ABSTRACT
Objective@#To establish a hypertension risk assessment model among the middle-aged and elderly populations based on residents' electronic healthcare records of the basic public health service program, so as to provide insights into prevention of hypertension.@*Methods@#Demographic features and physical examinations were collected among residents at ages of 40 years and older from residents' electronic healthcare records of the basic public health service program in a county of Zhejiang Province from 2019 to 2020. The risk factors of hypertension were identified using a multivariable logistic regression model, and the odds ratio (OR) for each risk factor was transformed into approximate relative risk (RR), which was included in the formula for calculation of the disease risk proposed by Harvard School of Public Health to create a hypertension risk assessment model. The predictive value of the model was evaluated using a receiver operator characteristic (ROC) curve.@*Results@#Totally 7 275 subjects were enrolled, with a mean age of (66.15±7.91) years, and the participants included 3 189 males and 4 086 females, with a male-to-female ratio of 0.78∶1. There were 190 cases with new-onset hypertension (2.61%). Multivariable logistic regression analysis revealed that overweight, obesity, central obesity, borderline high triacylglycerol (TG), elevated TG, abnormal fasting plasma glucose (FPG), prehypertension and family history of hypertension were included in the hypertension risk assessment model, with approximate RR values of 1.66, 1.96, 1.54, 1.17, 1.64, 1.45, 1.69 and 1.11. The area under the ROC curve (AUC) of the model was 0.678 (95%CI: 0.641-0.715, P<0.001), and the optimal positive cut-off was 0.899. The model predicted 139 subjects with RR>0.899 for hypertension, with a sensitivity of 73.16% and specificity of 55.79%.@*Conclusions@#The hypertension risk assessment model created in this study is feasible to predict the RR for developing hypertension among the middle-aged and elderly populations, which has a predictive value in healthcare management.
ABSTRACT
OBJECTIVES@#The Fourth Plenary Session of the 19th Central Committee of the Communist Party of China put forward the idea of "promoting the equalization of basic public services". The utilization of basic public health services by the floating population is an important indicator to measure the equalization of basic public health services. This study aims to understand the intergenerational differences in the utilization of basic public health services between the older generation and the new generation of floating population, and to analyze the influential factors.@*METHODS@#We employed the personal questionnaire (A) of the national health and family planning dynamic monitoring survey on floating population in 2017. Pearson Chi-square test, bi-grouping logistic regression, and Poisson regression were applied to analyze the basic situation of the floating population and the intergenerational differences in the use of basic public health services between the new and old generations.@*RESULTS@#The proportions of the new generation and the old generation who had established the residents' health records in the inflow area were 36.42% and 34.96%, respectively, with the significant difference (@*CONCLUSIONS@#Although the coverage of basic public health services for the two generations of floating population is obviously different, the utilization of basic public health services of the floating population is still at a low level both in the new generation and in the old generation. There is an urgent need to improve the utilization of public health services for the whole floating population according to the characteristics of generations.
Subject(s)
Humans , China/epidemiology , Educational Status , Health Services , Rural Population , Urban PopulationABSTRACT
Objective:To comprehensively evaluate the provincial basic public health service projects and put forward feasible policy recommendations for further improving the basic public health service projects and propose a more scientific and reasonable evaluation method of the implementation status of the projects. Methods:stratified ran-dom sampling method was used to obtain the data on basic public health service information system through institu-tional survey,and relevant policy documents were obtained from governmental institutions' websites. Through Delphi method ( -expert consultations),combined with analytic hierarchy process, evaluation indicators and weights were determined;and cost effect analysis and weighted TOPSIS method were applied to comparatively evaluate the perform-ance of basic public health service projects vertically and horizontally, respectively. Results: The actual per capita project subsidy standard was found to be low;the cost effectiveness of some projects has improved,especially the standard-ized health management of patients with chronic diseases;and there is still a relatively large disparity of the performance of basic public health service in different counties with the highest Ci value is 0.7811 while the lowest is only 0.2694. Con-clusions and Suggestions:Based on the evaluation analysis of this study,it was found that it is very meaningful to integrate the floating population into the budget scope and establish a dynamic growth mechanism;optimize the performance apprais-al program and comprehensively applying cost effect analysis and TOPSIS method to overcome the defects of a single meth-od;and increase fiscal investment to promote the construction of primary medical institutions.
ABSTRACT
Objective:To analyze the satisfaction degree and influencing factors of basic public health services in urban and rural areas in Hubei province,and to provide the evidence for further improvement of the quality of basic public health services. Methods:A total of 12 primary health institutions (6 urban community health service centers and 6 rural township hospitals) were selected from Wuhan,Huanggang,Jingzhou of Hubei Province. A questionnaire survey was conducted on the satisfaction,accessibility,comfort,safety and effectiveness of basic public health services among 719 residents. Results:The overall urban and rural residents'satisfaction score of basic public health service was 71.62 points,and the total satisfaction rate was 73.44%. The urban residents overall satisfaction score was 74.67 points,and the overall satisfaction rate was 75. 34%. The rural residents overall satisfaction score was 67.64 points,and the overall satisfaction rate was 71.52%. Among the specific indicators,the most satisfactory items were the convenience of visits (83.03%),privacy protection (80.25%),and indicators least satisfactory were medical technology(61.61%)and equipment facilities(64.53%). Logistics regression analy-sis showed that accessibility,comfort and safety of basic public health services had a greater impact on community residents' satisfaction;and gender and annual medical expenditure had a certain impact on residents'satisfaction. Conclusions:The over-all satisfaction of basic public health services in urban and rural residents of Hubei province is at a general level and still to be promoted. Urban residents'satisfaction is higher than that of the rural area. The basic public health services should further strengthen the quality improvement to further promote the equalization of basic public health services in rural as in urban areas.
