-shaped trend of sPPH over time and most of them had the highest incidence in 2018; ten provinces had an upward trend of sPPH and 3 provinces had a U-shaped trend. In 2019, the top five provinces with the highest sPPH incidence were Yunnan (1.88%), Beijing (1.45%), Jiangsu (1.31%), Guizhou (1.26%), and Ningxia Hui Autonomous Region (1.22%); the top five provinces with the lowest incidence were Henan (0.55%), Jiangxi (0.60%), Inner Mongolia Autonomous Region (0.64%), Liaoning (0.64%) and Gansu (0.69%). In 2019, the sPPH incidence in different types of medical institutions were as follows: tertiary public general hospital (1.15%), tertiary public specialized hospital (1.02%), secondary public general hospital (0.81%), private hospital (0.61%) and secondary public specialized hospital (0.58%). sPPH incidence was positively associated with proportion of twin pregnancies, macrosomia, primipara, and puerpera aged ≥35 years in maternity hospitals (P<0.05). Conclusions: sPPH incidence generally showes an increasing trend from 2016 and is stable at a high level in recent two years in China. It is warranted to further strengthen the monitoring of postpartum hemorrhage, and improve the capability of hierarchical management and treatment in maternity institutions and regions, in order to reduce sPPH incidence and maternal mortality.

Cohort Profile: Chinese Cervical Cancer Clinical Study.

Cervical cancer is the fourth most common cancer worldwide, but its incidence varies greatly in different countries. Regardless of incidence or mortality, the burden of cervical cancer in China accounts for approximately 18% of the global burden. The Chinese Cervical Cancer Clinical Study is a hospital-based multicenter open cohort. The major aims of this study include (i) to explore the associations of therapeutic strategies with complications as well as mid- and long-term clinical outcomes; (ii) to widely assess the factors which may have an influence on the prognosis of cervical cancer and then guide the treatment options, and to estimate prognosis using a prediction model for precise post-treatment care and follow-up; (iii) to develop a knowledge base of cervical clinical auxiliary diagnosis and prognosis prediction using artificial intelligence and machine learning approaches; and (iv) to roughly map the burden of cervical cancer in different districts and monitoring the trend in incidence of cervical cancer to potentially inform prevention and control strategies. Patients eligible for inclusion were those diagnosed with cervical cancer, whether during an outpatient visit or hospital admission, at 47 different types of medical institutions in 19 cities of 11 provinces across mainland China between 2004 and 2018. In a total, 63 926 patients with cervical cancer were enrolled in the cohort. Since the project inception, a large number of standardized variables have been collected, including epidemiological characteristics, cervical cancer-related symptoms, physical examination results, laboratory testing results, imaging reports, tumor biomarkers, tumor staging, tumor characteristics, comorbidities, co-infections, treatment and short-term complications. Follow-up was performed at least once every 6 months within the first 5 years after receiving treatment and then annually thereafter. At present, we are developing a cervical cancer imaging database containing Dicom files with data of computed tomography/magnetic resonance imaging examination. Additionally, we are also collecting original pathological specimens of patients with cervical cancer. Potential collaborators are welcomed to contact the corresponding authors, and anyone can submit at least one specific study proposal describing the background, objectives and methods of the study.

STUDY OF THE PECULIARITIES OF FORMING THE CREATIVE POTENTIAL IN PROSPECTIVE NURSES IN THE COURSE OF PROFESSIONAL TRAINING

