Provincial distribution differences and influencing factors of self-assessed health among elderly population in China / 环境与职业医学

Background Regional differences in economic development, natural environment, health care level, and social structure may lead to differences in the provincial distribution of the health status of the elderly population. Objective To explore the provincial distribution characteristics, regional differences, and influencing factors of the self-assessed health of the elderly population, with the aim of providing a policy basis for improving the health of the elderly population and promoting healthy aging according to local conditions. Methods Using 31 provinces (municipalities and autonomous regions) in China as the basicstudy unit and based on the method of Wagstaff, the self-rated health data of the elderly population (aged 60 years and above) in each province from the 2010 and 2020 national censuses and the 2015 1% National Population Sample Survey were converted into ill-health scores as a measure of self-assessed health, and higher scores represented worse health status perception. Global Moran's I was used to evaluate spatial autocorrelation, range [−1, 1], with a value of 1 as a perfect clustered pattern. Local Moran's I was used to evaluate the tendency of local autocorrelation, and high-high aggregation/low-low aggregation indicated that both target province and its neighboring provinces showed higher/lower ill-health scores. Spatial econometric models were selected by Lagrange multiplier test and Hausman test to explore influencing factors of the self-assessed health of the elderly population. Results In 2010, 2015, and 2020, the national ill-health scores of the elderly population were 1.831, 1.873, and 1.547, respectively, and the corresponding Global Moran's I statistics were 0.347, 0.482, and 0.511, respectively (P<0.01), indicating that the ill-health scores of the elderly population showed a significant spatial positive autocorrelation, and the degree of spatial aggregation was increasing gradually. From 2010 to 2020, the high-high aggregation of ill-health scores among the elderly population was concentrated in the inland northwest, while the low-low aggregation was concentrated in the southeast coast, gradually showing a "southeast-central-northwest" stepped incremental pattern of differentiation. The Lagrange multiplier test and Hausman test suggested that the fixed-effects spatial lagged model was a better choice, and the regression model showed a spatial autocorrelation in the ill-health scores of the elderly population, with an autocorrelation coefficient of 0.3969 (P<0.001); the ill-health scores of the elderly population were negatively correlated with the natural logarithms of gross regional product per capita, and the number of beds in health care facilities per 1000 population, with regression coefficients of −0.8297 and −0.0454 (P<0.05) respectively, and positively correlated with the annual average concentration of PM2.5, illiteracy rate, and the number of health technicians per 1000 population, with regression coefficients of 0.0033, 0.0297, and 0.0765 (P<0.05), respectively. Conclusion From 2010 to 2020, the overall self-assessed health level of China's elderly population showed an upward trend and a spatial positive autocorrelation, with better self-assessed health in the southeast coast and poorer ratings in the northwestern inland. Additionally, there was a gradual decline in self-assessed health of the elderly population from the southeast to the central regions and further to the northwest in terms of spatial distribution. Economic development level, environmental pollution, health resource allocation, and education level are important factors influencing the self-assessed health of the elderly population.

Construção de um índice de desenvolvimento sustentável e análise espacial das desigualdades nos municípios cearenses / Construcción de un índice de desarrollo sostenible y análisis espacial de las desigualdades en los municipios del estado de Ceará / Building a sustainable development index and spacial assessment of municipalities inequalities in the state of Ceará

Resumo O artigo apresenta a análise espacial da sustentabilidade nos municípios cearenses a partir da construção de um índice de desenvolvimento sustentável, embasado em dimensões social, ambiental, econômica e institucional. Os índices de sustentabilidade forçam instituições e governos a questionarem seus padrões e atuam como "forças motrizes" para a elaboração de políticas públicas. A validade dos índices de sustentabilidade depende da definição do conjunto de indicadores e das técnicas adotadas para definição dos ponderadores e agregação dos indicadores. A pesquisa é de natureza quantitativa, desenvolvida por meio de dados secundários, e adotou análise fatorial confirmatória para a construção do índice de desenvolvimento sustentável (IDS) e modelagem econométrica espacial para representação das desigualdades no mapa dos municípios cearenses. Os resultados da pesquisa revelam um ajuste regular do índice de desenvolvimento sustentável. O IDS permite uma visualização geográfica e identificação de associação espacial dos indicadores de desenvolvimento sustentável, e apresenta-se como uma ferramenta de suporte à definição de políticas públicas. A pesquisa revelou que áreas mais urbanas do estado do Ceará apresentam um melhor índice de desenvolvimento sustentável, e confirmou a fragilidade das políticas públicas em promover o equilíbrio regional.

