ABSTRACT
Due to factors such as an aging population, the Hospital Authority(HA) of Hong Kong is facing a contradiction between limited health resource supply and continuously increasing demand. In order to effectively address challenges, the HA prompted three measures to bridging the demand-supply gap. The HA relied on its management system advantages to continuously increase its capital construction to enhance the service capacity of public health institutions; transformed service delivery mode so as to improve the experience, quality, and efficiency of service delivery; established cooperation with private service providers and communities to shunt population health demand. The practices of HA can provide reference for public hospitals and their sponsors in other regions of China.
ABSTRACT
ObjectiveThe aim is to understand the current situation of death literacy among Chinese residents in the Guangdong-Hongkong-Macao Greater Bay Area and explore educational approaches to enhance the death literacy of the social public. MethodThe Death Literacy Index was conducted among 2，002 residents in the Guangdong-Hong Kong-Macao Greater Bay Area， which included 29 items from four dimensions namely practice， experience， fact， and community. ResultsThe average score of death literacy among the respondents was moderate （6.70）， with scores for practical and experiential knowledge （7.32， 7.50） higher than those for factual and community knowledge （6.20， 6.10）. The weakest content included discussing bereavement with people who have just lost loved ones （5.07）， laws and regulations related to death at home （5.35）， and providing support for the terminal person and their families in the community. ConclusionThe death literacy of the Chinese residents in the Greater Bay Area was moderate， in which community knowledge was the weakest with a lack of concern and support for the terminal person and the caregivers. Therefore， community health promotion strategies were proposed to strengthen death education for the public and promote the death literacy of the residents.
ABSTRACT
Medical physicists play an important role in the delivery of radiotherapy. Compared with China′s mainland, Hong Kong has established a more mature training mode and a more complete management system for medical physics talents. In this article, the authors introduced the current state of medical physics talent training, as well as the recruitment, certification and promotion of medical physicist in Hong Kong by querying the official websites of medical physics organizations, reviewing related literature and interviewing senior medical physicists in Hong Kong. The authors also analyzed the shortcomings in the construction of medical physics talent system in China′s mainland and made valuable suggestions.
ABSTRACT
OBJECTIVE To systematically analyze the status of health economic evaluation studies of influenza vaccination in Guangdong-Hong Kong-Macao Greater Bay Area （GBA） of China， and to provide a methodological reference for future scholars to carry out economic evaluations of influenza vaccine in GBA. METHODS Seven English databases such as PubMed and Embase and three Chinese databases such as CNKI and Wanfang database were searched. The economic evaluation studies of influenza vaccines with the study area of GBA were collected. The search time frame was from the inception to June 30， 2022. After screening the literature and extracting key information， descriptive analysis was conducted on the study design， evaluation methods， model settings， results and conclusions of these collected papers， and the quality of the papers was evaluated using Quality of Health Economic Studies. RESULTS A total of 12 papers were included， of which 7 had a study region of Hong Kong in China， 6 had an older target group， 5 had a society-wide perspective， and the study time frame ranged from 6 months to 9 years. Besides， 8 papers used cost-utility analysis， only 2 used an epidemic model； 8 papers conducted sensitivity analyses， and most of them conducted both one-way sensitivity analysis and probabilistic sensitivity analysis. Moreover， the results of the economic evaluation of 10 papers showed that （combined） vaccination or increased vaccination rates were more economical. In addition， 4 of the 12 papers had a quality score＞75， which were considered high-quality studies. CONCLUSIONS Although most of the included studies showed that vaccination was economical， the quality of the existing paper needed to be improved. It is recommended that subsequent studies on the economic evaluation of influenza vaccines in GBA may consider adding economic evaluations for Macau and other cities in Guangdong of China， prioritizing dynamic models and recent data from local residents， and referring to relevant tools and guidelines to improve thestandardization and scientificity of the study design.
