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Background: Safe Motherhood Program is a national priority programme that aims to reduce maternal and neonatal mortality and morbidity through demand and supply side incentives and free delivery care. The study investigates Safe Motherhood Program’s utilization, changes post-implementation, and associated factors in Jumla district to enhance maternal health care access and reduce preventable maternal deaths. Methods: A community based cross sectional study using quantitative approach was conducted where the women of reproductive age group having at least one child of 3-15 months of age were interviewed using the semi structured interview schedule (n=228). Chi square test was used to show the association with independent and depended variables. All the test was carried out at the statistically significant of p value <0.05. Results: The study revealed significant associations between utilization of maternal health care services and various factors: respondent's education level (p=0.034, OR=1.834, CI=1.043-3.223), husband's education level (p=0.007, OR=2.300, CI=1.252-4.228), respondent's employment status (p=0.003, OR=7.155, CI=1.650-31.029), husband's employment status (p=0.001, OR=2.778, CI=1.526-5.055), monthly income (OR=5.556, CI=2.005-15.393), and involvement in social groups (p=0.009, OR=2.312, CI=1.217-4.390). Conclusions: Despite strong awareness of delivery incentives, the program success was restricted by poor knowledge of checkup incentives. The study identified the sociodemographic factors influencing the appropriate use of Jumla’s Safe Motherhood Program scheme. Pregnancy was highly registered, however less than two thirds of women had the necessary number of examinations performed. Institutional deliveries increased but there was disparity during the service delivery.
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A series of systematic, criterion-based drug evaluation known as Drug utilization review are conducted on a regular basis to ensure that medication is utilized appropriately. It’s a mean of learning more about the issues brought on by drug usage, if done properly, may help to solve the issues. Medication adherence generally refers to a patient’s ability to take prescription drugs as directed and their continued use of those drugs. The increasing body of research linking medication non adherence to unfavorable outcomes and increased healthcare cost has raised concerns among clinicians, healthcare institutions, and other stakeholders. Pharmacovigilance, in which the procedures keeping an eye on the assessing adverse medication reactions, is essential to clinical practice, public health and efficient drug regulating system. Aim of the study was wo study about the role of pharmacist in drug utilization review, medication adherence and pharmacovigilance.
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Background: Drug utilization research (DUR) is essential in promoting rational use of medicine, aimed at understanding the patterns of prescription, administration, and utilization of medications. It provides valuable insights into the actual drug usage patterns for specific disease conditions. To evaluate the current utilization pattern of drugs in patients of urolithiasis in the Department of General Medicine and Surgery at Integral Institute of Medical Science and Research Hospital, Lucknow. Methods: Following the approval of the institutional ethics committee, a prospective observational study was conducted at Integral Institute of Medical Science and Research Department of general medicine and surgery over a six-month period. Urolithiasis patients’ prescriptions were analyzed to study the prescribing patterns. Information about patient demographics, co-morbidities, and the number and types of medications prescribed were collected and analyzed. Results: Out of 102 patients studied, a female preponderance over male patients was observed. The co-morbidities that are encountered most commonly were hydronephrosis, cystitis, and renal cyst. There is averaged 7 medicines per prescription, 15.25% of medicines written by the generic name, 83.33% of patients receiving antibiotics, 54.70% of patients receiving injections, and 83% of drugs prescribed are mentioned in the essential medicine list. Analgesics, antibiotics, nutritional supplements, antiemetic, alkalizing agents, and antispasmodics were among the class of medicines given. Conclusions: This study highlights the current use of medicines and drug utilization in urolithiasis management. The findings show important insights for healthcare professionals to enhance medication therapy, encourage cost-effective healthcare delivery and improve quality of patient in urolithiasis management.
