Hospitalization Expenses of Breast Cancer with Different Payments Based on Gamma Model

目的分析不同支付方式的女性乳腺癌患者住院费用,为合理控制乳腺癌住院费用提供依据。方法收集厦门市某三甲医院2004-2012年入院接受治疗且信息完整的女性乳腺癌患者的人口学、疾病、治疗和住院费用资料,采用Gamma模型分析医保与非医保患者的各项住院费用的差异,并估计边际均值及其95%可信区间。结果共纳入451例乳腺癌住院患者,其中医保患者占71.2%;医保与非医保患者中位住院费用分别为12696.4元和11216.5元,其中药品费分别占40.0%和38.8%,检查费分别占23.2%和22.5%,床位费分别占4.5%和4.3%。在控制协变量的影响后,医保和非医保患者的总住院费用(8889.5元vs 6807.6元)、药品费(1721.2元vs 1290.9元)、检查费(3366.5元vs 2400.6元)和床位费(488.9元vs 299.6元)差异均有统计学意义,医保患者的总住院费用、药品费、检查费和床位费分别是非医保患者的1.31、1.33、1.40和1.63倍。结论基于Gamma模型分析支付方式对乳腺癌住院费用的影响具有一定的科学合理性。医疗支付方式在一定程度上影响女性乳腺癌患者的住院费用,医保患者住院费用高于非医保患者,药品费、检查费和床位费是主要的差异来源。Objective To study the difference of hospitalization expenses between insured and uninsured female breast cancer patients with Gamma model. Methods The female patients with breast cancer in a tertiary hospital in Xiamen from Jan1,2004 to Dec 31,2012 were recruited into our study,whose demographics,disease situation,treatment and hospitalization expenses were collected. Gamma model was applied to analyze hospitalization expenses for insured and uninsured patients under control of other covariates,and to estimate marginal means. Results The study included 451 patients with 71. 2% of which were insured. For insured and uninsured patients,the median cost of hospitalization was 12696. 4 RMB and 11216. 5 RMB,respectively. The proportions of the compositions of hospitalization cost were 40. 0% and 38. 8% for drug cost,23. 2% and 22. 5% for examination cost,4. 5% and 4. 3% for bed cost,respectively. After controlling other covariates,total hospitalization cost(8889. 5 RMB vs. 8889. 5 RM B),drug cost( 1721. 2 RMB vs. 1721. 2 RMB),examination cost( 3366. 5 RMB vs. 3366. 5RMB),and bed cost(488. 9 RMB vs. 488. 9 RMB) between insured and uninsured patients were significantly different. Total cost,drug cost,examination cost and bed cost of insured patients were higher than uninsured patients with 0. 31,0. 33,0. 40,and0. 63 times respectively. Conclusion For its advantage in deal with skewed data,the Gamma model has its own rationality and validity on analysis of hospitalization expense. The hospitalization expense of female breast cancer patients with medical insurance was higher than uninsured patients. Drug cost,examination cost and bed cost made a main contribution of difference.国家自然基金青年项目(71403229);; 厦门市科技计划项目(3502Z20143006

教材语言调查统计方法的新发展——基于基础教育新课标人教版、苏教版、北师大版、语文版的比较

对于任何一门科学而言,其成熟的主要标志是研究方法的科学化、系统化。在教材语言研究的过程中,开始我们多使用频次、文本数和分布率、累计频率等统计方法。由于教材语言具有基础性、有限性和有序性的特点,我们进一步提出教材语言统计的新方法,即复现调查法、使用度调查和频率差等教材语言统计方法。调查方法的发展和演进,有助于我们对教材语言的特点、性质和面貌有更进一步的认识

Development of Multidimensional Health Assessment Scale of the Elderly

目的在多个国外已有常用量表中文版的基础上综合研制简短及适合我国国情文化的老年健康功能多维评定量表,为我国老年健康研究提供测量工具。方法首先,通过文献研究拟定量表维度并建立条目池;其次,通过dElPHI法确定维度并初筛条目获得初表,通过预试验进行文化调适;再次,通过联合经典测量理论、条目反应理论和dElPHI法进行条目再筛获得终表;最后,采用CrOnbACH'Sɑ系数和验证性因子分析对终表进行考评。条目再筛和终表考评数据分别来自由分层整群抽样得到的厦门市老年人面对面问卷调查。结果通过文献研究和dElPHI法确定量表维度为社会关系资源、日常生活能力、身体健康、精神健康、经济资源和认知功能;条目池包含120个条目;初筛后的初表包含60个条目;利用539名老年人数据进行条目再筛后的终表包含30个条目;根据2032名老年人数据进行终表考评,CrOnbACH'Sɑ系数为0.922,验证性因子分析的结果为CfI、nfI、IfI均大于0.90、rESMA小于0.08。结论本研究研制的老年健康功能多维评定量表包含社会关系资源、日常生活能力、身体健康、精神健康、经济资源和认知功能6个维度共30个条目,它不仅简短和适合我国国情文化,且具有良好的信度与效度。Objective To develop a concise multidimensional health assessment scale of the elderly which is suitable for Chinese conditions based on multiple Chinese versions of foreign existing health assessment scales,in order to provide a suitable tool for the studies on the health of Chinese elderly.Methods Firstly,domains of the scale w ere tentatively constructed and the item pool w as made by literature review method.Then domain ascertainment and preliminary selection resulting in initial scale w ere performed by the Delphi method.Items in initial scale encountered further culture adaptation by pre-test.Further selection w as executed by the methods of classical test theory( CTT),item response theory( IRT) and Delphi,resulting in final scale( the Multidimensional Health Assessment of the Elderly).Finally,evaluation of the final scale was performed by cronbach's ɑcoefficient and confirmatory factor analysis.The further item selection and final scale evaluation w ere completed by data from stratified cluster sampling and face-to-face survey among Xiamen elderly.Results In this study,w e determined the scale as six domains in w hich cognitive function w as included besides the five mentioned above.The item pool contained 120 items initially.And half of them w ere remained to be the initial scale after preliminary selection.Then 30 items w ere removed by the further selection w ith a sample of 539 old people in Xiamen,and the other 30 items formed the final scale.Evaluation of the final scale based on a sample of 2032 old people show ed that the CFI,NFI and IFI w ere all above 0.9,the RESM A w as below 0.069,and the Cronbach's ɑ coefficient w as 0.922.Conclusion The multidimensional health assessment scale of the elderly comprised six domains and thirty items.It is not only concise and suitable for Chinese conditions but also w ith good reliability and validity.厦门大学基础创新科研基金(中央高校基本科研业务费专项资金)(CXB2012017); 福建省自然科学基金计划资助项目(12YJA790030); 教育部人文社会科学研究项目资助(2012J01303

