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The great founding spirit of the Party is not only the source of the spirit of the Communist Party of China,but also the origin of the red doctor's spirit.As the enrichment and development of the great founding spirit of the Party,the red doctor's spirit in medical and health work embodies the unique advantages and distinctive characteristics of adhering to the truth and ideals,fully demonstrating the value position and goal of practicing the original intention and undertaking the mission,specifically demonstrating the heroic nature and strong will of fearless sacrifice and brave struggle,and clearly outlining the political character and public servant feelings of being loyal to the Party and not betraying the people.In the new era,to promote the great founding spirit of the Party in medical and health work,medical colleges,public hospitals,and medical staff should shoulder the heavy responsibility of inheritance,adhere to putting people's health at the center,and jointly promote the leapfrog development of medical and health services.
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With the continuous acceleration of the aging process in China,it is urgent to achieve new breakthroughs in the field of medical and nursing combined with education,improve the efficiency of talent training,and establish a complete and systematic talent training system.Under the guidance of new medical science,the cultivation of"medicine+X"interdisciplinary,high-quality,compound and applied medical and nursing talents needs to be promoted.The construction of an innovation paradigm of"1+MTE"top-level design for application-oriented talent training with deep integration of"talent chain,education chain"with"industrial chain,innovation chain"can promote the dual subjects of colleges and enterprises to cultivate talents in the medical and health care industry,and actively cope with population aging.Research in Shenyang Medical College on the cultivation of applied talents through the construction of medical and nursing personnel major groups and course groups,reform of teaching content and methods,and building distinctive practical training bases and double qualified teaching staff,promoting healthy aging.
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Policy tools are ways to quantitative analysis of policy text content and the construction of a "Policy Tools-Policy Objectives (X-Y Dimension)" framework to explore long-term stability and late-stage innovation of policy development. This paper reviewed the development process of medical and health policies since the founding of the People’s Republic of China, and divided 1949-2021 into four stages of reform breeding, institutional transformation, reform improvement and continuous deepening. Screening 121 medical and health policy texts issued at the national level since the founding of the People’s Republic of China, quantitatively analyzing 5 957 policy text cells from the perspective of policy tools, counting the use of policy tools in various periods, and excavating the inherent logic of policy texts, policy tools and policy objectives to derive development characteristics of internal logic deduction. The development of China’s medical and health policy in the new period will serve the people’s health in the first place, adhere to the development direction of equalization of basic public service, strengthen the coordinated development of scientific and technological innovation and talent training, build a health and healthy development system with Chinese characteristics.
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This paper analyzed the problems existing in China’s basic medical and health services from the perspective of fairness and efficiency, and the main restricting factors of balanced developmen. The main factors were: the far-reaching influence of "dual economic structure" between urban and rural areas, the government’s low-efficiency intervention in the allocation of health resources, the efficiency of hierarchical diagnosis and treatment system has not been fully released, the level of basic medical security needs to be improved, and the reform of the management and operation mechanism of medical institutions is lagging. It is proposed to adhere to the value concept of appropriate balance between fairness and efficiency, give full play to the functions of the government and the market, and take concrete measures to improve the financing mode, optimize the allocation of resources and improve the service system.
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Based on the characteristics of qualitative research, such as openness, flexibility, interaction and subjectivity, this paper discussed the related ethical challenges and responsibilities faced by institutional ethics committees and researchers in ethical review, informed consent, privacy protection and researchers’ influence in the application of medical and health fields. Ethics committees need to adopt review standards suitable for qualitative research characteristics and improve their review ability. Researchers need to consider from the perspective of research participants, improve their scientific ability and ethical awareness in the whole process of design, data collection, analysis and reporting, truly respect and protect the rights and interests of research participants, and finally produce valuable research evidence.
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With the intensification of global aging trends,the health needs of the elderly are becoming increasingly prom-inent.As one of the main forces in implementing the Healthy China strategy,medical and health institutions play a crucial role in building a scientific,systematic,and targeted health popularization system to improve the health status of the elderly and delay the aging process.However,medical institutions face numerous challenges in constructing a health popularization system for the elderly.Based on the perspective of aging,this article focuses on the hot and difficult issues encountered by the elderly when see-king medical treatment,pays attention to the blind spots and hot issues in elderly health,explores the importance and construction methods of health popularization systems for the elderly in medical and health institutions,in order to enhance the health aware-ness of the elderly,promote health behavior changes,and ultimately improve the health status and quality of life of the elderly.
