A novel method case-based reasoning was proposed for suspicious behavior recognition. The method is composed of three departs: human behavior decomposition, human behavior case representation and case-based reasoning....A novel method case-based reasoning was proposed for suspicious behavior recognition. The method is composed of three departs: human behavior decomposition, human behavior case representation and case-based reasoning. The new approach was proposed to decompose behavior into sub-behaviors that are easier to recognize using a saliency-based visual attention model. New representation of behavior was introduced, in which the sub-behavior and the associated time characteristic of sub-behavior were used to represent behavior case. In the process of case-based reasoning, apart from considering the similarity of basic sub-behaviors,order factor was proposed to measure the similarity of a time order among the sub-behaviors and span factor was used to measure the similarity of duration time of each sub-behavior, which makes the similarity calculations more rational and comprehensive.Experimental results show the effectiveness of the proposed method in comparison with other related works and can run in real-time for the recognition of suspicious behaviors.展开更多
Applying high-speed machining technology in shop floor has many benefits, such as manufacturing more accurate parts with better surface finishes. The selection of the appropriate machining parameters plays a very impo...Applying high-speed machining technology in shop floor has many benefits, such as manufacturing more accurate parts with better surface finishes. The selection of the appropriate machining parameters plays a very important role in the implementation of high-speed machining technology. The case-based reasoning is used in the developing of high-speed machining database to overcome the shortage of available high-speed cutting parameters in machining data handbooks and shop floors. The high-speed machining database developed in this paper includes two main components: the machining database and the case-base. The machining database stores the cutting parameters, cutting tool data, work pieces and their materials data, and other relative data, while the case-base stores mainly the successfully solved cases that are problems of work pieces and their machining. The case description and case retrieval methods are described to establish the case-based reasoning high-speed machining database. With the case retrieval method, some succeeded cases similar to the new machining problem can be retrieved from the case-base. The solution of the most matched case is evaluated and modified, and then it is regarded as the proposed solution to the new machining problem. After verification, the problem and its solution are packed up into a new case, and are stored in the case-base for future applications.展开更多
目的:全面分析疾病诊断相关分组(diagnosis related groups,DRG)支付方式对肺结核住院患者治疗费用的影响,为政策制定提供科学依据。方法:采用回顾性研究方法,选取2017年6月15日至2024年6月14日首都医科大学附属北京胸科医院收治的以肺...目的:全面分析疾病诊断相关分组(diagnosis related groups,DRG)支付方式对肺结核住院患者治疗费用的影响,为政策制定提供科学依据。方法:采用回顾性研究方法,选取2017年6月15日至2024年6月14日首都医科大学附属北京胸科医院收治的以肺结核为主要诊断的20369例患者为研究对象,以2022年实施DRG时间为节点,将患者分为实施前组(11653例)和实施后组(8716例)。通过双重差分(difference-in-differences,DID)模型控制年龄、性别、住院天数等变量后分析DRG政策的净效应,并利用平行趋势检验验证模型假设。结果:DRG实施后,患者住院天数由实施前的12d下降为6d,住院总费用中位数(16588.04元)相较于DRG实施前(20411.17元)降幅达18.88%;其中,药品费降幅为60.07%[(2801.14-7015.36)/7015.36],治疗费降幅为14.77%[(804.75-944.20)/944.20],但检查费微增了1.83%[(1066.20-1047.00)/1047.00],各项指标实施前后的差异均有统计学意义(U=-51.354,P<0.001;U=-25.708,P<0.001;U=-42.403,P<0.001;U=-17.628,P<0.001;U=-3.106,P=0.002)。平行趋势检验显示存在政策效应。DID模型分析显示,政策净效应使总费用、检查费、治疗费、药品费分别下降了32.20%、52.80%、48.00%和36.80%。结论:DRG支付改革显著缩短了肺结核患者住院天数,降低了患者住院费用,尤其在药品和治疗费用方面效果突出,体现了预付制对医疗成本控制的积极作用,对减轻患者负担、提高医保基金效率方面具有潜力,为结核病防治的支付改革提供了实证支持。但需关注检查费用的结构性变化,进一步细化分组标准、优化诊断流程。展开更多
