Geographical and household variation in health-related quality of life in Hong Kong.

OBJECTIVE: This study investigated individual, household, and area effects in the distribution of mental and physical health scores in Hong Kong. METHOD: Analysis of data from a large representative survey of randomly sampled 29,561 Chinese adults in 2002. Multilevel regression methods were used to model variance in the physical and mental component of the SF-12 at the individual, household and area levels. RESULTS: Little variance in scores occurred at the area level (0.3% for physical health and 2.1% for mental health), whereas substantial variance occurred at the household level (23.2% for physical health and 37.2% for mental health), and individual level (76.5% for physical health and 60.7% for mental health). CONCLUSIONS: Similar to studies conducted in Western countries, these results confirm the importance of individual-, household- and area-level characteristics as important determinants of both mental and physical health. It suggests that area-level characteristics may be more important for mental than physical health.

Perceived quality of communication amongst outpatients in western and traditional Chinese medicine clinics in a Chinese population.

OBJECTIVE: This study investigates differences in perceived communication by patients of the quality of outpatient episodes in an urban Chinese population. METHODS: A representative, population based survey was conducted in Hong Kong, China. A random sample of respondents aged >15 years who had received outpatient care the 30 days previous to enumeration were invited to evaluate communication with their doctors and the overall quality of their latest consultation. RESULTS: The majority thought that their clinicians were listening carefully (93.5%), explaining clearly (93.1%), expressing appropriate respect (93.8%), and were allocating sufficient time for consultation (89.5%). 97.6% gave 5-10 points out of 10 for overall healthcare quality. Compared to users of private western medicine (WM) services, multivariate analysis showed that traditional Chinese medicine (TCM) patients were more likely to rate their clinicians highly for listening skills but low for respect. Users of WM public services were more likely to be dissatisfied with all evaluated aspects. Favourable ratings were more likely to be expressed by those who are older, less educated, and those who paid by indemnity insurance. CONCLUSIONS: We have highlighted three unique observations: first, patients' perception of clinician-patient communication in out patients differs between WM and TCM. Second, patients who used public WM services rate the quality of their visits lower than those in the private WM sector. Lastly, we have observed a negative association between higher education background and satisfaction level. Further researches are warranted.

Nomograms of total renal volume, urinary bladder volume and bladder wall thickness index in 3,376 children with a normal urinary tract.

BACKGROUND: We have previously shown that urinary bladder volume index (BVI = length x width x depth of bladder) and bladder volume wall thickness index (BVWI = BVI at full bladder/average bladder wall thickness) are useful indicators of bladder dysfunction in children with enuresis and urinary tract infection. These indices show a good correlation with urodynamic studies. We have expanded the study to include normal paediatric subjects with a wide age range. We illustrate a simple sonography protocol with nomograms of different parameters, which provide useful references for functional assessment in children with urological abnormalities. OBJECTIVE: To construct nomograms of total renal volume, maximum BVI and BVWI based on a Chinese paediatric population with age range from newborn to adolescence. MATERIALS AND METHODS: Sonography was performed in consecutive children with normal urinary tracts on imaging, using a standardized protocol. Data were collected for construction of nomograms for different parameters. RESULTS: Nomograms of total renal volume, BVI and BVWI were constructed based on 3,376 consecutive paediatric subjects. All parameters consistently increased with age. CONCLUSION: Nomograms of total renal volume, BVI and BVWI could provide useful references for studying bladder dysfunction in children using noninvasive dynamic sonography.