ABSTRACT
OBJECTIVE@#Functional constipation (FC) is a common intestinal disease worldwide. Despite the presence of criteria such as Roman IV, there is no standardized diagnosis and treatment algorithm in Hong Kong that combines both Western and Chinese medicine approaches. This study integrates current effective and safe diagnosis and treatment methods for FC and provides a clear and scientific pathway for clinical professionals and patients.@*METHODS@#A systematic search of the PubMed, Cochrane Library, and China National Knowledge Infrastructure databases was performed from their inception to June 30th, 2022, collecting the current evidence about the efficacious integrative management for FC. We organized a meeting of professionals in fields relevant to treatment and management of FC to develop a consensus agreement on clinical pathway process.@*RESULTS@#We developed a clinical pathway for the treatment of FC based on the most recent published guidelines and consultation with experts. This pathway includes a hierarchy of recommendations for every step of the clinical process, including clinical intake, diagnostic examination, recommended labs, diagnostic flowchart, and guidance for selection of therapeutic drugs.@*CONCLUSION@#This pathway establishes clinical standards for the diagnosis and treatment of FC using Chinese medicine and Western medicine; it will help to provide high-quality medical services in Hong Kong for patients with FC. Please cite this article as: Wei DJ, Li HJ, Lyu ZP, Lyu AP, Bian ZX, Zhong LL. A clinical pathway for integrative medicine in the treatment of functional constipation in Hong Kong, China. J Integr Med. 2023; 21(6): 550-560.
Subject(s)
Humans , Hong Kong , Integrative Medicine , Critical Pathways , China , Constipation/therapyABSTRACT
Objective:To explore the experience of teachers from Guangdong and Macao in nursing teaching cooperation, the existing problems in current teaching cooperation and suggestions for improvement.Methods:From January to April 2021, using descriptive qualitative method to conduct in-depth among eight clinical tutors from The Third Affiliated Hospital of Guangzhou Medical University who teach Macao nursing students, and four teachers from Kiang Wu Nursing College of Macao using the purposive sampling method. And adopted content analysis for data analysis.Results:A total of 4 themes and 2 sub-themes were analyzed: the positive impact of cross-border teaching cooperation projects including developed the nursing business of the two places and deepened the cooperative relationship between the two places; limiting the depth and breadth of knowledge transfer because of the short cross-border learning time; the imbalance between students′ abilities and teachers′ expectations; expectations for homogeneous internships for heterogeneous groups.Conclusions:Cross-border nursing teaching cooperation is an important promoter for the development of nursing education between Guangdong and Macao, but there are still deficiencies in cooperation, and it is necessary for the two places to strengthen the construction of a sharing platform for teaching resources to promote the development of nursing education in the Guangdong-Hong Kong-Macao Greater Bay Area.
ABSTRACT
OBJECTIVE：To provide reference for furthe r promoting the high-quality development of the biomedical industry in Guangdong-Hong Kong-Macao Greater Bay Area. METHODS ：Through summarizing the development status and development environment of the biomedical industry in the Guangdong-Hong Kong-Macao Greater Bay Area ，the construction experience of foreign advanced biomedical industrial park was introduced ，and the problems and challenges faced by the biomedical industry in the Guangdong-Hong Kong-Macao Greater Bay Area were sorted out so as to put forward relevant countermeasures and suggestions. RESULTS & CONCLUSIONS ：Guangdong-Hong Kong-Macao Greater Bay Area has received multiple policy support，which is conducive to the development of biomedical industry. The industrial chain is complete ，and the scale advantage of biological industry is showing day by day. Biological industry has achieved fruitful innovation achievement ，and its R&D investment is in the leading position in the country. The pharmaceutical manufacturing industry is developed and the total amount of medical resources is large. The financial advantages are obvious ，and institutional innovation is conducive to the development of biomedical industry. The process of internationalization takes the leading place ，which is conducive to continuously promoting foreign cooperation. However ，compared with foreign advanced biomedical industrial parks ，Guangdong-Hong Kong-Macao Greater Bay Area still has some deficiencies in management mode ，service mode and “industry-university-institute”cooperation. It also faces the following problems that the legal systems and industry norms of the three places need to be further connected ；there is a talent gap ；the industrial chain is not perfect ；the support for new drug R&D is insufficient ；the“industry-university-institute” cooperation needs to be strengthened ；the level of financial support needs to be improved. Accordingly ，it is recommended to break down institutional barriers ，and promote the connection between the legal system and industry norms ；innovate talent policies ，and continue to attract excellent R&D talents ；introduce leading companies ，and improve the industrial chain ；open up clinical trial channels and promote the transformation efficiency of scientific research achievements ；strengthen“industry-university-institute” cooperation，and promote the improvement of biomedical innovation ability ；make good use of financial support to help the rapid rise of biomedical industry enterprises ，so as to promote the high-quality development of biomedical industry in Guangdong-Hong Kong-Macao Greater Bay Area.