目的:系统分析各类医生薪酬支付方式对医疗服务提供行为及结果的影响。方法:采用范畴综述法,以Web of Science和中国知网、维普及万方为数据源,“医生”“薪酬”“支付方式”和“医生行为”等为主题词,检索到相关文献2255篇,通过制定严...目的:系统分析各类医生薪酬支付方式对医疗服务提供行为及结果的影响。方法:采用范畴综述法,以Web of Science和中国知网、维普及万方为数据源,“医生”“薪酬”“支付方式”和“医生行为”等为主题词,检索到相关文献2255篇,通过制定严格的筛选程序最终纳入70篇相关研究。结果:按项目支付激励医生提供足量服务,但易导致过度医疗;固定薪水与按人头支付有助于控制成本,但易引发服务不足;DRG/DIP在医疗服务数量与质量方面的优势随患者病情加重而减弱。混合支付方式能够有效平衡医疗服务数量与成本,而按绩效支付在医疗质量提升方面总体表现突出。结论:医生薪酬单一支付方式难以实现医疗服务提供行为及结果最优化,且质量导向不足,多种支付方式与质量激励相融合的混合支付体系亟待构建。同时,建议深化医保结余薪酬转化机制改革,充分落实公立医院分配自主权,加快建立与医保支付和绩效考核协同的医生薪酬混合支付方式。展开更多
目的基于德尔菲法筛选出国家医疗保障疾病诊断相关分组(ChinaHealthcare Security Diagnosis Related Groups,CHS-DRG)付费下医保基金监管指标,提高医疗机构医保基金监管效能。方法采用德尔菲法,选择医保专业领域专家32人,通过两轮专家...目的基于德尔菲法筛选出国家医疗保障疾病诊断相关分组(ChinaHealthcare Security Diagnosis Related Groups,CHS-DRG)付费下医保基金监管指标,提高医疗机构医保基金监管效能。方法采用德尔菲法,选择医保专业领域专家32人,通过两轮专家问卷咨询,设计CHS-DRG付费下医保基金监管指标测评量表。咨询结果从积极性、权威性、协调性等3个方面进行测评。结果构建基于医保基金使用质量、效率和安全监管3个维度的医保基金监管指标体系,包含3个一级指标、7个二级指标、44个三级指标。结论CHS-DRG付费下医保基金监管指标体系构建应尊重临床诊疗实际,强化智能化监管方式,及时干预医保基金管理风险。展开更多
基金Project(50808025)supported by the National Natural Science Foundation of ChinaProject(2013GK3012)supported by the Science and Technology Project of Hunan Province,China
文摘A novel method case-based reasoning was proposed for suspicious behavior recognition. The method is composed of three departs: human behavior decomposition, human behavior case representation and case-based reasoning. The new approach was proposed to decompose behavior into sub-behaviors that are easier to recognize using a saliency-based visual attention model. New representation of behavior was introduced, in which the sub-behavior and the associated time characteristic of sub-behavior were used to represent behavior case. In the process of case-based reasoning, apart from considering the similarity of basic sub-behaviors,order factor was proposed to measure the similarity of a time order among the sub-behaviors and span factor was used to measure the similarity of duration time of each sub-behavior, which makes the similarity calculations more rational and comprehensive.Experimental results show the effectiveness of the proposed method in comparison with other related works and can run in real-time for the recognition of suspicious behaviors.
文摘Applying high-speed machining technology in shop floor has many benefits, such as manufacturing more accurate parts with better surface finishes. The selection of the appropriate machining parameters plays a very important role in the implementation of high-speed machining technology. The case-based reasoning is used in the developing of high-speed machining database to overcome the shortage of available high-speed cutting parameters in machining data handbooks and shop floors. The high-speed machining database developed in this paper includes two main components: the machining database and the case-base. The machining database stores the cutting parameters, cutting tool data, work pieces and their materials data, and other relative data, while the case-base stores mainly the successfully solved cases that are problems of work pieces and their machining. The case description and case retrieval methods are described to establish the case-based reasoning high-speed machining database. With the case retrieval method, some succeeded cases similar to the new machining problem can be retrieved from the case-base. The solution of the most matched case is evaluated and modified, and then it is regarded as the proposed solution to the new machining problem. After verification, the problem and its solution are packed up into a new case, and are stored in the case-base for future applications.
