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Objective To analyze the impact of medical service price adjustment on the average inpatient expenses in tertiary public hospitals, evaluate the implementation effects of the policy, and provide a basis for deepening the reform of the medical and health system and strengthening the internal control construction of public hospitals. Methods Inpatient average expenses data from five tertiary public hospitals in a certain area of Shanghai from January 2019 to December 2023 were extracted. The degree of structure variation and grey correlation analysis were used to analyze the changes in expenses before and after the implementation of the medical service price adjustment policy in the third quarter of 2021. Interrupted time series analysis was used to evaluate the immediate and long-term effects of the policy. Results The average inpatient expenses in tertiary public hospitals showed an increasing trend after the medical service price adjustment. Among them, the proportions of examination fees, laboratory fees, and sanitary material fees remained high, while the proportion of drug expenses decreased significantly, and the proportion of medical service fees did not show a significant upward trends The cumulative contribution rates of drug expenses and sanitary material expenses before and after the adjustment reached 67.17%. Sanitary material fees, drug expenses, and medical service fees showed a high correlation with the average expenses. The price adjustment policy had a long-term effect on alleviating the increasing trend of average inpatient expenses ((3=-169.91, P=0.02). Conclusion The cost control achieved certain results after the medical service price adjustment, but the value of technical labor was not fully reflected. Attention should be paid to the growth of consumables and examination fees. It is recommended to continuously optimize the cost structure, highlight the value of medical staff labor, improve the medical service price standards and dynamic adjustment mechanisms, and strengthen the internal control and supervision of medical institutions. [ABSTRACT FROM AUTHOR]

BackgroundThe Qingcaosha Reservoir is facing issues of algal blooms and eutrophication, and the resulting increase in the level of chlorination disinfection by-products in the water has been a major concern. ObjectiveTo evaluate the impact of "Algae Monitoring and Control Program in Qingcaosha Reservoir" (hereinafter referred to as the program) on the control of trihalomethanes (THMs) in conventional finished water. MethodsFrom 2011 to 2019, water samples were collected from the Lujiazui Water Plant once per season, one sample each time, and the concentrations of four THMs (trichloromethane, dichlorobromomethane, monochlorodibromomethane, and tribromomethane) were measured in the samples. Using 2014 when the program was implemented as a cut-off point, the entire study period was divided into two phases: pre-implementation (2011–2013) and post-implementation(2014–2019). Segmented linear regression with interrupted time series analysis was applied to assess the concentrations and trends of THMs in the finished water before and after the program launch. ResultsThe concentration of total THMs in finished water increased by 1.561 µg·L−1 (P=0.010) for each season of time extension before launching the program. The change in the concentration of total THMs in finished water was not statistically significant after the program launch, but the THMs concentration showed a decreasing trend as the slope was −0.626 (P=0.001). From 2017 until the end of 2019, the average concentration of THMs in finished water of Lujiazui Water Plant dropped to 10 μg·L−1 or less.ConclusionsThe algae and eutrophication control measures in Qingcaosha Reservoir have achieved good results, controlling THMs in finished water at a low level, and the trend of THMs has changed from a yearly increase pattern before the program to a yearly decrease pattern after the program.

Objective To analyze the changes of schistosomiasis epidemic trend before and after the implementation of schistosomiasis integrated control strategy in China from 1999 to 2015, and to evaluate its effects in the process of schistosomiasis transmission controL Methods The epidemic data of schistosomiasis in China from 1999 to 2015 were collected, and the interrupted time series (ITS) method was used to analyze the changes of positive rate of blood test, positive rate of fecal test, number of acute schistosomiasis cases, number of catde, and infection rate of catde before and after the implementation of the comprehensive control strategy of schistosomiasis. Results After the implementation of the integrated schistosomiasis control strategy, the number of acute cases -B2=-937.433, P < 0.001) and the infection rate of cattle (j82=_ 1*606, P=0.012) decreased immediately in 2005. After the implementation of the strategy, the positive rate of blood test 保二一1.164; P < 0.001), tlie positive rate of stool test (p=-1.157, P < 0,001), the number of acute cases 保二一 143.939, P < 0,001), and the infection rate of cattle 03二一0.513, P < 0.001) showed a downward trend year by year, which had a long-term effect on the prevention and control of schistosomiasis. Conclusion From 2006 to 2015, the positive rate of blood test, the positive rate of stool test, the number of acute cases, and the infection rate of cattle in China showed a decreasing trend, indicating that in the advancing stage of schistosomiasis transmission control in China, the integrated schistosomiasis control strategy based on source of infection control has a significant effect on schistosomiasis control. [ABSTRACT FROM AUTHOR]

