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Based on the analysis of the medical background of the current communities,the paper puts forward the construction of community medical service platform based on big data analysis,introduces the establishment of resident health record and precautions,module layout and function development of service platform,provides medical decision support for data mining technology,and improves the medical service level of communities.
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According to the present deficiency existing in contractual community medical service financing mechanism,it analyzed the financing difficulties and mutual interest game from the angle of game analysis of the various stakeholders in the financing process,explored the reasonable optimizing strategies for improving financing mechanism.The purposes aimed as:(1) determine the responsibility of each contractual community health financing body,reduce the fund shortage phenomenon caused by the lack of responsibility;(2) promote the stability and sustainable development of the financing mechanisms,to provide sufficient power to the development of contract services;(3) it was conducive to vigorously promote the contractual community medical service and lay the foundation for the grading system.
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Objective:To understand the responsiveness of community health service institutions in Henan Province. Methods:This research collected information through questionnaire investigations. The object of the investigations is key informants familiar with community health service institutions. Various dimensions of responsiveness within Henan province community health service institutions are determined through a multiple-input pecking order graph. The fuzzy comprehen-sive evaluation method is used to evaluate the level of responsiveness. Responsiveness inequality index is used to measure the distribution of reactions. Results:A total of 431 valid key informants were surveyed. The various dimensions of the questionnaire of Cronbach alpha coefficient was greater than 0. 623;the total scale of the Cronbach alpha coefficient was 0. 850;the correlation coefficient of each dimension of test-retest reliability were greater than 0. 907. The levels of responsive-ness and distribution index were 8. 33 and 0. 2744, respectively;each dimension by order of importance:timely attention>dignity>infrastructure>communication>confidentiality >social support >selective >autonomy. Approximately 50% of key informants considered that vulnerable groups in community health service institutions were sometimes or often treated unfairly. Conclusion:Key informants considered the responsiveness level of overall higher community health service institu-tions in Henan Province was high, and the distribution of responsiveness was relative equilibrium. However, there is a large shortage of infrastructure, privacy protection, doctor-patient communication, etc.
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Objective To evaluate the short-term impact of comprehensive community-based intervention programs on smoking cessation counseling services provided by community medical staff and related influencing factors in three districts of Hangzhou city.Methods Within the framework of Community Interventions for Health (CIH) Program,a community trial was conducted in two districts (Xiacheng and Gongshu) and a district (Xihu) as control,by a parallel comparison and random grouping based quasi-experimental design.Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the impact of intervention.Results There were 299 and 141 medical staff in the areas of intervention and ‘ control',respectively.For the intervention area,the quantity of available resources increased from 2to 3 and the quantity of used resources increased from 1 to 3 (both P＜0.001),while the area of control had a downward trend for both quantities.For the ratios of well-readiness for smoking counseling,in the intervention area were 35.5％,52.0％ before and after intervention (P＜0.001),while the ‘controlled' area they were 28.1％,39.3％,respectively (P=0.162).A slight increase was seen in the intervention area for the proportion of the medical staff who had been provided smoking cessation counseling,as ≥90％ patients (including asking smoking status,announcing risks related to the risks of smoking and advising smoking cessation programs etc.),while the proportion decreased in the area of ‘control'.The improvement of preparedness would promote medical staff to ask their patients about smoking status (OR=1.43,P=0.007),while all factors as a whole would not influence the medical staff to inform patients about the danger of smoking and advice patients to quit smoking.Conclusion Comprehensive community-based interventions could increase the opportunities for medical staff to acquire and utilize smoking cessation resources to some extent,as well as promote those staff' s preparedness.However,intervention itself might fail to improve the behavior of providing such services.Support that came from the policy or from the institutions also need to be strengthened.
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In recent years, the incidence of diabetes has been increasing year by year. Along with it, the problems of high medical cost and health resource shortage also make the diabetes the key chronic disease of health service management in our country. There are significant features and advantages in treatment of diabetes with traditional Chinese medicine. Therefore, the construction mode of two-way referral care for diabetes patients between TCM hospitals and community medical institutions is just unfolding. Based on the status quo of TCM treatment for diabetes, this article reviewed the present basic situation of the two-way referral care for diabetes patients in TCM hospitals and community medical institutions, discussed the significance of this mode for diabetes patients in TCM hospital, emphasized the feasibility and validity of implementing this mode, and provided beneficial exploration and consideration for further development of this mode for diabetes patients between TCM hospitals and community medical institutions.
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Objective To know the status of nutrition education of community medical staff and analyze its association with nutrition intervention consciousness and behaviors.Methods Three representative districts including Xiacheng,Gongshu and Westlake were selected and 846 community medical staff was involved in this study.Questionnaire investigation was applied to collect the information from mainly three aspects including training,consciousness and practice.Logistic stepwise regression analysis and Cochran -Mantel -Haenszel test were used.Results Most of the community medical staff was female (78.49%).78.95% of the staff had received the training of nutrition knowledge and its main influencing factor was working time.The Association was observed between the nutrition training and the preparation of nutrition consultation. The more training received,the higher self -assessment would be (P <0.05 ).Meanwhile,as the types of training increased,the awareness and attitude of medical staff was improved remarkably,such as knowing risks of unhealthy dietary,asking the dietary habit of the patients routinely,and advising patients to establish a good dietary habit to their children (all P <0.05 ).Nutrition training also had a positive association with nutrition intervention behavior ,such as implementing more measurement of blood pressure, weight, and blood cholesterol for community outpatients, communicating with them in the importance of balanced diet and proper nutrition,and giving weight loss suggestion to obese patients (all P <0.05).Conclusion Training on nutrition knowledge and intervention skills of community medical staff should be emphasized and reinforced in the future,in order to promote the effect on chronic diseases prevention of community -based intervention strategies.
