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Reducing doctor-patient conflict is an important part of coordinating doctor-patient disputes and easing doctor-patient relationship, which is conducive to building a harmonious medical environment and promoting the healthy development of medical undertakings. This paper constructs a multi-decision-maker mixed conflict model based on rough set theory, puts forward the matrix operation expression of the conflict degree theory in the Pawlak model, and gives a more objective and scientific evaluation function. Combined with hot issues of doctor-patient conflict, the proposed multi-decision-maker mixed conflict model is applied to doctor-patient conflict, examines the doctor-patient relationship in the medical institution system from multiple internal perspectives, and calculates feasible solutions in the conflict system. The results show that high medical quality, high standardize medication, high institutional efficiency, high staff efficiency, high hospital benefits, high hospital revenue, medium employee development, medium equipment development, or high medical quality, high standardize medication, high institutional efficiency, medium staff efficiency, medium hospital benefits, high hospital revenue, high employee development, and high equipment development are important conditions for building a harmonious medical environment and reducing doctor-patient conflicts.
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Dissidências e Disputas , Relações Médico-Paciente , Humanos , HospitaisRESUMO
OBJECTIVE: Antimicrobial resistance (AMR) has emerged as a serious global public health crisis. In response, 2016, 14 ministries in China, under the leadership of the National Health Commission, collaboratively issued the National Action Plan (NAP) to Contain Antibacterial Resistance (2016-2020). The NAP outlines strategies for medical institutions to adopt stewardship and implement AMR control. The purpose of this study was to comprehend stakeholders' perceptions of the NAP and explore the factors that influence its implementation in medical institutions. METHODS: Semi-structured interviews were conducted with practitioners from medical institution in March and April 2021. Interviews were audio-recorded, transcribed and analyzed using thematic analysis via the framework approach. RESULTS: Twenty practitioners, representing diverse roles (4 administrators, 7 clinicians, 3 microbiologists, 3 pharmacists, 3 nosocomial infection management personnel) from seven institutions, participated in the study. Substantial efforts have been undertaken to regulate the rational use of antibiotics and enhance the management of hospital infections. Participants demonstrated awareness and concern regarding antimicrobial resistance, with widespread support expressed for the NAP. Among all professions, there were varying opinions on whether they felt restricted in their daily work. The tertiary hospitals have established multidisciplinary cooperation mechanisms. Six main themes were identified as both barriers and facilitators to the implementation of the NAP in the medical institutions: individual factors, leadership, multidisciplinary collaboration, patient factors, training and culture. The capacity for administrative attention is constrained or limited, poor enforcement of guidelines, insufficient specialist staff and the liability pressure on clinicians were perceived barriers. To containing AMR in medical institutions, management of hospital infections, the public's knowledge of antibiotics' usage, routine education and multidisciplinary support would be facilitators. CONCLUSIONS: Practitioners from medical institutions were highly supportive for the NAP. Consideration of practitioners' perceived barriers and facilitators might enhance implementation of the NAP to contain antimicrobial resistance.
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Antibacterianos , Infecção Hospitalar , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Pesquisa Qualitativa , Pessoal Administrativo , Infecção Hospitalar/prevenção & controleRESUMO
BACKGROUND: Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support. OBJECTIVE: This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach. METHODS: A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app. After finalizing the app's content and features, we created the app's wireframe, which illustrated the app's proposed interface, navigation sequences, and features and function. Feedback was solicited on the wireframe via key informant interviews with health care providers (n=5) and a focus group and in-depth interviews with patients with GDM (n=12). Incorporating their input, we built a minimum viable product, which was then user-tested with 18 patients with GDM and further refined to obtain the final version of the GDM-DH app. RESULTS: Participants in the focus group and interviews unanimously concurred on the utility and relevance of the proposed mobile app for patients with GDM, offering additional insight into essential modifications and additions to the app's features and content (eg, inclusion of example meal plans and exercise videos).The mean age of patients in the usability testing (n=18) was 28.8 (SD 3.3) years, with a mean gestational age of 27.2 (SD 3.0) weeks. The mean usability score across the 10 tasks was 3.50 (SD 0.55; maximum score=5 for "very easy"); task completion rates ranged from 55.6% (n=10) to 94.4% (n=17). Findings from the usability testing were reviewed to further optimize the GDM-DH app (eg, improving data visualization). Consistent with social cognitive theory, the final version of the GDM-DH app supports GDM self-management by providing health education and allowing patients to record and self-monitor blood glucose, blood pressure, carbohydrate intake, physical activity, and gestational weight gain. The app uses innovative features to minimize the self-monitoring burden, as well as automatic feedback and data visualization. The app also includes a social network "follow" feature to add friends and family and give them permission to view logged data and a progress summary. Health care providers can use the web-based admin portal of the GDM-DH app to enter/review glucose levels and other clinical measures, track patient progress, and guide treatment and counseling accordingly. CONCLUSIONS: To the best of our knowledge, this is the first mobile health platform for GDM developed for a low-income country and the first one containing a social support feature. A pilot clinical trial is currently underway to explore the clinical utility of the GDM-DH app.