The article analyzes the process of forming the creative potential in prospective nurses in the course of professional training. The main reason for the existing problems connected with forming the creative potential in prospective nurses lies in the predominance in the students the external motives for choosing a profession since a significant number of the prospective nurses lose interest in the profession in the educational process. This takes place due to the imperfect methods, tools and forms used in the professional training in the educational institution. Other reasons of this situation are connected with the small number of practical activities, imperfections and outdated content of educational material. This, in turn, leads to a reproductive style of thinking and low cognitive motives in the perspective nurses when they do not want to develop pertinent skills and abilities, to improve their personality due to low level of inquisitiveness and weak persistence in achieving the goals. &#x0D; It is proved that modern requirements to professional functions and social role of specialists in the sphere of nursing activity necessitate the modernization of the educational environment for the prospective competitive nurses. This presupposes the creation of innovative systems of professional development with taking into account the changes and consequences of their impact on professional activities of the prospective nurses. This can be realized by implementing a special course "Skills and professional inspiration of a nurse", designed to train the prospective nurses in the 5th semester. &#x0D; It is established that one of the effective directions of developing the creative potential in the prospective nurses is related with updating the prospective nurses' professional training through the introduction of innovative educational technologies and interactive teaching methods into the educational process. &#x0D; It is also found out that the reform of professional and professional before-higher education determines the tendency to actualize individualized training in medical institutions concerning self-development of specialists' personality in the context of their future professional activity, as well as forming individual psychological qualities, professionally significant qualities in all participants in the educational process, providing opportunities for individual research activities, improving the educational process in different types of medical institutions. To accomplish this, the prospective specialist must turn from an object of educational influence into a subject whose main features are activity, individuality and independence. This, in turn, presupposes the integration of the students into the creative educational environment of the educational institution, strengthening its development capabilities as a complex of systematized innovative educational resources with pertinent methodological, technological, organizational support.

Antibiotic prescriptions for children younger than 5\u2009years with acute upper respiratory infections in China: a retrospective nationwide claims database study

BackgroundIn China, there were few studies to estimate antibiotic use for children with upper respiratory infections at the national level. The aim of this study was to describe the antibiotic prescribing practice for children aged < 5 years old with upper respiratory infections (URIs) using a nationwide claims database.MethodsThis was a retrospective cross-sectional study using a sampled database from the China Health Insurance Research Association (CHIRA). Study subjects included children younger than 5 years with outpatient visits in 2015 that resulted in a diagnosis of a upper respiratory infection. We calculated the percentage of visits who received antibiotics, the proportion of injection formulations, the percentage of combined antibiotics and the proportion of each antibiotic class. The patterns of antibiotic prescription were also described by medical institution type, city level and geographical region.ResultsAmong the 92,821 visits, 27.1% were prescribed antibiotics, of which 27.0% received injection formulations. The rate of antibiotic prescribing varied by age group (P < 0.001), with the lowest (16.0%) in infants and the highest in patients at age 3 to < 4 years (29.9%) and age 4 to < 5 years (32.5%). The Midwestern region, underdeveloped cities and low-level hospitals represented relatively higher rates of prescribing antibiotics (P < 0.001) and higher proportions of injection dosage forms (P < 0.001). The most 3 common antibiotic classes prescribed of all visits with antibiotic prescriptions were the third-generation cephalosporins (34.9%), macrolides (24.3%), and the second-generation cephalosporins (23.3%).ConclusionsIn mainland China, the overall rate of antibacterial prescribing and the proportion of injection formulations prescribed in children under 5 years with URIs were at a low level, but still higher in underdeveloped regions and cities. Moreover, the overuse of the second and third generation cephalosporins, macrolides, remains a serious issue. Further efforts should be focused on reducing those non-first-line antibiotic prescribing and narrowing the gaps among regions and cities.

Friendly or condescending?

This article illustrates how participants’ sense of appropriate language use is discursively negotiated, examining entries in online discussion boards regarding medical practitioners’ use and non-use of honorifics. The analysis shows social factors deemed relevant by the discussion board participants regarding their evaluations on honorifics use and non-use such as interlocutors’ age and social distance as well as the location and type of medical institution. Participants’ evaluations, the article demonstrates, are based on their views of medical practice (whether it is similar to or different from other types of service, whether it is similar to first-time encounters, and so forth). Medical practitioners’ non-use of honorifics tends to be accepted and appreciated in a context in which the addressee (patient) experiences urgency, vulnerability, and/or anxiety. Lastly, the study illustrates the process of enregisterment of honorific usage.

