The productive efficiency of community health service stations in China: Taking Shandong province as a case.

The present study evaluated the efficiencies of community health service (CHS) stations based on a survey of 1246 CHS stations, covering nine subcategories in 16 cities in Shandong province. Data envelopment analysis (DEA) was applied to investigate the overall efficiency, the technical and the scale efficiency of community health care resources. The results are, the overall efficiency was 9.47%, and the overall efficiency was generally higher in the central-west region than in the east. There were 23.27% of CHS stations showing technically efficient. The technical efficiency was higher in the east (31.11%) relative to the central-west (19.72%), and 72.71% of CHS stations had a technical efficiency higher than the regional average efficiency. The scale efficiency was 9.31% for CHS stations in Shandong province, being the decisive factor for overall efficiency, and 68.96% of CHS stations showed a scale efficiency above the regional average. Stations held by enterprises and universities, and extended by tertiary hospitals had lower efficiencies than other types of CHS stations. In conclusion, the CHS stations had low efficiencies in general, and scale inefficiencies were the main cause. Related suggestions to improve the efficiency are provided accordingly.

County level study of the interaction effect of PM2.5 and climate sustainability on mortality in China.

Introduction: PM2.5 and climate change are two major public health concerns, with majority of the research on their interaction focused on the synergistic effect, particularly for extreme events such as hot or cold temperatures. The climate sustainability index (CLS) was introduced to comprehensively explore the impact of climate change and the interactive effect on human health with air pollution. Methods: In this study, a county-level panel data in China was collected and used. The generalized additive model (GAM) and geographically and temporally weighted regression (GTWR) was used to explore the interactive and spatial effect on mortality between CLS and PM2.5. Results and discussions: Individually, when CLS is higher than 150 or lower than 50, the mortality is higher. Moreover, when PM2.5 is more than 35 µg/m3, the influence on mortality is significantly increased as PM2.5 concentration rises; when PM2.5 is above 70 µg/m3, the trend is sharp. A nonlinear antagonistic effect between CLS and PM2.5 was found in this study, proving that the combined adverse health effects of climate change and air pollution, especially when CLS was lower (below 100) and PM2.5 was higher (above 35 µg/m3), the antagonistic effect was much stronger. From a spatial perspective, the impact of CLS and PM2.5 on mortality varies in different geographical regions. A negative and positive influence of CLS and PM2.5 was found in east China, especially in the northeastern and northern regions, -which were heavily polluted. This study illustrated that climate sustainability, at certain level, could mitigate the adverse health influence of air pollution, and provided a new perspective on health risk mitigation from pollution reduction and climate adaptation.

The impact of health resource enhancement and its spatiotemporal relationship with population health.

Objective: This study investigated the impact of health resource enhancement on health and spatiotemporal variation characteristics from 2000 to 2010 at the county level. Methods: Multiscale Geographically Weighted Regression and curve fitting were used to explore the characteristics of spatiotemporal impact and divergence mechanism of health resource enhancement on population health. Results: From 2000 to 2010, China's population health continued to rise steadily, and health resource allocation improved. Population health demonstrated the significant spatial autocorrelation, and its spatial clustering patterns were relatively fixed. Health resource allocation was relatively equal. Health technicians per 1,000 persons had a significant positive effect on population health in 2000 and 2010. Meanwhile, its impact tends to be consistent across regions, and the impact scale has been continuously expanding. A quantitative relationship exists between population health and health resource inputs. When life expectancy ranged from 73.68 to 84.08 years, the death rate ranged from 6.27 to 9.00%, and the infant mortality rate ranged from 0.00 to 6.33%, investments in health resources, especially related to health technicians, were beneficial for population health. Conclusions: The government should improve the science and rationality of health resource planning. Planning meets regional realities by combining the impacts of economy and geography. The influence of health resources on population health depends on the overall allocation of health technicians. The number of health technicians needs to be further increased to improve the health resources' effective allocation between regions.