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Based on the Global Burden of Disease study 2019, the standardized mortality rate and disability-adjusted life years (DALYs) rate of children under 5 years old were selected as evaluation indicators to compare and analyze the current situation and differences of disease burden of children under 5 years old between China and other regions from 1990 to 2019. The change trend and difference of disease burden of children under 5 years old in China were analyzed by sexes. From 1990 to 2019, the all-cause standardized mortality rate of children under 5 years old in China decreased from 1 153.81/100 000 to 160.39/100 000, and the all-cause standardized DALY rate decreased from 104 426.40/100 000 to 16 479.01/100 000. In 2019, neonatal preterm birth, congenital heart anomalies and lower respiratory infections ranked the top three disease burden of children under 5 years old in China. Except that the disease burden of neonatal preterm birth was lower than that in North America, they were much higher than that in Western Europe and North America in the same period. The burden of unintentional injury diseases, including pulmonary aspiration and foreign body in airway and drowning, was higher than that in Western Europe and North America. The standardized mortality and DALY rate of the top ten diseases and injuries in boys and girls under 5 years old in China showed a downward trend (P<0.05), and most of them were higher in boys than girls (P<0.05). From 1990 to 2019, the disease burden of children under 5 years old in China decreased significantly. However, compared other regions, it is still necessary to strengthen the prevention and control of neonatal premature birth, birth defects and unintentional injuries, and take different sex-specific interventions to improve the overall health of children.
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Child , Child, Preschool , Female , Humans , Infant, Newborn , Male , Accidental Injuries , China/epidemiology , Cost of Illness , Premature Birth/epidemiology , Quality-Adjusted Life Years , Risk FactorsABSTRACT
Objective: The study aimed to explore the initial effect of the Luohu healthcare group reform in Shenzhen based on the patient’s perspective. Methods: The questionnaire survey was conducted to investigate the views of patients in 3 hospitals and 23 community health centers in Luohu district. Results: A total of 936 valid ques-tionnaires were collected and analyzed. The valid response rate was 94. 55% . More than 90 percent of the total sur-veyed patients provided a good or very good evaluation on the healthcare services, service attitude, medical referral services and interpretation, communication skills, and better family doctor skills. More than 80 percent of the sur-veyed patients perceived well or very well on medical treatment, the convenience of medical referral, the referral process of the community health centers, and the specialists serving in community health centers mechanism. Conclu-sions: The results showed that patients had a slightly high satisfaction with family doctors and community health cen-ter, and after the group was founded, the proportion of patients who preferred going to community health centers after illness has been increasing significantly more than before. In future, a further development of the advantages of healthcare group should be brought into action and improve the relevant supporting policies. The long-term effect de-serves a further observation.
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Objective: The study aimed to explore the initial effect of the Luohu Healthcare Group Reform in Shenzhen based on the employee’s perspective. Methods: The questionnaire survey was conducted to investigate the views of employees in 3 hospitals and 23 community health centers in Luohu district. Results: A total of 480 ques-tionnaires were distributed and only 412 valid questionnaires were collected and analyzed. The valid response rate was 85. 83% . 37. 21% of doctors responded that they had motive power to work in community health centers; 75. 38 per-cent of employees stated that their healthcare organization changed a lot; Employees’average work satisfaction scores, interpersonal relationship and healthcare organization development were all above 4. 20, and the consistency of em-ployee evaluation was high. Conclusions: Most of the surveyed employees evaluated the initial stage of the Luohu health reform positively. Since the hospital group started to operate two years ago, the development of the affiliated health facilities has been on an upward trend. The formation of vertical alliance within the hospital group has e-merged; and physicians of secondary and higher-grade hospitals have had increasing willingness of working at the community health centers, especially in the departments of internal medicine and traditional Chinese medicine. The hospital group has been guiding all affiliated facilities to develop its unique signature specialty so that facilities can col-laborate with each other and evolve as a whole. Group employees have expectations that the hospital group will coordi-nate and incorporate interests of all stakeholders, fulfill the commitments, and develop a better future for the group.
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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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Health system reform at district-level is an important but often neglected component in health system reform of China. According with the national policy-strategy guidance and the local health needs and problems within its jurisdiction,Luohu District has taken a series of effective reform measures for promoting a comprehensive reform since 2015,in which the crucial part was the establishment of"LuoHu Hospital Group". The reform in Luohu was initiated by the district-level government under the favorable policy and external conditions. The district government departments explored and innovated,and developed a featured district-level health system reform road. This experi-ence shows that district-level government should be an active actor in the local health system reform in China. The re-form in Luohu is still on the way,and more effect is yet to emerge, but the experience is of important reference for the health system reform in other regions/cities of China.