Социокультурный аспект деятельности Комитета Сибирской железной дороги

The article draws attention to the sociocultural aspect of the Siberian Railway Committee's activities in the early twentieth century. Historiographic analysis showed a research interest in the status of the Committee in the context of the organization of management of the Russian Empire's Eastern outskirts. Taking into account the broad powers of the Siberian Railway Committee, the author notes isolated studies of the social aspect in its activities. The aim of this publication is an attempt to create a holistic view of the activities of the Committee for the implementation of social tasks aimed at improving the life of railway employees at the TransBaikal section of the railway in the early twentieth century. The study was conducted on the basis of the documentation of the Siberian Railway Committee. A number of documents are introduced into scholarly discourse for the first time. Based on the structural and functional approach, using a set of historical research methods, it has been revealed that, after the commissioning of the Trans-Baikal section of the Siberian Railway, considerable attention was paid to solve sociocultural problems aimed at improving the life of railway employees. The preparatory commission chaired by A.N. Kulomzina and the Main School Committee implemented social programs. The author has defined the procedure for the formation of the committee, its structure, and principles of its activity. For the first time, personal data of the school committee's members elected on the Trans-Baikal Railway are introduced into scholarly discourse. The information of the committee's activities of the opening and maintenance of primary schools at railway stations has been summarized. The obtained statistics convincingly prove the effectiveness of the committee in the field of school education. The author notes that the Siberian Railway Committee achieved a very successful development of the school network by applying administrative and financial efforts. The author, for the first time, provides data on the organization of libraries and public convocations for the employees on the Trans-Baikal Railway. She draws attention to the organization of medical care for the employees; establishes the organization order and types of medical institutions; generalizes information about the staff of hospitals and obstetric centers, and the number of patients. The author concludes that the Siberian Railway Committee had an organized and balanced approach to solving sociocultural problems that occupied an important place in its activities. The Siberian Railway Committee's social programs in a number of areas were ahead of those of other government departments.

Forecasting the Territorial-Spatial Development of the System of Children’s Medical Complexes in Ukraine

Abstract The forecast development prediction in time-space of the urban system of pediatric treatment facilities of Ukraine is given at the national-territorial level, based on three complementary information sources for the future: the author's structure of the urban system of healthcare, its components, and promising types of medical institutions; retrospective analysis and patterns of organization and development of the urban system of medical institutions in the leading countries of the world, which indicate the general direction of extrapolation of systems; projected population of Ukraine (optimistic, optimal and pessimistic options), which are obtained through many years of statistical research. The paper presents the results of modeling, which demonstrate the forecast scenarios for the system development of pediatric treatment facilities at the national level of the urban network of primary care facilities and hospital networks. The model’s scenarios contain time prospects of the forecast for 2030, 2040, 2050, 2060, and 2100. The probable non-linear deviations characteristic of the space-time development of the open system and many internal and external probable points of system bifurcations are considered. The research should be challenging and effective for international scientists who study the range of issues of the urban and spatial development of urban systems, their forecast models, and deployment scenarios. The study is also valuable for countries that face the problems of stable depopulation, have an ineffective and cumbersome healthcare system, and are in the process of looking for ways to reform the medical system in an urban planning context.

Application of SWOT-CLPV Model in China’s Hierarchical Medical Mode

Medical service system is a complex system composed of different interest related factors. The core of hierarchical medical mode is to deal with different levels and types of medical institutions to ensure the coordinated operation. In view of the reform of medical and health system, combined with the current situation of China’s medical system, this paper constructs the SWOT-CLPV model of hierarchical medical in China, sorts out the advantages, disadvantages, opportunities and threats of the hierarchical medical mode in China, further explores its inhibition, problem, leverage effect and vulnerability, and studies the development strategy of hierarchical medical.

