Participating in patients for patient safety program will help place patients at the center of efforts to improve patient safety. This paper presented a brief introduction to patients for patient safety program and its significance and functions.
In the context of actively coping with aging, China has introduced a series of health care integration policies. Using the advocacy coalition framework theory, this paper aims to analyze the process of health care integration policy changes in China from three dimensions: policy beliefs, external events and policy learning. The policy subsystem of health care integration in China includes two coalitions: top-down cascade promotion and bottom-up absorption and radiation. External events and policy learning triggered policy change, where policy learning included endogenous learning within the coalition and exogenous learning between the coalitions. A policy impasse occurs when the two advocacy coalitions are at odds, and policy brokers and professional forums can get rid of the policy impasse. In the process of policy change in China’s health care integration, the two major advocacy coalitions have reached a certain consensus. It is recommended to alleviate the problems in the integration of health care by strengthening the external factors in the change of health care policy, enhancing the policy learning in the change of health care policy, and making full use of the information resources in the change of health care policy, so as to promote the high-quality development of the integration of health care.
ObjectiveTo explore the comprehensive hospital administrative management system for urban and rural cooperation in the process of medical reform.
MethodsBy reviewing literature and interviewing directors of the administrative departments and hospital medical staff, we gradually established and improved the administrative management system for urban and rural hospital counterpart support.
ResultsBetween 2010 and 2013, 123 medical workers were dispatched to support eight county-level hospitals, after which the comprehensive capacity, and technology and quality control in those hospitals were largely improved. Till the end of 2013, two of those hospitals were promoted to be grade-three class-B comprehensive hospitals; two were promoted as grade-two class-A comprehensive hospitals; three passed the reassessment to be grade-two class-A comprehensive hospitals; and another three county-level medical centers were promoted to be city-level key disciplines.
ConclusionThe comprehensive administrative management system improves the management level of grass-roots hospitals at the county level; promotes the social public welfare of tertiary public hospital counterpart support; facilitates the process of medical system reform at the county level; establishes a series of administrative management modes such as unified support, personnel management, assessment standards and evaluation system; and promotes the sustainability of long-term counterpart support system.
This paper introduces the concept, characteristics, similar concepts, system of knowledge, theoretic model and typical example of improvement science in health care sector, and analyzes a project of quality improvement in order to demonstrate the practical implication. It attempts to provide evidence and reference for future relative studies.
Objective To systematically review the prevalence of depression and anxiety among health care workers in designated hospitals during the COVID-19 pandemic. Methods The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect cross-sectional studies on the prevalence of depression and anxiety among health care workers from December 2019 to April 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. Results A total of 21 cross-sectional studies were included, involving 38 372 participants. Meta-analysis results showed that during the COVID-19 epidemic, the prevalence of depression and anxiety among health care workers in designated hospitals were 31.00% (95%CI 0.25 to 0.37) and 44.00% (95%CI 0.34 to 0.53). The results of subgroup analysis showed that individuals of female, married, bachelor degree or above, nurses, junior professional titles, and non-first-line medical staff had higher prevalence of depression and anxiety. Conclusions During the COVID-19 pandemic, the incidence of depression and anxiety among health care workers in designated hospitals remain high. Therefore, more attention should be paid to the mental health of health care workers in designated hospitals. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verify the above conclusions.
In Shaanxi, some medical institutions especially the primary medical institutions, have outstanding problems such as unbalanced and inadequate development of infection prevention and control efficiency. The concept, knowledge and attention of infection prevention and control of the medical institution managers need to be improved. With the strong support of the health administration department, the Infection Control Professional Committee of Shaanxi Provincial Preventive Medicine Association has given full play to its functions and explored innovative service models for infection prevention and control in recent years. This paper is written to share the measures and achievements for building a multi-dimensional leadership improvement platform to improve the infection prevention and control ability, aiming to offer a reference for other medical institution managers and infection prevention and control professionals.
ObjectivesTo evaluate the fairness of medical resource allocation in the five provinces in Northwest China from 2006 to 2017 so as to provide scientific basis for the optimal allocation of medical resources in Northwest China.MethodsThe Gini coefficient and Theil index were adopted to evaluate the fairness of medical resource allocation from the two dimensions of population and geography.ResultsThe Gini coefficient was above 0.4 in terms of population allocation and geographical distribution in the five provinces in Northwest China from 2006 to 2011, which indicated the medical resources were unbalanced in the five provinces. The Gini coefficient had gradually declined from 0.4 from 2012 to 2017, which indicated the equity of medical resource allocation in the five provinces in Northwest China had gradually become reasonable. The total Thiel index of medical resources in the five northwest provinces in Northwest China from 2006 to 2017 ranged from 0.0829 to 0.187 4. Equity of medical resource allocation: allocation by population was superior to that by geography.ConclusionsIt is necessary to optimize the structure of human medical resources in the five northwest provinces, promote the coordinated development of medical human resources allocation, and narrow the gap of medical resources among the five provinces in Northwest China.
Objective To explore the research progress of the multimodal clinical support system (CSS). Methods With recognized development and operation of the multi-model CSS, and compared to the traditional CSS, to explore the research progress of the multimodal CSS. Results Based on the realization of the concept, purpose and characteristics of the multimodal CSS, it has been known that the international research progress of the multimodal CSS. Conclusion The developing and evolving of the CSS model have offered a new assist to the multi-disciplinary treatment model, and have enhanced the improving system associated with the practice of evidence-based medicine. However, the application of clinical support system program (CSSP) in our country still needs more research.
ObjectiveTo analyze the choice of initial antibiotic treatment for health care-associated pneumonia (HCAP).
MethodA retrospective study was conducted in patients with HCAP hospitalized in the Emergency Department of West China Hospital from January 1st to December 31st, 2014. A total of 156 HCAP patients were divided into anti-multidrug-resistant treatment group (group A, n=72) and quinolone monotherapy group (group B, n=84). The baseline characteristics, comorbidities, severity, pathogen distribution, antibiotics and clinical outcomes were compared between the two groups.
ResultsIn group B, there were 46 males and 38 females with the age of (59.9±10.9) years, and the pneumonia severity index (PSI) score was 89.5±22.7; in group A, there were 44 males and 28 females with the age of (62.2±12.2) years, and the PSI score was 94.4±23.6. The differeces between the two groups were not significant (P>0.05). The duration of using antibiotics in group B was (14.5±3.7) days, which was longer than that in group A[(12.8±3.8) days, P=0.005]. The detection rate of multidrug-resistant bacteria, the proportion of changing antibiotics, the average length of hospitalization, the proportion of using mechanical ventilation, the proportion of patients transferred into Intensive Care Unit and 30 days mortality in group B was 17.9%, 34.5%, (16.9±3.6) days, 11.9%, 9.5%, and 4.8%, respectively; which were similar to those in group A[15.3%, 22.2%, (17.3±3.9) days, 16.8%, 12.5%, and 4.2%, respectively] (P>0.05).
ConclusionsIt is unnecessary for all HCAP patients to receive anti-multidrug-resistant treatment. We should regard the risk factors and the popular local features of microbiology to determine the choice of antibiotic treatment.
