Objective To investigate the disease constitution of Yaqian Township Health Center (YQT) in Xiaoshan District of Zhejiang Province from 2008 to 2010, so as to provide baseline data for further study. Methods Questionnaire and focus interview were carried out to collect inpatients’ case records from 2008 to 2010. The first diagnoses were classified according to ICD-10, and the data of discharge diagnoses were rearranged and analyzed by using Excel 2003 and SPSS 13.0 software. Results a) The total numbers of inpatients were 182, 195 and 248 from 2008 to 2010, respectively; b) The disease spectrum included 9-14 categories, which accounted for 47.6%-66.7% of ICD-10; c) The top 6 systematic diseases accounted for 37.37%-75.39%, which included the circulatory, injury, digestive, respiratory, neoplasms and urinary and reproductive systematic diseases; d) A total of 8 of the top 15 single diseases were the same, including hypertension, great saphenous vein varices, redundant prepuce, lung cancer, fracture, superficial injuries, acute appendicitis, and inguinal hernia; and e) The constitution ratio of the chronic diseases, compared with the acute ones, was higher in 2008, but lower in 2009 and 2010. Conclusion a) In recent three years, the main systematic diseases seen in YQT have been circulatory, injury, digestive, respiratory, neoplasms, and urinary and reproductive systematic diseases. The newly increased diseases in 2010 were pregnancy, childbirth and puerperium. The acute diseases mainly are fracture and injure, while the chronic diseases mostly are hypertension; b) A total of 8 of the top 15 single diseases are the same, indicating the stability of the common inpatients’ diseases; and c) Attention should be paid in future to the chronic diseases management, women’s health and specialized subject construction.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
ObjectiveTo investigate the guidance centers for promoting equalization of basic public health services in Sichuan province, in order to provide evidence for construction and development.
MethodsBy questionnaire survey, we collected relevant information and data about the guidance centers at all levels in Sichuan province. The EpiData 3.0 was used to establish a database and the SPSS 16.0 was used to analyze data.
ResultsA total of 202 guidance centers had been set up in Sichuan province. All disciplines of the basic public health services were covered by these centers. There were 2 020 technicians, whose average age was 41.37, more had college degree, and intermediate professional title. 54.5% of the guidance centers didn't work together, and there were 92.7% part-time technicians. Only 40% city and 20% county guidance centers got working funds. The average working funds of province, city and county were 890 000 yuan per year, 101 000 yuan per year and 89 000 yuan per year, respectively.
ConclusionThe guidance centers of Sichuan province at all levels have effectively promoted the basic public health services project, but we should improve and perfect the management mechanism and guarantee mechanism.
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.
Objective
To investigate and compare the demands of dosage forms and specifications of essential medicine for children in different levels of medical institutions, so as to provide references for selection of essential medicines for children by levels of medical institutions.
Methods
In 13 provinces or municipalities, 104 medical institutions, including tertiary, secondary and primacy medical institutions, were investigated by questionnaires. Kinds of drugs, dosage forms, requirement types and requirement levels of drugs were analyzed and compared in different levels of medical institutions.
Results
Tertiary medical institutions had higher demands than other levels of medical institutions for the number of drugs types, dosage forms and level of demand on each drug (P < 0.05), secondary medical institutions were higher than primacy medical institutions (P < 0.05), but community health service centers were the same as township health centers.
Conclusion
The demands of dosage forms and specifications of essential medicine for children in different levels of medical institutions are different. So future studies should develop the essential medicines list for children depend on different levels of care.
