Evaluating patients' perception of service quality at hospitals in nine Chinese cities by use of the ServQual scale

Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQual scale method was used in a survey involving patients at outpatient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, productmoment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coefficients were positive and statistically significant. Visitors to out-patient facilities reported more positive perception than visitors to in-patient facilities on tangibles (t = 4.168, P < 0.001) and reliability (t = 1.979, P < 0.05). Patients of 60 years of age and above reported more positive perception than those between 40 and 49 on reliability (F = 3.311, P = 0.010), assurances (F = 2.751, P < 0.05) and empathy (F = 4.009, P = 0.003). For the five dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coefficients showed statistically significant (P < 0.001) positive values for all ServQual dimensions. Empathy (β = 0.267) and reliability (β = 0.239) most strongly predicted perception of service quality. Conclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.

Clinicopathologic correlation between CD4-positive T lymphocyte counts and superficial lymphadenopathy in HIV-positive/AIDS patients / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the clinicopathological correlation between CD4(+) T lymphocyte count and superficial lymphadenopathy HIV/AIDS patients.</p><p><b>METHODS</b>A total of 1066 HIV/AIDS patients were included in this study. The incidence of superficial lymphadenopathy, peripheral blood CD4(+) T lymphocyte counts and histological features of superficial lymphadenopathy were analyzed.</p><p><b>RESULTS</b>Among 1066 patients, 126 cases (11.8%) presented with superficial lymphadenopathy. Of the 126 cases, there were 69 cases with CD4(+) T lymphocyte counts < 100/µl and clinical diagnoses including tuberculosis (37 cases), reactive hyperplasia (8 cases), AIDS-related lymphadenopathy (18 cases), penicillium diseases (12 cases), fungal infection (5 cases) and non-tuberculous mycobacterial infection (1 case). Twenty-six cases had CD4(+) T lymphocyte counts between 100/µl to 200/µl and clinical diagnosis including tuberculosis (12 cases), reactive hyperplasia (8 cases), AIDS-related lymphadenopathy(6 cases), penicillium disease (2 cases) and non-Hodgkin lymphoma (1 case). Twenty-nine cases had CD4(+) T lymphocyte counts > 200/µl and clinical diagnoses including tuberculosis (11 cases), reactive hyperplasia (12 cases), AIDS-related lymphadenopathy (3 cases), Penicillium diseases (1 case) and non-Hodgkin lymphoma (4 cases). The CD4(+) T lymphocyte counts among patients with tuberculosis, AIDS-related lymphadenopathy and Penicillium diseases were significantly different (χ(2) = 8.861, P = 0.012). A significant correlation between the incidence of superficial lymphadenopathy and CD4(+) T lymphocyte counts was found (χ(2) = 375.41, P = 0.000).</p><p><b>CONCLUSIONS</b>The most common cause of superficial lymphadenopathy in HIV/AIDS patients is tuberculosis, followed by lymph node reactive hyperplasia, AIDS-related lymphadenopathy and Penicillium disease. Low CD4(+) T lymphocyte count correlates with an increased incidence of superficial lymphadenopathy and the risk of opportunity infection. Therefore, determination of peripheral blood CD4(+) T lymphocyte count should become an integral marker for the early diagnosis and treatment of superficial lymphadenopathy in HIV/AIDS patients.</p>

Identification of Mycobacterium tuberculosis and rifampin-resistant strains by gene-chips / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the gene-chip detecting rifaman-resistance Mycobacterium tuberculosis applied in TB diagnosis and drug-resistant detection.</p><p><b>METHODS</b>Mycobacterium tuberculosis and rifaman-resistant strains among 35 rifaman-resistance isolated strains and 102 sputa specimens from TB patients, 27 sputa specimens from other patients were examined the gene-chips. Results obtained were compared with sputum examination, bacteriological culture and standard drug susceptibility test of Mycobacterium tuberculosis.</p><p><b>RESULTS</b>Thirty-five rifaman-resistance strains were detected by gene-chips and 33 were identified as rifaman-resistance strains and the concordance with the traditional drug susceptibility test of Mycobacterium tuberculosis was 94.29%. Twenty-seven sputa specimens from other patients were examined Mycobacterium tuberculosis by the gene-chips, 2 were positive, the detection specialty was 92.59%. Using three methods detecting Mycobacterium tuberculosis among 102 sputa specimens the positive rate respectively was, sputum examination 35.29% (36/102), bacteriological culture 28.43% (29/102), gene-chip 77.45% (79/102). Among 102 sputa specimens only 29 examined Mycobacterium tuberculosis by the traditional drug susceptibility test and 8 were rifaman-resistant strains. While using gene-chip, there were 20 among 102 sputa specimens identified as rifaman-resistance strains. Among total 55 rifaman-resistance strains detected by the gene-chips, the most frequent mutations were those associated with codon 531 (23 of 55; 41.8%), 526 (15 of 55; 27.27%) and 516 (9 of 55; 16.36%).</p><p><b>CONCLUSION</b>Results showed that this was a rapid, simple and highly specific method when using gene-chip to detect Mycobacterium tuberculosis and rifaman-resistant strains.</p>