中国医疗卫生事业效益分析之系列研究——2005-2009年全国传染病医院效益分析

目的:中国是肝炎大国,研究全国传染病医院投入与产出效益分析并找出影响因素并提出对策。方法:收集2005年-2009年统计数据,采用平均增长量、平均发展速度、平均增长速度计算出投入、产出指标值。结果:职工人数(包括医生数)、医疗仪器设备、房屋建筑面积(包括业务用房面积)等投入指标保持年均正增长速度。诊疗人次数、入院人数、病床工作日、病床周转次数等社会效益产出指标保持年均正增长速度,病床使用率提高16.4个百分点,出院者平均住院日每年缩短0.55日。净资产经济效益产出指标年均增长速度达32.47%,病毒性肝炎出院者人均医药费用年增长速度4.6%。结论:全国传染病医院属于朝阳事业,但应加大传染病预防的宣传力度,加强卫生管理,从源头消除传染源。加快完善新型农村合作医疗、城镇居民和职工医疗保险。     

河北省城市综合承载力分析与“城市病”防治

基于城市综合承载力和"城市病"的内涵和内在联系,针对河北省城市发展特点,选取了水资源承载力、土地资源承载力、交通资源承载力和环境资源承载力4个指标,建立了城市综合承载力的评价指标体系。通过选取2003—2008年的相关数据,以省会城市石家庄为例,对河北省城市承载力进行综合评价,得出如下结论:环境污染、水资源匮乏、交通拥挤等城市病现象是制约城市承载力的短板因素,最后提出了关于河北省提高综合承载力的建议和对策。     

高速公路运营隧道病害整治探讨

本文结合工程实例,根据隧道病害情况和隧道检测报告,利用Midas GTS对隧道衬砌结构的变形和内力进行分析,探讨隧道相关整治措施,对已通车运营的隧道进行整治,以期为隧道病害治理工作提供参考。     

Identification of critical airports for controlling global infectious disease outbreaks: Stress-tests focusing in Europe

As the global population increases and transportation connectivity improves in quality and prices, the demand for mobility increases, especially in long-haul services. According to the 2017 report of the European Commission in Mobility and Transport, the performance of all modes for passenger transport (roadways and airways) are reaching record highs. Although the benefits of the increased demand for mobility are substantial and welcome, an effort should be paid such as to ameliorate possible threatening side-effects that may also arise. As World Health Organization (WHO) denotes and as has been evident from the global COVID-19 epidemic outbreak, infectious diseases can be spread directly or indirectly from one person to another under common exposure circumstances such as air transportation (especially long-haul airline connections) that may act as the medium for transmitting and spreading infectious diseases. In this paper, analytical and realistic models have been integrated, for providing evidence on the spread dynamics of infectious diseases that may face Europe through the airlines system. In particular, a detailed epidemiological model has been integrated with the airlines’ and land transport network, able to simulate the epidemic spread of infectious diseases originated from distant locations. Additionally, a wide set of experiments and simulations have been conducted, providing results from detailed stress-tests covering both mild as well as aggressive cases of epidemic spreading scenarios. The results provide convincing evidence on the effectiveness that the European airports' system offer in controlling the emergence of epidemics, but also on the time and extent that controlling measures should be taken in order to break the chain of infections in realistic cases.     

Epidemics and macroeconomic outcomes: Social distancing intensity and duration

We analyze the determination of the optimal intensity and duration of social distancing policy aiming to control the spread of an infectious disease in a simple macroeconomic–epidemiological model. In our setting the social planner wishes to minimize the social costs associated with the levels of disease prevalence and output lost due to social distancing, both during and at the end of epidemic management program. Indeed, by limiting individuals’ ability to freely move or interact with others (since requiring to wear face mask or to maintain physical distance from others, or even forcing some businesses to remain closed), social distancing has on the one hand the effect to reduce the disease incidence and on the other hand to reduce the economy’s productive capacity. We analyze both the early and the advanced epidemic stage intervention strategies highlighting their implications for short and long run health and macroeconomic outcomes. We show that both the intensity and the duration of the optimal social distancing policy may largely vary according to the epidemiological characteristics of specific diseases, and that the balancing of the health benefits and economic costs associated with social distancing may require to accept the disease to reach an endemic state. Focusing in particular on COVID-19 we present a calibration based on Italian data showing how the optimal social distancing policy may vary if implemented at national or at regional level.     

Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims

Abstract

Objective:

Relapse is a common measure of disease activity in relapsing-remitting multiple sclerosis (MS). The objective of this study was to test the content validity of an operational algorithm for detecting relapse in claims data.

Methods:

A claims-based relapse detection algorithm was tested by comparing its detection rate over a 1-year period with relapses identified based on medical chart review. According to the algorithm, MS patients in a US healthcare claims database who had either (1) a primary claim for MS during hospitalization or (2) a corticosteroid claim following a MS-related outpatient visit were designated as having a relapse. Patient charts were examined for explicit indication of relapse or care suggestive of relapse. Positive and negative predictive values were calculated.

Results:

Medical charts were reviewed for 300 MS patients, half of whom had a relapse according to the algorithm. The claims-based criteria correctly classified 67.3% of patients with relapses (positive predictive value) and 70.0% of patients without relapses (negative predictive value; kappa 0.373: p?<?0.001). Alternative algorithms did not improve on the predictive value of the operational algorithm. Limitations of the algorithm include lack of differentiation between relapsing-remitting MS and other types, and that it does not incorporate measures of function and disability.

Conclusions:

The claims-based algorithm appeared to successfully detect moderate-to-severe MS relapse. This validated definition can be applied to future claims-based MS studies.     

特殊食品侵权的认定

随着社会的发展,具有特殊功效、配方或特殊生产工艺,针对特殊消费人群的特殊食品市场迅速增长。但这些特殊食品是否具有功效,是否存在副作用等都还不是十分了解。因此,如何定义特殊食品侵权就成为一个值得研究的问题。特殊食品侵权的认定,就是要在界定特殊食品及其缺陷的基础上,结合相关法律法规,深入探讨特殊食品缺陷致人损害的侵权责任构成要件,以期为我国构建更为完善的缺陷食品侵权救济机制。     

铁路曲线常见病害的预防与整治

本文根据作者的实际工作经验,从困扰铁路工务养护人员的常见曲线病害诸如方向不良、鹅头反弯、接头支咀、接头塌碴及钢轨磨耗等,系统介绍了病害表现及防治措施。     

《家畜传染病学》教学改革探索

针对较为单调、枯燥、不利于提高学生综合素质的旧的教学方式,通过近几年的尝试和探索,初步形成了一套及时更新教学内容、幻灯、多媒体、生产实践相结合的新的家畜传染病教学模式。对促进学生理论联系实际,提高分析问题、解决问题及综合设计能力起到了良好的作用。