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Objective To investigate the number, distribution, and types of radiation of non-medical radiation institutions in Hebei Province, China, and to explore the current radiation protection in the employing units and occupational health management of radiation workers in 2022. Methods A questionnaire survey was conducted in the non-medical institutions engaged in nuclear technology application in Hebei Province, and different types of employing units were selected to monitor the radioactivity level in the workplace. Results A total of 681 non-medical institutions engaged in radiation technology application completed the survey, covering all cities with subordinate districts in the province, including 1605 radioactive devices, 2960 active devices, 45 non-uranium metal mines, and 14 non-sealed workplaces. A total of 8617 radiation workers were surveyed, with a personal dose monitoring rate of 70.9%, a radiation protection training rate of 61.1%, and an occupational health examination rate for radiation workers of 59.3%. A total of 614 radiation protection monitoring instruments were provided, with a personal protective equipment allocation rate of 51.1% and a personal dose alarm device allocation rate of 51.8%. The radiation occupational hazardous factor testing was completed for 54 workplaces, and the results were all qualified. Conclusion There are still significant deficiencies in personal dose monitoring in the radiation work units in non-medical institutions and occupational health examination in the radiation work units in our province. The health administrative departments should strengthen health supervision and law enforcement, enhance radiation protection and skill training for employers, and more effectively control the impact of radiation hazards on personnel health.
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ObjectiveThis study aims to understand the recognition of practitioners in traditional Chinese medicine （TCM） hospitals on hospital-based health technology assessment （HB-HTA）， assessment needs， challenges， and suggestions， so as to provide references for the future work. MethodThe convenient sampling method was adopted to survey the relevant practitioners in TCM hospitals. The questionnaire included 39 questions in 4 dimensions and was distributed through the online platform Weijuanxing. ResultA total of 244 questionnaires were recovered， and the obtained data were analyzed in SPSS. The results showed that 137 practitioners were very familiar with HB-HTA and there was no significant difference in the recognition of practitioners in different occupations （F=0.251； P=0.778）. The practitioners in Hong Kong， Macao， and Taiwan had lower recognition than those in other regions. In terms of the assessment needs， 127 practitioners believed that it was very necessary to carry out HB-HTA in TCM hospitals in the future. Chinese patent medicines/Chinese herbal medicine decoction pieces （5.91） and TCM appropriate technology （5.57） had higher assessment priority scores. The assessment needs were high for the effectiveness （235 practitioners） and safety （224 practitioners） of health technology. The lack of specialized organization and standardized evaluation process system and the shortage of talents were considered to be the major challenges for the future development in this field. ConclusionThe stakeholders carrying out the health technology assessment in TCM hospitals had certain awareness of HB-HTA. Most practitioners believed that it was necessary to carry out HB-HTA in TCM hospitals in the future， while the work might face challenges such as the lack of organizations and system and the shortage of talents， which requires policy support.
