ABSTRACT
The medical alliance is an important carrier for the construction of hierarchical medical treatment system.In the study,the medical alliance under public and private partnership is explored and analyzed,the necessity of private medical institutions participating in the medical alliance construction is expounded.The feasibility of the construction of medical alliance under public and private partnership is illustrated from three aspects,such as policy,theory and practice.Based on the policy background and market environment of China,challenges of the construction of public and private partnership is analyzed,and the corresponding suggestions are proposed to provide ideas for the long-term development of medical alliance in China.
ABSTRACT
The medical alliance,as a new exploration of the joint structure of medical institutions at present,can promote the sinking of quality medical resources and promote the integration of medical resources in the region.Medical governance is one of the most important way for medical reform in China.In the paper,the path choice of the corporate governance of medical alliance is explored,and the corresponding policy suggestions are proposed.
ABSTRACT
As the medical and health service model China currently vigorously promotes,the medical alliance is of great significance for implementing the five basic medical and health systems and perfecting the medical and health service system.At the same time,the construction of medical alliance can't be separated from the medical treatment,medical insurance and medicine linkage.Clarifying the relationship between the medical alliance and synergy among hospitals is conducive to solving many problems in the construction of medical alliance,and to promoting the healthy and sustainable development of medical alliance.
ABSTRACT
At present,the functional positioning,service capabilities and resource allocation of various medical institutions differs in China,the tertiary public hospitals,which are rich in high-quality resources,are playing a significant role in integrating medical resources,improving the accessibility and affordability of services and achieving the Chinese national health goal.Through the analysis of the importance and key problems of leading hospitals in a variety of medical alliance,the paper explores the basic ideas and pathways of public hospitals' leading role in various forms of medical alliances.
ABSTRACT
Under the construction of health and family planning comprehensive supervision system,the main problems hindering the development of the health family planning comprehensive supervision are summarized through the analysis of the present situation of legislation,executive system and health-law enforcement team.It is suggested to formulate the basic health law,and perfect the legal system;promote the construction of comprehensive supervision system,and consolidate the resources of administrative law enforcement;strengthen the construction of law-enforcing team,and improve law enforcement efficiency and service quality.
ABSTRACT
Objective:To analyze the health service utilization and burden on medical expenses of outpatients with chronic kidney diseases in Wuhan,to understand the security effects of patients with chronic kidney diseases under the basic medical insurance system,put forward suggestions to the development strategies and optimizing suggestions on strengthening the comprehensive management of chronic kidney diseases.Methods:Questionnaires were used to investigate 267 CKD outpatients of 6 first-class hospitals in Wuhan.Expert consultation method was used to interview the kidney doctors.Descriptive analysis method was used to analyze the utilization of health services,disease economic risk,catastrophic expenditure phenomenon and medicare satisfaction.Results:CKD patients had more frequent utilization of outpatient services,average outpatient expenditures of Urban Employer Medical Insurance outpatients were higher than the others,drug expenditures of New Rural Cooperative Medical System(NCMS) patients were significantly higher than the others.Most patients believed that the current medical outpatient policy could not meet the demand.Conclusion:More attention needed to be paid for NCMS,to strengthen prevention education and early management,improve the management of chronic kidney disease outpatient insurance policy.
ABSTRACT
The chronic kidney disease (CKD) had became one of the elements which threatened the population health and led to death,further resulted the stability of society.It focused on the medical insurance policy of CKD,combined with the current situation of Chinese CKD medical insurance management,it analyzed the issues arise during the policy implementation period and proposed the corresponding countermeasure and suggestion so as to provide references for improvement of the CKD and other chronic disease medical insurance policy.
ABSTRACT
Along with the development of society and the rapid economic growth in the past decades,hypertension and other chronic diseases have become important reasons for people's poverty caused by illness in China.This study collected a total of 5857 people from 2010 to 2013 randomly from the database of the Medical Insurance Department (MID),including 3229 people in Hubei province and 2628 people in Guangdong province.One-way ANOVA was used to compare the total medical expense,out-of-pocket (OOP)expense and hospital stay between variables.A multiple linear regression analysis was done to identify possible risk factors of total medical expense.The results showed that the average total medical expense per capita was 5709.89 yuan,and the medical expense per capita was 7053.58 and 4555.97 yuan in Guangdong province and Hubei province,respectively.The medical expense of hypertensive inpatients decreased from 7222.32 yuan in 2012 to 4894.66 yuanin 2013.There were no significant differences in medical expenses between different genders of hypertensive patients (P＞0.05).People of different ages,provinces,medical insurances and medical institution levels showed significant differences in medical expenses.The government should increase the investment in chronic disease management and treatment in the central and western regions to narrow the gap with the eastern region.Medical insurance fund payment should be improved to ensure the fairness of the use of medical services in different medical insurances.And measures should be taken to encourage chronic patients to visit primary medical institutions to effectively reduce medical expenses.