Objective To survey the current status of residents’ health examination in township medical units in Shuangliu county, so as to provide references for exploring the residents’ health examination mode suitable for the well-off rural hospitals, and for improving the effects of physical examination. Methods The self-designed questionnaires were made to survey the current situation of health examination for the residents in 24 township medical units in Shuangliu County, including 3 central township hospitals, 3 community health centers and 18 general township hospitals; and the outline was designed to interview the people responsible for managing and implementing the resident’s examination work. The Epidate 3.1 was used for data input, the SPSS 17.0 was used for descriptive statistics and stratified analysis, and the classification method was adopted for qualitative research of personal interview data. Results The number of primary health care units for carrying out residents’ health examination got gradually increased year by year from 2008 to 2010; and all 24 township-level medical units had already carried out that examination by 2010. But some issues still existed such as lower participation rate and ineffective utilization of the archives. Conclusion a) It is necessary to prepare well, enhance organizing, expand publicity, and increase participation rate when primary health care units carry out the health examination for residents; b) It is necessary requires to fasten the informatization construction of health archives, and to quicken the process and analysis of examination information; and c) It is advisable to constantly optimize the examination items according to exam information, to improve the qualification of medical staffs, and to fasten the construction of exam team.
ObjectiveBased on the off-label drug use (OLDU) record application of alprostadil injection (Lipo-PGE1) which was the only one rejected in the Guangdong General Hospital in 2013, we retrospectively investigated all the background information of inpatients' OLDU of Lipo-PGE1 in 2012, so as to provide references for intervention of OLDU and effect evaluation.
MethodsAccording to OLDU in dose record application of clinical departments, we summarized medical orders about inpatients' use of Lipo-PGE1 during hospitalization in 2012 and analyzed OLDU situation according to drug labels. Then, we summarized situation of drug use in all departments, analyzed OLDU incidence in dose, calculated prescribed daily dose (PDD) and drug use density (DUD) in each department to evaluate the degree of OLDU in dose.
Resultsa) A total of 106 576 medical orders involving 8 620 case-times were analyzed. According to the data of cases, medical orders and drug use amount, the OLDU incidences were 34.43%, 25.16% and 41.37%, respectively. Lipo-PGE1 was used in every clinical department in this hospital and OLDU occurred in 69.44% departments (25/36). b) According to the number of medical orders, there were 6 departments with the OLDU incidence in dose > 50% and 5 departments with the OLDU incidence in dose during 50% to 20%. c) The average of PDD of the whole hospital was 12.77 μg. A total of 25 departments' PDDs were off-label, and 10 departments' PDDs were above the average level of the whole hospital. The ICU's PDD was the highest, with 2.35 times more than label dose. d) The PDD in each department was not directly proportional to DUD, which indicated the degree of OLDU in dose was not directly proportional to use intensity. This may be caused by different disease burdens in departments.
ConclusionLipo-PGE1 is widely used in the Guangdong General Hospital where OLDU in dose occurs commonly. Since PDD and DUD reflect different contents, the two indicators should be combined to monitor OLDU.
Objective To compare the cl inical results between high-flexion and standard cruciate-stabling prostheses in total knee arthroplasty (TKA) by using the 36-item short form health survey (SF-36). Methods Between August 2007 and January 2009, 98 patients (106 knees) underwent TKA with standard cruciate-stabl ing prostheses (standard group), and 46 patients (50 knees) underwent TKA with high-flexion prostheses (high-flexion group). In standard group, there were30 males (32 knees) and 68 females (74 knees) with an age of (70.0 ± 3.5) years, including 78 cases (82 knees) of osteoarthritis (OA) and 20 cases (24 knees) of rheumatoid arthritis (RA) with a disease duration of (14.5 ± 3.3) years; the Hospital for Special Surgery Scoring System (HSS) and the range of motion (ROM) were 56.1 ± 21.6 and (89.0 ± 16.1)°, respectively. In high-flexion group, there were 8 males (10 knees) and 38 females (40 knees) with an age of (68.6 ± 8.9) years, including 44 cases (47 knees) of OA and 2 cases (3 knees) of RA with a disease duration of (13.9 ± 4.1) years; the HSS and ROM were 58.9 ± 25.3 and (91.0 ± 19.3)°, respectively. There was no significant difference in the general data (P gt; 0.05) between 2 groups, so the cl inical data of 2 groups had comparabil ity. Results In standard group, poor wound heal ing and persistent headache caused by cerebrospinal fluid leakage occurred in 1 case, respectively. In high-flexion group, transient common peroneal nerve palsy occurred in 1 case. There was significant difference (P lt; 0.05) in the hospital ization expense between standard group [ (39 000 ± 6 000)] and highflexion goup [ (52 000 ± 8 000)]. The follow-up time was 12-26 months (18 months on average) in standard group (91 cases, 98 knees) and 11-19 months (13 months on average) in high-flexion group (44 cases, 47 knees). The SF-36 showed significant difference in role-physical score (P lt; 0.05), but no significant difference in other 7 indices scores (P gt; 0.05). At the final follow-up, the ROM was (129.1 ± 19.2)° in high-flexion group and (123.6 ± 16.7)° in standard group; showing significant difference (P lt; 0.05). The HSS was 91.2 ± 17.6 in high-flexion group and 92.5 ± 14.5 in standard group; showing no significant difference (P gt; 0.05). Conclusion After TKA, the ROM in high-flexion group is superior to that in standard group, but there is no obvious advantages in terms of the HSS and SF- 36 outcomes.