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RESUMO Os benzodiazepínicos, medicamentos mais prescritos no mundo, são extremamente úteis no manejo de patologias relativas ao sistema nervoso central, porém, nem sempre sua prescrição está relacionada com uma patologia. Este estudo buscou identificar os fatores influenciadores na prescrição de benzodiazepínicos na Atenção Básica do Sistema Único de Saúde e suas consequências, em uma região com alta vulnerabilidade social. Foram utilizados os princípios de um estudo qualitativo com amostra intencional de médicos prescritores construída com a ajuda dos Informantes-Chave e com tamanho (n = 10) definido pelo princípio da saturação teórica. A coleta de dados ocorreu mediante entrevistas semiestruturadas nas unidades básicas onde os profissionais atuavam. Os temas identificados relativos aos motivos da prescrição foram: relativos ao paciente (demanda do paciente; problemas sociais); relativos ao medicamento (dependência); relativos ao prescritor (uso irracional). A prescrição do benzodiazepínico deu-se devido às baixas condições sociais dos usuários nessa região e as consequências dessa conjuntura (vulnerabilidade social, problemas angustiantes de difícil resolução). Educação permanente para profissionais, ações interprofissionais e integralidade do cuidado foram demandas dos profissionais. O problema extrapola a ação do médico, e são sugeridas políticas públicas que garantam, às populações com essas características, acesso a saúde, trabalho e educação.
ABSTRACT Benzodiazepines, the most prescribed medications in the world, are extremely useful in managing conditions related to the central nervous system, however, their prescription is not always related to a pathology. This study sought to identify the factors influencing the prescription of benzodiazepines in Primary Care of the Unified Health System and their consequences, in a region with high social vulnerability. The principles of a qualitative study with intentional sampling of prescribing physicians were used, constructed with the help of Key Informants and with a size (N=10) defined by the principle of theoretical saturation. Collection took place through semi-structured interviews in the basic units where the professionals worked. The themes identified regarding the reasons for prescription were Patient-related (patient demand; social problems); Relating to medication (dependence); Relative to the prescriber (irrational use). The prescription of benzodiazepine was due to the low social conditions of users in this region and the consequences of this situation (social vulnerability, distressing problems with difficult resolution). Continuous education for professionals, interprofessional actions, and comprehensive care were demands of the professionals. The problem goes beyond the doctor's scope of action, and public policies that guarantee such populations access to health, work, and education are suggested.
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Background: Health, nutrition, yet education are the three basic elements of human resource development, and they are all combined in a unique program known as the integrated development of children service Scheme.Methods: A quasi experimental design where Pre and post-test with equivalent control group design was used to carry out the study. Mothers with children from selected rural and urban area who were fulfilling the inclusion criteria were selected by using non-probability convenient sampling technique. Total 40 samples were included in the study. Results: The study findings revealed the utilization scores of mothers on ICDS service majority mother 335 (83.8%) were not satisfied followed by 65 (16.3%) were moderately satisfied, the pretest and post knowledge scores of subjects in experimental group mean percent of mother on utilization of ICDS service was 37.63% with mean score 14.3 was in pretest, where as in posttest 57.23% with mean score 21.75, the overall pretest and post attitude scores of subjects in experimental group mean percent of mother on utilization of ICDS service was 28.75% with mean score 28.75 and standard deviation 4.610 was in pretest, where as in posttest 46.35% was mean percent, with mean score 46.35 and standard deviation 4.487. Conclusions: The structured awareness programme on ICDS services and its utilization among mothers proved its beneficial effects in terms of satisfaction, awareness and attitude level.
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Background: The prevalence of disability in the activities of daily living (ADL), could probably have a significant impact on the healthcare utilization amongst the geriatric population with disability. Methods: A cross-sectional study in the urban and rural field practice areas of a medical college in Tamil Nadu, using a sample size of 402 elderly individuals. Using the pre-tested, semi-structured questionnaire; the socio-demographic variables, healthcare utilization variables and a comprehensive Katz ADL assessment were used. Results: The overall prevalence of ADL limitation amongst the elderly was seen in 49 (12.2%) elderly individuals mostly with a score of 5 (mildest form) was found in 36 (74%) of the elderly. There was an association found between the follow-up care at health centres, frequency of visits, distance from home to health centres and the ADL limitation with a P- value less than 0.05 (C.I.-95%) using the Pearson chi-square test using SPSS v.26.0. Conclusions: The association between ADL limitation and healthcare utilization calls for initiatives at the family and community level.
