Health poverty alleviation is an important practice in implementing the basic strategy of precision poverty alleviation. It is also an important measure to win the battle against poverty in rural areas. Through the investigation of local medical and health conditions, West China Hospital of Sichuan University built a demand-oriented framework for medical poverty alleviation in Ganzi Prefecture, and gradually carried out precision top-level design, discipline construction, technical training, talent training, endemic disease prevention and control; through establishinga regional medical cooperation network, built featured specialies, built the backbone of medical and health forces, achieved the prevention of endemic diseases throughout life cycle, and improved the overall medical and health service capacity of Ganzi Prefecture. This article introduces the exploration and practice of the demand-oriented model in Ganzi Prefecture by West China Hospital of Sichuan University, aiming at providing a guide for the precision health poverty alleviation in China.
ObjectiveTo discuss the impact of health education for the patients with decompensated cirrhosis and their family members on patients' family life quality, psychological conditions, medication compliance, and re-admission rates.
MethodsWe selected 100 decompensated cirrhosis patients between December 2012 and December 2013, and randomized them into two groups with 50 patients in each. One week prior to discharge, we conducted a comprehensive nursing assessment for the patients and developed hospital care regimen. Patients were followed up after discharge for six months. The control group underwent routine health education and extended care, while the experimental group had an addition of health education and extended care intervention on their family members.
ResultsAnxiety and depression were alleviated in both the two groups. The psychological conditions of patients in the experimental group were significantly better than the control group (P<0.01). The total scores of quality of life was significantly different compared with the scores before intervention (P<0.01). Medication compliance improved more significantly in the experimental group after intervention (P<0.05). Re-admission rates decreased more significantly in the experimental group than the control group (P<0.01).
ConclusionHealth education and extended care intervention for patients and their family members can improve patients' psychological conditions, promote medication compliance, reduce readmission rates, and improve patients' quality of family life.
The shortage of health workforce in rural and remote areas has been commonly concerned by every country around the word. It is one of world health issues, challenging the aspirations of achieving equity. In this regard, WHO developed the Global Policy Recommendations to improve the accessibility of the health workforce in rural and remote areas through improved retention. This article focuses on the key steps of the policy guideline developed from evidence-based medicine methodology and from angle of guideline development, mainly about background, issues, evidence retrieval and selection, quality grading of evidence, and the forming of recommendation plan, in order to further explore how to correctly understand, obtain, evaluate and apply currently available research evidence, and how to use the GRADE system to make scientific and feasible recommendations in the decision-making process, emphasizing the importance of evidence and the GRADE system in the evidence-based health decision-making.
Objective To investigate current situation of medical service and management in Gaozha Central Township Health Center (GzC), so as to provide baseline data for township health centers in both key techniques research and product development of drugs allocation and delivery. Methods A questionnaire combined with a special interview was carried out, which included the general information, human resources, medical service and management, and the practice of essential medicine list. Results a) The hardware condition of GzC was not good enough, and the economic status of the service recipients was lower than the average level of both Wuzhong City and China mainland; b) The constituent ratio of general practitioner (GP) and nurse, and GP and laboratorian were all lower than those of national level, while, the constituent ratio of GP and technician was a little bit higher. GzC was in short of medical technical personnel and, especially, the professional pharmacists. The logistics technical workers were as the same proportion as the nurses. The medical technical personnel without professional education background accounted for 3.4%, and about 38% of the staff members had no college degree, about 86.2% had at most primary profession titles. There was no personnel turnover of GzC in recently years; c) The bed utilization ratio was lower than national level (46.4% vs. 60.7%), while the average duration of stay and the in-patient and out-patient service workload of GP were longer or heavier than national level (8 vs. 4.8, 9 vs. 8.3, 4 vs. 1.3); d) The out-patient service in 2010 decreased 26.9% compared to 2009; and the in-patient service in 2010 decreased 42.4%; e) The average medical expense per outpatient and per inpatient increased 127.3% and 56.2%, respectively in 2010 compared to 2009; and f) Essential medicine list was put into practice in April 1st of 2010 and there was only 195 species available in GzC, which has not met the requirements of the national essential medicine list. Conclusion In order to meet the standards of general rural township health center in western China, GzC needs to cope with challenges of insufficient hardware conditions, short of staff, unreasonable personnel structure, low educational background and professional title of the staff, none human resources flow and low technical level of medical service. GzC dose well in drug expenses control, and the hospitalization costs are lower than those of the national level. However, it increases rapidly in 2010. The management of GzC may be influenced by zero-profit sale of the essential drugs, and appropriate subsidy and policy support are necessary to maintain its service quality. And it is required to complement the medicine based on the evidences, to carry out staff training and usage guidance of essential medicine, and to finally guarantee the safe and reasonable use of medicines.