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Objective To insight into the status of literature research of drug unpacking in medical institutions in China,to provide decision basis for decision makers to further standardize the management of drugs.Metheds By using the method of systematic review,searching China biomedical literature database (CBM) that articles published before October 15,2016.After two rounds of literature screening,ultimately 67 articles were analyzed.Results The study of drug unpacking in China began in 1997.Of the 67 studies included in this research,a total of 17.9％(12/67) literature was the original study,and a total of 67.2％ (45/67) studies were performed in tertiary hospitals.There were 14 studies that reported the objective of drug unpacking in outpatient pharmacy.Some studies reported the manner of drug unpacking,some reported the system construction of drug unpacking in institution,and some reported the common problems of drug unpacking and quality improvement measures.Conclusion At present,there are few original studies on the drug unpacking in China,most of included studies are carried out in tertiary hospitals and focus on the problems because of drug unpacking.The actual size of drug unpacking of the medical institution (the number of varieties,amount) is not known.It is necessary to carry out large-scale field research.
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<p><b>OBJECTIVE</b>To describe the pregnant women's utilization of prenatal screening for Down's syndrome and its influencing factors.</p><p><b>METHODS</b>From October 2007 to December 2008, 4250 lying-in women in 54 hospitals were surveyed by stratified cluster sampling method in Zhejiang, Hunan and Sichuan, which located in Eastern, Central and Western China, respectively. Demographic characteristics, knowledge and health behaviors were collected by the questionnaire of lying-in women's utilization and influencing factors of prenatal screening for Down's syndrome. Whether to use prenatal screening was determined by the lying-in women's medical history. Chi-square test and logistic regression analysis were used to analyze data.</p><p><b>RESULTS</b>Respondents' age was (26.92 ± 4.60) years old. The total utilization rate of prenatal screening for Down's syndrome was 40.0% (1696/4237), and screening utilization rates in Zhejiang, Hunan and Sichuan were 48.23% (682/1414), 41.73% (616/1476) and 29.55% (398/1347), respectively. Screening utilization rates of respondents with college degree or above and high school or below were 72.68% (697/959) and 30.46% (998/3276), respectively. Screening utilization rates of urban and rural respondents were 63.00% (952/1511) and 27.11% (732/2700), respectively. Screening utilization rates of respondents under 35 years old and over 35 years old were 41.40% (1645/3973) and 19.32% (51/264). All differences were significant (all P values < 0.05). A total of 79.14% (1419/1793) of respondents thought it was necessary to take prenatal screening for Down's syndrome, and 79.47% (1506/1895) of respondents received doctors' suggestions, 24.2% (654/2702) of respondents who heard of prenatal screening for Down's syndrome could figure out the main pathogenic factors, while 23.0% (621/2702) didn't know any factors; 77.8% (2102/2702) of respondents heard of prenatal screening for Down's syndrome, but 12.3% (259/2102) didn't know the appropriate gestational weeks to uptake the screening, 47.0% (988/2102) knew of prenatal screening for Down's syndrome through healthcare providers. Logistic regression analysis result demonstrated that living in Zhejiang (OR = 1.62, 95%CI: 1.26 - 2.08), city residence (OR = 2.06, 95%CI: 1.63 - 2.60), with positive attitude to screening (OR = 5.00, 95%CI: 3.97 - 6.29), pregnant women's age below 35 years old (OR = 3.86, 95%CI: 2.53 - 5.89), receiving advices from healthcare providers (OR = 12.64, 95.0%CI: 9.97 - 16.02), college degree or above educational level (OR = 2.67, 95%CI: 2.03 - 3.50) were facilitating factors on utilization of prenatal screening for Down's Syndrome.</p><p><b>CONCLUSION</b>Pregnant women's use of prenatal screening for Down's syndrome was not enough, and living in zhejiang, higher education level, rural respondents with age under 35 years old, receiving advice from healthcare providers or not and their attitude toward necessity were significant promotive factors of utilization of prenatal screening for Down's syndrome.</p>
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Adult , Female , Humans , Pregnancy , Young Adult , China , Down Syndrome , Factor Analysis, Statistical , Prenatal Diagnosis , MethodsABSTRACT
<p><b>OBJECTIVE</b>To compare FOLFOX6 and FOLFIRI regimen in the treatment of metastatic colorectal cancer with cost-effective analysis.</p><p><b>METHODS</b>Cost-effective analysis was conducted based on the efficacy results of V308 clinical trial of FOLFOX6 and FOLFIRI regimen and the medical system price in Zhongshan hospital.</p><p><b>RESULTS</b>The minimal cost analysis showed FOLFIRI followed by FOLFOX6 had the cost of RMB 206365.78 Yuan for each patient during the whole treatment period, and RMB 170468.89 Yuan for the FOLFOX6 followed by FOLFIRI regimen. Incremental analysis showed FOLFIRI followed by FOLFOX6 regimen could prolong one month of overall survival with additional cost of RMB 39885.44 Yuan in each patient while compared with the regimen of FOLFOX6 followed by FOLFIRI.</p><p><b>CONCLUSIONS</b>Both FOLFOX and FOLFIRI regimens are able to prolong the survival time of patients with metastatic colorectal cancer, but cost of such treatments are still quite expensive for Chinese patients. FOLFOX6 regimen suggests better cost-effectiveness than FOLFIRI.</p>