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Objective:This paper summarizes the practical problems encountered in the implementation of the tuition-free medical students' policyin rural areas of Sichuan Province, and provides a reference for the implementation of this policy across the province. Methods :Semi-structured interviews were conducted with the principals of the orientation management policies of the health administrative departments and county level and primary health care in-stitutionsin Sichuan, and the focus group interviews were used to understand the dynamics of directed students. Results :The survey results showed that there were limited channels for students to understand the policy ; students' barren understanding of the work of grass-roots doctors ; credit and integrity files played a relatively low role in retaining medical talent students;the willingness of orientation students is higher, but there is a contradiction between applying for graduate students and retaining grassroots in rural areas ; and the relevant departments lacked a rational and efficient management mode for students. Conclusions :In order to ameliorate the construction of rural health human resources,policy administrators should place their emphasis on cultivating the sense of honor and responsibility in the rural-oriented tuition-free medical students'policy, improve the reward and punishment mechanism in policies, optimize the management and assessment process, and promote the orientation of the work among the various policy-participating departments in a more harmonious and orderly manner.
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Through literature review and theoretical analysis,an initial scale was designed with five dimensions namely"evidence influence","organizational support","channel connectivity","communication and collabora-tion"and"decision-makers impetus". The reliability and validity of the scale were evaluated through questionnaire survey on HTA researchers. It is reported that the overall Cronbach's α coefficient of the questionnaire was 0.904, meanwhile the Cronbach's α coefficient of each dimension was more than 0.80 except the dimension of"decision-makers impetus". The average variance extraction of each dimension was more than 0.50. The maximum of correla-tion coefficients between each dimension was 0.571,which was less than the threshold value of 0.85. Additionally, for certain dimensions,the standardized correlation coefficients to each other dimensions was less than regarding arith-metic square root of average variance extraction.
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<p><b>OBJECTIVE</b>To explore the integrated application of sales of child-specific over-the-counter (OTC) cold related medications in retail pharmacies and healthcare visits of children for influenza-like illness (ILI) in surveillance and early warning of influenza among children.</p><p><b>METHODS</b>An integrated surveillance system (ISS) was implemented since 2012 in Qianjiang County, a rural area in Hubei Province of China. The daily information from August 1, 2012 to February 28, 2013 of health care visits of children for ILI reported by 80 health facilities and sales of 14 child-specific over-the-counter (OTC) cold related medications reported by 11 pharmacies were extracted from ISS database. Cumulative sums (CUSUM) model was conducted to analyze the degree of fitting and the early warning signal generated; the correlationship was then analyzed further.</p><p><b>RESULTS</b>In 212 days, 983 visits of children for ILI and 12 819 sales by person of child-specific OTC were reported. Conducting CUSUM model, the fitting degree was in the acceptable range, 31 warning signals were generated from ILI data series with 3 peak periods and 14 from OTC data series with 2 peak periods. A similar time trend of two data series was observed with a correlation(r = 0.497, P < 0.05), but without any spatial clustering. And the optimal correlation(r = 0.505, P < 0.05) appeared at a time offset of 4 days preceded by OTC sales.</p><p><b>CONCLUSION</b>The availability of integrated surveillance system for symptoms could be applied for surveillance of influenza among children; while it could explore the possibility of real epidemic in the very early stage.</p>
Subject(s)
Child , Humans , China , Epidemiology , Disease Outbreaks , Influenza, Human , Epidemiology , Nonprescription Drugs , Population SurveillanceABSTRACT
<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>