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Purpose/Significance Based on the typical use scenario of sensitive personal information in medical and health institu-tions,the implementation of the secure use of sensitive personal information is explored.Method/Process For user registration,internal utilization and interaction,medical device/wearable device collection and information disclosure and other scenarios,the paper analyzes the risk of sensitive personal information leakage,explores the application scenarios,advantages and disadvantages of various technical means such as identity authentication,access control,data encryption,data desensitization and detection audit.Result/Conclusion The application of technical means can assist medical and health institutions to further protect the security of patients'personal information.
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Objective@#To investigate the willingness to pay integrated medical and elderly care services and identify the influencing factors among the elderly in Hohhot City, Inner Mongolia, so as to provide insights into promoting integrated medical and elderly care services.@*Methods@#The elderly at ages of 60 years and older were sampled using a convenient sampling method from public venues in four districts of Huimin, Saihan, Yuquan and Xincheng in Hohhot City from June to December 2021. Basic characteristics, health and disease burdens, social support and willingness to pay integrated medical and elderly care services were collected, and factors affecting the willingness to pay integrated medical and elderly care services were identified among the elderly using a multiple linear regression model. @*Results@#A total of 1 008 valid questionnaires were recovered, with an effective recovery rate of 96.74%. The respondents included 519 men (51.49%) and 489 women (48.51%), and had a mean age of (69.47±6.42) years. The monthly average fees of willingness to pay integrated medical and elderly care services were (2 076.49±36.79) Yuan, and there were 636 participants with 2 000 Yuan and less monthly average fees of willingness to pay integrated medical and elderly care services (63.10%). Multiple linear regression analysis showed that place of residence (β=180.832), satisfaction with housing (satisfied, β=-140.760), physical self-care ability (completely self-care: β=-238.244; mostly self-care: β=-254.557), burdens of disease diagnosis and treatment (able to afford: β=452.488; partly afford: β=228.626), monthly income (β=347.144), expenses of medications (β=0.019) and total score of social support (β=17.116) were factors affecting the willingness to pay integrated medical and elderly care services among the elderly. @*Conclusions@#The willingness to pay integrated medical and elderly care services among the elderly in Hohhot City is associated with place of residence, monthly income, satisfaction with housing, physical self-care ability, burden of disease diagnosis and treatment, expenses of medications and social support.
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Objective:In order to strictly prevent academic misconduct, effectively improve the understanding and judgment ability of researchers on medical ethics issues involved in papers, and ensure scientific and standardized research results, strict ethical review is crucial.Methods:It mainly reviews whether the clinical research paper to be submitted has obtained an ethical approval certificate, whether the content of the paper exceeds the scope of ethical approval permission or violates research ethical standards, etc., and establishing a sound paper ethics review mechanism.Results:This paper summarizes the issues, points and considerations of ethical review before submission of clinical research papers, hoping to provide some practical methods and references for the ethical review of clinical research papers in China.Conclusions:Medical and health institutions mostly carry out biomedical research involving humans, and should pay more attention to ethical norms and requirements, educate and guide researchers to strengthen ethical awareness, and improve their attention and judgment ability to medical ethical issues in papers.
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Objective:To analyze the current situation of Investigator-Initiated Trials in medical and health institutions in Shandong Province, the problems in the process of conducting clinical research, and put forward proposals for the establishment of a clinical research management system with effective supervision, sound systems and supporting services, taking into account the progress of the projects since the pilot work was carried out.Methods:A questionnaire was created, an online survey was conducted, a database was set up, a status analysis was conducted and a post-launch analysis of the progress of the pilot was carried out using the National Medical Research Registry Information System, culminating in recommendations using the literature summary method and empirical analysis.Results:Statistical analysis of the questionnaire found that 29.39% of the institutions have a dedicated clinical research management department, and 75.97% of the institutions have a management approach. 25.52%, 40.30%, and 43.07% of institutions established biobanks, clinical research centers, and follow-up centers. There was a statistically significant difference in the establishment of clinical research centers, biobanks, and follow-up centers in secondary and tertiary medical institutions ( P<0.05). The number of general clinical research projects filed, the number of submissions and the number of ethics committees filed in the filing system have all increased significantly after the pilot work, with growth percentages of 126%, 141% and 62% respectively. Conclusions:Shandong Province clinical research pilot work has begun to bear fruit, the current clinical research project still exists in the lack of special funding support, perfect service platform and system support and training system to be improved and other issues.
