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Objective:To examine the status of personnel and facilities of radiotherapy in county hospital of Chinese mainland and to evaluate the equity of allocation.Methods:All the county level radiotherapy units were chosen for study, and the data were extracted from the 9 th national survey on radiation oncology departments conducted by Chinese Society of Radiation Oncology of Chinese Medical Association from April 10, 2019 to September 20, 2019. Descriptive statistics and statistical analysis were performed. For the further analysis on the equity, the Gini coefficient, Theil index and agglomeration degree were calculated. Results:The number of county level radiotherapy units was 191 in the eastern region, 172 in the central region and only 59 in the western region, and there was no radiotherapy unit in the county area of some provinces in the western region. For the counties with larger population (population over 500 thousand) in Chinese mainland, 23.4% of the counties in the western region had radiotherapy units, lower compared to the eastern region (48.9%) and central region (41.8%). The Gini coefficients of all kinds of radiotherapy health resources according to population allocation were in alert states, and in highly unfair states according to geographical allocation. The intra-regional gap in radiotherapy resource allocation was larger than the inter-regional gap, and the intra-regional gap mainly came from the western region. HRADi,HRADi/ PADi in the eastern and central regions were all greater than 1, while those in the western region were all less than 1. Conclusions:The overall configuration of county level radiotherapy units in Chinese mainland is insufficient, and there is a regional difference. The fairness of geographical allocation of radiotherapy resources is generally poor. Radiotherapy resources should be scientifically configured to improve the fairness of radiotherapy resource distribution.
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Objective:To analyze the current development status, research hot-spots and development trends of county-level Chinese hospitals in China.Methods:By retrieving the papers of county-level Traditional Chinese Medicine (TCM) hospitals in China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodicals Full-text Database (VIP), Wanfang and China Biomedical Database (SinoMed ) with CiteSpace 5.5.R2 software to draw maps of the author, institution and keyword and make analysis.Results:A total of 598 papers are included in this study, and the trend of publications shows an upward trend and then a downward trend. Researchers conduct research in the form of forming research teams. The research institutions are mainly medical colleges and scientific research institutions. The most frequently showed keyword is "medical reform". The keyword knowledge map shows that the research content mainly involves medical reform, problem analysis and countermeasures, economic operation efficiency, TCM service capability, data envelopment analysis and so on.Conclusions:The county-level TCM hospitals generally show sound development trend in China. The research trend is dominated by county-level TCM hospitals. Scale development has been transformed into the study of hospital operation efficiency. County-level TCM hospitals need to start from their own actual conditions, strengthen cooperation in the form of teams and strengthen academic cooperation among institutions, so as to realize the basic TCM services for ordinary people.
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In the context of the construction of " double sinking and double upgrading" in Zhejiang province, a provincial hospital explored a pilot talent working mechanism of " provincial hospital recruit staff and county hospital get experts" in the process of cooperating with county hospitals. In view of the problem that high-quality medical human resources were difficult to sink, with the flexibility of the reform of post filing and staffing, we put forward the idea of " provincial hospital recruit staff and county hospital get experts" , established key support disciplines, recruited staff by provincial hospitals, and arranged experts to precisely " sink as needed" to help disciplines of county hospitals. It helped to explore the establishment of a long-term mechanism to promote the flow of excellent medical talents to remote mountain areas, built a " specialized community" of provincial and county hospitals, and improved the medical service capacity, medical quality and discipline construction of county hospitals.
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Objective How to make good use of the construction opportunity of the medical association to integrate resources,build scientific research platform and establish practical operation mechanism,to improve the technology innovation ability of district county-level hospitals.Methods Through literature analysis and empirical study,this paper discusses the feasibility and operation mechanism of the construction of research platform in district county-level hospitals.Results The research platform can be built with the help of medical association construction.The operation mechanism can effectively improve the research level of district county-level hospitals,by taking the chance of discipline construction,implementing the institutional mechanism for rewards and punishment.Conclusions With the help of superior medical experts,two-way referral,academic lectures and other activities,advanced scientific culture idea was spread;The training of scientific research personnel,resource integration,and project cooperation increased opportunities.All of this to set up a new platform for district county-level hospitals to promote their scientific and technological innovation abilities.By taking the chance of discipline construction,clarified target responsibility,to carry out the rewards and punishment system and the implementation of the scientific and technological innovation incentive mechanism,can force them to actively promote the ability of scientific and technological innovation,actively carry out scientific research and improve the level of business.