The Trend of Clostridioides difficile Infection in Korean Hospitals with the Analysis of Nationwide Sample Cohort

Background: Clostridioides (Clostridium) difficile is an important pathogen that causes diarrhea in people who take antibiotics. The recent status of C. difficile infection is not wellknown in Korea. Methods: The long-term trend of C. difficile infection in Korean hospitals was analyzed using a nationwide sample cohort. The data also included sociodemographic characteristics, disease severity, and healthcare facilities. C. difficile infection was defined by the prescription of oral vancomycin or all metronidazole prescriptions under C. difficile infectious disease code (A047). Results: The rate of C. difficile infection has steadily increased from 0.030% in 2006 to 0.317% in 2015. The increased rate correlated to age (0.033% for &lt;50 years, 0.421% for 70-79 years, and 0.758% for &gt;80 years of age) and the Charlson comorbidity index score (0.048% for zero versus 0.378% for three or more points). It differed by the type of medical institution (0.270 % at referral hospitals versus 0.056 % at general hospitals and mental hospitals). Conclusion: The rate of C. difficile infection in Korea is significant in patients with advanced age and disease severity. The results show that C. difficile infection trend has been increasing steadily in Korea.

The secular trends in the use of medications for osteoporosis in South Korea using Intercontinental Medical Statistics Health Sales Audit 2006–2018

ObjectivesOsteoporosis medications are widely available in South Korea, and well reimbursed by the Government Health Insurance; however, some expensive drugs are not reimbursed. The prescription of anti-osteoporosis drugs (AODs) are increasing for the elderly and for postmenopausal women. We investigate the secular trends of AODs in South Korea. MethodsWe used the Intercontinental Medical Statistics Health Sales Audit between January 1, 2006 and December 31, 2018. We analyzed the total sales costs and market share of AODs including bisphosphonates, selective estrogen receptor modulators (SERMs), parathyroid hormone (PTH), calcitonins, and denosumab using the number of days of therapy (DOT). Changes of prescription patterns including original versus generic drugs, vitamin D combination, and types of medical institutions were also analyzed. ResultsBisphosphonates were the most frequently used drug during the study period although its DOT declined from 92.5% in 2008 to 80.0% in 2018. SERMs were the second-most used medication, and has maintained around 13% since 2015. The proportion of calcitonins has decreased since 2011, mainly due to malignancy risk. In contrast, the DOT of PTH and denosumab increased to 0.8% and 4.7% in 2018, respectively. The use of generics, vitamin D combination, and intravenous bisphosphonates has been increasing throughout the study period. ConclusionsPrescription patterns using DOT are changing probably due to the increase in older adult patients and severely osteoporotic patients. There are other issues including safety and the launching of new drugs.

Non-pharmacological labor pain management and associated factor among skilled birth attendants in Amhara Regional State health institutions, Northwest Ethiopia

BackgroundHealthcare providers have a responsibility to provide pain management support to women during labor. Labor pain management in low and middle income countries primarily relies on non-pharmacological methods, as there is little access to pharmacologic pain management. This study aimed to determine the utilization of non-pharmacological labor pain management (NPLPM) and associated factors among skilled birth attendants (SBAs) in Amhara Regional State health institutions, Ethiopia.MethodsA cross-sectional study was conducted on 592 SBAs working in the Amhara Region, Ethiopia. A multistage sampling was used to collect data using a pretested interview-administered questionnaire. Descriptive analysis was done to characterize the study population. Logistic regression was used to model predictors of NPLPM utilization among SBAs, including age, qualifications, type of medical institution, knowledge, attitudes, and the presence of a protocol.ResultNearly forty seven percent 277(46.8%) of SBAs in the study cohort utilized NPLPM. SBAs who had adequate knowledge of NPLPM had 2.8 times increased odds of using NPLPM than SBAs who had inadequate knowledge. (95%CI 1.89–4.014). SBAs who had a positive attitude had 4.12 times increased odds of using NPLPM than SBAs with a negative attitude (95%CI 2.36, 7.2). SBAs who had labor a pain management protocol in their facility had 3.98 times increased odds of using NPLPM than those who didn’t have a labor pain management protocol (95%CI 1.83, 8.62).ConclusionsThe analysis pointed to a gap in the utilization of NPLPM in the Amhara Region facilities studied. Less than half of SBAs used NPLPM when caring for laboring women. Professional factors related to use of NPLPM included the age of SBAs, their attitudes, level of education, and knowledge concerning pain management. NPLPM was also significantly associated with the availability of labor pain management protocols.