ObjectivesTo evaluate the quality of health information on diabetes in Chinese internet, so as to understand the current status of diabetes network health information, and provide reference for improving and enriching the three-level prevention of diabetes.MethodsThe three most common Chinese search engines: Baidu, Sogou and Haosou Search were searched with the keywords " diabetes” and " diabetes treatment”, using the health information evaluation tool DISCERN score to evaluate the quality of the information, and the integrity and accuracy of information content were evaluated with reference to the " Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 Edition)” issued by the Chinese Diabetes Society of Chinese Medical Association.ResultsA total of 300 links were accessed and included in 17 websites. The DISCERN review showed that only 1 item's average score exceeded 3 points. According to website content score, the excellent part accounted for 11.7%, the good part accounted for 35.2%, the fair part accounted for 47.1%, and the poor part accounted for 5.8%. 50% of websites contained error messages, and the subject of the most error-prone information was diagnosis and treatment. There was a positive correlation between the content score and the DSCERN score in the credibility score and the verbosity score (r=0.71, 0.73, P<0.001). The websites were evaluated by attributes, and the quality evaluation of diabetes-related information in some general-purpose websites was higher than that of diabetes specialist websites.ConclusionsThe quality of diabetes health information on Chinese websites is insufficient. It is necessary for China to establish a web-based information platform for diabetes. China has not yet formed a unified network health information evaluation standard in line with its national conditions. The key to solving the problem lies in the collaboration between professional health personnel and website developers.
Objective
To investigate the correlation between the initial arterial blood lactic acid and Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score in trauma patients and its value in prognosis.
Methods
From August 1st 2015 to July 31st 2016, the clinical data of trauma patients treated in Department of Emergency were analyzed retrospectively. All patients were divided into survival group and death group by observing 28-day prognosis. We compared the relationship between the initial blood lactate level and APACHEⅡ score, and analyzed the relationship between the above indexes and the prognosis of the patients.
Results
A total of 743 patients were enrolled, with692 in survival group and 51 in death group.The APACHEⅡ score and initial blood lactate level in the survival group [(9.93±4.62) points, (2.02±1.44) mmol/L] were significantly lower than those in the death group [(22.84±7.26) points, (4.60±3.69) mmol/L] with significant differences (t=18.20, 9.77; P<0.01). The APACHEⅡ score and the mortality rate of patients with lactic acid level >4 mmol/L were significantly higher than those of patients with lactic acid of 2-4 mmol/L and <2 mmol/L; the differences were significant (P<0.05). The blood lactate and mortality in patients with APACHEⅡ score >20 were significantly higher than those in the patients with ≤10 and 11-20; the differences were significant (P<0.05). There was a significant positive correlation between initial blood lactate level and APACHEⅡ score (r=0.426, P<0.01).
Conclusions
The initial blood lactate level and APACHEⅡ score of trauma patients are correlated with the severity of injury and mortality. Both of the increase of initial blood lactic acid level and APACHEⅡ score suggest the risk of death in trauma patients.
The study investigates the current status of corporate governance structures in medical insurance agencies in typical cities and provinces in China, highlighting the challenges faced by corporate governance in these institutions. It advocates for the continued comprehensive promotion of the nationwide establishment of a unified corporate governance framework for medical insurance agencies. Furthermore, it recommends enhancing the legislative support system for corporate governance in medical insurance agencies to ensure the effective implementation of decision-making powers within these organizations. Additionally, the study proposes actively establishing social evaluation and supervision mechanisms for corporate governance to further enhance the corporate governance structure of medical insurance agencies in China.
ObjectiveTo carry out health education to day surgery patients, assist the smoothness of their operation, promote early recovery of patients and improve the quality of nursing and patients' degree of satisfaction.
MethodsA total of 1 888 operations from January to May, 2013 were chosen to be the control group; and 2 136 operations from January to May, 2014 were regarded as the trail group. Patients in the control group accepted routine nursing and health education, while patients in the trail group accepted health education before and after surgery, and through telephone during the follow-up period.
ResultsThe rate of failure to keep the appointment, the readmission rates, and the satisfaction rate to the nursing work were 0.28%, 0.94% and 94.71% respectively in the trial group, while were 3.50%, 3.07%, and 90.20%, respectively in the control group. the differeces between the two groups were significant (P<0.05).
ConclusionPersonalized health education can ensure the smooth operation of day surgery, advance wound healing of the patients, and improve the day surgery ward care quality and patient satisfaction.
Objective To learn and evaluate the effect of health education of schistosomiasis in the Three Gorges Reservoir Area, so as to provide scientific basis for establishing the comprehensive prevention and control model in potential epidemic area of schistosomiasis. Methods Through adopting the multi-stage stratified cluster sampling method, the questionnaires were distributed to residents selected randomly from the demonstration, inside and outside control areas. The survey data were input with EpiData 3.0 software by two reviewers, and the differences among groups were analyzed by using SPSS 18.0 software to further evaluate the effect of health education of schistosomiasis. Results All the questionnaires distributed to 1 420 residents were retrieved (100%). The results of analysis showed that for the residents in the demonstration area, the average score of being aware of schistosomiasis prevention was (7.51±2.89), which was markedly higher than those in the inside (2.52±2.97) and the outside (3.13±3.51) control areas, with significant differences (Plt;0.05); and the passing rates were 78.15%, which was also obviously higher than those in the inside (17.26%) and the outside control areas (32.16%), with significant differences (Plt;0.05). Conclusion The health education of schistosomiasis can improve residents’ knowledge about schistosomiasis prevention, and it is very important to prevent and control the potential prevalence of schistosomiasis in the Three Gorges Area.
