Gini coefficient, overall, technical and scale efficiency scores and returns to scale characteristics for health resources allocation and health services utilization of each province.

<p>Numbers in cells show the coefficient of each province for each index. * IRS: increasing return to scale. † DRS: decreasing return to scale.</p

The eastern, central and western regions of China.

<p>The eastern, central and western regions of China.</p

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China

<div><p>Background</p><p>This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China.</p><p>Methods</p><p>We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators.</p><p>Results</p><p>The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the “best practice frontier”. The other 8 (25.8%) provinces were technically inefficient.</p><p>Conclusions</p><p>Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.</p></div

Mini-Incision versus Standard Incision Total Hip Arthroplasty Regarding Surgical Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

<div><p>Purpose</p><p>It remains controversial whether mini-incision (MI) benefits patients in total hip arthroplasty (THA). We performed a meta-analysis of randomized controlled trials (RCTs) to assess the effects of MI on surgical and functional outcomes in THA patients.</p> <p>Methods</p><p>A systematic electronic literature search (up to May 2013) was conducted to identify RCTs comparing MI with standard incision (SI) THA. The primary outcome measures were surgical and functional outcomes. According to the surgical approach taken, MI THA patients were divided into four subgroups for sub-group meta-analysis. Standardized mean differences (SMDs) or risk differences (RDs) with accompanying 95% confidence intervals (CIs) were calculated and pooled using a fixed-effect or random-effect model according to the heterogeneity.</p> <p>Results</p><p>A total of 14 RCTs involving THA 1,174 patients met the inclusion criteria. The trials were medium risk of bias. The overall meta-analysis showed MI THA reduced total blood loss (95% CI, -201.83 to -21.18; p=.02) and length of hospital stay ( 95% CI, -0.67 to -0.08; p=.01) with significant heterogeneity. However, subgroup meta-analysis revealed posterior MI THA had perioperative advantages of reduced surgical duration ( 95% CI, -8.45 to -2.67; P<.001), less blood loss ( 95% CI, -107.20 to -1.73; P=.04) and shorter hospital stay ( 95% CI, -0.74 to -0.06; p=.002) with low heterogeneity. There were no significant differences between MI and SI THA groups in term of pain medication dose, functional outcome (HHS), radiological outcome or complications (P>.05, respectively).</p> <p>Conclusions</p><p>Although no definite overall conclusion can be arrived at on whether MI THA is superior to SI THA, posterior MI THA clearly result in a significant decrease in surgical duration, blood loss and hospital stay. It seems to be a safe minimally invasive surgical procedure without increasing the risk of component malposition or complications.</p> </div

Meta-analysis of randomized controlled trials evaluating surgical duration.

<p>Meta-analysis of randomized controlled trials evaluating surgical duration.</p

Risk of bias summary and graph.

<p>Risk of bias summary and graph.</p

Meta-analysis of randomized controlled trials evaluating doses of pain medication.

<p>Meta-analysis of randomized controlled trials evaluating doses of pain medication.</p

Meta-analysis of randomized controlled trials evaluating blood loss.

<p>Meta-analysis of randomized controlled trials evaluating blood loss.</p

Meta-analysis of randomized controlled trials evaluating length of hospital stay.

<p>Meta-analysis of randomized controlled trials evaluating length of hospital stay.</p

Funnel plot showing minimal publication bias of the complication outcome- infection.

<p>SE(RD), standard error (risk differences). </p