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Objective To learn the prevalence of chronic diseases and risk factors control among the elderly of community health management in Zhejiang Province.Methods The elderly residents over 60 years of urban areas in Zhejiang Province were investigated through multi-stage stratified sampling,and key health examination information in year 2015 of respondents was collected.The prevalence of chronic diseases and risk factors control were analyzed among the respondents who had accepted community elderly health management.Results Among 1 215 elderly who accepted community health management,self-reported prevalence rate of common chronic diseases was 84.36％,with hypertension 60.66％,cataract 21.32％ and diabetes 20.58％.The control rates of hypertension and diabetes were 64.04％ and 60.00％,respectively.The proportions of light weight,normal weight,overweight and obesity were 3.51％,50.04％,35.51％ and 10.94％ respectively.The prevalence rate of central obesity was 54.75％,female (59.00％) higher than male (48.47％) (P ＜ 0.001).The proportions of normal,borderline high and abnormal total cholesterol (TC) were 66.75 ％,23.95％ and 9.30％ respectively.The proportions of normal,borderline high and abnormal triglyceride (TG) were 65.73％,17.05％ and 17.22％ respectively.The proportions of normal TC and TG were both lower in female (both 61.94％) than those in male (TC:74.07％、TG:71.52％) (P ＜ 0.05).The prevalence rates of hypertension (OR =1.41,95％ CI:1.11-1.79),cataract (OR =2.19,95％ CI:1.65-2.91),coronary heart disease (OR =1.59,95％ CI:1.14-2.21)and cerehmvascular disease (OR =2.06,95 ％ CI:1.29-3.30)were significantly increased in the 75 years group than that in the 60-74 years group.The prevalence of cerehrovascular disease in elderly men in the age group of 60 -74 (OR =1.73,95％ CI:1.09-2.75) and chronic obstructive pulmonary disease (OR =2.41,95％ CI:1.04-5.59) were higher than that in female,while the prevalence of rheumatoid arthritis (OR =0.54,95％CI:0.35-0.84)were lower than that in male.Conclusion Among the elderly who accepted community health management,the prevalence rate of chronic diseases is similar with the general elderly population in Zhejiang Province.Female central obesity and blood lipids control should be strengthened in the community.
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Objective To explore regional variations of basic public health services implementation in Zhejiang Province at prefectural,county and township level,respectively.To find key problems which obstacle the equalization of basic public health services in Zhejiang Province.Methods Descriptive analysis was made on surveillance data of basic public health services in Zhejiang Province,2014.Gini coefficient of key indicators was calculated at prefectural,county and township level,respectively.To the key indicator with higher Gini coefficient,Lorenz curve was plotted and Gini coefficient of each prefectural-level city was calculated.Results An increasing tendency from prefectural to township level was showed in Gini coefficient of all twenty-five analyzed indicators.The Gini coefficient at township level was 0.497 for the average financial fund per migrant person,and the highest prefectural -level cities were Taizhou (0.709 ),Lishui (0.838 ), Quzhou(0.918).The Gini coefficient at township level of other indicators were 0.314 and 0.235 for the children and elderly health management of traditional Chinese medicine,and lower than 0.05 for maternal &children health care, immunization,and coverage rate of electronic health record,and between 0.066 to 0.179 for health management of chronic disease and severe mental illness patients.Conclusion Average financial fund per migrant person and health management of traditional Chinese medicine are current major problems which obstacle the equalization of basic public health services in Zhejiang Province.
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Objective Estimate type I and type II error probability (α,β)of sampling deduction,using sample size set in national basic public health services supervision.Methods Assuming a series of population indicator value of supervised area,αand βwas calculated based on binomial & hypergeometric distribution theory according to the sample size and indicator requirements set in supervision plan.Results When the population indicator value of supervised area was just equal to indicator requirements,probability of type I error was as follows,health record utilization rate(0.41 ),health record qualification rate(0.26),children systematic management rate(0.32),postpartum visit rate(0.32),the elderly health examination form completion rate (0.35 ),standard administration rate of patients with hypertension or diabetes (0.37),control rate of blood pressure of hypertension patients(0.34),control rate of blood glucose of diabetes patients (0.43),standard administration rate of severe mental illness patients(0.50).When the population indicator value of supervised area was 0.05 lower than indicator requirements,probability of type II error of those indicator was as follows, 0.41,0.54,0.53,0.53,0.51,0.50,0.57,0.47,0.38.Conclusion Current sample sizes of all indicators result in weak sensitivity of unqualified area detection.In order to avoid mistake,the sample size should be improved.
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<p><b>OBJECTIVE</b>To explore an optimal model of hypothetical work injury insurance scheme, which is in line with the wishes of workers, based on the problems in the implementation of work injury insurance in China and to provide useful information for relevant policy makers.</p><p><b>METHODS</b>Multistage cluster sampling was used to select subjects: first, 9 small, medium, and large enterprises were selected from three cities (counties) in Zhejiang Province, China according to the economic development, transportation, and cooperation; then, 31 workshops were randomly selected from the 9 enterprises. Face-to-face interviews were conducted by trained interviewers using a pre-designed questionnaire among all workers in the 31 workshops.</p><p><b>RESULTS</b>After optimization of hypothetical work injury insurance scheme, the willingness to participate in the scheme increased from 73.87%to 80.96%; the average willingness to pay for the scheme increased from 2.21% (51.77 yuan) to 2.38% of monthly wage (54.93 Yuan); the median willingness to pay for the scheme increased from 1% to 1.2% of monthly wage, but decreased from 35 yuan to 30 yuan. The optimal model of hypothetical work injury insurance scheme covers all national and provincial statutory occupational diseases and work accidents, as well as consultations about occupational diseases. The scheme is supposed to be implemented worldwide by the National Social Security Department, without regional differences. The premium is borne by the state, enterprises, and individuals, and an independent insurance fund is kept in the lifetime personal account for each of insured individuals. The premium is not refunded in any event. Compensation for occupational diseases or work accidents is unrelated to the enterprises of the insured workers but related to the length of insurance. The insurance becomes effective one year after enrollment, while it is put into effect immediately after the occupational disease or accident occurs.</p><p><b>CONCLUSION</b>The optimal model of hypothetical work injury insurance scheme actually realizes cross-regional mobility of workers, minimizes regional differences, and embodies the fairness. The proposed model will, to some extent, protect the rights and interests of enterprises, as well as the healthy rights and interests of workers when they are unemployed.</p>