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Purpose: This study aimed to analyze first-choice medical institutions for middle-aged and older adults in Fujian Province to promote the development of hierarchical diagnosis and treatment for them. Patients and Methods: Single factor analysis, disordered multi-classification logistic regression, and multiple correspondence classification were used to analyze the influencing factors of first-choice medical institutions for middle-aged and older adults. A total of 486 valid questionnaires were obtained. The questionnaire was based on Health Service Integration Theory and the behavioral model of Andersen. Results: Age, education level, living area, monthly income, nearest medical institution to home, and integrated health service system understanding significantly influenced respondents' preference of first medical institution. Middle-aged and older adults were more inclined to visit county and municipal hospitals first. The treatment center's proximity was also an important determinant of their first-choice selection of medical care. Conclusion: To realize high-quality hierarchical diagnosis and treatment and integrated health service system construction, it is important to improve the service capacity of primary medical institutions, increase the training of family doctors, implement the contract coverage of family doctors, optimize the allocation and geographical layout of primary medical institutions, ensure adequate income levels, and promote township hospital staff.
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In recent years, with the rapid development of Chinese domestic surgical robot technology and the expansion of the application market, the "industry-university-research-medicine" collaborative innovation transformation mode has gradually developed and formed. Medical institutions play an important role in multi-party cooperation with enterprises, universities, and research institutes, as well as in product planning, technology research and development, achievement transformation, and personnel training. On the basis of reviewing the current situation of the development of the "industry-university-research-medicine" collaborative innovation transformation mode of domestic surgical robots, this study explores the multiple roles played by medical institutions in this mode and challenges, further putting forward corresponding recommendations.
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Medicina , Robótica , Humanos , Universidades , Indústrias , TecnologiaRESUMO
Background: Primary medical staff (PMS) are the guardians of population health. However, their loss further worsens the shortage and uneven distribution of human health resources, which should be addressed immediately. This study aimed to investigate the current status of turnover intention of rural PMS in Xinjiang Production and Construction Corps (XPCC) in China and its influencing factors atthe individual and institutional levels to provide reliable baseline data for intervention strategies to protect valuable rural PMS. Methods: Participants were recruited from rural public health institutions of the XPCC using a cross-sectional multistage sampling process. Data on participants' turnover intention and individual- and institution-level indicators were obtained through standardized electronic questionnaires and statistical reports of regional health administrative departments. The key factors influencing PMS turnover intention were identified us ingunivariateandmulti-level logistic regression analysis. Findings: Overall, 20.5% (447/2182) of participants reported turnover intention. Univariate analysis showed that the occurrence of turnover intention was significantly influenced by marriage, education, age, year of working, monthly income, human resource management practices (HRMP), job satisfaction, per capita served population (PCSP) and number of beds (p < 0.05). Multi-level logistic regression analysis showed that bachelor's degree or above and intermediate professional title were closely related to the occurrence of turnover intention (p < 0.05), age 41-50 years old and above, high human resource management practice, and high job satisfaction effectively reduced the odds (p < 0.05). The odds of turnover intention increased by 37% (p < 0.10) for PMS in institutions with PCSP more than 250 people. In contrast, the odds of turnover intention decreased to 68% (p < 0.05) for PMS in institutions with more than 50 beds. Conclusion: Government-run primary medical institutions face the risk of PMS turnover intention. From a personal perspective, the high-risk population fortheturnover intention was mainly the PMS with bachelor's degrees or above and intermediate professional titles. The low-risk population was the PMS with aged over 40 years, a higher evaluation of human resource management practice, and job satisfaction. From the perspective of primary medical institutions, larger institutions can reduce the turnover intention of individuals, whereas the size of the service population has the opposite effect.
