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Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research， we believe that five aspects need to be prioritized for a strong system. First， we should change the perspective on public health， using the word “gonggong jiankang” to replace “gonggong weisheng” and the word “gonggong jiankang tixi” to replace “gonggong weisheng tixi”， to lead the public health system development. Second， we should develop a suitable public health system and continuously improve the health capacity for governance. Third， we should make it clear that the goal of building a strong system is not far-fetched， and we need to consolidate the existing institutional advantages of China’s public health system： when encountering major problems， we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However， we need to make up for shortcomings one by one， especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth， we should pursue excellence and consolidate the“suitable” mechanism proven in the process of coping with the COVID-19， so that efficient mechanisms to deal with major issues can be used in routine work， and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response，so as to achieve the balanced development of regions categories and units.Finally， it is necessary to strengthen the coordination of government and research institutions， in the aspects of technological innovation， talent team building and accurate consulting services， and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.
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Objective:To identify the key convergence points in the medical-nursing combined care among literature, and establish a mechanism for medical-nursing combined care integration from the perspective of the synergy theory, for the purpose of promoting the integrated development of such care in China.Methods:Relevant literature on the medical-nursing combined care were retrieved from the CNKI database from September 2013 to September 2021. The search formula used was TI= "the medical-nursing care integration" AND SU=(convergence+ transformation+ coordination+ mechanism), while supplementary searches were made using " pkulaw.com database" and Baidu Scholar database. The method of literature content analysis was used to screen key points of the medical-nursing combined care, and the convergence mechanism was built based on the perspective of the synergy theory.Results:A total of 42 literatures were included in this study, 8 key convergence points of medica-nursing combined care integration were identified. Namely the 4 key horizontal convergence points of medical care, aging care, rehabilitation and nursing, the 3 key vertical convergence points of home care, institution care and community care, and the one key convergence point of institutional medical care. Based on the synergy theory and the 8 key convergence points, the " 431" convergence mechanism of medical-nursing combined care was constructed. This mechanism refered to the horizontal linkage of healthcare, nursing, rehabilitation and aging care, the vertical redirection among home care, institution care and community care modes, and the development mode focusing on institutional aging care.Conclusions:At present, the poor convergence between aging care and nursing care in China is a key roadblock hindering the integrated development of aging and nursing care. Medical-nursing combined care should be conducive to the " 431" convergence development, achieving horizontal linkage, vertical redirection, and resource sharing, for the purpose of high-quality development of China′s aging care system.
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Objective To explore the present human resources and problems at community health centers in Shandong province .Methods PPS sampling method was used to extract data of 333 community health centers in 17 cities in Shandong province in 2015 .Then the human resource status was analyzed and evaluated by descriptive research indexes .Results Data showed that 333 community health centers had 19809 employees ,and 12271 of them having staffing quota. These employees include 6355 physicians ,5169 nurses ,and 3064 medical and pharmaceutical technicians .For the physicians ,4841 of them are medical practitioners ,1313 were assistant medical practitioners ,while the numbers of obstetricians and gynecologists ,general practitioners ,and TCM practitioners were 756 , 2124 and 432 respectively .Conclusions These community health service centers are faced with such problems as lack of human resources ,irrational personnel makeup ,and obvious shortage of public health ,general practitioners and medical/pharmaceutical professionals. It is recommended to increase and optimize manpower by means of motivating existing personnel ,introducing new manpower and training opportunities for the retention.Medical alliances are expected to encourage more high-end professionals to the primary institutions .
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@#Objective To analyze the status, trends and issues of professionals in rehabilitation institutions in China, and provide policy recommendations on rehabilitation professional development.Methods The data from database and statistical bulletin of CDPF has been analyzed using descriptive analysis and deviation analysis.Results The quantity of professionals of rehabilitation institutions increased 24,900 (12.62%) in 2016. Average professionals per institution had been decreased from 33.89 in 2012 to 28.33 in 2016. In regard to the structure of distribution, the rehabilitation professionals at provincial level had been decreased 21.95% in 2015 than that of in 2012. Both training programs and the number of trainees from rehabilitation institutions had decreased.Conclusion There were big gap between services provision and needs of professionals. The distribution of professionals at provincial, city and county level was under optimization. The on-job training for rehabilitation professionals should be improved. It is recommendated to develop national plan for professionals development to meet the needs of rehabilitation services, advance the on-job training for professionals, develop the higher education of rehabilitation and improve attractiveness of rehabilitation to retain and recruit more professionals.
