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Objective:To investigate the current status and influencing factors of outpatient institution choice for hypertensive patients with basic medical insurance in Beijing, for reference to promote the implementation of the hierarchical medical system and guiding hypertensive patients to seek healthcare in primary care.Methods:Based on data of hypertensive outpatients from the basic medical insurance database of Beijing from April 2019 to January 2020, we analyzed major demographic characteristics of hypertensive patients, the selection of outpatient institutions and its influencing factors. The chi square test was used for comparison between groups, and the multivariate logistic regression model was used to analyze influencing factors.Results:2.842 1 million outpatients with hypertension were enrolled. 39.03% of them chose primary healthcare institutions, 5.16% chose secondary healthcare institutions, and 17.34% chose tertiary healthcare institutions, while the rest 38.47% chose two or more types of healthcare institutions. Gender, age, type of medical insurance, place of residence, utilization of Chinese herbal drugs, utilization of Chinese patent drugs, polypharmacy, needs of outpatient tests and examinations were the influencing factors for their selection of primary healthcare institutions for hypertensive outpatients under Beijing basic medical insurance.Conclusions:At present, the primary institutions have become the first choice for the majority of hypertensive patients with medical insurance in Beijing, but there are still many influencing factors on their choice of institutions. In the future, we should optimize the allocation of medical resources, promote the reform of medical insurance payment methods, strengthen the construction of primary medical institutions, expand the coverage of contracted services of family doctors, and reasonably guide the patients to seek healthcare in primary healthcare institutions.
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[Objective] To detect and genotype HPV in cutaneous wart tissue.[Methods] This study recruited 132 outpatients with cutaneous warts in the Affiliated Hospital of Zunyi Medical College.Of the 132outpatients,46 had verruca vulgaris,38 had verruca plantaris,and 48 had verruca plana.Ten healthy human and 15 patients with condyloma acuminatum served as the control.Tissue specimens were obtained from the lesions of these patients as well as from the normal skin of the healthy controls.DNA was extracted from the specimens followed by PCR amplification with general and type-specific primers.[Results] Of the 132 wart specimens,128 (97.0％) were positive for HPV,111 (84.1％) for HPV2,89 (67.4％) for multiple types of HPV,55 (41.7％) for two types of HPV,28 (21.2％) for three types of HPV,and 6 (4.6％) for four types of HPV.The most prevalent HPV types were HPV2 followed by HPV1 in verruca vulgaris and verruca plantaris,HPV2 followed by HPV10,HPV3 and HPVl in verruca plana.Multiple types of HPV were identified in 50.0％(23/46) of the verruca vulgaris specimens,76.3％ (29/38) of the verruca plantaris specimens,and 77.1％(37/48) of the verruea plana specimens.Among patients infected with more than one type of HPV,the combination of HPV1 and 2 was the most common (35,39.3％),followed the combination of HPV1,2 and 10(12,13.5％).[Conclusion]s The most prevalent HPV type appears to be HPV2,followed by HPV1,in patients with cutaneous warts in Zunyi area of Guizhou province.HPV2 infection is associated with various types of cutaneous warts.There is a high incidence of coinfection with multiple types of HPV in patients with cutaneous warts,especially in those with verruca plana.Moreover,HPV3 and 10 are newly identified in verruca vulgaris,HPV 10 in verruca plantaris,HPV 1 and HPV7 in veruca plana.
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An analysis of the existing incentives mechanism of performance appraisal for community health service centers, and insight into the challenges for linking the post performance appraisal in community health service centers with incentive measures. It is pointed out the administrators should take a variety of measures including material incentive, target incentive, knowledge incentive, and emotional incentive among others. In addition, such measures should be used sophistically, flexibly and reasonably, while timing of incentives should meet the human resource needs of the institution, notably a combination of positive incentive with negative ones,, mostly the former incentive.
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A brief description of performance appraisal as used in the healthcare sector, and an analysis of problems existing in performance appraisal for posts in community heahhcare organizations in the country. The paper proposes a job-analysis based performance appraisal for such posts, featuring the appraisal model of "performance + skills + attitude+ work intensity". On the basis of work analysis, a job description should be worked out for such healthcare workers as doctors, nurses and prevention workers in community healthcare organizations, aided by a targeted job-based performance appraisal system. These efforts can effectively enhance the job performance in such organizations, catering to the healthcare needs of community residents.