ABSTRACT
Objective: To investigate the rare variant types of abnormal -α3.7 deletion band samples detected by commercial kits commonly used in thalassemia, and analyze their blood type phenotype, so as to provide reference for clinical consultation. Methods: Peripheral blood samples of 4 238 patients from June 2016 to September 2019 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were collected for routine blood analysis. DNA was extracted from whole blood, and the common mutation genes of thalassemia were detected by gap-polymerase chain reaction (Gap- PCR) and reverse dot blot (RDB). Gap-PCR and Sanger sequencing were used to detect rare mutations of α-thalassemia. Results: A total of 109 cases of -α3.7 deletion band were detected by routine genetic testing for thalassemia, among which 15 cases had abnormal -α3.7 deletion band. Gap-PCR and Sanger sequencing showed that 14 cases were confirmed to contain Hong Kong αα (HKαα) gene and 1 case was NG_000006.1: g.34569_38382 del 3 812 bp rare deletion. The misdiagnosis rate of abnormal -α3.7 deletion bands by routine Gap-PCR test for thalassemia was 13.76%. Conclusion: Patients with abnormal -α3.7 deletion bands should be detected for further confirmation by testing rare type of α-thalassemia, which will help provide more accurate genetic diagnosis results and genetic counseling.
ABSTRACT
BACKGROUND@#China is the most populated country and the second economic entity worldwide. Hong Kong and Shenzhen are two adjacent cities in southern China, with similar environmental, cultural, ethnic groups, and economic development. They both have a very interesting turning point in their destiny, leading to a miraculous economic development. However, their government structure and health care system are totally different.[1] This is a vivid example of Deng Xiaoping's formulation of the principle of "one country, two systems".
ABSTRACT
OBJECTIVE：To study the current situation of traditional Chinese medicine （TCM）industry policy in Guangdong- Hong Kong-Macao greater bay area ，and to provide suggestions for the follow-up planning and layout. METHODS ：The content analysis method was used to code and measure the policy text of TCM industry in Guangdong-Hong Kong-Macao greater bay area issued by the central government and local government as of April 2020 from the perspective of policy tools. The current development focus and existing problems of the industry were summarized to put forward reasonable suggestion. RESULTS & CONCLUSIONS：A total of 34 relevant policy texts were retrieved ，including 9 at the central government level and 25 at the local government level. In respective of essential policy tool ，the supply-oriented ，demand-oriented and environmental policy tools of TCM industry in Guangdong-Hong Kong-Macao greater bay area accounted for 58.10％，22.86％ and 19.05％，respectively. Among supply-oriented policy tools ，hardware construction accounted for 40.98％，internal communication for 26.23％，quality construction for 22.95％，and international exchange for 9.84％；there was no specific implementation rules and programs for policy tools ，which affect their operability. The demand-oriented policy tools included health service （75.00％），international trade （16.67％），service outsourcing （4.17％）and government subsidies （4.17％）；the use of the latter three approaches limited the openness of the industrial market. The environmental policy tools included target planning （40.00％），access rules （25.00％）， intellectual property （30.00％）and financing support （5.00％），but needed to improve the support of laws and regulations and relevant measures. In respective of the value chain of TCM industry ，34 policy texts showed 4 contents，including platform construction（36.19％），scientific and technological innovation （19.05％），market expansion （23.81％），exchange and cooperation （20.95％）；the lack of scientific and technological innovation and exchange and cooperation limited the standardization ， modernization and internationalization of TCM. It suggested to optimize the supply-oriented policy tools ，improve the operability of policies； pay attention to the demand-oriented and environmental policy tools ， highlight the role of marketization and standardization；pay attention to the integration of basic policy tools and industrial value chain ，and achieve the standardization ， modernization and international development of TCM in Guangdong-Hong Kong-Macao greater bay area.
