Design and analysis of two groups interrupt time series / 中华流行病学杂志

Interrupted time-series (ITS) is a quasi-experimental design which evaluates the effectiveness of an intervention based on time-series outcome variables. Compared with the single group of ITS, the two groups of ITS can better control the influence of pre-interventional confounding factors and evaluate the effectiveness of the intervention. This paper summarizes the principles and statistical methods of two groups of ITS by an example of evaluating vaccine effect on the incidence of a disease in two cities. The regression model is fitted by Prais-Winsten method and Newey-West method and the results are explained and compared in detail. When the intervention is performed with other confounding interventions at the same time, the two groups of ITS can be more effective to balance the existing trends before the intervention, and evaluate the effectiveness of intervention. The method of two groups of ITS has important practical significance, providing new insights in program evaluation.

The design of interrupted time series and its analytic methods / 中华预防医学杂志

Interrupted time series (ITS) is a statistical method for the quasi-experimental design specific to the outcome of time series, in which the effectiveness of an intervening measure is evaluated by examining change in slope and immediate change in level. The key feature of ITS is that the secular trend of time series prior to the intervention can be effectively controlled so as to accurately estimate the intervention effect. The design principle and statistical method for ITS were illustrated by an example of evaluating halving policy for the expert registration fee in the general hospital of a city. The segmented linear regression was used to fit the above time series data and the results were explained in detail. Meanwhile, the study design and model fitting along with explanations of the results with respect to the effects of two types of successive interventions and on different time-points of an intervention were illustrated as well in this paper. The existed upward or downward trend should be taken into account in order to accurately estimate the intervention effect as it exists in most of the public health surveillance data. Two parameters, known as change in slope and immediate change in level, were employed to evaluate the effect of the intervention. The ITS analysis can be widely applied to the program evaluation as it could enrich methods of the evaluation compared to the traditional model of the program evaluation.

Survey on the service contract signature of primary medical and health institutions in China / 中华医院管理杂志

Objective To understand the status of service contract signing conducted by primary medical and health institutions.Methods A questionnaire survey and in-depth interview methods were used to study the service contract signing at primary health care institutions.Results The contract signing rate of the institutions surveyed was 1 9.1%,and valid contract signing rate was 76%.Senior people above 65 years old accounted for 33.5% of those signers,while hypertension patients accounted for 1 9.5% and diabetes patients for 10.6%.Interviews to the general practitioners team at the primary health institutions found that main factors affecting residents′ intention to sign were drug availability, attraction for signing the services,treatment habits among others.Interviews to the staff the primary health institutions found that contracted services are facing such difficulties as medical staff shortage,lack of motivation,lack of competence among others.Interviews to leaders of the primary health institutions found that the lack of publicity and support of medical insurance also has great influence to service contract signing.Conclusions The enthusiasm of general practitioners and residents to sign up for the service remains to be improved.

Effect of sign-contract service on blood pressure control and patients satisfaction of hyperten-sive patients in primary health centers:Based on investigation in 10 provinces / 中国卫生政策研究

Objective:To investigate the effects of sign-contract services on hypertension patient disease control and the satisfaction of medical staff. Methods:a face-to-face questionnaire survey was conducted among hypertension patients selected from 20 primary health centers in 10 provinces in China. Results:This paper collected 1 ,881 valid questionnaires, and the average age of the population was 65. 72 ± 10. 88. Respondents that received sign-contract services accounted for 53. 88%, and there was no difference between patients who signed the service contract and who did not in terms of demographics. In self-reporting of blood pressure controls, respondents who signed the service contract, aged 40~50 years old, enjoyed the free medical care, preferred to seek medical services from primary a-gencies ( i. e. community health centers and township hospitals) for minor illnesses, controlled their blood pressure better ( P<0. 05 ) . Respondents enjoyed the civil resident medical insurance, preferred to seek medical care from community health centers for minor illnesses and signed the service contract were more likely to be satisfied with their medical practitioner (P<0. 05). After adjusting for age, gender, education level, medical insurance style, patient willingness to seek medical care for minor illnesses, signing service contracts was found to be an independent factor both associated with blood pressure self-control and attitudes towards medical service providers, with the odds ratio of 3. 007 (95%CI:2. 572 -3. 517) and 1. 814 (95%CI: 1. 563 -2. 105) respectively. Conclusion: Contracts are correlated with blood pressure control and satisfaction toward medical practitioners, which means that patients who signed the service contract control their blood pressure better and are more satisfied with their medical deliverers.

Impacts of community health reform pilot on the staff satisfaction in Bao' an District / 中华医院管理杂志

Objective To evaluate impacts of Community Health Reform Pilot in Bao'an District,Shenzhen,on the staff satisfaction in community health centers.Methods Guanlan and Xixiang Street were chosen as treatment group and Songgang Street as comparison group.Date that one year before and after community reform was retrieved from Electronic Information System both from two groups.Double Differences was employed to estimate the impacts of intervention on the staff satisfaction.Results Community Health Reform program resulted in relieving staff financial stress and occupational stress by 42.4％(P＜0.001)and 46.4％ (P＜0.001)respectively and increasing the sense of equity,the sense of achievement,job satisfaction by 67.7 ％ ( P ＜ 0.001 ),54.5 ％ ( P ＜ 0.001 ) and 14.4 ％ ( P ＜ 0.05 )respectively.Conclusion The community reform in Bao 'an district has impact on increasing job satisfaction in treatment group.

Evaluation of the Effect of Bilingual Teaching in the Course of Medical Epidemiology for the 7-year Clinical Medical Undergraduates / 中华医学教育探索杂志

Objective: To understand the effect of bilingual teaching in the course of clinical epidemiology for the 7-year clinical medical undergraduates.Method: There were totally 45 clinical medical undergraduates selected to respond the questionnaire.The method of Focus Group Discussion had been used in the study.Results:91.11% of the students thought bilingual teaching was necessary for them and 73.33% thought the proportion of English teaching was reasonable,but 68.89% of them were not satisfied with the text book.80% said they could understand the teaching on the whole,but not clearly and deeply enough.86.67% of the students were content with the course.Conclusion:Bilingual teaching could help students to improve their professional English capability and English listening level.The key to the interest of bilingual teaching is teacher.The mode of teaching and text book should be improved.

Experimental Study on the Immunoprotective Effect and Mechanism of Action of Specific Active Immunization with Tumor Cell Vaccine / 中国肿瘤生物治疗杂志

Through several murine transplantable tumor models, we studied the immunoprotective effect and mechanism of action of specific active immunization with various tumor cell vaccines (TCV) treated by: (1) Oleum Curcuma Aromatica (OCA, a Chinese anticancer medicament) and its effective monomer ?-elemene; (2) MMC and glutaraldehyde; (3) ~(60)Co and X-ray irradiation; and (4) vaccinia virus (VV) and newcastle disease virus (NDV), including virus infected TCV membrane fraction (Mfr). The reproducible results of immunoprotective effect indicated that the specific active immunotherapy with such TCVs might be of practical value in clinical immunological approaches to cancer therapeutics.