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BACKGROUND: While emergency medicine (ER)-based emergency care is prevalent in many countries, in Japan, the "department-specific emergency care model" and the "emergency center model" are mainstream. We hypothesized that many secondary emergency medical institutions in Japan have inadequate systems. Using a questionnaire, we investigated the status of and problems in the emergency medical services system in secondary emergency medical institutions in Japan. Until date, there has not been an exhaustive survey of emergency facilities on a countrywide scale. The main objective of this study was to investigate problems in the Japanese emergency medical services system and thereby improve optimal care for emergency patients. RESULTS: A nationwide questionnaire survey involving 4063 facilities (all government-approved emergency medical facilities certified by prefectural governors) in Japan was conducted. Of the facilities that responded, all secondary emergency facilities were included in the analysis. Responses from 1289 facilities without a tertiary emergency medical care center were analyzed. Among them, 61% (792/1289) had ≤ 199 beds, and 8% were emergency department specialty training program core facilities. Moreover, 42% had an annual patient acceptance number of ≤ 500, 19% did not calculate the number of acceptances, 29% had an acceptance rate of ≥ 81%, and 25% had an acceptance rate of 61-80%. Pregnant women (63%) and children (56%) were the major types of patients that affected the acceptance rate. Factors affecting facilities with a response rate of 81% or higher were "hospitals designated for residency training" and "facilities making some efforts to improve the quality of emergency care and the emergency medical system" (logistic analysis, P < .001). CONCLUSION: Relevant authorities and core regional facilities should consider and implement specific measures for regions and hospitals with a shortage of emergency medicine specialists and physicians (e.g., development of ER-based emergency medicine and provision of education). This study may lead to further improvement in the optimal care of emergency patients through the nationwide establishment of the proposed measures as well as through grouping and integrating the structures and systems in emergency and other medical facilities.
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As a patient safety management practice in outpatient cancer drug therapy at community pharmacies, continuous follow-up after the dispensing of medication is required. In 2013, QOL Pharmacy Kohoku and its affiliated stores started the "Telephone Follow-up for Cancer Patients" program, which utilizes telephones and information communication devices to communicate with patients and provide information to hospitals. Specifically, follow-up, including phone calls, is used to ascertain medication status and side effects before the next visit to the hospital, and feedback is provided to the prescribing source using trace reports. In some cases, this initiative has led to an early detection of side effects, reduction in the usage of anticancer drugs, and enhancement of supportive care, leading to patient safety and security. In addition, on August 1, 2021, a new pharmacy accreditation system was launched with two new functional categories, namely "Community Cooperative Pharmacies" and "Specialty Medical Institution Cooperative Pharmacies." Specialty medical institution-linked pharmacies are defined as pharmacies that can provide specialized and more advanced pharmacological management and dispensing of medications in cooperation with other pharmacies and medical institutions for patients who require specialized pharmacological management, such as in the case of cancer. Following our certification as a specialized medical institution collaborative pharmacy, we intend to continue the efforts we have invested to date and create a community that can assume a prevailing role in patient safety management.
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Neoplasias , Farmácias , Farmácia , Humanos , Farmacêuticos , Segurança do Paciente , Seguimentos , Qualidade de Vida , Telefone , Pacientes AmbulatoriaisRESUMO
Introduction: Mental health at the workplace (WMH) is an important indicator for the optimum functioning of a medical institute. To establish an effective WMH, it is essential to understand the level of awareness, perceptions, and felt needs of students and staff of a medical institute regarding mental health services within the campus. Material and Methods: A cross-sectional web-based survey was conducted in an institution of national importance in Central India using a semistructured questionnaire based on Kobo Toolbox. Felt need for periodic mental health screening within the institutional campus (FN-S) and felt need of having a separate cell for mental healthcare of students and employees (FN-C) were analyzed using univariable and multivariable logistic regression. Results: A total of 526 out of 2190 eligible students and staff completed the survey (response rate 24.1%). About half of the participants were not aware, of whom to contact on campus in case of mental health concerns (MHCs), more than three-fourths were not aware of the rights for seeking treatment, and three-fourths thought that getting diagnosed with an MHC would negatively impact their academic course or work. There was a high felt need for mental health screening services (91.1%), and almost two-thirds felt the need for a separate mental health cell. The FN-S was higher among those from rural areas, those not using social media, those without a preexisting MHC, and those without FN-C. FN-C was higher in those not using social media, those having sleep disturbances, those with unawareness of the rights of a mentally ill person, those without any MHC, and those not having FN-S. Conclusion: Active efforts are needed to roll out a mental health screening policy and separate mental health cells within the medical institute. Future research should focus on a qualitative inquiry into the details of the above findings.