Relationship Between Severe Respiratory Depression and Codeine-Containing Antitussives in Children: A Nested Case-Control Study.

BackgroundGuidelines recommend against all codeine use in children for its common indications of analgesia and cough suppression because of uncertain benefits and potential risk of death. However, because of its rarity, the occurrence of severe respiratory depression associated with codeine-containing antitussives has been poorly investigated. The objective of this study was to investigate the association between codeine-containing antitussives and severe respiratory depression in children.MethodsWe retrospectively identified Japanese children who were prescribed antitussives for respiratory diseases from a large Japanese administrative claims database (JMDC, Tokyo, Japan). We collected data on baseline characteristics including age, sex, and comorbidity. Each case was matched with four controls with the same sex and age in the same year from the same type of medical institution. We then examined the association between codeine-containing antitussives and subsequent severe respiratory depression using multivariable conditional logistic regression analysis.ResultsOf 164,047 children, 18,210 (11.1%) were prescribed codeine-containing antitussives. Of the children who took codeine-containing drugs, seven experienced severe respiratory depression. After adjusting for confounding factors, there was no significant difference in the proportion of severe respiratory depression between children with and without codeine-containing antitussives (odds ratio 1.15; 95% confidence interval, 0.48–2.78).ConclusionOccurrence of respiratory depression was very rare, and the association of codeine with respiratory depression was insignificant, even in a large sample of children in Japan.

Factors Affecting the Incidence of Hospitalized Pneumonia after Influenza Infection in Korea Using the National Health Insurance Research Database, 2014-2018: Focusing on the Effect of Antiviral Therapy in the 2017 Flu Season.

BackgroundThis study aimed to investigate the effect of antiviral therapy following influenza outpatient episodes on the incidence of hospitalized pneumonia episodes, one of secondary complications of influenza.MethodsIn the National Health Insurance Research Database, data from July 2013 to June 2018 were used. All of the claim data with diagnoses of influenza and pneumonia were converted to episodes of care after applying 100 days of window period. With the 100-day episodes of care, the characteristics of influenza outpatient episodes and antiviral therapy for influenza, the incidence of hospitalized pneumonia episodes following influenza, and the effect of antiviral therapy for influenza on hospitalized pneumonia episodes were investigated.ResultsThe crude incidence rate of hospitalized pneumonia after influenza infection was 0.57% in both males and females. Factors affecting hospitalized pneumonia included age, income level except self-employed highest (only in females), municipality, medical institution type, precedent chronic diseases except hepatitis (only in females) and antiviral therapy. In the 2017 flu season, the relative risk was 0.38 (95% confidence interval [CI], 0.29–0.50) in males aged 0–9 and 0.43 (95% CI, 0.32–0.57) in females aged 0–9 without chronic diseases, and it was 0.51 (95% CI, 0.42–0.61) in males aged 0–9 and 0.42 (95% CI, 0.35–0.50) in females aged 0–9 with one or more chronic diseases in the aspect of the effect of antiviral therapy on pneumonia. It suggests that antiviral therapy may decrease the incidence of pneumonia after influenza infection.ConclusionAfter outpatient episode incidence of influenza, antiviral treatment has been shown to reduce the incidence of hospitalized pneumonia, especially in infants and children, during pandemic season 2017. Antiviral therapy for influenza is recommended to minimize burden caused by influenza virus infection and to reduce pneumonia. In addition, medical costs of hospitalization may decrease by antiviral therapy, especially in infants and children.

The Primary Care Performance of Three Types of Medical Institutions: A Public Survey using the Korean Primary Care Assessment Tool

The Primary Care Performance of Three Types of Medical Institutions: A Public Survey using the Korean Primary Care Assessment Tool

Recent 5-Year Trend of Endoscopic Retrograde Cholangiography in Korea Using National Health Insurance Review and Assessment Service Open Data.