ABSTRACT
Along with the development of society and the rapid economic growth in the past decades,hypertension and other chronic diseases have become important reasons for people's poverty caused by illness in China.This study collected a total of 5857 people from 2010 to 2013 randomly from the database of the Medical Insurance Department (MID),including 3229 people in Hubei province and 2628 people in Guangdong province.One-way ANOVA was used to compare the total medical expense,out-of-pocket (OOP)expense and hospital stay between variables.A multiple linear regression analysis was done to identify possible risk factors of total medical expense.The results showed that the average total medical expense per capita was 5709.89 yuan,and the medical expense per capita was 7053.58 and 4555.97 yuan in Guangdong province and Hubei province,respectively.The medical expense of hypertensive inpatients decreased from 7222.32 yuan in 2012 to 4894.66 yuanin 2013.There were no significant differences in medical expenses between different genders of hypertensive patients (P＞0.05).People of different ages,provinces,medical insurances and medical institution levels showed significant differences in medical expenses.The government should increase the investment in chronic disease management and treatment in the central and western regions to narrow the gap with the eastern region.Medical insurance fund payment should be improved to ensure the fairness of the use of medical services in different medical insurances.And measures should be taken to encourage chronic patients to visit primary medical institutions to effectively reduce medical expenses.
ABSTRACT
In the new situation of deepening medical and health system and promoting the health of China and successful aging,the health of China should be a guide for the development of nursing.The paper described the developmental status of nursing and new requirements,discussed the necessity and operability of the development of nursing in the field of social service.
ABSTRACT
Government departments,pharmaceutical enterprises,health providers and patients were the four main stakeholders who involved in drug supply support reform in Sanming City.The paper centered on stakeholders' role and basic appeal,their influence on the reform or the influence of reform on them and the probable problems of reform,to make the motivation and resistance of the reform clearly and provide evidence for the sustainability and reproducibility of the reform.
ABSTRACT
Remote medical care had stepped into synthetical consideration stage,during the new period of the Healthy China construction.It was an important issue to settle the remote medical patients,which needed to be solved.Analyzing the design for remote medical treatment based on theory could not only benefit the national policy planning but also benefit each province to carry out the policies.It attempted to provide policy recommendations for optimizing the system of medical treatment in different places according to the collected administrative policies of 21 provincial.
ABSTRACT
It is one of the hot spots in recent years to provide immediate settlement services for a large number of remote medical groups.Based on the related concepts and the design of the national policy,it clarifies the connotation and types of remote medical treatment and remote medical treatment,analyzes the existing policy orientation,and puts forward the main problems of real-time settlement in different places.In the new stage of the medical and health system reform,combined with the relevant reform and practice,it proposes the realization path of real-time settlement of medical treatment in different places.
ABSTRACT
The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed. Data were collected with regards to the implementation of the national antibiotic stewardship program (NASP), the overall usage and the prophylactic use of antibiotic for type I incisions. Univariate analysis was used for microbiological diagnosis rate before antimicrobial therapy, prophylactic use of antibiotics for type I incision operation, and so on. For multivariate analysis, the use of antibiotics was dichotomized according to the guidelines, and entered as binary values into logistic regression analysis. The results were compared with the corresponding criteria given by the guidelines of this campaign. The antibiotic stewardship in China was effective in that more than 80% of each kind of hospitals achieved the criteria of recommended antibiotics varieties. Hospital type appeared to be a factor statistically associated with stewardship outcome. The prophylactic use of antibiotics on type I incision operations decreased by 16.22% (P<0.05). The usage of combination antibiotic therapy for type I incisions was also decreased. Region and bed size were the main determinants on surgical prophylaxis for type I incision. This national analysis of hospitals on antibiotic use and stewardship allows relevant comparisons for bench marking. More efforts addressing the root cause of antibiotics abuse would continue to improve the rational use of antibiotics in China.
