ABSTRACT
OBJECTIVE： To provide reference for improving medication compliance and therapeutic efficacy in community patients with type 2 diabetes mellitus （T2DM） in China. METHODS： The data was from the “Economic Study of Diabetic Medications in Patients with T2DM in China”， which was conducted by China Center for Health Economic Research of Peking University. Both univariate analysis and Logistic regression model were used for single factor analysis and multiple factor analysis of medication compliance. RESULTS： Totally 2 236 community T2DM patients were included. The rate of good medication compliance was estimated at as low as 23.48％. Monthly household income and duration of the disease had significant impact on medication compliance. Incidence of good the medication compliance for patients with monthly household income ≥6 000 yuan and during 3 000-＜6 000 yuan， compared to those with monthly household income ＜3 000 yuan， were 70.8％ [95％CI（0.532，0.944）] and 78.5％ [95％CI（0.614，1.004）] respectively. Incidence of good medication compliance for the patients with 5 to 10 years and ＞10 years of disease duration， compared to those with ＜5 years of disease duration， were 69.0％ [95％CI（0.542， 0.878）] and 59.1％ [95％CI（0.459， 0.760）] respectively. CONCLUSIONS： The medication compliance among community patients with T2DM in China was generally poor. Longer duration of the disease and higher monthly household income are associated with poorer medication adherence.
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OBJECTIVE： To provide reference for improving the treatment compliance and therapeutic effect of patients with type 2 diabetes mellitus （T2DM） in China. METHODS： The follow-up data was from the issue of Pharmacoeconomic Study of Diabetic Drugs in China， which was conducted by China Center for Health Economic Research （CCHER） of Peking University. Using follow-up endpoint HbA1c level as clinical output indicator， univariate analysis and multivariable regression analysis of binary and numerical variables were performed to evaluate the effect of treatment compliance on short-term clinical outcomes. RESULTS： Totally 2 236 community T2DM patients were included for the analysis. The patients with good and poor medication compliance accounted for 23.48％ and 76.52％； the patients with good and poor blood glucose monitoring compliance accounted for 7.02％ and 93.98％； 66.3％， 23.5％ and 10.2％ of the patients had good， medium and poor diet control compliance， respectively. Univariate analysis showed that there was a significant difference in the “good control” group of blood glucose and the “poor control” group of blood glucose in terms of patient age， body mass index， education level， duration of disease， exercise， and eating habits，etc （P＜0.05）. Similar results were obtained in the analysis of multiple Logistic regression and multivariate loglinear regression models， that is， blood glucose monitoring compliance and diet control compliance had significant positive effects on end-point HbA1c （P＜0.05）， but drug compliance had no significant effect （P＞0.05）. CONCLUSIONS： The treatment compliance among community patients with T2DM in China was generally poor. After controlling for other variables， patients’ treatment compliance has a positive effect on end-point HbA1c， especially better blood glucose monitoring compliance and diet control compliance contribute to blood glucose control， but medication compliance has no significantly effect.
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To understand the management level and international positioning of Chinese hospitals, we devel-oped a comprehensive survey instrument of chinese hospital management survey following the well-adapted methodolo-gy of world management survey which has been widely used internationally. The survey was conducted on 20 manage-ment practices covering four major management dimensions including operations management, performance manage-ment, target management and talent management respectively. Based on the CHMS structure and setting, the four-di-mension and twenty-item management model was analyzed with construct validity test. From the test, the middle level managers were recruited from more than 400 chinese national representative hospitals. The results showed that the chi-square/degree of freedom (CMIN/DF) is 2. 209, and RMSEA (root mean square error approximate) is 0. 039, indicating a good model fitting. The further indications of model fit such as GFI, IFI and CFI were all above 0. 9 which is the typical benchmark for model acceptance. This study provides evidence for correspondence between con-ceptual and empirical hospital management and the insight of model fitting on the current data. The results conclude that CHMS has satisfied validation in Chinese hospital management practices, and can be used as an effective sur-vey method to assess the level of Chinese hospital management and to provide a general platform for international comparison.
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Objective:It examined the impact of Urban Resident Basic Medical Insurance(URBMI) program launched in 2007 on labor supply.Methods:Using ordinary least square and instrumental variable estimation,the regression analysis was conducted on URBMI household survey data.Results:Although the URBMI increased the accessibility to medical services and decreased residents' financial burdens,the unemployment rate for residents with URBMI were increased by 13％.Conclusion:In respect to the problems of aging and labor force reduction in China,the policy-maker should not ignore the potential negative labor market outcomes while expanding public health insurance coverage.
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Objective:To acquire the differences in health and healthcare utilization among different regions with various economic development in China,so as to provide references for improving health inequalities related to economic development.Methods:Decomposing the health and healthcare utilization among different income groups.Results:Inequalities in health and healthcare utilization were captured,whereas the gaps among groups were enlarging over time in terms of low birth weight newborns and healthcare utilization.Conclusion:In order to promote the equality in newborns,more attention should be paid to high income regions.In order to improve the equality in healthcare utilization,more attention should be drawn to low income regions and rural areas.
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Objective To explore methods to measure the management level of Chinese hospitals in natural conditions of Chinese hospitals, for improvement of their operation efficiency. Methods The methodology of World Management Survey( WMS) was introduced, and the questionnaire was localized using expert consultation method. Double-blind telephone interviews were conducted to investigate the management level of Chinese hospitals in the four dimensions of standardized operation, performance monitoring, target setting and talent management. Results The management level of hospitals in China varied greatly from places. Among them, the hospital management scoring was found to range from 2. 50 to 2. 75 in most cases, averaging 2. 55. These hospitals scored relatively poor at the four specific management practices of hospital layout(2.48), performance communication(2.27), talents retention, and clarity and comparability of objectives(2. 45). Management level of a hospital was correlated to such factors as its history, ownership form, human capital and hospital size. Conclusions This study uses WMS methodology to quantify Chinese hospital management. The overall management level of Chinese hospitals is expected to improve with much gaps to cover. At this stage, it is imperative to solve the unbalanced and inadequate development of hospital management levels, among regions, hospital grades and forms of ownership.