Background/AimsThe utilization of endoscopic retrograde cholangiopancreatography (ERCP) is variable and largely dependent on a patient’s age, sex, and region. Herein we analyzed the publicly available Health Insurance Review and Assessment (HIRA) database with the aim of understanding the current status and trend of ERCP use in Korea.MethodsBetween 2013 and 2017, information regarding ERCP was acquired from the HIRA database using the procedural codes of the Korean Standard Classification of Disease. We analyzed the annual number of patients according to age in 10-year increments, sex, type of medical institution, and administrative division.ResultsThe total number of patients and number of patients undergoing ERCP per 100,000 people increased from 40,516 and 78.6 in 2013 to 47,027 and 91.3 in 2017, respectively those aged 70 years accounted for the highest number, and the increase was the most prominent in those aged 80 years or older. Men underwent more ERCPs than women, except in younger patients (<40 years). Most ERCPs were performed at tertiary and general hospitals; however, the ratios between the two types of institutions were different according to the procedure. There were different patterns of patients associated with each procedure according to the administrative division. Therapeutic ERCP was performed more frequently than diagnostic ERCP.ConclusionsMost procedures in Korea were therapeutic, and the increase in patients was most prominent in those aged 80 years or older. The utilization of ERCP increased markedly and varied depending on age, sex, type of medical institution, and region.

Job training and organizational performance: Analyses from medical institutions in China

The benefit of training on economic outcomes has been well-documented in previous literature, as training is generally recognized as one of the important approaches in human capital investment. However, the return of employee training on organizational level performance is not verified sufficiently, especially in the healthcare field. By taking advantage of a dataset with the information on all medical institutions in Sichuan, China over 2012–2016, this paper investigates the effects of employee training on medical institution’s performance through the Propensity Score Matching (PSM) method and the Event Study approach. The results show that training benefits medical institution performance in some indicators, such as total visits, outpatient visits, non-medical-insurance, and local competitiveness. These effects, however, vary across different types of medical institutions. Grassroot medical institutions in the county area that serve as a health gatekeeper (known as primary health care institution, PHCIs) gain most in hospital visits after training. In addition, training results in a 16.5% increase in the average performance wage for county-PHCIs, and a 52.8% increase in the employees’ performance wage for higher-level general hospitals in cities. In general, by participating in training, PHCIs in county region gain more in the overall revenue through the non-medical-insurance income.

Inequity in Access: Cataract Surgery Throughput of Chinese Ophthalmologists from the China National Eye Care Capacity and Resource Survey

ABSTRACTPurpose: To investigate the distribution of cataract surgery performed by ophthalmologists in China.Methods: A cross-sectional study was designed to investigate nationwide ophthalmological resources and capacity for cataract surgery in China⁠—The 2014 China National Eye Care Capacity and Resource Survey. Data analyzed in this report included regional distribution, urban-rural comparison, levels and types of medical institutions, and cataract surgery types and volume per surgeon. In China, only ophthalmologists at or above the level of attending are eligible to perform cataract surgery independently, so the ability of cataract surgery for ophthalmologists at or above the level of attending is analyzed in the current study. Descriptive statistics were used.Results: 36,333 ophthalmologists were included in this survey, which is an average of 1.33 ophthalmologists to every 50,000 population. Of the surgeons in this survey, 23,412 (50.22%) were attending or more senior ophthalmologists and were mainly distributed in eastern urban areas. Annual average cataract surgeries per ophthalmologist in China were 259 in 2017, less than 300 cases.Conclusion: The average number of ophthalmologists per population in China has achieved the goal of WHO’s Vision 2020; however, these surgeons are concentrated in urban areas. Further, the ability of cataract surgery among ophthalmologists is unbalanced. The annual average cataract surgeries performed by ophthalmologists are insufficient, which is an important factor resulting in the current situation in China that ophthalmic service capacity has not met the requirements for eliminating cataract blindness.