文摘目的:全面分析疾病诊断相关分组(diagnosis related groups,DRG)支付方式对肺结核住院患者治疗费用的影响,为政策制定提供科学依据。方法:采用回顾性研究方法,选取2017年6月15日至2024年6月14日首都医科大学附属北京胸科医院收治的以肺结核为主要诊断的20369例患者为研究对象,以2022年实施DRG时间为节点,将患者分为实施前组(11653例)和实施后组(8716例)。通过双重差分(difference-in-differences,DID)模型控制年龄、性别、住院天数等变量后分析DRG政策的净效应,并利用平行趋势检验验证模型假设。结果:DRG实施后,患者住院天数由实施前的12d下降为6d,住院总费用中位数(16588.04元)相较于DRG实施前(20411.17元)降幅达18.88%;其中,药品费降幅为60.07%[(2801.14-7015.36)/7015.36],治疗费降幅为14.77%[(804.75-944.20)/944.20],但检查费微增了1.83%[(1066.20-1047.00)/1047.00],各项指标实施前后的差异均有统计学意义(U=-51.354,P<0.001;U=-25.708,P<0.001;U=-42.403,P<0.001;U=-17.628,P<0.001;U=-3.106,P=0.002)。平行趋势检验显示存在政策效应。DID模型分析显示,政策净效应使总费用、检查费、治疗费、药品费分别下降了32.20%、52.80%、48.00%和36.80%。结论:DRG支付改革显著缩短了肺结核患者住院天数,降低了患者住院费用,尤其在药品和治疗费用方面效果突出,体现了预付制对医疗成本控制的积极作用,对减轻患者负担、提高医保基金效率方面具有潜力,为结核病防治的支付改革提供了实证支持。但需关注检查费用的结构性变化,进一步细化分组标准、优化诊断流程。
文摘目的:系统分析各类医生薪酬支付方式对医疗服务提供行为及结果的影响。方法:采用范畴综述法,以Web of Science和中国知网、维普及万方为数据源,“医生”“薪酬”“支付方式”和“医生行为”等为主题词,检索到相关文献2255篇,通过制定严格的筛选程序最终纳入70篇相关研究。结果:按项目支付激励医生提供足量服务,但易导致过度医疗;固定薪水与按人头支付有助于控制成本,但易引发服务不足;DRG/DIP在医疗服务数量与质量方面的优势随患者病情加重而减弱。混合支付方式能够有效平衡医疗服务数量与成本,而按绩效支付在医疗质量提升方面总体表现突出。结论:医生薪酬单一支付方式难以实现医疗服务提供行为及结果最优化,且质量导向不足,多种支付方式与质量激励相融合的混合支付体系亟待构建。同时,建议深化医保结余薪酬转化机制改革,充分落实公立医院分配自主权,加快建立与医保支付和绩效考核协同的医生薪酬混合支付方式。
文摘目的基于德尔菲法筛选出国家医疗保障疾病诊断相关分组(ChinaHealthcare Security Diagnosis Related Groups,CHS-DRG)付费下医保基金监管指标,提高医疗机构医保基金监管效能。方法采用德尔菲法,选择医保专业领域专家32人,通过两轮专家问卷咨询,设计CHS-DRG付费下医保基金监管指标测评量表。咨询结果从积极性、权威性、协调性等3个方面进行测评。结果构建基于医保基金使用质量、效率和安全监管3个维度的医保基金监管指标体系,包含3个一级指标、7个二级指标、44个三级指标。结论CHS-DRG付费下医保基金监管指标体系构建应尊重临床诊疗实际,强化智能化监管方式,及时干预医保基金管理风险。