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Objective:To explore the problems of medical and preventive integration at primary healthcare institutions in China, for references for promoting the development of medical and preventive integration in China.Methods:This study searched for literatures covering the integration of medical and preventive at primary healthcare institutions on CNKI, Wanfang, and VIP databases(from the establishment of the database until March 1, 2023), and extracted text mentioning problems of the medical and preventive integration in primary healthcare institutions. The macro model of the health system was used for problem classification analysis, while the social network analysis method was used to measure the network density, point centrality, and intermediary centrality of the problem, and determine the key issues.Results:A total of 25 papers were included, and 28 problems of medical and preventive integration at primary medical and health institutions were extracted, including 6 problems at the external environment level, 15 problems at the structural level, 6 problems at the process level, and 1 problem at the result level. The results of social network analysis showed that the network density of these problems was 0.71. The point centrality and intermediary centrality of key problems were both high, including the lack of incentive mechanisms for medical and prevention integration (point centrality=69, intermediary centrality=21.44), fragmentation of health information systems(68, 15.70), insufficient awareness of medical and prevention integration among grassroots personnel(65, 17.47), shortage of talent at primary medical and health institutions(64, 11.69), weak service capabilities of primary medical institutions(50, 19.23), and insufficient information sharing(48, 15.80).Conclusions:A variety of problems were found in the integration of medical and preventive at primary medical and health institutions in China, which were closely interrelated. It was urgent to solve six key problems, including the lack of incentive mechanisms, talent shortage, and information system fragmentation, etc. It was suggested that primary medical and health institutions should further improve the incentive mechanism for medical and preventive integration, strengthen the construction of grassroots health talent teams, promote health information exchange and sharing, and enhance the awareness of medical and preventive integration.
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Objective:To analysis the incentive level of family doctors in primary medical and health institutions in Beijing, and to explore its influencing factors, so as to provide references for promoting family doctors′ contract service.Methods:From October to December 2021, 40 family doctors were randomly selected from 135 urban community health service centers in 8 districts of Beijing, and a survey was conducted on basic demographic information, institutional organizational capacity evaluation, and family doctor incentive level evaluation (including four dimensions of work value, organizational environment, personal development, and reward compensation), and the influencing factors of family doctor incentive level was analyzed. Chi-square test and Pearson correlation analysis were used for univariate analysis, and multiple linear regression analysis was used for multivariate analysis.Results:A total of 4 568 family doctors were included, and the score of family doctors′ incentive level was 3.75±0.81, among which the work value score was the highest(3.89±0.77), followed by the organizational environment score(3.69±0.92) and personal development score(3.75±0.90), and the lowest score was reward(3.75±0.90). Age, education, professional title, working years and average total working hours per week negatively affected the incentive level( P<0.05), while the average monthly income, the frequency of attending training and further study, and the organizational ability of the organization positively affected the incentive level( P<0.05). Conclusions:The overall incentive level of family doctors in primary medical and health institutions in Beijing needed improvement, and there were many factors that affect the incentive level of family doctors. It was recommended to appropriately increase the salary and benefits of family doctors, reasonably arrange the workload of family doctors, strengthen the training mechanism of family doctors, and strengthen the organizational capacity building of primary medical and health institutions.
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Objective:To compare the social support levels as understood by family doctor team members in township hospitals/community health centers, and village clinics/community clinics, and their influencing factors, in order to provide reference for improving the work status of family doctor team members and enhancing the quality of family doctors′ contracted services.Methods:A multi-stage random cluster sampling method was used to sample medical workers from contracted family doctor teams in township hospitals/community health centers and their subordinate village clinics/community clinics in 6 counties (cities, districts) of Tai′an city, Shandong province. In August 2020, a questionnaire survey was conducted on the perceived level of social support among family doctor team members using the perceived social support scale. Descriptive analysis was conducted on the data, and independent sample t-tests and one-way ANOVA were used to conduct univariate analysis on the influencing factors of perceived social support scores of family doctor team members at different levels, while multiple linear regression analysis was used to conduct multivariate analysis. Results:A total of 765 valid questionnaires were collected, with 203 and 562 from township hospitals/community health centers and village clinics/community clinics, respectively. The total perceived social support scores of family doctor team members in township hospitals/community health centers and village clinics/community clinics were (65.56±10.29) and (67.31±10.14), respectively, featuring statistically significant differences ( t=-2.11, P<0.05). In-mirage marital status ( β=0.18, P=0.008), good/very good self-rated health status ( β= 0.25, P=0.048), participation of work-related training within one year ( β=0.17, P=0.010), relatively satisfied/very satisfied for job promotion ( β= 0.17, P=0.046), as well as above/far above average self-rated economic status as ( β=-0.15, P=0.027), were the influencing factor on the perceived social support scores of family doctor team members in township hospitals/community health centers. In-marriage marital status ( β= 0.12, P=0.002), good/very good self-rated health status ( β=0.14, P=0.026), junior or intermediate level or above professional title ( β=-0.11, P=0.003; β=-0.10, P=0.006), participation of work-related training within one year ( β= 0.14, P<0.001), and relatively satisfied/very satisfied for job promotion ( β= 0.16, P<0.001) were the influencing factors on the perceived social support scores of family doctor team members in village clinics/community clinics. Conclusions:Members of the family doctor teams in primary medical institutions in Tai′an city had a higher level of understanding of social support. There were differences in the social support levels of family doctor team members between the two levels of primary medical and health care institutions, and the influencing factors were not completely consistent. Targeted measures should be taken based on specific circumstances to enable them to better receive and perceive support from family and friends, and to improve the quality of family doctors′ contracted services.
