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Objective:To learn the key driving factors in the management of scientific and technological achievements transformation in public hospitals, so as to provide basis for improving the effectiveness of achievements transformation.Methods:From March to July 2021, 1 226 medical staff from 7 municipal hospitals in Hangzhou were investigated by stratified random sampling. The questionnaire included the main demographic information, the perceived importance and actual performance of the management mechanism(6 dimensions, 18 items)which was scored by Likert 5. Descriptive analysis was carried out and paired samples were compared by t-test, and the difference was significant when P<0.05. Importance matrix analysis was carried out on all items to identify the key driving factors for the transformation of achievements in public hospitals. Results:1 157 valid questionnaires were finally included. The difference between the scores of perceived importance and actual performance of the various management mechanisms was significance( P<0.001). The gap was presented as follows: evaluation mechanism(1.29), investment mechanism(0.88), organization and leadership mechanism(0.87), guarantee mechanism of services(0.44), benefit and distribution mechanism(0.15), incentive mechanism(-0.11). Matrix analysis results showed that, " special funds support" , " grasp market demand and accurately connect" , " formulate corresponding supporting systems" , " professional transformation team with multidisciplinary background" , " classified and multi-level achievement transformation evaluation index system" , " full life cycle management" , " incorporate into central work and key tasks" and " scientific and technological achievement transformation reporting system and application monitoring system" were the key driving factors for the transformation of scientific and technological achievements in public hospitals. Conclusions:The perceived importance of medical staff to the transformation of scientific and technological achievements in public hospitals is acceptable, while the actual performance is relatively weak. The management effectiveness should be improved and give priority to consolidate the management foundation, build index evaluation system, provide the life cycle management service and improve scientific interaction as well as consultation service mechanism.
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Objective:To investigate and analyze the status quo and influential factors of the elderly in the community.Methods:From July to September 2021, 543 elderly people were investigated in 9 community healthcare service centers in Hangzhou by using the Comprehensive Frailty Assessment Instrument (including four dimensions: physical, psychological, social, and environmental frailty) and the Social Support Rating Scale (including three dimensions: subjective support, objective support, and support availability). Independent sample t-test, analysis of variance, correlation analysis, and multiple linear regression were conducted to examine key determinants of frailty. Results:The total score of frailty among older adults in the community was (43.1±12.0). The results showed that the total score of social support was negatively associated with frailty of community-dwelling older adults ( r=-0.449, P<0.01); age ≥80 years old ( β=0.229, P<0.001) was positively associated with frailty; not living alone, children′s household support, children′s spiritual support, the accessibility of elderly care facilities within a 15-minute walk, and social support score were negatively associated with frailty ( β=-0.118, -0.081, -0.260, -0.155, -0.250,all P<0.05). Conclusion:The elderly in the community have a moderate degree of frailty, which affected by age, living condition, children′s support, the accessibility of elderly care facilities, and social support.
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Objective:To analyze the use and satisfaction of smart healthcare in public hospitals in Hangzhou from the perspective of patient experience.Methods:From August to September 2020, 501 patients from 2 class A tertiary hospitals and 5 community health centers in Hangzhou were randomly selected for questionnaire survey. The survey included their usage and satisfaction of smart healthcare. Based on SERVQUAL theory, the patient satisfaction scale included 5 dimensions of tangibility, reliability, reactivity, assurance, and empathy. The factors affecting patient satisfaction were analyzed by single factor and multi factor analysis.Results:The average score of patient satisfaction was 3.94±0.56. The satisfaction with tangibility(4.25±0.64), assurance(4.07±0.71)and reactivity(4.02±0.73)was higher, while the scoring of empathy(3.84±0.77)and reliability(3.52±0.70)were lower than the average score. The results of multiple linear regression analysis showed that patients′ educational level, occupational type and UTAUT score had a certain impact on satisfaction( P<0.05). Conclusions:The overall satisfaction of patients with smart healthcare in Hangzhou is high. In the future, we should pay more attention to big data security and personal privacy protection, upgrade the smart medical system, improve the hospital Internet platform, empower smart healthcare service system through digital technology, and promote the comprehensive digital transformation of health.