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Background: Pregnancy applications are more prevalent than other fitness and health applications. They also utilize immediate connection to seek expert advice and comfort. Recently, apps have emerged as a fresh method for delivering prenatal information that is easily available at the press of a button, for little to no money, at any time, and anywhere. Method: A total of 50 rural and urban primi gravida mothers were included in the study. Utilization statements and knowledge questionnaire and opinionnaire-Likert scale on perception was used to collect data from sample. Results: The majority of primi gravida mothers in rural areas, 15 (60%) expressed neutrality, 10 (40%) expressed dissatisfaction, in contrast, majority of primi gravida mothers in urban areas, 22, (88.0%) expressed neutrality, 3 (12.0%) expressed satisfaction. Majority of urban primi gravida mothers (20) had average knowledge and the remaining 5 (20%) had bad knowledge, the majority of 24 (96.0%) had poor knowledge and 1 (4%) had average knowledge, in contrast, the majority of rural primi mothers 20 out of 20 had unfavorable perceptions, with 60 (24%) having somewhat positive perceptions and the majority of 19 (76.0%) having unfavorable perceptions. Conclusions: The results showed the urban primi gravida mothers were greatly utilizing mobile based application for maternal and foetal outcome, and rural mothers are not aware of mobile based application for maternal and health services and need to teach on mobile based application so that they utilize all governmental services and schemes.
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Objective: To investigate the use of medicines by women deprived of their liberty in a municipality in the east of Minas Gerais. Method: The research was conducted in three stages: (I) documentary investigation, (II) analysis of medical records, and (III) application of semi-structured questionnaires. Women deprived of liberty who were part of the prison system evaluated participated in the study. The research was carried out between June 2020 and June 2021. Result: Seventeen women deprived of their liberty participated in the study, most of them black and brown (88.24%), between 30 and 49 years old (n = 9; 52.9%), and who used a total of 56 different medications, with the psychotropic class being the most prevalent (n = 28; 50%), followed by cardiovascular system drugs (n = 15; 26.8%). Conclusion: The medications most used by study participants belonged to the class of antidepressants and antiepileptics. Furthermore, the women's medical records lacked crucial information regarding medication use. These data, combined with difficulties in access, highlight the importance of complying with public policies in favor of comprehensive health care for women deprived of their liberty, especially the right to access and rational use of medicines.
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Femenino , Utilización de MedicamentosRESUMEN
Background: This study aimed to determine the profile of the antibiotic utilization in defined daily dose (DDD) units and DU 90% at surgical ward of secondary government hospital in Indonesia within six months period of study. Methods: A retrospective cross-sectional study was conducted over six months on surgical ward patients prescribed with at least one oral or parenteral antibiotic during hospitalization. Data were collected from pharmacy dispensing data and evaluated using World Health Organization (WHO) DDD. Antibiotics DDD were analysed using DU 90% segmentation in order to know the 90 percent cumulative of antibiotic consumption in surgical ward. WHO prescribing indicators were used to examine the antibiotic prescribing pattern in DU 90% segment. Results: Out of 319 antibiotic prescribed to surgical ward patients, 219 prescriptions were belonging to DU 90% segment including ceftriaxone (38.94%), moxifloxacin (16.41%), fosfomycin (14.06%), metronidazole (12.43%), and gentamicin (7.69%) in decreasing fashioned. Of the five groups of antibiotics belong to DU90%, ceftriaxone was the highest in DDD (272.5). The average number of antibiotic prescribed to patients were 1.64±0.92. The percentage of antibiotic prescribed by its generic name as well the prescribing of antibiotic from National list of essential medicines were 70.79% and 72.51%, respectively (optimal value 100%). Conclusions: Our findings on using drug utilization 90% and prescribing indicators are practical for assessing the most widely used antibiotics in ward or hospital setting and to evaluate the quality of prescribing pattern. The antibiotic utilization profile in this study can be used to provide comparative data between hospital and beneficial for future policy making to improve prescribing practice.