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Objective To establish the questionnaire of nursing assistant requirements of county hospital, test and analyze its reliability and validity. Methods According to the nursing assistant requirements framework had been constructed, document literature and interview to develop a questionnaire item pool, then established the prequestionnaire after research group discussion and expert evaluation. 250 clinical nurses were selected for investigation. Then item analysis,factor analysis, correlation analysis and reliability analysis were applied to test the scale′s validity and reliability. Results The effective questionnaire was 224 copies. Questionnaire of nursing assistant requirements was consisted of 44 items, the factor analysis of the questionnaire identified six principal factors and explained for 53.225% total variances. Correlation coefficient between each dimension and the total scale was 0.532-0.794, the Cronbach α coefficient of each dimension was 0.789-0.910,the Cronbach α of whole scale and split- half coefficient were 0.923 and 0.868. Conclusions The questionnaire of nursing assistant requirements of county hospital has high reliability and validity.It can provide a scientific basis for county hospital to carry out nursing assistance.
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OBJECTIVE: To explore the influence of occupational stress on mental health and job-leaving intention and the mediating roles of coping styles among county hospital clinicians. METHODS: By stratified cluster random sampling method,352 clinicians from 6 county hospitals in Guangxi Province were selected as study subjects. They were required to complete the questionnaires. The assessment was carried out by General Health Questionnaire,Occupational Stress Scale,Trait Coping Style Questionnaire and Questionnaires on Job-Leaving Intention. RESULTS: The rate of mental disorder in the clinicians was 27. 6%,and it showed no difference in different genders( P > 0. 05). The occupational stress,negative coping style and mental health were positively correlated with job-leaving intention( P < 0. 01). The positive coping style was negatively correlated with mental health and job-leaving intention( P < 0. 01). The occupational stress had significantly direct effects on mental health and job-leaving intention( the standard path coefficients were 0. 58 and 0. 46 respectively,P < 0. 01). The positive coping style showed indirect effects between occupational stress and mental health,as well as occupational stress and job-leaving intention( the effect values were 0. 04 and 0. 08 respectively,P < 0. 05).The negative coping style showed indirect effects between occupational stress and mental health( effect value was 0. 10,P < 0. 05). CONCLUSION: Among county hospital clinicians,the positive coping style had a part mediating effect in occupational stress,mental health and job-leaving intention. Negative coping style only had a part mediating effect in occupational stress and mental health.
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Introduced and analyzed in the paper are a reform made in Suichang county of Zhejiang province,in which a general community health center is established as an affiliate to the county TCM hospital which oversees the medical personnel,financial and properties of primary health centers in the country.An analysis of the merits and setbacks of the practice,the authors hold that the reform to build vertical medical consortiums between county-level public hospitals and primary health centers should emphasize the principles of “Consolidating the primary level and benefiting the people”,keep the rights and obligations consistent,and emphasize functional integration and resources sharing in terms of patient flow,personnel,facilities,technology,information and management.
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Objective To investigate and analyze the nursing assistance requirements and the influencing factors of county hospital of Nanchang city.Methods A total of 327 nurses in 6 country-level hospital of Nanchang city were surveyed by the self-made questionnaire.Results The total demand score of county hospital was (4.29±0.47) scores,which was in a high level.The helping content demand was the highest,the form of assistance needs was the lowest.From the specific items of view,prevention of incision infection,nursing training,critically ill patients with bedsore nursing were higher in the content of assistance.Send a nurse to support education,nursing training,hospital experts on-site guidance were higher in the form of assistance.Long term assistance for 1 years,short-term assistance for 4-6 months were the highest in demand of helping times.The main factors of influencing county hospital nursing assistance were work area,department,degree,title etc.The work area was the important influencing factor of nursing assistance of county hospital.Conclusion The relevant departments are recommended to develop personalized assistance scheme according to the recipient hospital needs.
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Objective To analyze influencing factors of physicians' turnover intention at public county hospitals from career stage perspective.Methods Physicians career life was divided into three stages according to professional ranks and titles.The sample was drawn using stratified multistage random methods from public county hospitals in Shandong province and 677 questionnaires were completed,giving a 90.3％ valid response rate.Data were analyzed using multi-group stepwise linear regression.Results The percentage of responders with middle and high-level turnover intention was 23.0％and 6.5％ respectively,and there was no statistically significant difference in turnover intention across three stage subgroups.In physicians at stage 1,the most important factors to predict turnover intention were superiors ' appreciation (r =-0.22,P ＜ 0.05) and payment rationality (r =-0.21,P＜0.05),while in physicians at stage 2,the most important predicting factors were autonomy (r=-0.39,P＜0.05)and learning demand(r=-0.22,P＜0.05),and in physicians at stage 3 were career development(r=-0.31,P＜0.05)and autonomy(r=-0.21,P＜0.05).Conclusion Autonomy and workload are common factors of turnover intention with different predicting power across three career stages.Physicians adjust their career needs to self-actualization with development of career stage,so welltargeted incentives should be taken to stabilize the medical staff of public county hospitals.