ObjectiveTo investigate the educational background of practitioners from the hospital infection control departments located in the mainland of China and reveal the necessity and employment prospects of setting up a major of hospital infection control for a bachelor degree in universities.MethodsA self-designed questionnaire was used to conduct an online survey on the Shanghai International Forum for Infection Control and Prevention and the WeChat group of nosocomial infection control from March 12th to March 25th, 2018. The convenient sampling method was used to investigate the leader of infection prevention and control department in each hospital. The survey included the regional distribution, attention on nosocomial infection control, existing staff structure, future staff needs and employment prospects of hospitals in 2018, and the attention on nosocomial infection control in the same period in 2014.ResultsA total of 1 654 questionnaires were obtained, from 30 provincial-level regions, including 103 maternal and child health hospitals, 143 other special hospitals, 258 hospitals of traditional Chinese medicine, and 1 150 general hospitals. Hospitals upgraded more attention on nosocomial infection control in 2018 than in 2014 [(3.76±0.98) vs. (2.94±1.14) points; t=-36.112, P<0.001]. Currently, there were 5 068.5 labors engaged in nosocomial infection control. The educational background of the current practitioners was mainly nursing [60.52% (3 067.5)]. In the next 5 years, 83.50% (820/982) of the hospitals that had recruitment plans planed to recruit graduates specialized in the hospital infection control, and respectively, 44.86% (742/1 654) and 17.35% (287/1 654) of the respondents believed that the employment prospects of graduates with bachelor degree specialized in the hospital infection control were good or very good.ConclusionThere is a tremendous demand for the graduates specialized in the hospital infection control, and it is imperative to set up this undergraduate major.
Objectives To evaluate pulmonary physicians’knowledge level about prevention and treatment of chronic obstructive pulmonary disease( COPD) in some urban areas in China. Methods A total of 258 pulmonary physicians were interviewed face-to-face in 24 hospitals from July to October in 2006. The questionnaire included the knowledge of COPD, prescriptions at initial visit and follow-up, pulmonary function test monitoring, assessment and intervention in stable COPD, knowledge and evaluation of the commonly used medicines, the effects of smoking cessation and adopted measures, as well as the knowledge of treatment prospects and patients’ education. Results Eighty-eight percent of pulmonary physicians considered themselves knowledgeable on COPD, and 95% were familiar with the severity classification. Most of them knew about GOLD and Chinese Guideline of Prevention and Treatment to COPD, and paid attention to chest X-ray and pulmonary function test during diagnosis. The standards in evaluation of stable COPD patients were not well understood, and 92% of physicians claimed for pulmonary function test in stable stage. Seventy-nine percent of physicians actively suggested the patients quit smoking. The prescription for COPD patients at iniative and maintenance therapy met the guideline on the whole, but the mucolytic agents were appreciated too much and used too frequently. Thirty-three percent of physicians took it necessary to treat stable COPD,and 69% believed that pharmacotherapy for stable COPD could rersult in satisfactory quality of life.Conclusions In some big cities in China, the pulmonary physicians have good knowledge about COPD. But long-term prevention and intervention, especially in pharmacotherapy, are still unsatisfactory.