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Background: Schizophrenia is a chronic severe psychiatric illness affecting nearly 0.4 to 1.4% of people in India. Many newer anti-psychotic drugs are used now-a-days in schizophrenia. Poor adherence to the treatment given to patients of schizophrenia is observed very often. Although, the quality of life of schizophrenia patients is very much compromised; at the same time, quality of life of the caregiver is also compromised. Methods: A cross-sectional Observational study was conducted among patients already diagnosed with Schizophrenia and on treatment, after ethical approval. Data relevant to study variables was collected in a pre-designed case record form. Evaluation of drug utilization pattern was done by WHO core drug prescribing indicators. Medication adherence was assessed through modified Morisky scale. Quality of life of relative or caregiver was assessed through WHO-QOL BREF questionnaire scale. Results: Patients of 18 years and above were enrolled. Among them, average age was 35.8±5.5 years. In my study, female patients were 64.7% and male patients were 35.3%. Average number of drugs per prescription was 3.8. Drugs prescribed by generic name were around 86.2%. Around 56.9% of drugs were prescribed from national list of essential medicines. Atypical antipsychotics were prescribed in 32% of all prescriptions for Schizophrenia; Whereas Benzodiazepines were prescribed in 19% of all prescriptions. Average Medication adherence score using MMS scale was 3.7±2.2. Patients with high adherence to the medications prescribed were nearly 71% and patients with low adherence to the medications prescribed were 29%. Mean total WHOQOL-BREF score was 75.2±6.5 out of 120. Conclusions: Most prescribed class of drugs was atypical anti-psychotics. Pharmacotherapeutic adherence among patients with schizophrenia was relatively high. Quality of life of patients’ relative or caregiver was impaired to some extent, more impaired in physical health and social relationships domain.
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Background: Tinea infections are chronic superficial fungal infections, highly prevalent in tropical countries like India. Therefore, long-term therapy is needed and this can inflict a financial burden on the patients. Aim of the study was to assess drug utilization patterns in patients diagnosed with tinea infection and to evaluate the cost variability of anti-fungal agents. Methods: A cross-sectional observational study was conducted in patients for 3 months after taking permission from IEC. All adult patients already diagnosed with tinea infection were enrolled. Evaluation of drug utilization pattern was carried out using WHO core drug prescribing indicators and percentage of cost variability was calculated between different brands of anti-fungal agents. Results: A total of 252 patients were enrolled. Tinea corporis and cruris were the most commonly diagnosed tinea infection. Pruritus was the most common presenting symptom. Past history of similar illness was seen in 74 (29.4%) patients mean of 3.83±0.87 drugs were prescribed per patient. Drugs prescribed from NLEM was only 42.1%. Most commonly prescribed drugs were oral itraconazole and topical miconazole. Percentage of cost variability was seen maximum with capsule itraconazole 200 mg (237.5%) by oral route and luliconazole 30 gm (175.6%) by topical route. Conclusions: Prescribing practices of drugs can be improved by promoting generic drug and prescribing drugs from NLEM. Wide range of cost variation can lead to high economic burden in tinea infected patients.
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Background: The study is being carried out mainly to understand the prevention of coagulation of blood after a patient undergoing various types of cardiac surgeries, using different anticoagulation therapies suitable to particular types of cardiac surgery. This study was conducted to know the types of anticoagulants prescribed to patients who have undergone different types of cardiac surgeries along with the prescribed anticoagulants. Methods: The study method used was a retrospective and prospective observational study carried out on 50 patients who underwent cardiac surgeries in the department of cardiology and medicine. Results: A total of 50 patients were enrolled for this study who satisfied the inclusion criteria, out of which 64% of patients were males, and 36% were females. The highest number of patients were found to be in between the age group of 61-70 yrs (34%), whereas age group between 51-60 yrs (28%), age group 71 and above (18%), 41-50 (14%), 21-30 yrs (4%) and 18-20 yrs (2%) respectively. Most of the patients had undergone Coronary Artery bypass grafting. It was seen that the highest Anticoagulant being prescribed was Heparin in most of the post-cardiac surgeries. Whereas drugs like dalteparin, acenocoumarol, and warfarin were prescribed the majority in valvular heart surgeries. Conclusions: Various cardiac surgeries were taken into consideration for the study. The most common anticoagulants prescribed were heparin, dalteparin, acenocoumarol, and warfarin in coronary artery bypass surgery and valvular heart surgeries respectively.