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Objective To investigate outpatients' awareness of the essential medicine system and their intention to use it at county hospitals,analyze the problems in the implementation process and give suggestions.Methods Using questionnaires to survey randomly intercepted patients.Data so acquired were keyed in twice with Epidata 3.0 and SPSS 16.0 was used for analysis featuring descriptive statistics.Results Among the 1064 patients surveyed,only 159 (14.9％)have heard of essential medicines,and the top three ways of awareness were respectively from medical staff,television and Internet; patients pay most attention to drug efficacy in their daily life and the majority of them follow doctors' advices.Conclusion It is necessary to strengthen promotions,formulate diversified publicity strategy,train doctors to guide patients to use essential medicines rationally.
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Drug price plus policy had been in place at public hospitals since 1954 and began to phase out since 2009.Hubei province studied the profile and reform progress of 20 pilot county public hospitals before June 2012,and measured the drug income loss incurred by abolishment of this policy since 2012.It is recommended that the reform to abolish drug price plus policy in the province be made based on investigation,evaluation and academic research,prioritizing medical service pricing adjustment aided by government compensation.The authors proposed a new approach of medical service pricing to make up for the revenue gap caused by the abolishment.
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County hospitals function as comerstones in China's health system,as their sustainable development plays a key role for the ongoing health reform.Disciplines are the most primary functional units of a hospital,and their disciplinary culture characteristic of the county hospital' s disciplines and fitting their current development status are definitely the most important and fundamental factor for sustainable development of the discipline.Based on extensive research,authors identified no less than eight cultural elements,namely values of life,self-confidence,a comprehensive model of talent development,safety first,teamwork,communication,scientific pursuit and health management.This study aimed at providing thoughts for the current county hospital development.
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OBJECTIVE To investigate drug-resistance status of Klebsiella pneumoniae in county hospital and provide the reference for rational application of antibiotics.METHODS Drug-resistance was analyzed by K-B methods.The ESBLs producing strains were detected by disc confirmed test.RESULTS The detection rate of ESBLs producing K.pneumoniae was 34.7% in our hospital.Among 216 strains of K.pneumoniae,the susceptibility rates to imipenem and meropenem were all 100.0%.And the resistant rate to amikacin was 25.0%.The resistant rates to the other 9 antibiotics were all over 30.0%.CONCLUSIONS Drug-resistance status of K.pneumoniae is very serious in county hospital.We should think highly of monitoring and controlling drug-resistance of clinical strains in order to prevent breaking out and surveillance.
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County hospitals occupy an important place in the delivery of community health service as they are the center of technological guidance, the base for training in general medicine, and a coordinator of and participant in the community health service of the county seats. To do a good job of community health service, county hospitals ought to make efforts in the following aspects: restructuring of human resources, cooperation between various community health institutions, diversified training programs for personnel engaged in community health service and doctors at the grass-roots level, transformation of ideological concepts, and updating of knowledge and skills.
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OBJECTIVE To investigate distribution status and drug-resistance of pathogens from infected urinary tract and offer scientific evidence for reasonably clinical usage of antibiotics.METHODS A total of 336 strains of pathogenic bacteria isolated from urinary tract infection from 2003 to 2007 were identified,and antibiotic susceptibility test was performed by K-B methods.RESULTS The total isolating rate of Gram-negative bacilli was 78.3%.And that of Gram-positive cocci was 16.4%.Escherichia coli accounted for 64.9%,ranking the first.Except for 100% sensitive to vancomycin in Gram-positive cocci and 100% sensitive to imipenem in Gram-negative bacilli,all pathogens were resistant to the other antibiotics in different degrees.The detection rate of extensive-spectrum beta-lactamases(ESBLs) producers in E.coli and Klebsiella pneumoniae were 25.7% and 28.0%,respectively.CONCLUSIONS The drug-resistance of pathogenic bacteria from infected urinary tract emergs in Yinshan County.We should adopt effective measurement to prevent and control it.