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Objective:To evaluate the degree of trust of patients in community traditional Chinese medicine(TCM)physicians, based on the TCM service capability promotion program, and to analyze the impacts by TCM prevention and health care service.Methods:1 391 patients at 22 primary health service centers in 3 cities from Zhejiang province were investigated using the Chinese version of Wake Forest Physician Trust Scale(WFPTS)in September, 2017. Quantitative and qualitative variables were described by mean±SD, and ratio respectively. Differences were compared by t test, ANOVA and Kruskal-Wallis test. Results:Chinese version of WFPTS had good reliability and validity in measuring community TCM physicians. The average scoring of patients′ trust in community TCM physicians was 38.00±6.42, while their benevolence and competence were 19.14±3.41, 18.82±3.50 respectively.For patients with different demographic characteristics, their quantity and the way to acquire and utilize TCM prevention and health care service had different degrees of trust in community TCM physicians. Patients′ gender, age, awareness and utilization of TCM prevention and health care service, etc. affect the degree of trust in community TCM physicians.Conclusions:Patients have higher degree of trust in community TCM physicians, and improving the rate of awareness and utilization of TCM prevention has positive impacts on the degree of trust in these physicians. It is proposed that health knowledge education be strengthened and skills of community TCM physicians′ capacity be enhanced through various ways.
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Objective To study the factors leading to the increased risk of falls when the elderly cross obstacles with different load distributions in their hands, and to explore the gait strategies to prevent falls for elderly people with different load distributions during obstacle crossing. Methods Twelve young healthy (control group) and 12 elderly healthy participants performed walking tasks with or without obstacle crossing at their daily speed under different load distributions. Surface electromyography (sEMG) signals were collected from both sides of the lateral femoris, rectus femoris and medial femoris. Then the average sEMG was analyzed and compared. The numbers of contact incident during obstacle touching were also recorded. Results Age, weight carrying and obstacle all had significant influences on the activity level of lower limb muscles in elderly people. A total of 9 contact incidents occurred in 1 152 obstacle crossing tests. In addition, the contribution of right vastus medialis muscle was the greatest in the elderly and young adults when they completed the weight carrying and obstacle crossing tasks. Conclusions The elderly people had the lowest risk of falling down by taking advantage of the dominant side of the leg to take the lead in obstacle crossing under the uniform distributions of load. The research findings provide references for systematic assessment of fall risk in the elderly and have certain guiding significance for lower limb exercise or rehabilitation training in the elderly.
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Objective@#To evaluate the degree of trust of patients in community traditional Chinese medicine(TCM)physicians, based on the TCM service capability promotion program, and to analyze the impacts by TCM prevention and health care service.@*Methods@#1 391 patients at 22 primary health service centers in 3 cities from Zhejiang province were investigated using the Chinese version of Wake Forest Physician Trust Scale(WFPTS)in September, 2017. Quantitative and qualitative variables were described by mean±SD, and ratio respectively. Differences were compared by t test, ANOVA and Kruskal-Wallis test.@*Results@#Chinese version of WFPTS had good reliability and validity in measuring community TCM physicians. The average scoring of patients′ trust in community TCM physicians was 38.00±6.42, while their benevolence and competence were 19.14±3.41, 18.82±3.50 respectively.For patients with different demographic characteristics, their quantity and the way to acquire and utilize TCM prevention and health care service had different degrees of trust in community TCM physicians. Patients′ gender, age, awareness and utilization of TCM prevention and health care service, etc. affect the degree of trust in community TCM physicians.@*Conclusions@#Patients have higher degree of trust in community TCM physicians, and improving the rate of awareness and utilization of TCM prevention has positive impacts on the degree of trust in these physicians. It is proposed that health knowledge education be strengthened and skills of community TCM physicians′ capacity be enhanced through various ways.