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Background: Sickle cell disease is a major genetic disease that manifests early in life and may lead to significant morbidities. It is an inherited disorder resulting from an abnormality in the structure of a protein in the red blood cell called haemoglobin characterized by the presence of crescent-shaped erythrocytes. Sickle cell disease is one of the most prevalent genetic disorders among the African populations. This study assessed the knowledge and utilization of premarital screening for sickle cell disease among residents of semi-urban community of Bauchi State, Nigeria. Methods: A descriptive cross-sectional design was used for the study. A multistage sampling technique was used in selecting 308 participants and a semi structured questionnaire was used in collecting data for the study. Data was analyzed using SPSS version 26 at 5% significance level and 95% confidence interval and presented in tables of frequencies and percentages. Results: The result revealed that 73.1% of the participants had good knowledge of premarital screening for sickle cell disease and their commonest sources of information were family and friends (45.6%). More than half of the respondents (66.8%) had good utilization. Conclusions: Majority of the respondents had good knowledge and utilization of premarital screening for sickle cell disease. We recommend that there should be more emphasis on health education and awareness programmes at community level on premarital screening for sickle cell disease. Also, genetic screening services should be made available in all primary health care centers.
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Background: Factors affecting maternal health care utilization determine maternal mortality rate (MMR). Therefore this study has been carried out to out to assess the level and determinants of maternal health care service utilization in an urban slum of north-east India. Methods: A cross-sectional study design was used. The study area comprised of four municipal wards with well-defined geographical boundaries. All married women in the age group 18-45 years who were either pregnant and/ or had at least one child under 3 years of age on the day of survey residing in that area for a minimum of one year were the study population. Data collection was done by house-to-house visit. Descriptive analysis and chi-square test was used for data analysis. Results: Adequate utilization of IFA and TT was 86.3% and 84.4%, respectively. Adequate utilization of maternal health care was found to be 79.8% and 20.2% respectively. Age, educational status, income of the participants and birth order of the relevant child was found to be significantly associated with the maternal health care utilization. Conclusions: The study concludes that maternal health care utilization was found adequate among 79.8% of study participants, out of which antenatal care, intranatal care and postnatal care utilization rate was found in 85.4%, 89.8% and 82.5% respectively. Age, education, income of the women and birth order of their children were significantly associated with maternal health care utilization.
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Background: Technology continues to impact various spheres of life, including learning. Over the years, eLearning has experienced a steady rise in popularity. At Kenya Medical Training College (KMTC), the influence of technology on education became more noticeable due in part to a policy directive. This directive, prompted partly by the COVID-19 pandemic, emphasized adopting online teaching to address the loss of instructional hours. This study addressed a specific gap in KMTC's internal quality assurance efforts by accumulating evidence related to the extent of E-learning and user satisfaction. Methods: The study employed a descriptive cross-sectional design, utilizing qualitative and quantitative techniques. It involved KMTC campuses conveniently selected from the Coast and Nairobi regions, with 1139 students selected through simple random, stratified, and proportionate sampling methods. A mixed questionnaire (both open and closed-ended questions) was used to collect data. Specifically, the study aimed to assess the level of eLearning utilization among students in selected KMTC campuses and identify the determinants of this utilization. Results: Most of the respondents (89.2%) participated in online classes; 11.8% of those who did not participate cited reasons such as lack of gadgets, bundles, and poor internet connectivity, among others. Despite widespread e-learning utilization, 76.8% of learners strongly preferred face-to-face classes. Conclusions: Key factors linked to e-learning utilization included effective instructional strategies, quality technical support, and well-conducted online classes. The choice of communication channels, particularly platforms like WhatsApp, was strongly linked to e-learning utilization. Therefore, this study recommends that KMTC should acknowledge the strong preference for face-to-face classes and offer hybrid learning options. Further, the KMTC should address accessibility challenges and competing responsibilities at home by supporting data connectivity, ensuring user-friendly online platforms, and providing flexible scheduling options for diverse learner needs.
