Disease burden among people aged 70 years or older in countries with different developmental levels from 1990 to 2016 / 中南大学学报(医学版)

To examine differences in burden of disease among people aged ≥70 years old in countries with different developmental levels from 1990 to 2016. 
 Methods: The sociodemographic index (SDI) of global burden of disease (GBD) was used to divide 195 countries into five developmental levels: high, high middle, middle, low middle and low. The results of the Global Burden of Diseases Study 2016 (GBD 2016) were extracted to examine disability-adjusted life years (DALY) and the health loss from the top 10 diseases and risk factors among the people aged ≥70 years old in countries with different SDIs. 
 Results: Between 1990 and 2016, the age-standardized DALY rate among people aged ≥70 years old in countries with different SDIs all showed a downward trend. Different decreases in DALY rate in over-seventy old people were observed across countries with different SDI levels: -23.9% in high SDI, -21.3% in high-middle SDI, -23.4% in middle SDI, -18.8% in low-middle SDI and -16.3% in low SDI. In 1990, the age-standardized DALY rate among people aged ≥70 years old in low and low middle SDI countries was 1.67 and 1.49 times of that in high SDI countries; and the gaps rose to 1.83 and 1.59 times in 2016. The DALY rate of the aged people remained remarkably higher in low middle and low SDI countries in 2016, and the gap widened compared with that in 1990. The reduction of age-standardized DALY rate was mainly due to the decrease of years of life lost (YLL). In 2016, low SDI and low-middle SDI countries suffered much higher burden of disease from infectious diseases and chronic non-communicable diseases. Analysis of leading causes and risk factors of DALY showed significant disparities across different SDI countries; burden of disease caused by environmental pollution and adverse health conditions was much higher in the low SDI and lower-middle SDI countries than that in the other countries.
 Conclusion: During 1990-2016, the burden of disease in countries of all 5 SDI levels declined. But the reductions in the developing countries were less than those in the developed countries, widening health disparities for the elderly between low and high SDI countries. International organizations and individual governments should take measures to narrow health gaps among old adults across countries with different developmental levels.

Analysis of the status and influential factors for prenatal care and postpartum visit among pregnant women based on the First Health Service Survey in Hunan Province / 中南大学学报(医学版)

To evaluate the status and influential factors for prenatal care and postpartum visit among pregnant women in Hunan Province from 2008 to 2013 based on the data from the First Health Service Survey in Hunan Province.
 Methods: Based on the data of prenatal care and postpartum visit among pregnant women from the First Health Service Survey of Hunan Province in 2013, proportion of pregnant women, who didn't meet the criteria for prenatal care and postpartum visit, were calculated (≥5 times for prenatal care and ≥2 times for postpartum visit, according to the National Basic Public Health Service program, 2009 Edition). Multivariable logistic regression models were used to identify the influencial factors.
 Results: A total of 1 035 eligible women were included in data analysis. The proportion of pregnant women who did not meet the criteria were 40.12% (95% CI 24.91%-55.33%) for prenatal care and 64.88% (95% CI 39.70%-90.06%) for postpartum visit. After adjusting other confounding factors, pregnant women with middle- and high-income had lower proportions of not meeting the criteria than those with low-income, with adjusted odds ratios of 0.41 and 0.39, respectively. Multiparae had higher proportion of not meeting the criteria than primiparas, with adjusted odds ratio of 1.54, and pregnant women with age 25-34 years and 35-64 years had lower proportions of not meeting the criteria than those with age 15-24 years. In term of postpartum visit, pregnant women with middle- to high-income had lower proportions of not meeting the criteria than those with low-income, with adjusted odds ratios of 0.50, 0.46 and 0.54, respectively; multiparae had higher proportion of not meeting the criteria than primiparas, with the adjusted odds ratio of 2.30.
 Conclusion: Proportions of pregnant women of not meeting the criteria are high in Hunan Province. Local government should strengthen the management to decrease the proportions of pregnant women who do not meet the standard in prenatal care and postpartum visit, especially for those mulparae with low family income and young age.

Analysis of satisfactions for services among outpatients and inpatients at the age of equal to or more than 15 years old in Hunan province / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the satisfaction of service for outpatient within two weeks and for inpatient service within a year in Hunan Province in 2013 and to analyze the influential factors.
@*METHODS@#Using the data from the First Health Service Survey of Hunan Province, we evaluated the satisfactions for service in outpatients and inpatients based on the listed satisfaction indicators of the Fifth National Health Service Survey questionnaire. Weighted logistic regression was used to examine the influential factors for patients' satisfactions. SURVEYFREQ and SURVEYLOGISTIC procedures in SAS9.2 were used to conduct statistical analysis.
@*RESULTS@#The overall satisfaction proportion was 73.85% (95% CI: 68.67%-79.03%) and 66.31% (95% CI: 61.28%-71.34%) for outpatients and inpatients, respectively. After adjusting the location, gender, age and household income, high degree of satisfaction for outpatients was associated with good patience and trust in medical personnel as well as the low medical costs, with the adjusted odds ratios of 3.64, 5.38 and 3.34, respectively; high degree of satisfaction for inpatients was associated with a good attitude from medical personnel to patients' questions, high patients' trust in medical personnel and low medical costs, with the adjusted odds ratios of 2.56, 4.69 and 4.35, respectively.
@*CONCLUSION@#Most of outpatients and inpatients were satisfied with medical services in 2013 in Hunan province. High degree of satisfaction is associated with good attitude from medical personnel to patients' questions, good patience and trust in medical personnel, and low medical costs.

Injury mortality in China, from 1990 to 2010 / 中华流行病学杂志

Objective To analyze the changing pattern of injury mortality from 1990 to 2010 in China.Methods Data related to injury mortality between 1990 and 2010 from the estimates of the Global Burden of Disease 2010 were analyzed by sex,age,causes and risk factors,under the linear regression model.Results The rates on mortality of injuries showed a significant decline between 1990 and 2010,especially in women and in children aged 0-4 years.In 2010,there were around 796 thousand people died from all kinds of injuries,with an age-standardized mortality as 57/100 000 population.Rates on injury mortality were higher in men and in people aged 70 years or over,than in women or in younger age groups.In contrast to the substantial increase on mortality rate caused by road injury,all the other causes induced mortalities showed distinct decrease.In 2010,injuries accounted for 9.6 percent of the total number of deaths in China,which exceeded the number of deaths caused by communicable,maternal,neonatal diseases or nutritional disorders.The leading causes of injury mortality were road traffic injury,self-hurt,drowning and falls in 2010.In addition,major risk factors that causing injury mortality reduced during the study period,and the top three risk factors showed as occupational-related,alcohol use,and low bone mineral density (osteoporosis).Conclusion Despite the fact that rates on injury-related mortality were decreasing,injury remained a critical public health problem in China.