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Objective:To analyze the input and output status of health resources in primary medical and health institutions and their allocation efficiency in different regions of China, and to provide an empirical basis for optimizing the allocation of primary medical and health resources in China among regions.Methods:The input index data (number of beds and number of health personnel) and output index data (number of primary medical and health institutions visits, number of family health services, number of hospital admissions) of primary medical and health institutions in China in 2020 were extracted from the China Health Statistical Yearbook 2021. Based on the BCC ( Banker, Charnes, Cooper) model of data envelopment analysis ( DEA), the Bootstrap- DEA method was used to correct bias, the allocation efficiency of primary medical and health resources in 31 provinces was calculated and the regional differences were analyzed. Results:After bias correction, the technical efficiency (TE) of resource allocation in primary medical and health institutions decreased by 0.102. The average TE score of all 31 primary medical and health institutions was 0.669, indicating a serious problem of ineffective use of technology. The TE of the eastern, central and western regions was 0.694, 0.663, and 0.649 respectively. There was obvious polarization in the central regions.Further analysis of the efficiency improvement of non DEA efficient provinces showed that 2 DEA weakly efficient provinces and 16 DEA ineffective provinces had several reference provinces for efficiency configuration improvement; The provinces that have been referenced more than 10 times were Zhejiang, Chongqing, Sichuan, and Ningxia, while the provinces that were listed as the first reference by other provinces were Ningxia, Chongqing, Zhejiang, and Tibet.Conclusions:The resource allocation efficiency of primary medical and health institutions in China is relatively low, and regional differences are obvious. The balance between different inputs and outputs should be considered when allocating the resources. Non DEA effective provinces can use DEA analysis to find the most suitable reference object and make reference improvements in the short term.
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The construction of a countywide community for medical and health services is designed to upgrade the service capacity of primary medical and health institutions, to promote resource sharing and collaborative services, and promote the hierarchical medical system. Huzhou of Zhejiang province has launched its initiative in building a countywide community for medical services since 2018. The authors summarized its main practices in promoting the integration of the management system and optimizing operating mechanism of countywide medical and health institutions, promoting the reform of the county medical and health governance system, as well as the achievements and shortcomings, with a view to providing reference for promoting the high-quality development of the countywide medical and health service system.
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ObjectiveTo analyze the equity of medical and health resource allocation in 12 cities of Inner Mongolia Autonomous Region and to provide policy suggestions for further optimizing the allocation of medical and health resources. MethodsBased on two dimensions of geography and population， a comprehensive evaluation of the equity of medical and health resource allocation was conducted using location entropy， health resource density index （HRDI）， entropy-weighted TOPSIS method， and GIS spatial analysis. ResultsLocation entropy showed that the allocation of medical resources in each league city exceeded or approached 1 in the population dimension， but less than 1 in the geography dimension. HRDI revealed that the number of health institutions in Tongliao City was 8.3 times that of Alxa League； the number of beds， health technical personnel， practicing （assistant） physicians， and registered nurses in Wuhai City was 20.3 times， 18.2 times， 15.2 times， and 22.7 times that of Alxa League. The entropy-weighted TOPSIS method showed that the top three weighted indicators were registered nurses （24.14%）， health technical personnel （22.63%）， and practicing （assistant） physicians （21.13%）. Allocation of medical resources in Hulunbuir City， Xilinguole League， and Alashan League was significantly inequitable； GIS spatial analysis showed that the equity of medical resource allocation exhibited a decreasing distribution pattern from the central region to the western and eastern regions. ConclusionThere is a significant disparity in the equity of medical and health resource allocation among various leagues and cities， with resource allocation in the population dimension being better than in the geographical dimension. Allocation of medical and health human resources should be strengthened.