ABSTRACT
Introduction@#Hong Kong SAR (China) achieved measles elimination status in 2016, and the incidence of measles infection had been low over the past few years. However, the Centre for Health Protection (CHP) at the Department of Health was notified on 22 March 2019 of an outbreak of three cases of measles infection among workers at the Hong Kong International Airport (HKIA).@*Methods@#We reviewed notifications of measles received by CHP from 1 January to 17 May 2019. We defined a confirmed case of measles as having laboratory evidence of measles infection. All confirmed cases among airport workers or those with epidemiological information suggesting they had been infected by contact with airport workers were included in the review. We described the epidemiological features and reviewed the control measures against the outbreak.@*Results@#We identified 33 cases, 29 of which were among airport workers. They comprised 22 men and 11 women, aged 20–49 years (median 25 years). The majority of people with confirmed measles presented with fever and rash. All required hospitalization. None developed complications. Control measures, including enhanced environmental hygiene and improved ventilation at HKIA and vaccinations for the airport community, were implemented.@*Discussion@#Early recognition of the outbreak and prompt control measures, especially targeted vaccination of the exposed population, effectively controlled the outbreak in just two weeks.
ABSTRACT
Atractylodis Macrocephalae Rhizoma is a common traditional Chinese medicine with huge demand. In this paper, quality standards of Atractylodis Macrocephalae Rhizoma in Chinese Pharmacopoeia, Japanese Pharmacopoeia, Korean Pharmacopoeia, European Pharmacopoeia and Hong Kong Chinese Materia Medica Standards were compared and analyzed. It aims to understand the similarities and differences of the quality standards of Atractylodis Macrocephalae Rhizoma between Chinese Pharmacopoeia and other pharmacopoeias, and learn the advantages of them to provide the reference for improving the quality standard of Atractylodis Macrocephalae Rhizoma.
ABSTRACT
Informationization as conducted by the Hospital Authority (HA) of Hong Kong features the following aspects.Collective deployment of IT professionals from its medical institutions is designed for development of a unified,coordinated and clinical centered information system among its medical institutions.In addition,HA has built a control center for centralized information system operation & maintenance,which enjoys sufficient funding support for health informationization.In the course of information sharing,HA pays close attention to patients' privacy protection.Shanghai Hospital Development Center can take HA's experience on municipal hospitals health informationization,for the purposes of building a unified,coordinated and clinical centered information system and furthering Shanghai municipal hospital's health informationization.
ABSTRACT
BACKGROUND/AIMS: In addition to the globally endorsed Barcelona Clinic Liver Cancer (BCLC) staging system, other algorithms or staging systems have been developed, including the Hong Kong Liver Cancer (HKLC) staging system. This study aimed to validate the HKLC staging system relative to the BCLC staging system for predicting survival for hepatocellular carcinoma (HCC) patients in Korea. METHODS: From 2004 to 2013, 2,571 patients newly diagnosed with HCC were consecutively enrolled at three Korea University medical centers. RESULTS: Both staging systems differentiated survival well (p < 0.001). However, 1-year and 3-year survival were predicted better using the HKLC system than the BCLC system (area under the receiver operating characteristic curve: 0.869 vs 0.856 for 1 year, p=0.002; 0.841 vs 0.827 for 3 years, p=0.010). In hypothetical survival curves, the HKLC system exhibited better median overall survival than the BCLC system (33.1 months vs 19.2 months). In evaluations of prognosis according to either BCLC or HKLC treatment guidelines, risk of death was reduced in the group following only HKLC guidelines compared with the group following only BCLC guidelines (hazard ratio, 0.601; 95% confidence interval, 0.443 to 0.816; p=0.001). CONCLUSIONS: Although both staging systems predicted and discriminated HCC prognoses well, the HKLC system showed more encouraging survival benefits than the BCLC system.