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Background@#The Philippine Primary Care Studies (PPCS) is a network of pilot studies that developed, implemented, and tested strategies to strengthen primary care in the country. These pilot studies were implemented in an urban, rural, and remote setting. The aim is to use the findings to guide the policies of the national health insurance program (PhilHealth), the main payor for individualized healthcare services in the country.@*Objective@#The objective of this report is to compare baseline outpatient benefit utilization, hospitalization, and health spending, including out-of-pocket (OOP) expenses, in three health settings (urban, rural, and remote). These findings were used to contextualize strategies to strengthen primary care in these three settings.@*Methods@#Cross-sectional surveys were carried out using an interviewer-assisted questionnaire on a random sample of families in the urban site, and a stratified random sample of households in the rural and remote sites. The questionnaire asked for out-patient and hospitalization utilization and spending, including the OOP expenses. @*Results@#A total of 787 families/households were sampled across the three sites. For outpatient benefits, utilization was low in all sites. The remote site had the lowest utilization at only 15%. Unexpectedly, the average annual OOP expenses for outpatient consults in the remote site was PhP 571.92/per capita. This is 40% higher than expenses shouldered by families in the rural area, but similar with the urban site. For hospital benefits, utilization was lowest in the remote site (55.7%) compared to 75.0% and 78.1% for the urban and rural sites, respectively. OOP expenses per year were highest in the remote site at PhP 2204.44 per capita, probably because of delay in access to healthcare and consequently more severe conditions. Surprisingly, annual expenses per year for families in the rural sites (PhP 672.03 per capita) were less than half of what families in the urban sites spent (PhP 1783.38 per capita). @*Conclusions@#Compared to families in the urban site and households in the rural sites, households in remote areas have higher disease rates and consequently, increased need for outpatient and inpatient health services. When they do get sick, access to care is more difficult. This leads to lower rates of benefit utilization and higher out-of-pocket expenses. Thus, provision of “equal” benefits can inadvertently lead to “inequitable” healthcare, pushing disadvantaged populations into a greater disadvantage. These results imply that health benefits need to be allocated according to need. Families in poorer and more remote areas may require greater subsidies.
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Objective To investigate the need for and utilization of health services among six Zhiguo ethnic minority groups in Yunnan Province,aiming to provide further evidence for the improvement of healthcare.Methods Using stratified random sampling,1921 individuals from six Zhiguo ethnic minority groups,aged 15 and above,were investigated with a structured questionnaire between August and December 2022.A structured questionnaire was used to collect participants'information on health service needs and utilization.Results Am-ong the surveyed participants,the two-week prevalence rate was found to be 22.54%,while the prevalence rate of chronic diseases was 38.52%.Among the residents,the risk of two-week prevalence was higher for females(OR=1.564),individuals aged≥60 years(OR=1.727),and those who reported poorer health utility value(OR=5.277),while it was lower for residents of Keno(OR=0.470)and Lahu(OR=0.659)ethnicity,as well as those who reported higher EQ-VAS scores(OR=0.446/0.174).Meanwhile,residents aged≥45 years(OR=3.392/7.072)were at higher risk for chronic disease prevalence,while it was lower for Keno ethnicity(OR=0.409),unmarried individuals(OR=0.479),and those with higher education levels(OR=0.629/0.603),higher EQ-VAS scores(OR=0.208)P<0.05.Additionally,among the participants,the treat-ment rate for two-week illness was 14.32%,while the non-treatment rate stood at 36.49%.Furthermore,the one-year hospitalization rate was reported as 19.89%,with a corresponding rate of individuals who needed hospitalization but did not receive it being recorded at 15.86%.Among the residents,the likelihood of treatment for two-week illness was higher for females(OR=1.461)and residents aged≥45 years(OR=1.510/1.560),whereas it was lower for individuals with higher EQ-VAS scores(OR=0.445).The likelihood of hospitalization within one year was also higher for residents aged≥60 years(OR=2.029)and individuals of Nu(OR=1.599),Lisu(OR=1.688),and Keno(OR=1.968)ethnicity,whereas those with high EQ-VAS scores(OR=0.325)had a lower risk(P<0.05).Conclusion In Yunnan Province,the need for healthcare services among six Zhiguo ethnic minority groups in this study is relatively low;however,the high prevalence of chronic diseases raises concerns.The utilization of healthcare services appears to be relatively sufficient,but the utilization of outpatient services still needs to be improved.