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Since 2007, the State Administration of TCM has implemented the preventive treatment of TCM health project, support the development of the Preventive treatment Section, issued the TCM health management service standards for special groups, and vigorously established the TCM preventive health service system. The thought of preventive treatment in TCM fully embodies the thinking mode of preventive and health care for TCM, but health management is a specific process of monitoring, evaluation, intervention and follow-up of health risk factors. In this paper, through comparative research methods, we analyzed the similarities and differences between preventive treatment of TCM and health management from historical origins, ideological content, guiding ideology, and key strategies and techniques, and we have discovered preventive treatment of TCM has more obvious advantages in theoretical height and comprehensive conditioning, and modern health management is more advanced in the application process and technical means. Their common points in the pursuit of health promotion and disease prevention, the emphasis on holistic medical concepts, and the focus on health risk factors, and the possible fusion of preventive treatment of TCM and health management in core ideas, theory and practice and technical methods, especially for prevention, treatment and rehabilitation of sub-health, constitution bias, chronic diseases and other groups. The phased monitoring-assessment-intervention approach under the guidance of the idea of preventive treatment can provide suggestions for the development ideas of TCM health management. Research on TCM health risks monitoring and assessment in different life cycles needs to be strengthened.
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Objective To learn customer satisfaction for health management centers at public hospitals in Hangzhou. Methods From July to September 2015, 660 customers from the health management centers of 6 public hospitals in Hangzhou were randomly selected for questionnaire survey. The survey included their satisfaction for the technical attitude, service content design, waiting time, environment facilities, management regulations, and service charges. Univariate analysis was carried out on the satisfaction scores of customer demographics. Two-class logistic regression was used to analyze the factors affecting customer satisfaction. Results The average customer satisfaction score was 3. 62 ± 0. 55. Their satisfaction with technical attitude, service content design, environmental facilities and management regulations was higher. They were less satisfied with waiting time(3. 20 ± 0. 85) and service charge(3. 36 ± 0. 71). Conclusions Overall satisfaction of customers for such centers is high. In the future, we should further strengthen the information management and procedures of these centers, and link health management services with commercial insurance, for less economic burden on the people.
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Objective:The aim of this paper is to analyze and evaluate the equity and utilization efficiency of public health resource allocation in 31 provinces and cities in China, and provides reference and basis for public health resource allocation planning. Methods:The allocation of public health resources was evaluated by cluster anal-ysis and used data envelopment analysis was to explore the efficiency of public health resource allocation. Results:The degree of aggregation of public health resources in densely populated and economically developed provinces and cities were greater than or close to 1 , and the difference with the population concentration was mostly less than 0 . The degrees of aggregation in less economically backward provinces were less than 1 , and the difference with the popula-tion concentration was mostly more than 0 . The average technical efficiency of public health resource allocation was 0. 44, and the mean of pure technical efficiency and scale efficiency were 0. 74 and 0. 64 respectively. Conclusion:The degrees of aggregation of public health resources in economically developed provinces and cities are higher, but the corresponding population is poorly distributed based on population distribution. For economically backward prov-inces and cities, the geographical availability of public health resources is poor. In addition, due to unreasonable re-source allocation structure and proportion, public health resources configuration efficiency is relatively low.
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Objective To explore the influencing factors for usage of the official App of a hospital, based on Unified Theory of Acceptance and Use of Technology (UTAUT).Methods 616 outpatients were randomly sampled from outpatient clinics of three tertiary hospitals in Hangzhou for questionnaire survey, to learn the usage and intention for hospital′s official App.Results It was found that women (0.134), high performance expectancy (0.321), facilitating conditions (0.256), high effort expectancy (0.224), and desirable social influence (0.100) all contributed positive influence (P<0.05) to usage of such App.Conclusions It is recommended to enhance service functions of such App and simplify its usage, in addition to better promotion and online security measures.
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Objectives To understand the current situation and evaluation about the employer's demand of knowledge level and comprehensive ability of professional undergraduate talents in the health management. Methods Using self-designed questionnaire, the investigation was carried out on the company executives and teachers from 12 health management-related enterprises where health management graduates of Hangzhou Normal University practice internships . A total of 31 valid questionnaires were recovered . SPSS 19.0 software was used to conduct descriptive analysis, hierarchical analysis and rank-sum test of one-way ordinal data. Results Employers believe that students need to strengthen the knowledge of health man-agement and medical knowledge, and the top three skills that students are most likely to improve are common disease management skills, health risk factors intervention skills and health monitoring skills. Amongst those areas of professional abilities that need improving, three of the most important skill sets include suffi-cient fundamental knowledge in medicine and pharmacology, analytical and problem-solving abilities and teamwork as well as communication skills. There is a significant difference among the level of students' pro-fessional knowledge, the level of their professional skills and the level of their comprehensive ability by the rank-sum test (P<0.05). Conclusion According to the results of the demand-side's survey, training of health management undergraduate talents should increase the proportion of teaching about medical theory knowledge, redesign practical teaching modules, carry out foreign language learning as well as promoting the training method of health talents by the means of information, in order to optimize the training of profes-sional health talents through multi-angle as well as multi-level.