Subject(s)
Humans , Academic Medical Centers , Carcinoma, Hepatocellular , Hong Kong , Korea , Liver Neoplasms , Liver , Neoplasm Staging , Prognosis , ROC CurveABSTRACT
Mainland China's healthcare system reform has achieved remarkable results. As the reform progresses ,more efforts could be made in policy-learning from other Chinese societies with more successful experiences. Hong Kong Special Administrative Region has an internationally renowned healthcare system, ranked at the top in the world's most efficient health systems. This paper reviews Hong Kong's health governance system, the challenges it has faced, its reform initiatives in the recent years, and discusses their implications for the mainland China. Heath governance in Hong Kong has fully realized the separation of regulationswith operation, thus overcoming major institutional barriers. The Hospital Authority of Hong Kong has demonstrated very high efficiency and managerial professionalism. However, Hong Kong's healthcare system is also facing various daunting challenges, and the government has introduced a series of reform initiatives, including the Voluntary Health Insurance Scheme, Public-Private Partnership, and Elderly Health Care Voucher. Many reform ideas and policy instruments can be of reference value for healthcare system reforms in the mainland.
ABSTRACT
Until 1st July 1997, Hong Kong was under the governance of the British Government; therefore, the British system of education was followed. After internship, 7 years of general surgical training is required to obtain registration and fellowship qualifications of the College of Surgeon of Hong Kong and Edinburg. After having become a specialist in general surgery, the surgeon could choose to specialize in colorectal surgery with an additional 3 to 5 years of specialist training in an accredited centre and 6 months of overseas training with subsidies. On the contrary, China has more than 600 medical schools, and students can enroll in different programs to become a medical practitioner. Despite a great discrepancy exists in the quality of teaching and supervision but there are comprehensive regulations governing the accreditation of hospitals, credentialing of operations, medical records, etc. to ensure medical and patient safety. Vast amounts of resources are being invested to strengthen the quality and to advance the technology used in patient care, not only by supporting basic and clinical research but also by providing extra resources to “import” experts and help develop services with clinical excellence. To accomplish this, the aim of the “three fames project” with a 5-year funding of 3 million United States dollar is to invite overseas experts to help build medical teams in specific areas. Due to its huge population (more than 1.3 billion people), China is a country full of potential for development in clinical research, collaboration, knowledge exchange, and the provision of premier medical services.
Subject(s)
Humans , Accreditation , China , Colorectal Surgery , Cooperative Behavior , Credentialing , Education , Fellowships and Scholarships , Financial Management , Health Care Reform , Hong Kong , Internship and Residency , Medical Records , Organization and Administration , Patient Care , Patient Safety , Schools, Medical , Social Control, Formal , Specialization , United StatesABSTRACT
The reimbursement on high-value drug expenses for patients is an important approach of catastrophic disease medical insurance.Hong Kong has established in a drug safety network, that has achieved remarkable results in improving the accessibility to high-value drugs and the burden of disease and effectively alleviated patients' financial burden.This paper systematically analyzes the history, process of adding drugs to directory, application conditions for drugs and patients, development status, and characteristics of drug safety network in Hong Kong.This study points out that although Mainland China has gradually established the high-value drug directory for catastrophic disease through the method of drug negotiation, the mechanism of high-value drug directory is not mature yet.To achieve the convergence between high-value drug directory, basic medical insurance drug directory, and new rural cooperative medical scheme drug directory, Mainland China needs to: 1) First, learn from the drug safety network in Hong Kong and establish access and exist mechanism for high-value drug directory;2) Then, expand insurance coverage of high-value drugs by establishing a multi-channel and socialized financing mechanism;3) Finally, strengthen the major disease medical insurance by adhering to the principles of buying drugs and getting drugs for free and reforming the fixed-ratio-reimbursement model.