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The great anti-epidemic spirit is a magic weapon for the Chinese people to fight against the COVID-19. Taking the Dr. Zha’s Diary of Fighting the COVID-19 as an example to explore the practical basis and scientific connotation of the great anti-epidemic spirit is of great significance for telling Chinese stories and transmitting Chinese spirit. The anti-epidemic experience described in the book reflects the professional qualities of medical staff who are people-oriented and life first in the fight against the epidemic, the overall view of respecting science and precise prevention and control by various forces in society, and the overall pattern of national unity and shared destiny in China, vividly interprets the precious connotation of the new era medical and health professional spirit.
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This review article aims to explore the major challenges that the healthcare system is currently facing and propose a new paradigm shift that harnesses the potential of wearable devices and novel theoretical frameworks on health and disease. Lifestyle-induced diseases currently account for a significant portion of all healthcare spending, with this proportion projected to increase with population aging. Wearable devices have emerged as a key technology for implementing large-scale healthcare systems focused on disease prevention and management. Advancements in miniaturized sensors, system integration, the Internet of Things, artificial intelligence, 5G, and other technologies have enabled wearable devices to perform high-quality measurements comparable to medical devices. Through various physical, chemical, and biological sensors, wearable devices can continuously monitor physiological status information in a non-invasive or minimally invasive way, including electrocardiography, electroencephalography, respiration, blood oxygen, blood pressure, blood glucose, activity, and more. Furthermore, by combining concepts and methods from complex systems and nonlinear dynamics, we developed a novel theory of continuous dynamic physiological signal analysis-dynamical complexity. The results of dynamic signal analyses can provide crucial information for disease prevention, diagnosis, treatment, and management. Wearable devices can also serve as an important bridge connecting doctors and patients by tracking, storing, and sharing patient data with medical institutions, enabling remote or real-time health assessments of patients, and providing a basis for precision medicine and personalized treatment. Wearable devices have a promising future in the healthcare field and will be an important driving force for the transformation of the healthcare system, while also improving the health experience for individuals.
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Humans , Artificial Intelligence , Wearable Electronic Devices , Monitoring, Physiologic/methodsABSTRACT
In order to further promote hierarchical medical system and enhance the capacity of primary healthcare services, China began to build compact county medical community. At present, the development of China′s compact county community still exists such problems as the construction of service system, the basic institutional mechanism, the quality of supply capacity and the core guarantee mechanism. In order to solve the existing problems, the authors took Shaxian District of Sanming City, Fujian Province, Dancheng County of Zhoukou City, Henan Province, and Yangqu County, Taiyuan City, Shanxi Province as examples to summarize the experience of the advanced pilot areas of the policy. In the future, the construction of compact county community in China should be based on the construction of " single-core multi-layer" system, starting from the five levels of collaborative management, practical operation, system construction, basic guarantee and multi-party supervision, to comprehensively enhance the healthcare services, and finally achieve the goal of the strategy of hierarchical medical and Healthy China.
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@#Abstract: Objective （ ） To investigate the current status of medical radiation protection in medical and health institutions MHI Methods - （ ） in Tibet Autonomous Region. Sixty one MHIs in seven prefectures cities of Tibet Autonomous Region were selected as the study subjects by stratified random sampling. The radiological protection equipment and personal protective ， equipment were investigated and the quality control of radiological equipment and radiation protection monitoring in Results ， radiological workplace were monitored. There were 368 radiation workers in 61 MHI institutions accounting for 4.8% （ ） ∶ ， 368/7 701 of the total number of radiation workers. The ratio of male to female was 2 1 and the average was six people/ institution. The quantity of radiation monitoring equipment and personal protective equipment at all levels of MHI was less than ， 1.00 sets/person. Among them tertiary MHI had the lowest number of personal protective equipment configurations. The （ monitoring qualified rates of radiation equipment quality control and radiation protection in radiation workplace were 73.3% 88/ ） （ ）， 120 and 95.8% 115/120 respectively. The lowes tmonitoring qualified rate of radiation equipment quality control was 55.2% （ ） ， （ ， ）Conclusion 32/58 with digital radiography and the second was computed tomography 84.8% 28/33 . The monitoring ， qualified rate of radiation protection in MHI workplaces at all levels in Tibet Autonomous Region is high. However radiation monitoring equipment and personal protective equipment should be increased.