Analysis of the current status and influencing factors of cross-regional hospitalization services utilization by basic medical insurance participants in China − taking a central province as an example

BackgroundThe geographically uneven distribution of healthcare resources has resulted in a dramatic increase of cross-regional hospitalization services in China. The over-use of cross-regional hospitalization services may hinder the utilization and improvement of local hospitalization services. It is of great practical significance to study the utilization of cross-regional hospitalization services and its influencing factors in order to effectively allocate medical resources and guide patients to seek medical treatment rationally. Therefore, this study aims to analyze the current situation and influencing factors of the utilization of cross-regional hospitalization services by patients insured by basic medical insurance in China.MethodsA total of 3,291 cross-provincial inpatients were randomly selected in a central province of China in 2020. The level of medical institutions, hospitalization expenses and actual reimbursement rate were selected as indicators of hospitalization service utilization. Exploratory factor analysis was used to assess the dimensionality of influencing factors and reduce the number of variables, and binomial logistic regression analysis and multiple linear regression analysis to explore the influencing factors of the utilization of cross-regional hospitalization services.ResultsThe proportion of cross-provincial inpatients choosing tertiary hospitals was the highest with average hospitalization expenses of 24,662 yuan and an actual reimbursement rate of 51.0% on average. Patients insured by Urban Employees’ Basic Medical Insurance (UEBMI) were more frequently (92.9% vs. 88.5%) to choose tertiary hospitals than those insured by Urban and Rural Residents’ Basic Medical Insurance (URRBMI), and their average hospitalization expenses (30,727 yuan) and actual reimbursement rate (68.2%) were relatively higher (p < 0.001). The factor “income and security,” “convenience of medical treatment” and “disease severity” had significant effects on inpatients’ selection of medical institution level, hospitalization expenses and actual reimbursement rate, while the factor “demographic characteristics” only had significant effects on hospitalization expenses and actual reimbursement rate.ConclusionCross-provincial inpatients choose tertiary hospitals more frequently, and their financial burdens of medical treatment are heavy. A variety of factors jointly affect the utilization of cross-provincial hospitalization services for insured patients. It is necessary to narrow down the gap of medical treatment between UEBMI and URRBMI patients, and make full use of high-quality medical resources across regions

Thermal analysis in thin-film fluid regions of rectangular microgroove

The effects of contact angle and superheat on thin-film thickness and heat flux distribution occurring in a rectangle microgroove are numerically simulated. Accordingly, physical, and mathematical models are built in detail. Numerical results indicate that meniscus radius and thin-film thickness increase with the improvement of contact angle. The heat flux distribution in the thin-film region increases non-linearly as the contact angle decreases. The total heat transfer through the thin-film region increases with the improvement of superheat, and decreases as the contact angle increases. When the contact angle is equal to zero, the heat transfer in the thin-film region accounts for more than 80% of the total heat transfer. Intensive evaporation in the thin-film region plays a key role in heat transfer for the rectangle capillary microgroove. The liquid with higher wetting performance is more capable of playing the advantages of higher intensity heat transfer in thin- film region. The current investigation will result in a better understanding of thin- -film evaporation and its effect on the effective thermal conductivity in the rectangle microgroove

Analysis on three-dimensional flow and heat transfer in a cross wavy primary surface recuperator for a microturbine system

In this paper, three-dimensional periodic numerical model for fully developed flow in a cross wavy primary surface recuperator for a microturbine system is built. The performance of flow and heat transfer is analyzed. The fields of flow and temperature in a gas and air channel are obtained. Different working conditions are numerically simulated. Numerical results are compared with experimental data concerned. Analysis results show that the flow in the gas and air channel is anti-symmetry along the centre of channel. The flow of fluid is fluctuant. The flow velocity of gas is much higher than that of air. The thermal ratio of cross wavy primary surface recuperator can reach 95.2%. The thermal ratio decreases with the improvement of gas inlet temperature. When gas inlet temperature increases by 100 K, the thermal ratio decreases by about 1%. The thermal ratio increases with the reduction of flow rate in the channel. When flow rate reduces by 40%, the thermal ratio increases by about 4%. The research results can be used to guide checking the performance of a recuperator

Influence of void ratio on phase change of thermal energy storage for heat pipe receiver

In this paper, influence of void ratio on phase change of thermal storage unit for heat pipe receiver under microgravity is numerically simulated. Accordingly, mathematical model is set up. A solidification-melting model upon the enthalpy-porosity method is specially provided to deal with phase changes. The liquid fraction distribution of thermal storage unit of heat pipe receiver is shown. The fluctuation of melting ratio in PCM canister is indicated. Numerical results are compared with experimental ones in Japan. The results show that void cavity prevents the process of phase change greatly. PCM melts slowly during sunlight periods and freezes slowly during eclipse periods as void ratio increases. The utility ratio of PCM during both sunlight periods and eclipse periods decreases obviously with the improvement of void ratio. The thermal resistance of void cavity is much higher than that of PCM canister wall. Void cavity prevents the heat transfer between PCM zone and canister wall

Finite Element Analysis of Stress on Cross-Wavy Primary Surface Recuperator Based on Thermal-Structural Coupling Model

In order to study the stress, strain and deformation of the recuperator, the thermal-structural coupling finite element analysis model of cross-wavy primary surface recuperator of gas microturbine was established. The stress of cross-wavy primary surface recuperator after operation under design conditions was analyzed by finite element method. The reliability of the material selected for the recuperator was verified, and the effects of pressure ratio and gas inlet temperature on stress and displacement of the recuperator were analyzed. The research results show that the maximum stress and strain on the gas outlet side of the recuperator are higher than the maximum stress and strain on the gas inlet side when only pressure is considered, and the result is the opposite when pressure and thermal stress are considered. The air passage of the recuperator deforms to the side of the gas passage, the air passage becomes larger, and the gas passage shrinks. With the increase of pressure ratio between air side and gas side, the maximum stress of recuperator passage also increases. When the pressure ratio increases to 8.4, the strength limit of the heat exchange fin material is reached. When the gas and air outlet temperatures remain unchanged and the thermal ratio decreases, as the gas inlet temperature increases, the maximum stress increases. For every 50 K increase in the gas inlet temperature, the maximum stress of the recuperator increases by about 2.3 MPa. The research results can be used to guide the designing and optimization of recuperator

Enhanced photoelectrochemical performance of quantum dot-sensitized TiO2 nanotube arrays with Al2O3 overcoating by atomic layer deposition

Conformal Al2O3 overcoating by ALD can drastically enhance the PEC performance of quantum dot-sensitized TiO2 nanotube arrays.</p