ABSTRACT
Objective To compare the prognostic ability of Hong Kong Liver Cancer (HKLC) staging system with that of Barcelona Clinic Liver Cancer (BCLC) staging system for Chinese patients with hepatocellular carcinoma (HCC) after receiving transarterial chemoembolization (TACE).Methods The clinical data of 180 Chinese patients with primary HCC,who were treated with TACE during the period from August 2008 to December 2015,were retrospectively analyzed.HCC staging of each patient was scored by two staging methods separately.Kaplan-Meier analysis was adopted to separately calculate the median survival time of each stage that was judged by the two staging methods.The likelihood ratio (LR) x2 values,the Akaike information criterion (AIC) value and Harrell's C value of the two staging methods were calculated.Results Statistically significant differences in the survival time of each period existed between the two staging systems.AIC value,LRx2 value and Harrell's C value of HKLC staging system were 1360,66.6,and 0.813 respectively,while those of BCLC staging system were 1365,61.8,and 0.772 respectively.Conclusion Compared with BCLC staging,HKLC staging is more suitable for predicting the survival time of Chinese patients with primary liver cancer treated with TACE.
ABSTRACT
We are living in an age where artificial intelligence and astounding technological advances are bringing truly remarkable change to healthcare. Medical knowledge and skills which form the core responsibility of doctors such as making diagnoses may increasingly be delivered by robots. Machines are gradually acquiring human abilities such as deep learning and empathy. What, then is the role of doctors in future healthcare? And what direction should medical schools be taking to prepare their graduates? This article will give an overview of the evolving technological landscape of healthcare and examine the issues undergraduate medical education may have to address. The experience at The University of Hong Kong will serve as a case study featuring several curricular innovations that aim to empower medical graduates with the capabilities to thrive in the future.
Subject(s)
Humans , Artificial Intelligence , Curriculum , Delivery of Health Care , Diagnosis , Education, Medical, Undergraduate , Empathy , Hong Kong , Learning , Schools, Medical , Students, MedicalABSTRACT
This paper examined whether the preventive measures taken by the Hong Kong's colonial authorities were legitimate during the 1894 Hong Kong plague epidemic, and illuminated the correlation between the plague epidemic and hospital space in Hong Kong in the late 19th century. The quarantine measures taken by the colonial authorities were neither a clear-cut victory for Western medicine nor for a rational quarantine based on scientific medical knowledge. Hong Kong's medical officials based on the miasma theory, and focused only on house-to-house inspections and forced quarantine or isolation, without encouraging people to wear masks and without conducting disinfection. Even after Hong Kong plague spread, the Hong Kong's colonial authorities were not interested in what plague bacilli were, but in where they were to be found and how to prevent and control an outbreak of the disease. The germ theory brought significant changes to the disease classification system. Until the 1890s, Hong Kong's colonial authority had classified cause of death mainly on the basis of symptoms, infectious diseases, parts of the body and diseases of systems. Microbiological analysis of the cause of death in Hong Kong was started by Hunter, a bacteriologist, in 1902. He used bacteriological tests with a microscope to analyze the cause of death. New disease recognition and medical recognition brought large changes to hospital space as well. In particular, from the 1880s to the early 1900s, Western medical circles witnessed shifts from miasma theory to the germ theory, thereby influencing Hong Kong's hospital spaces. As the germ theory took ground in Hong Kong in 1894, the bacteriological laboratory and isolation ward became inevitable facilities, and hospital space were reorganized accordingly. However, the colonial authorities and local elites' strategy was different. As a government bacteriologist, Hunter established a central facility to unify several laboratories and to manage urban space from ouside the hospital. On the contrary, the Tungwah Hospital tried to transform hospital space with isolation ward and Receiving Ward System as the eclectic form of Chinese and Western medicine. The 1894 Hong Kong plague promoted the introduction of germ theory and the reorganization of hospital space.