Subject(s)
Female , Humans , Male , Anti-Bacterial Agents , Therapeutic Uses , China , Epidemiology , Drug Prescriptions , Drug Utilization , Hospitals , Inpatients , Outpatients , Surgical Wound , Epidemiology , Microbiology , TherapeuticsABSTRACT
Hepatic echinococcosis, also called echinococcosis, is a health-threatening disease commonly found in pasture, and belongs to parasitic zoonoses. The purpose of this study was to investigate the prevalence and the risk factors of echinococcosis in Qinghai province in order to provide fundamental data for prevention and control of echinococcosis in Qinghai province. A total of 23 445 people from 21 counties were enrolled in this study by multi-stage stratified random sampling. Echinococcosis was diagnosed by using B-mode ultrasonography and serological tests. The results showed that the prevalence of echinococcosis was 4.47% (95%CI: 4.21%-4.73%) and serum positive rate (seroprevalence) was 15.47% (95%CI: 14.92%-16.02%) in 2010. The distribution of echinococcosis differed in age, sex, ethnicity, occupation and regions in Qinghai (P<0.05). GLMM analysis revealed that gender (female vs. male), ethnicity (Tibetan vs. other ethnicities), profession (herders vs. other professions) and region (autonomous prefectures vs. cities) were significant risk factors for echinococcosis (P<0.05). It was concluded that the prevalence of echinococcosis in 2010 was about 4% in Qinghai province, and the distribution of echinococcosis in Qinghai was associated with age, sex, ethnicity and profession.
Subject(s)
Adolescent , Adult , Aged , Animals , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Age Factors , Antibodies, Helminth , Blood , China , Epidemiology , Echinococcosis, Hepatic , Diagnostic Imaging , Epidemiology , Parasitology , Echinococcus , Allergy and Immunology , Physiology , Epidemics , Host-Parasite Interactions , Occupations , Prevalence , Risk Factors , Seroepidemiologic Studies , Sex Factors , UltrasonographyABSTRACT
With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
Subject(s)
Humans , Anti-Bacterial Agents , China , Drug Prescriptions , Drug Utilization , Drug Utilization Review , Methods , Geography , Hospitals , Classification , Inpatients , OutpatientsABSTRACT
With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
ABSTRACT
Hepatic echinococcosis, also called echinococcosis, is a health-threatening disease commonly found in pasture, and belongs to parasitic zoonoses. The purpose of this study was to investigate the prevalence and the risk factors of echinococcosis in Qinghai province in order to provide fundamental data for prevention and control of echinococcosis in Qinghai province. A total of 23 445 people from 21 counties were enrolled in this study by multi-stage stratified random sampling. Echinococcosis was diagnosed by using B-mode ultrasonography and serological tests. The results showed that the prevalence of echinococcosis was 4.47% (95%CI: 4.21%-4.73%) and serum positive rate (seroprevalence) was 15.47% (95%CI: 14.92%-16.02%) in 2010. The distribution of echinococcosis differed in age, sex, ethnicity, occupation and regions in Qinghai (P<0.05). GLMM analysis revealed that gender (female vs. male), ethnicity (Tibetan vs. other ethnicities), profession (herders vs. other professions) and region (autonomous prefectures vs. cities) were significant risk factors for echinococcosis (P<0.05). It was concluded that the prevalence of echinococcosis in 2010 was about 4% in Qinghai province, and the distribution of echinococcosis in Qinghai was associated with age, sex, ethnicity and profession.
ABSTRACT
OBJECTIVE@#To get scientific basis for further health education through the research of the road construction workers' KBP before and after the interventions of highway AIDS prevention project.@*METHODS@#Multi-stage random sampling method was employeed to select workers of 8 sites from 14 sites along highway to investigate their AIDS knowledge, belief and performance (KBP) before and after highway AIDS prevention project.@*RESULTS@#Over 90% of the investigated workers had ever heard about AIDS, and the non-skilled workers of lower educational level improved more after intervention. The correct answer rate of the three transmitting ways of AIDS of drivers which is the focused group of highway before and after intervention had the obvious statistical significance (P<0.05), and the other group's correct answer rates also had improved after intervention. Most people's understanding of preventing AIDS through correct use of condoms when having sex had a statistically significant difference(P<0.05) after prevention. The rates of using condoms of foremen and skilled workers when having sex with commercial sex worker/casual partner increased after intervention.@*CONCLUSIONS@#The health education of HIV among the road construction workers is effective and further health education of HIV prevention should be carried out among the road construction workers to improve their knowledge and awareness of avoiding the high-risk behaviors.