Journal of the Chinese Medical Association : JCMA
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Comparative Study
Determination of the painful level in osteoporotic vertebral fractures--Retrospective comparison between plain film, bone scan, and magnetic resonance imaging.
Determining the actual painful vertebral level is difficult when evaluating osteoporotic vertebral fracture, especially when there are acute and chronic fractures simultaneously. In this study, we retrospectively evaluated and compared the findings between plain film, bone scan, and magnetic resonance imaging (MRI) in the diagnosis of new fracture in osteoporotic vertebral fractures. ⋯ For patients with single-level compression fracture, the painful level in osteoporotic vertebral fractures can be determined by plain film and bone scan testing. Vacuum cleft sign noted on plain film may be enough to localize the level of pain. However, MRI testing is further needed in multiple osteoporotic vertebral fracture patients.
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Chronic obstructive pulmonary disease (COPD) has been associated with increased oxidative stress or reduced antioxidant resources. The main goal of this study was to evaluate the levels of serum ischemia-modified albumin (IMA), oxidized low-density lipoprotein (ox-LDL), total oxidant status (TOS), and total antioxidant status in patients with stable COPD, compared with a control group. ⋯ Our study indicated that serum IMA, ox-LDL, and TOS may be increased as a result of chronic hypoxia, inflammation, and oxidative stress in patients with severe and very severe stable COPD. Our findings also revealed that IMA is higher in patients with Global Initiative for Chronic Obstructive Lung Disease Stages II, III, and IV, while TOS and ox-LDL are higher in patients with Global Initiative for Chronic Obstructive Lung Disease Stage IV. Measurements of serum IMA, TOS, and ox-LDL levels may be useful markers in the evaluation of stable COPD.
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Comparative Study
Effects of diagnosis-related group payment on health-care provider behaviors: A consecutive three-period study.
This study aimed to evaluate the impact of diagnosis-related group (DRG) payments on health-care providers' behavior and the potential best course of action to make a profit under a DRG payment mechanism. ⋯ The introduction of DRG payment resulted in significantly reduced examination fee, slightly decreased medical costs without significant difference in several detailed items, a reduced number of GA cases without statistical significance, and more patients receiving additional operations. The possible solution to make a profit under the DRG payment scheme is to curtail the costs of radiological images and medication, lower GA percentage, perform fewer additional operations, and correct recording of complications or comorbidities.
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Review
Overview of the health care system in Hong Kong and its referential significance to mainland China.
Hong Kong's health system was established within the framework of a perfect market-oriented economic matrix, where there are wide-ranging social security and medical service systems. There are many differences in the economic foundations, social systems, and ideologies between Hong Kong and mainland China, therefore, it would probably be entirely impossible to copy Hong Kong's health care system mode. However, under the framework of one country, two systems, the referential significance of relevant concepts of Hong Kong's medical service system to mainland China cannot be ignored, and merits further study.
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Total joint replacement (TJR) accounts for a substantial proportion of the total expenditures for health care. Efficient utilization of health resources requires information regarding the trends of TJR. This study investigated the association of TJR with the demographic characteristics in Taiwan from 1998 to 2009. It also estimated the demand for total knee replacement (TKR) and total hip replacement (THR) in the next two decades. ⋯ This study gives an insight into the current status burden of TJR in Taiwan. TJR rate projection would be useful for future planning of budget and resources for TJR in Taiwan.