Resumen El artículo presenta el análisis espacial de la sostenibilidad en los municipios cearenses a partir de la construcción de un índice de desarrollo sostenible, basado en dimensiones social, ambiental, económica e institucional. Los índices de sostenibilidad obligan a instituciones y gobiernos a cuestionar sus patrones y actúan como "fuerzas motrices" para la elaboración de políticas públicas. La validez de los índices de sostenibilidad depende de la definición del conjunto de indicadores y de las técnicas adoptadas para definir los ponderadores y la agregación de los indicadores. La investigación es de naturaleza cuantitativa, desarrollada por medio de datos secundarios, y adoptó análisis factorial confirmatorio para la construcción del índice de desarrollo sostenible (IDS) y modelado econométrico espacial para representación de las desigualdades en el mapa de los municipios cearenses. Los resultados de la investigación revelan un ajuste regular del índice de desarrollo sostenible. El IDS permite una visualización geográfica e identificación de asociación espacial de los indicadores de desarrollo sostenible, y se presenta como una herramienta de apoyo a la definición de políticas públicas. La investigación reveló que áreas más urbanas del estado de Ceará presentan un mejor índice de desarrollo sostenible, y confirmó la fragilidad de las políticas públicas en promover el equilibrio regional

Abstract The paper builds a sustainable development index based on environmental, social, economic and institutional dimensions and presents a spatial assessment of municipalitties inequalities in the State of Ceará. Sustainability indices force institutions and governments to question their standards and act as "driving forces" for public policy-making. The validity of sustainability indexes is heavily dependent on how their components are weighted and aggregated. The research is quantitative developed through secondary data acquired in public agency databases of the country (Brazil) and federal unit (State of Ceara). Data analysis included confirmatory factor analysis for the construction of general sustainability indexes, descriptive analysis of these indices and spatial econometric modeling to represent on the map of Ceará municipalities. The survey results reveal a regular adjustment of the sustainable development index. The model allows a geographical view of sustainable development indicators and presents with a tool in the definition of public policies for social equity, environmental and economic. The analysis of social, economic, environmental, institutional and general indices revealed that the most urban areas of the State of Ceará have a greater sustainable development and confirms the fragility of public policies in promoting regional balance.

Análisis estadístico de indicadores de calidad del hospital Dr. Joaquín Castillo Duany / Statistics analysis of quality indicators of the hospital Dr. Joaquín Castillo Duany

La presente investigación se desarrolla en la sala de cuidados intensivos del hospital Dr. Joaquín Castillo Duany, de Santiago de Cuba, donde se aplica el análisis multivariado con el objetivo de determinar un modelo econométrico que permita estimar y evaluar los costos de calidad, contribuyendo significativamente a la obtención de la excelencia en los servicios de salud y al proceso de perfeccionamiento hospitalario. La investigación se sustenta en la aplicación de la correlación canónica como técnica multivariante muy potente y poco explotada, utilizando los principales pilares de la econometría como ciencia aplicada, donde se recopilan los indicadores de calidad y eficiencia con la finalidad de realizar un análisis multivariado, que ha permitido obtener un modelo econométrico para la estimación de los costos de calidad en el servicio seleccionado. El modelo aplicado, ha permitido cuantificar y evaluar el comportamiento de los costos de calidad, siendo de gran utilidad para generalizarlo a otros servicios en el sector de la salud. Constituye una herramienta de trabajo para la dirección de la entidad al permitir mejorar el proceso de toma de decisiones en relación con los costos de calidad y evaluar los niveles de eficiencia en los servicios de salud(AU)

The present investigation was done at the intensive care unit of the hospital Dr. Joaquín Castillo Duany in Santiago de Cuba. Multivariate analysis is applied in order to determine and apply a scientific econometric model that helps to estimate and evaluate quality costs, this model will contribute significantly on obtaining a better health service in the hospital. The investigation helps the general fundamental theory upon the quality cost and the application of the canonical correlation as a very potent and little exploited multivariate technique using the principal pillars of the econometrics as an applied science. The indicators of quality and efficiency with the final statistics has permitted us to obtain a mathematical model that permits the estimation of quality cost in the service selected. The above mentioned model application has permitted us to quantify and evaluate the conduct of the quality cost, making it a great utility to generalise to other entity services which constitutes a tool for improve decision making in relation with the cost of quality. It also benefits the evaluation of efficiency level in the health service(AU)

Estimation of demands for medical services and regional health planning / 中华医院管理杂志

Objective To seek a rational method of estimating the demands for medical services so as to work out regional health planning in a scientific way. Methods A metropolis including 19 counties and districts was selected as a region and demands for medical services were forecasted via retrospective analysis and the econometric model. Results A model of the demands for outpatient and inpatient services was obtained based on the impact of many social and economic factors on medical health services, and illustrations were given to indicate the demands for medical health services in the 19 counties and districts in future when prices should rise by 15% and 20%. Conclusion The econometric model can be used as a tool for estimating the demands for medical health services, and yet improvements need to be made.