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Based on the analysis on protections of civil rights in public health crises, this paper reviewed some related issues about the right of life, personal liberty, etc. It was found that the system of emergency laws was not perfect, and the articles about basic civil rights protections among different laws was inconsistent, we are also lack of a comprehensive management department to coordinate crisis response. The government should perfect laws and adjust management functions to protect citizens’ legitimate rights.
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Objective: To understand the gambling relations between the stakeholders of catastrophic medical insurance policy under New Rural Cooperative Medical System ( NCMS) , and provide theoretical references for the smooth operation of catastrophic medical insurance policy of NCMS. Methods:Analyzing the game relationships among the four sides:the government, business insurance agencies, designated medical institutions and participating farmers suffering from catastrophic diseases through game theory. Results: The government and business insurance agency, and the government and designated medical institution belong to cooperative games. The farmers participated in catastrophic medical insurance tend to choose cooperative strategy. Non-cooperative games exist in business insurance agency, designated medical institution and participating farmers. Conclusion: Strategic relationship of close cooperation should be established between the business insurance agencies and designated medical institutions. The government should strengthen the regulatory constraints between the business insurance agencies and designated medical institutionsi, at the same time, it needs to establish the incentive mechanism soon.
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Objective: As the breakthrough for public hospital reform in China, County public hospital comprehensive reform has become the main part of the reform, the reasonable use of New Rural Cooperative Medical System(NCMS) would strongly push the process of new medical reform. Methods: The method of mathematical modeling was applied in policy imitate of hospital operation historical data, to estimate the increasing of decreasing status of NCMS hospital compensation expenditure after the implementation of county-level public hospital comprehensive reform measurement in 10 county-level public hospital. Results: Through analyzing the operation data of applying county-level public hospital comprehensive reform measurement in 10 county-level public hospital from 2010 to 2012, there was 66.67% annual time, the NCMS compensation expenditure for public hospitals increased to 23.075 6 million yuan, which increased by 1.691 7 yuan averagely. Conclusion: After the implementation of comprehensive reform policies, the influencing factors of NCMS funds on the decreasing degree of county-level public hospital expenditure were mainly the proportion of pre drug addition ratio and basic drug sales in the total drug sales.
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<p><b>BACKGROUND</b>Since 2009, health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility, and to achieve sustained population-wide health improvement. This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China, especially hypertension people and children aged 0-6 years.</p><p><b>METHODS</b>A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children. Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients, and for children, public services provided were vaccination on schedule and regular physical check-up. Logistic regression was used to determine the predictors for effective management.</p><p><b>RESULTS</b>A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range, and the rate in urban areas (43.61%) was higher than that in rural (31.88%). And 34.68% of them could receive more than 4 times follow-ups by the medical technician. Of 754 children, 79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly. Children living in rural areas were more likely to have regular check-ups (83.96%) and regular vaccination (nearly 99%). Overall, geographic location and education level were the determinants of people access to essential public health services.</p><p><b>CONCLUSIONS</b>Implementation of the health reform since 2009 has headed China's public health system in the right direction and promoted the improvement of public health system development. Our study highlights the growing needs for more public health services in China, and China's public health system needs to be greatly improved in terms of its quality and accessibility.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant, Newborn , Male , Middle Aged , Young Adult , Cross-Sectional Studies , Health Care Reform , Health Services Needs and Demand , Hypertension , Public HealthABSTRACT
The paper covered key progress of the management system reform for China's public hospitals and analyzed main roadblocks in the reform.It proposed such policy recommendations as clearly separating the regulation and management affairs,concentrating management authorities to build an integrated management system,establishing a clear-cut appraisal criteria for accountability,and completing supportive reforms for effective management.
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The active components from Centipeda minima were extracted by water or ethanol, and identified by FTIR spectroscopy and UV-visible spectrophotometer. The molluscicidal effect of aqueous extract and ethanol extract from Centipeda minima against Oncomelania hupensis was determined as referring to the WHO guidelines for laboratory molluscicidal test. Treated with over 2.0 g/L aqueous extract and ethanol extract for five days, the mortality of O. hupensis was up to 100%, and their LC50 for snails was 0.50 g/L and 0.62 g/L, respectively. The molluscicidal activity of aqueous extract was higher than that of ethanol extract. The main components of aqueous extract and ethanol extract were sesquiterpens lactones and sterols.