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Described in the paper is the reform made at public hospitals in Zhejiang province,with analysis of its problems and causes. Based on such,the authors proposed the following actions:to accelerate the reform of public hospitals centering on health promotion, and encourage such hospitals to shoulder the health care responsibility on behalf of the government; to proceed with hierarchical medical system and contract-based service focusing on capacity building of general practitioners; to attract private capital into building the healthcare system; and to motivate non-governmental organizations to cater to diversified healthcare needs of the people.
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Objective: To explore the preventive and therapeutic effects of Compound Zhuye Shigao Granule (CZSG), a compound Chinese herbal medicine, on radiation-induced esophagitis in rats. Methods: Fifty-six Wistar rats were randomly divided into 5 groups: normal control group (8 rats), model group (12 rats), and high-, medium- and low-dose CZSG groups (12 rats in each group). The rats in the normal control and model groups were given normal saline 10 mL/kg body weight and those in the CZSG-treated groups were given solution of CZSG at doses of 1.15, 2.30, or 4.60 g/kg body weight respectively by intragastric administration once a day for 7 days. Then esophagitis was induced by local irradiation of (60)Co ray (490.25 cGy/min, totaled 30 Gy). The administration was continued for another 7 days or 14 days, meanwhile body weight and daily food intake of the rats were recorded. Seven days after the irradiation, 4 rats in each group were sacrificed under anesthesia, then, the esophageal tissue was obtained for histopathological examination and the degrees of esophageal tissue injury and neutrophil infiltration were scored. Fourteen days after the irradiation, all the survival rats were dealt in the same way. Results: (1) Seven days after the irradiation, the esophageal tissue sections in the model group showed typical histopathological changes of radiation-induced esophagitis, whereas in the CZSG groups the histopathological changes were lessened dose-dependently and in the high-dose CZSG group the esophageal tissue remained basically intact. (2) The scores of esophageal tissue injury and cellular infiltration in the high- and medium-dose CZSG groups were both significantly less than in the model group (P<0.05). (3) The body weight of the rats increased in the normal control group, whereas it decreased obviously in the model group. In the medium- and high-dose CZSG groups, it did not decrease significantly. The decrease of body weight in the high-dose CZSG group was less than that in the model group (P<0.05). (4) Compared with the normal control group, the daily food intake was reduced in the other groups. However, it was significantly greater in the low, medium- and high-dose CZSG groups than in the model group (P<0.05). Conclusion: In rats with radiation-induced esophagitis, CZSG can effectively relieve the esophageal tissue injury and cellular infiltration, increase daily food intake, and prevent rats from lose of body weight dose-dependently, which show that CZSG has the preventive and therapeutic effects for radiation-induced esophagitis in rats.
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Objectives To analyze the influence factors for promoting appropriate health technologies to rural health workers in Zhejiang province. Methods 1957 health workers from county and township levels were surveyed by questionnaires, regarding their use of appropriate technologies. Results The influence factors for rural health workers to employ such technologies include their medical competency, training approach and technical categories. Those medical workers of higher education are
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Objective To explore the anti-inflammatory mechanisms of three stains. Methods Airpouch induced acute inflammation rat model was developed by subcutaneous injection of carrageenan.Inflammatory invasion and tumor necrosis fator-alpha (TNF-α) expression levels of the inflammed skins were examined by immunohistochemical methods and digital image analysis. The anti-inflammatory action of the 3 different statins was compared. Results Stains could inhibit inflammatory invasion and the expression of TNF-α. Conclusion The statins have demonstrated strong inhibition of inflammation.
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Seminar is an exploratory learning model with problem-based and project-or-ganized characteristics.The application practice of Seminar learning model in the process of teaching and training postgraduates of health management shows that the model has an important influence on improving the quality of postgraduates in our country.