贴片散斑法及其应用

贴片散斑法将一种可剥离铝箔贴附在试件表面,经随机划痕制栅后,以其精细的光学结构和高度的反射本领,在白光或激光照射下,表面辐射率随机分布函数作为散斑场,采取直接记录手段,用全息底片对此作物体变形前后的两次曝光,所得到的散斑底片将包含宽广的空间频谱范围,且全场分析条纹清晰、灵敏度高、量程调节范围大。此方法不仅适用于各种材料的直接散斑法测量,具有经济、可靠、操作简便的特点,还能应用于平面及可展曲面构件的现场量测

卒中后失眠的研究进展 Research Progress of Insomnia after Stroke

卒中后失眠是在卒中后首次出现并达到失眠诊断标准的一组临床综合征，与临床常见失眠相类似，主要表现为睡眠深度异常和平均每晚睡眠时间少于6 h。meta分析显示，卒中急性期、亚急性期及恢复期患者符合失眠障碍诊断标准的比例分别为32.5%、34.8%和37.1%。卒中后失眠不仅增加了卒中死亡及复发风险，而且对卒中康复与预后造成不利影响。本文对卒中后失眠的发病情况、发病机制及治疗等进行综述，以便为临床实践提供信息，并为卒中后失眠提供针对性干预治疗措施。 Abstract: Post stroke insomnia (PSI) is a group of clinical syndromes that first appear after a stroke and meet the diagnostic criteria for insomnia. Similar to common clinical insomnia, the main manifestations are abnormal sleep depth and average sleep time less than 6 hours per night. Meta-analysis showed that 32.5%, 34.8% and 37.1% of patients in acute, subacute and convalescent stages of stroke met the diagnostic criteria for insomnia disorders, respectively. PSI not only increases the risk of stroke death and recurrence, but also has adverse effects on stroke rehabilitation and prognosis. This paper reviews the incidence, pathogenesis, and treatment of insomnia after stroke, in order to provide information for clinical practice and provide targeted intervention and treatment measures for insomnia after stroke

The Statistical Method of Rank and Its Role in Teaching Material Language Survey

频级统计法是指在同一个语料调查中所有的词语按频级高低排序的一种方法。在对教材语言调查的过程中我们使用了此种方法,它有助于我们对教材语言的特点和性质有进一步的认识,是一种简单而实用的统计方法。The statistical method of rank refers to a frequency level which is ranked of all the words in the same corpus survey.We use this method in the process of teaching language survey,as it helps the understanding of the character and nature of teaching language,and it is a simple and practical statistical method

白光散斑的直接记录和非相干光分析

近二十余年来,激光散斑法在实验应力分析领域中广为重视.它的突出优点是灵敏度可调,无损以及能给出全场信息.测试者可根据待测应变量的大小,调节滤波孔高度,选择适当的条纹密度进行测量.因而这种方法对于弹性、塑性应变均能适用.是目前较理想、有潜力的测试手段之一

JF12复现激波风洞平板边界层转捩实验研究

高超声速边界层转捩是制约高超声速科技发展的基础科学问题之一。尽管高超声速边界层层/湍流转捩的相关研究已经开展长达半个多世纪,由于高超声速流动的复杂性以及触发转捩的因素繁多,研究人员对于转捩过程的认识并不透彻,阻碍了先进高超声速飞行器的设计。1.1数值模拟文章采用高精度格式求解二维Navier-Stokes方程,研究平板边界层的基本规律,分别应用五阶WENO格式离散对流项、六阶中心差分格式离散粘性项,时间推进采用

土壤养分和下行效应对滨海湿地植被的 联合调控机制研究进展

In coastal wetland ecology, most studies only consider the bottom-up effect, that is, the effect of abiotic factors on plant survival, growth and reproduction, while ignoring the top-down effect (i. e. , herbivory). On the other hand, the eutrophication situation is more serious than ever before in global coastal wetland, soil nutrient enrichment may affect the top-down effect and then in fluence the coastal wetland vegetation. Therefore, this paper aims to synthesize the mechanisms of soil nutrient and the top-down effect jointly regulating the coastal wetland plant population and community. Then we pointed out the limitations in current studies to provide references for the future studies: (1) How the unique plant groups and environmental factors of the coastal wetland responding to the joint influences of soil nutrient enrichment and the top-down effect needs to be studied; (2) lack of the long-term mechanism of soil nutrient enrichment and top-down effect on the coastal wetland vegetation; (3) investigating the top-down effect of parasitic and bacte rial consumers on the coastal wetland vegetation is rare. Additionally, we introduced the long-term experimental platform of soil nutri ents and top-down effects of the coastal wetland in Yellow River Delta, and it may provide important information to guide the conserva tion of coastal wetland vegetaion of the Yellow River Delta under the background of global change