Objective To systematically review the impact of Beijing's comprehensive reform of medical consumption linkage on medical expenses, hospital services, and hospital income. Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, and Web of Science were searched to collect empirical research on evaluating the impact of Beijing's comprehensive reform of medical consumption linkage on patient medical expenses and hospital operation (service volume and income structure) from June 15th, 2019 to August 15th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature and extracted data. Results A total of 23 studies were included, and most of them found a relatively small change in the average outpatient and emergency medical expenses after the reform. However, the average inpatient expenses in some hospitals showed an increasing trend; the service volume of most hospitals increased slightly, and the income structure was optimized (e.g., surgery and other medical technology services revenue and its proportion increased). Conclusion The comprehensive reform of the medical consumption linkage in Beijing is the practice of deepening the reform of the medical service price mechanism. Based on the summary of the reform effect, it is recommended to further improve the price mechanism, improve service quality, and promote hierarchical diagnosis and treatment.
In response to the education and teaching reform, West China School of Medicine/West China Hospital, Sichuan University, initiated a general course on clinical engineering technology assessment and evaluation for the undergraduates in 2018. Through the course practice in the past two years, the number of students increased significantly, and we also achieved certain teaching achievements. At the same time, the teaching evaluation among undergraduates was excellent. Nevertheless, there are still certain deficiencies in the content of teaching, teaching methods and faculty. Therefore, this article summarizes the experience and lessons since the start of the course, and proposes corresponding teaching reform measures, providing reference for the establishment or reform of related interdisciplinary courses such as clinical engineering technology assessment and evaluation in the future.
Objective To compare the effectiveness of three teaching modes, namely traditional teaching, online teaching, and online and offline blended teaching, in the teaching of the clinical nutrition elective course, and to evaluate the advantages of the online and offline blended teaching mode. Methods A total of 316 students taking the clinical nutrition elective course at Sichuan University in one of the three semesters, Fall 2019-2020, Spring 2019-2020, and Fall 2020-2021, were enrolled as the study population. In the offline group, 69 students used the traditional teaching mode; in the online group, 133 students used the online teaching mode through Chaoxing Xuexitong application; in the online and offline blended teaching group, 144 students used the traditional teaching mode combined with the online teaching. The final exam results and questionnaire satisfaction of the three groups were analyzed and compared. The exam results were presented as median (lower quartile, upper quartile). Results The exam results of the online group [males: 88.0 (85.0, 93.0); females: 91.0 (86.0, 94.0)] and the online and offline blended group [males: 90.0 (83.0, 94.0); females: 91.0 (87.5, 95.0)] were significantly higher than those of the offline group [males: 83.0 (77.0, 89.0); females: 77.5 (67.0, 87.0)] (P<0.001). Compared to the offline teaching mode and online teaching mode, the female students’ satisfaction with the online and offline teaching mode was better (P<0.01). Conclusion The online and offline blended teaching mode can significantly improve students’ performance and learning motivation, and provide a basis for promoting the reform of the clinical nutrition elective course.
Objective To explore the impact of Diagnosis-Intervention Packet (DIP) reform on the operation of pilot county-level hospital, analyze the challenges that hospitals may face in DIP reform, and propose strategies to adapt to the reform. Methods The settlement list data of inpatients insured by medical insurance for 2022 from a county-level tertiary public hospital in Jiuquan City, Gansu Province were collected, where DIP was planned to operate. The DIP payment was simulated, and the operational status of the hospital and departments after implementing DIP reform was analyzed based on enrollment status, cost deviation, length of stay, hospitalization expenses, and DIP payment as relevant indicators. Results Under the implementation of DIP payment, the overall enrollment rate of the hospital was 98.1%, including 85.4% in the core group, 7.0% in the comprehensive group, and 7.6% in the grassroots group. Normal costs accounted for 88.9%, deviation costs accounted for 11.1%, with high magnification cases accounting for 1.9% and low magnification cases accounting for 9.2%. The payment standard for all cases included in the hospital according to DIP was 15.464 million yuan, the total amount paid by the pooling fund was 19.986 million yuan, and the difference between DIP payment and payment by project was –4.522 million yuan. Conclusion There is a significant difference in the medical insurance payments received by county-level hospitals after implementing DIP payment, and there is an urgent need to adapt to the DIP payment reform as soon as possible.
The evaluation of student performance is an important but difficult part of the implementation of problem-based learning (PBL). This article introduces the background to the reform of evaluation in PBL, analyzes the principles of such evaluation, and gives a critical review of the methods applied in the reform of student evaluation in PBL, so as to help medical schools adopt practical and efficient evaluation methods.
Objects The center of Evidence Based Medicine (EBM) in China has organized several extra-curricular trainings in summer vacations for medical students, so as to enable them get involved in the practice of Evidence Based Medicine, we were wondering whether these training courses served as an effective supplement to EBM education in class and what it exactly brought to us, with a primary concern about research capability in field of EBM. Methods We conducted questionnaire survey with undergraduate students whose enrolling years range from 2001 to 2005 in West China Medical School of Sichuan University, and divided them into a stratification of five groups according to enrolling years. Then we paired the trained students with untrained ones at a ratio of 1׃2. The final number of included students was 216, of which 72 had been trained while other 144 had not. Epidata 3.0, Excel and SPSS 13.0 were used for data collecting and analyzing, respectively. Chi-square test was adopted for result interpretation. Results Compared to those without training experience, trained students were prone to choose medical specialized databases (Plt;0.05) when they search for some academic publications. In terms of selecting and quality evaluation, the trained were more dependent on systematic reviews (Plt;0.05). Meanwhile, they also showed critical thinking more than that of untrained (Plt;0.05). In addition, the fruit of published theses was in favor of those trained ones. Conclusions Those who have taken part in extra-curricular training of EBM surpass those untrained in ability of scientific research. To some extent, we are still in shortage of educational resources; this extra-curricular training course can play a complementary role for EBM education, as effective and necessary.
Objective To evaluate the changes in oral health knowledge, behavior and attitude of undergraduate students majoring in preventive medicine before and after the course “Oral Preventive Medicine”, and to provide empirical evidence for the teaching reform of preventive medicine undergraduate programs, thereby enhancing teaching effectiveness and the significance of the course. Methods A questionnaire survey was conducted among the undergraduate students majoring in preventive medicine at the West China School of Public Health, Sichuan University in 2024, before and after the compulsory course “Oral Preventive Medicine”. Results A total of 124 undergraduate students majoring in preventive medicine were surveyed. After the course, undergraduate students majoring in preventive medicine had changed their oral related knowledge, behaviors, and attitudes. The correctness of the answers and the usage rate of Bass brushing technique were both increased; The self-evaluation of oral health status (χ2=5.017, P=0.025) and brushing effect (χ2=22.200, P<0.001) were both improved; The perceived benefits of brushing (t=2.515, P=0.013) and behavioral intention to brush teeth (t=5.381, P<0.001) were both improved, while the perceived barriers to brushing was reduced (t=−3.999, P<0.001). Conclusions The course “Oral Preventive Medicine” effectively enhanced the oral health literacy of undergraduate students majoring in preventive medicine, confirming its practical value in undergraduate teaching reform. It provides an important reference for optimizing the curriculum system of preventive medicine, has positive significance for cultivating public health talents with comprehensive health literacy.