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Objective To analyze the allocation and utilization efficiency of hospital beds from 2017-2021,and to provide a reference for the optimal allocation of hospital bed resources in Shenzhen.Methods Descriptive statistics method,bed efficiency index and bed utilization model were used to evaluate the hospital bed allocation and utilization efficiency of Shenzhen hospitals for 5 years.Results The number of beds in Shenzhen increased every year,with the highest growth rate of 21.54%,and the number of beds per 1000 resident population increased from 3.04 in 2017 to 3.25 in 2021.From the bed efficiency index,all three types of hospitals(general hospitals,specialized hospitals,traditional Chinese medicine hospitals)in Shenzhen are operating at low efficiency.Government-run hospitals are operating at high efficiency except for 2020,while socially-run hospitals are operating at low efficiency for five years,with bed efficiency indexs below 0.4.From the bed utilization model,Shenzhen general hospitals are turnover hospitals,Chinese medicine hospitals are bed-pressure hospitals for the first two years and then turn into efficiency hospitals,and specialty hospitals are idle hospitals.The government-run hospitals were efficient hospitals for 5 years,while the socially-run hospitals were idle hospitals for 5 years.Conclusion It is necessary to reasonably allocate health resources to increase the number of beds,improve the ability of hospitals to admit and absorb patients,and improve the operational efficiency of beds;the improvement and upgrading of beds in various types of hospitals should be tailored to local conditions to promote the realization of the continuity of care by integrating the concept of health care.
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With the rapid development and expansion of the scale of the industry of Chinese materia medica,a large number of by-products in the process industrialization of Chinese materia medica have been produced,among which,the solid by-products of Chinese materia medica have been favoured by researchers due to the fact that they are rich in a large number of proteins,cellulose,hemicellulose,lignin,etc.,which can be used in the preparation of high value-added products.Therefore,the authors elaborated on the research on biochemical conversion,thermochemical conversion,resource oriented chemical components,preparation of biomass fuel,new composite materials and high-efficiency adsorbent of solid by-products in the process of industrialization of Chinese materia medica in recent years,aiming to provide theoretical basis for the comprehensive and high-value utilization of the solid by-products of Chinese materia medica and extension of the industrial chain.
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In recent years, the rapid development of medical information technology has made it critical to analyze large-scale diagnosis and therapeutic data and extract rules based on real medical environment. This has become an essential approach for marketing evaluation and regulatory decision-making of drugs and devices both domestically and internationally. Real world study （RWS）, as a novel methodology for clinical evaluation of drugs in the field of drug utilization research （DUR）, have presented opportunities and challenges for observational studies in assessing actual efficacy or effectiveness. However, despite being a popular methodological approach among scholars in the field, there are still limitations and deficiencies when analyzing population medication characteristics in RWS. Systematic evaluation research methods have not yet been established, leading to inadequate generation of real-world evidence （RWE）. The research design, methodological pathways, evaluation indicators, confounding factors, and bias management involved in DUR based on real-world data （RWD） were reviewed in this artical with the intention of providing guidance for further exploration into DUR.