Objective To research the effect of centralized procurement of coronary stent on total hospitalization expenses and structural expenses, explore the possible changes in treatment behavior and provide basis for the formulation of relevant operation management focus after the centralized procurement of coronary stent. Methods We collected the data of patients who underwent coronary stent implantation from January 2019 to December 2022 in a 3A hospital, using the interrupted time series analysis, descriptive analysis method, chi - square test and Welch' s ANOVA test to analyze the data at 48 time - observation points before and after centralized procurement. Results Centralized procurement immediately reduced the average hospitalization expenses of coronary stent implantation by 19 954. 38 Yuan (0, = -19 954. 381, 95% CI: - 21 546. 085 ~ - 18 362. 676) and medical materials cost dropped most (侯=-16 410. 418, 95% CI: - 17 548. 630 ~ -15 272. 206), other categories expenses had also varying degrees decrease (P <0.05). After centralized procurement, the average hospitalization expense of coronary stent implantation was gradually rising (艮=315. 605, 95% CI: 198. 061 -433. 148), mainly due to the rise in the expenses of medical examination (角=110. 484, 95% CI: 95.525 -125.443) and materials (民=265.433, 95% CI: 181. 378 - 349. 487), the proportion of medical service fees was gradually decreasing (P < 0. 05). Conclusion The centralized procurement of coronary stent reduces the total hospitalization expenses of related patients. However, the cost of medical examination and materials continues growth after the centralized procurement of coronary stent, so hospital managers should strengthen supervision to avoid unreasonable recovery of expenses. [ABSTRACT FROM AUTHOR]

ObjectiveTo analyze the epidemiological characteristics of varicella in Minhang District， Shanghai from 2013 to 2022， and to evaluate the impact of adjusting the varicella vaccination program to a two-dose regimen and its inclusion in the Shanghai immunization program on the incidence of varicella.MethodsData on reported varicella cases from 2013 to 2022 in Minhang District were collected. Interrupted time series analysis and segmented regression models were used to analyze the changes in varicella incidence before and after the adjustment of varicella immunization strategies.ResultsFrom 2013 to 2022， the average annual incidence of varicella was 76.58/100 000， with the highest incidence in 2017 （119.21/100 000） and the lowest in 2022 （27.02/100 000）. The varicella incidence exhibited seasonal patterns with peaks occurring from March to June and October to January of the following year. Prior to the adjustment of varicella immunization strategies （2013‒2017）， the varicella incidence showed an upward trend （z=2.20， P=0.03）， while after the adjustment （2018‒2022）， a adownward trend was observed （2018‒2022） （z=-2.25， P=0.02）. Interrupted time series analysis showed that following the adjustment of varicella immunization strategies， an immediate change of -33.91/100 000 （t=-4.35， P

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Objective: To analyze influence on HIV related fatality of implementation of 'Four Free Services One Care' policy in China during 1993-2012, and evaluate effectiveness for the policy of HIV/AIDS prevention and treatment. Methods: The data during 1993-2003 (before the implementation of the policy) and during 2005-2012 (after the implementation of the policy) were collected from the national HIV/AIDS Comprehensive Response Information Management System for the analysis on HIV related fatality in Chinese, especially in rural residents. Interrupted time series analysis was used to analyze the trends of HIV related fatality during 1993 and 2012. Results: During the twenty years from 1993 to 2012, the HIV related fatality in China decreased, and the HIV related fatality in rural areas was higher than the overall HIV related fatality. Compared with the period before the implementation of the policy, the overall HIV related fatality decreased by 1.5 % ( P =0.156) and the HIV related fatality in rural residents decreased by 2.6 % in 2004 when the policy was implemented ( P =0.094). As for the change of slope, the overall slope rate after the policy implementation was -0.466 ( P =0.005), indicating a decrease trend of HIV related fatality. The slope rate after the policy implementation in rural residents was-0.592 ( P =0.005), indicating a decrease trend of HIV related fatality. At the same time, the slope rate after the policy implementation in rural residents infected through blood transmission route was-0.766 ( P <0.001), indicating a decrease trend of HIV related fatality. Conclusions: The implementation of the 'Four Free Services One Care' policy in China has made remarkable progress in free HIV antiviral therapy.