ABSTRACT
Objective: It analyzed the current situation and influencing factors of provincial essential public health service level index(PHI) in 2016. The ordinary least square(OLS) and the geographically weighted regression model(GWR) were constructed respectively. The advan-tages of GWR in the field of health economics were compared. Methods: Moran’s I was used to analyze spatial auto-correlation and hetero-geneity of PHI. OLS and GWR models were constructed to estimate the main influencing factors and their directions. Results: There were a positive spatial auto-correlation in provincial PHI and a weak agglomeration pattern in geographical distribution; the level of economic devel-opment and government funding, population size, population structure and population urbanization level were the main influencing factors of the PHI. There was spatial heterogeneity in provincial regression indexes estimated by GWR. Conclusion: When dealing with geographically related issues in the health economics, the GWR model was better than the OLS with a higher degree of goodness of fit.
ABSTRACT
Objective To scientifically measure the workload of basic public health services project on village level .Methods 257 village doctors and 24 public health administrators that work in rural health clinics in Qianjiang city ,Hubei province and Qianjiang distrcit ,Chongqing city were sampled ,with questionnaire survey and key informant in-depth interview methods used to screen basic public health service projects affordable on village level ,for workload measurement .Results 35 basic public health service projects were chosen as the measurement projects regarding their relative workload. Hypertension follow-up workload 100 was set as the benchmark ,finding the rest relative workload of other projects range from11～936 .Conclusions It is reasonable to use the relative value measurement based on RBRVS theory on village level basic public health service projects. Results of this study can offer support for the pricing and further dynamic modification of the basic public health service projects .
ABSTRACT
Objective:To summarize the cost of basic community public health service in Chinese community for the period 2009 to 2016 and to provide suggestions for the formulation of the compensatory policy and work in-struction in each region.Methods: The literature search conducted on Chinese literature database(including CNKI, VIP, Wan Fang) from the period of 2009 to 2016.The literature was analyzed with the help of NoteExpress managing Literatures,and the relevant papers and their references were comparatively analyzed by using Microsoft excel 2007. Results:There were a total of 817 relevant articles,of which,48 were included in this study and 19 with detailed re-search results.For the 48 articles,41.7% adopted full costing method and 20.8% used activity-based costing meth-od,54.2% using six-item screener. More research of cost estimation applied to current evaluation of public health service in community,the results of cost estimation showed that the cost of basic community public health service per capita was significantly different among the studies in the period of 2009to2011 (20.9 RMB to 95 RMB).The man-power cost was the main cost of basic community public health service(between 56.59% and 74.9%).Conclusions:Further exploration and research on the cost estimation of national basic community public health service in China re-quires to be performed,and the cost estimation methods are supposed to improve in practice.
ABSTRACT
Objective To investigate the cost of public health service in Qingpu District and provide evidence for the government in funds investment.Methods On the basis of the basic public health service items of Shanghai City in 2014,the items in this research were determined by experts consultation,and then economics methods were used for the cost estimates.Results In this research,it was proved that 664 public health personnel were needed to fulfill the task of public health service stipulated by the government of Shanghai City while the actual number was 579,lacking 85 personnel.In 2013,the investment input on public health service in Qingpu District amounted to ￥8 987.75×104 while the actual need was ￥13 438.10×104 according to this research,so there was a lack of ￥4 450.36×104.Conclusion On the basis of the population and service area in Qingpu District,the number of personnel working on public health service and the investment input by the government were not adequate to accomplish the stipulated task,so the government should increase health personnel and investment input on public health service.And a compensation mechanism should be set to motivate the related work in secondary or tertiary hospitals.
ABSTRACT
Objective To understand the correlation between TCM service utilization and health behavior of community residents.MethodsAself-designed questionnaire about TCM service utilization and health behavior status was used to investigate 200 people from 4 communities on random sampling. The items in the questionnaire were evaluated and analyzed to test the correlation of TCM service utilization and health behavior of community residents.Results The two indexes significantly correlated in 0.01 level (bilateral),r=0.674, bilateralP=0.000.Conclusion The correlation between TCM community service utilization and health behavior status is positive. The higher the level of TCM community services utilization is, the higher the index value of health behavior status will be.
ABSTRACT
Objective: To describe the status of the basic public health service in township health centers, analyze the resource allocation which influences the supply of basic public health service. Methods: The data is based on monitoring project surveys collected by the health statistical information center, Spss13.0 and Excellare applied to make descriptive statistic analysis. Results:Overall, basic public health service has been carried out well in each area, but there are differences among the application rates of different basic public health service items; basic public health service can be effected by the level of basic public health input and the number of public health workers.