ABSTRACT
Objective To learn the disease status and living conditions of Kaschin-Beck disease (KBD) patients and implementation of related control measures in Aba Autonomous Prefecture,Sichuan Province.Methods A total of 26 KBD villages and 12 non-KBD villages nearby were selected in Aba Autonomous Prefecture with stratified cluster sampling method in the year of 2009 to 2011.One thousand three hundred and forty-seven KBD patients from KBD villages and 447 residents from non-KBD villages were interviewed with a self-designed questionnaire.The investigation includes:①General demographic characteristics such as name,gender,age,educational level,family income,marital status and so on.②The basic information about KBD patients including the time and location of diagnosis,treatment,hand X ray diagnosis taken or not and suffering from dental fluorosis and skeletal fluorosis.③The basic living habits such as drinking water,staple food sources,staple food types,grain storage places,tea-drinking habits and so on.Results A total of 522 (38.8％,522/1 347) KBD patients and 12 (2.7％,12/447) controls were confirmed that their parents were KBD patients.The vast majority of KBD patients (99.0％,1 334/1 347) were diagnosed in county of Chinese Center for Disease Control and Prevention or county level hospitals within 2-5 years after onset of the disease and 97.6％ of them (1 314/1 347) treated their disease by taking painkillers,sodium selenite or vitamin E.Most KBD patients had suffered from dental fluorosis (66.3％,893/1 347) and skeletal fluorosis (59.9％,807/1 347).Both the KBD patients and the controls mainly drank river water and 96.7％ of them (1 716/1 774) took locally grown food,93.5％ of them (1 660/1 775) took barley and corn as staple food in the past (before the year of 2004).But now (from the year of 2004 until now) they mainly drink tap water and 96.9％ of them (1 727/1 783) take commodity grain or two kinds of source food,98.4％ of them (1 765/1 794)changed their staple food to rice and flour.94.1％ of KBD patients (1 267/1 347) used to drink tea.Conclusions The measures of changing water and grain are well implemented in Aba Autonomous Prefecture.The government should improve the overall local KBD disease status and the quality of life of KBD patients by taking health promotion and prevention in key families,strengthening the local medical security system and targeted treatment combined with specific local conditions.
ABSTRACT
Objective:To examine the utilization and cost of outpatient care and their influencing fac-tors among middle and aged peasant-workers in China. Methods:The data of China Health and Retire-ment Longitudinal Study ( CHARLS) collected in 2011-2012 were used and the data on peasant-workers aged 45 years and older were analyzed with Two-part Model. Results: The four-week outpatient rate of middle and aged peasant-workers was 13. 7% (407/2 974). The determinants of the rate included gen-der, marital status, economic level, household size, the place of insurance enrollment, self-assessed health and having or having no chronic diseases. The average outpatient cost was (400. 3 ± 56. 7) yuan (RMB) and the median was 138. 0 yuan. Multivariate analyses showed that outpatient costs were higher for those males who lived in Eastern China and worked at the same place with insurance enrollment, with fair to bad self-assessed health and chronic diseases. Conclusion:Allowing higher flexibility for migrants to transfer the new rural cooperative medical system ( NCMS ) between rural and urban areas and thus making reimbursement for medical services provided by undesignated providers received immediately could increase the use of outpatient services.