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Objective To investigate the effect of workplace intervention programs related with health-promoting lifestyles among community medical staff members in the communities of Hangzhou city.Methods Three representative districts including Xiacheng,Gongshu and Westlake were chosen and all the community medical staff was involved in the study.Questionnaire survey was applied to collect the information from all the community medical staff.Three aspects including 1,environmental support and policies on healthy lifestyles 2,lectures and activities related to healthpromoting programs provided,and 3,peer effect on health promotion,were studied.Chi square test and logistic stepwise regression analysis were applied.Results Intervention strategies on smoking,diet and physical exercises were analyzed respectively.It was indicated that none of the lectures,regulations or individual counseling regarding smoking cessation was associated with the decrease of smoking behavior.Medical staff that taking part in the lectures on balanced diet showed higher frequencies of vegetable/fruit intake,with the frequencies of vegetables/fruits consumption on 4 or more days/per week appeared 1.74 times more than that in the control group.As for the physical exercise intervention was concerned,the peer effect was found to be obvious.Medical staff that taking exercise with colleagues tended to do more exercises with frequency in taking moderate or high intensity exercises 5 or more days/per week as 1.62 times than that of the control group.Data also indicated that regardless of intervention programs on diet or on physical activities,the combination effect could statistically improve the healthy behavior on diet or physical exercise.Conclusion Intervention programs on both balanced diet and physical exercises were preliminarily found to be associated with enhanced health promotion behavior for workplace health promotion strategies but need to be verified through further intervention studies of the same sort.
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OBJECTIVE:To probe into rational use of drugs in community medical institutions of our city and to provide reference.METHODS:1106 outpatient prescriptions were collected from 12 community medical institutions in our city.Rational use of drugs was evaluated.RESULTS:There were severe irrational uses of drug in community medical institutions of our city.Especially antibiotics,hormones,vitamins abuse and excessive use of intravenous infusion phenomenon was particularly prominent.CONCLUSION:Community medical institutions should further improve understanding for the importance of rational use of drugs.Clinical pharmacists should enhance knowledge of rational use of drugs and supervision of rational use of drugs.
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OBJECTIVE: To discuss the importance for pharmacists to participate in community medical care. METHODS: The key role of pharmacists in community medical care was analyzed and some specific suggestions were put forward. RESULTS & CONCLUSIONS: To strengthen communication between pharmacists and patients,give community lectures on medication consultation,set up medication counseling bulletin board,and encourage pharmacists to participate in community medical care helped to standardize drug treatment and greatly satisfied patients’ demands on receiving medical treatment.
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In the course of the establishment of the basic medical insurance system, medical and health institutions at various levels are going to face the readjustment of functional orientation and transformation of the current pattern of medical setups will produce a far reaching effect on medical institutions. While “reducing burdens”, big hospitals must try actively to suit the needs of the medical market under the new circumstances, give full play to their strong points, such as high concentration of talents, knowledge and resources, and provide quality, high efficiency and high value added medical service. It must also be brought to peoples awareness that third tier hospitals are not just the supplement and extension of community medical service but should also serve as its guarantee and backing.
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Objective To grasp the basic situation concerning visits by emergency outpatients to big urban hospitals before the implementation of reform in the medical insurance system in our city. Methods An investigation was made by means of profile survey questionnaires into the form of medical security of emergency outpatients, the sources of patients, referrals of patients, and the evaluation of doctors. Results Current emergency outpatient services in big urban hospitals have the following features: fairly great medical demands and attraction, widespread sources of patients, and pretty strong advantages in comprehensive clinical treatment. At the same time, before the implementation of reform in the basic medical insurance system, existing medical security setups, which are in the stage of transition, are characterized by a variety of types, a pretty narrow coverage in the provision of medical security and a rather high proportion of self-paying patients. Conclusion It is imperative to actively promote reform of the medical insurance system, formulate regional health plans that conform to the situation in our country, and expand the functions of community medical healthcare.
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Objective To utilize the expert resource in central hospital for helping doctors in community hospital to make suitable diagnosis and treatment,improve the technical level of community medical care. Methods The Telemedicine Diagnosis System is developed based on B/S mode and Microsoft Visual Studio.net C#2005 in Windows platform. Results The Telemedicine Diagnosis System has been developed, and realized the function of interface display, information management, medical image transmission and telemedicine diagnosis. Conclusion The system has friendly interface, simple operation, more reliability and quick data transmission, and it can accurately realize the experts' telemedicine diagnosis in time.
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In this paper,the development trend of medical monitor system is analyzed.The portable trend and network function become more and more popular among all kinds of medical monitor devices.The architecture of medical network monitor system is provided: pocket medical monitor devices based on embedded platform is developed to interact with center database on networks;the telecommunication interface based on 802.11b/g and CDMA is designed to rebuild and extend the functions of traditional imaging devices(ultrasonic?CT?MRI) and the implementation details of terminal,monitor center software,distributed database and two kinds of medical information terminal are especially discussed;distributed medical database is designed for hospital center according to DICOM information model and HL7 standard;hand terminal based on WINCE is developed for nurse's routine care and doctor's auxiliary diagnosis.