RESUMO
OBJECTIVE:To systematically review the current situation and facing problems of hierarchical diagnosis and treat-ment in China,and provide basis for nation health-related decisions. METHODS:Using"hierarchical diagnosis and treatment"as keyword,relevant literatures in CNKI,VIP database,and Wanfang database from building to Jun. 2016 were retrieved. Study for current situation of hierarchical diagnosis and treatment in China was comprehensively collected,and systematical review was con-ducted from aspects of outcome evaluation indicators and facing problems. RESULTS:Totally 23 studies were included,in which, 18 were investigative studies,3 were retrospective/investigative studies,1 was retrospective study,and 1 was randomized con-trolled study. In the outcome evaluation indicators,9 took awareness of hierarchical diagnosis and treatment as review indicators, showing that the public had poor awareness;7 took the current situation as review indicator,showing that the overall current situa-tion was unsatisfactory;3 took human resources as review indicator,showing that human resources in primary medical institutions were not ideal;3 took satisfactory degree as review indicator,showing that the public were generally satisfied with hierarchical di-agnosis;2 took the implementation model as review indicator,showing that the current model had been able to promote hierarchi-cal diagnosis and treatment;2 took medical cost as review indicator,showing that individuals paid higher. In the facing problems, 19 studies suggested the imperfect systems for hierarchical diagnosis and treatment,16 suggested that primary medical treatment was limited in capability,7 suggested that patients still preferred big hospitals to primary medical institutions,and 7 suggested that it lacked publicity. CONCLUSIONS:The current situation of hierarchical diagnosis and treatment is certainly not ideal but still fac-ing many problems in China. Improving the levels in primary institutions,hierarchical diagnosis and treatment system and patients' willingness to primary medical institutions,and increasing its publicity can deeply promote the implementation of hierarchical diag-nosis and treatment and provide objective and valuable reference for health decision-making.
RESUMO
@#Objective To systematically review the effect of picture exchange communication system (PECS) on social communication and speech in children with autism spectrum disorder (ASD). Methods Literatures were retrieved from PubMed, Medline, EBSCO, Elsvier, VIP, CNKI, evaluated and screened out. Results Six articles were included in the systematic review. Two of them researched the effect of PECS on social communication and speech, two for social communication and other two for speech. Four of them supported that PECS might promote the social communication, three of them supported that PECS promote the speech, and one indicated that PECS did less for speech. Conclusion PECS benefits social communication in children with ASD, especially for the request, and may facilitate the increase of the vocabulary and speech. The characteristics of children with ASD may associate with the efficacy of PECS.