Interdisciplinary family doctor team building and its management in urban community health service: perspectives from primary health workers / 中华全科医师杂志

Objective To survey the perspectives from primary health workers on the building and management of interdisciplinary family doctor team in urban community health service.Methods Primary health workers from 24 community health centers of 14 provinces were selected to participate in a questionnaire survey on March 2016.The attitude and satisfaction of participants with interdisciplinary family doctor team in urban community health setting were surveyed and analyzed.Results There were 765 questionnaires were distributed and 738 valid ones were returned with a retrieve rate of 96.5％.The survey showed that 70.73 ％ (522/738) of participants supported the interdisciplinary family doctor teamwork,while the overall satisfaction with items regarding its building and management was 48.61％ (2 870/5 904).Participants were mostly dissatisfied with performance appraisal and incentive mechanism (32.25％),autonomy of team (40.92％),job division of team members (44.44％) and rationality of professional allocation in the team (48.78％).There were significant differences in overall satisfaction rate among primary health workers in different positions and from different regions (x2 =176.86 and 57.17,both P ＜ 0.05).The overall satisfaction of participants in western regions was only 35.65 ％ (636/1 784) and that of public health workers was 43.91％ (534/1 216).Conclusion Currently,the building and management of interdisciplinary family doctor team in urban community health service are in a initial stage,although its importance has been recognized.Team composition,responsibility of various team members and effective incentive mechanism should be further improved,and more attention should be paid to western regions and for public health workers.

Measurement and analysis of staffing standards of family doctor interdisciplinary team / 中华医院管理杂志

Objective To measure and analyze the staffing standards of family doctor interdisciplinary team by means of the WHO workload indicator of staffing need (WISN)method,for reference of the government in building family doctor interdisciplinary teams.Methods 150 community health centers in 16 provinces were selected.The related data from 150 centers were collected to analyze the population served by each family doctor,and the staffing standards of family doctor interdisciplinary team by means of the WHO workload indicator of staffing need(WISN)method.Results There were 10 721 community health professionals in the sample centers which provide 132.14 million standard equivalents of service to the public.1 9 6 1 6 community health professionals were needed to ensure the quality of service and no extra workload after work for professionals.Averagely,each family doctor can serve 1 558 residents,who needs 1.3~1.5 nurses or public health workers.Conclusions A huge gap was found for community health professionals.The population served by each family doctor should be lowered compared to the governmental requirement and more nurses should be introduced to the family doctor interdisciplinary team.

Study on spousal notification in HIV discordant couples and associated factors in four provinces of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>This study was aimed to investigate the ways of spousal notification and its associated factors among HIV discordant couples.</p><p><b>METHODS</b>A face-to-face questionnaire survey was conducted in Henan, Yunnan, Sichuan provinces and Guangxi Zhuang Autonomous Region in China. Information including democratic characteristics, knowledge and behaviors correlated with HIV infections and ways of HIV infectious status notification was collected. 'Data information system' on AIDS prevention and control was used to collect information on the transmission route.</p><p><b>RESULTS</b>A total of 770 pairs of HIV discordant couples were studied, among which 414 (53.77%) HIV positive respondents reported as self-notification, with another 44.68% were notified by medical staff. Factors associated with ways of notification included gender, nation, transmission route, and education level. HIV positive respondents who were female, under Han nationality, being paid blood donors, having had higher education level, were more likely to inform their HIV negative spouse by themselves.</p><p><b>CONCLUSION</b>Nationality and HIV transmission route of the HIV positive individuals were found as significant factors associated with ways of spousal notification. Therefore, HIV discordant couples notification should be strengthened, especially in the Minority-living areas and areas where HIV transmission was predomint through sexual contact and/or via injected drug use.</p>

Measurement and analysis of community health staffing standards / 中华医院管理杂志

Objective To measure the gap of community health staffing and establish new norms for community health facilities by means of the WHO Workload indicator of staffing need (WISN) method,for reference of the government in evaluation and decision making of community health staffing. Methods With Xicheng District of Beijing as an example,we collected data on community health staffing and calculated the total demand,measuring the total demand and supply,and gap or surplus in the staffing.Results in 2013,the demand of community health staffing was about 1 7.18 million standard equivalents in Xicheng,while the supply was 10.5 12 million.The WISN ratio was 0.67 for community health supply and demand,in which the ratio of physicians was close to 1,while that of nurses and public health workers was far below 1.850 extra community health staff was needed to reach the total of 2 602 persons.Conclusion The demand and supply of community health service in Xicheng District was seriously unbalanced,a huge gap featuring overstaffing of nurses and inadequate public health workers.This results from the enhancement of primary public health services and rising utilization of community healthcare services in recent years,which deserves high attention from government of all levels,by increasing the staffing of community health staffing standards.

Impact analysis on the health management programs among community-based 0-36-month-olds on their growth and development / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the impact of implementation on health management programs among the community-based 0-36-month-olds regarding their growth and development.</p><p><b>METHODS</b>18 Monitoring Bodies in 8 pilot areas were selected to enroll this study, using a multistage stratified cluster sampling method. All the children aged 0 to 36 months were followed, according to the health management specification, and their health archives were collected.</p><p><b>RESULTS</b>A total of 13 464 children were involved in the specified management program with a total of 59 648 person-time under follow-up, with 54.26% of them were boys. Results from the multi-layer linear model indicated that the average height of children in the specified management group was higher than that in the non-standardized management group. Children in the specification management group, their weight gain had also been more effectively controlled. At the same time, with the increasing number of follow-ups according to the specification, the prevalence rates of under weight, stunt, emaciation and overweight were all significantly decreased (P < 0.05).</p><p><b>CONCLUSION</b>The implementation of the community-based programs on 0-36-month-olds regarding their health management specification had improved children's growth and development.</p>