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Background: As China's population ages, its disease spectrum is changing, and the coexistence of multiple chronic diseases has become the norm with respect to the health status of its elderly population. However, the health institution choices of older patients with multimorbidity in stabilization period remains underresearched. This study investigate the factors influencing the choices of older patients with multimorbidity to provide references for the rational allocation of healthcare resources. Methods: A multistage, stratified, whole-group random-sampling method was used to select eligible older patients from September to December of 2022 who attended the Community Health Service Center of Guangdong Province. We adopted a self-designed questionnaire to collect patients' general, disease-related, social-support information, their intention to choose a healthcare provider. A binary logistic regression and decision tree model based on the Chi-squared automatic interaction detector algorithm were implemented to analyze the associated factors involved. Results: A total of 998 patients in stabilization period were included in the study, of which 593 (59.42%) chose hospital and 405 (40.58%) chose primary care. Our binary logistic regression results revealed that age, sex, individual average annual income, educational level, self-reported health status, activities of daily living, alcohol consumption, family doctor contracting, and family supervision of medication or exercise were the principal factors influencing the choice of medical institutions for older patients with multimorbidity (p < 0.05). The decision-tree model reflected three levels and 11 nodes, and we screened a total of four influencing factors: activities of daily living, age, a family doctor contract, and patient sex. The data showed that the logistic regression model possessed an accuracy of 72.9% and that the decision tree model exhibited an accuracy of 68.7%. Prediction using the binary logistic regression was thus statistically superior to the categorical decision-tree model based on the Chi-squared automatic interaction detector algorithm (Z = 3.238, p = 0.001). Conclusion: More than half of older patients with multimorbidity in stabilization period chose hospitals for healthcare. Efforts should be made to improve the quality of healthcare services and increase the medical contracting rate and recognition of family doctors so as to attract older patients with multimorbidity to primary medical institutions.
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Objective To determine the current situation of radiological health management in medical institutions in Nanyang, China, to analyze existing problems and propose improvement measures, and to improve the management level of radiological diagnosis and treatment practice in medical institutions. Methods According to the work plan of the Occupational Disease Prevention and Control Project in Henan Province, China, 66 medical institutions engaged in radiological diagnosis and treatment at different levels were selected for a questionnaire survey, in combination with on-site inspections, inquiries, and access to relevant materials. Results Of 66 medical institutions, 65 institutions held radiological diagnosis and treatment licenses, with a license holding rate of 98.5%. There were 17 “new construction, reconstruction, and expansion” projects, with an evaluation rate of 94.1%. In this survey, a total of 391 radiological diagnosis and treatment equipment were involved, and 387 units of equipment were tested for status, with a detection rate of 99.0% and a qualification rate of 94.8% (367/387); 55 units of equipment were tested for stability, with a detection rate of 14.1%; the workplace protection detection rate was 99.0%, and the qualification rate was 100%; 66 medical institutions had 1809 radiation workers, with an occupational health examination rate of 97.8%; 1262 people were trained, with a training rate of 95.7%; 1773 people were monitored for individual dose, with a monitoring rate of 98.0%. Conclusion Medical institutions should further strengthen management in licensing change, construction project evaluation, and equipment stability monitoring to improve the level of radiological health management.
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In recent years, with the rapid development of Chinese domestic surgical robot technology and the expansion of the application market, the "industry-university-research-medicine" collaborative innovation transformation mode has gradually developed and formed. Medical institutions play an important role in multi-party cooperation with enterprises, universities, and research institutes, as well as in product planning, technology research and development, achievement transformation, and personnel training. On the basis of reviewing the current situation of the development of the "industry-university-research-medicine" collaborative innovation transformation mode of domestic surgical robots, this study explores the multiple roles played by medical institutions in this mode and challenges, further putting forward corresponding recommendations.
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Humanos , Robótica , Universidades , Medicina , Indústrias , TecnologiaRESUMO
Blockchain technology has the advantages of decentralization, secure sharing and tamper resistance, and high privacy, which can solve the current problem of sharing electronic medical records in medical institutions in China. A tertiary hospital established an electronic medical record sharing services convenience service platform based on blockchain in collaboration with China mobile gansu company in September 2021. The hardware architecture of the platform consisted of a hospital data warehouse, a local front-end computer and a blockchain platform. The functional architecture included platform front-end services, the blockchain electronic medical record archiving and service platform. The technical architecture included the underlying blockchain, service layer, interface layer and application layer, which was embedded with asymmetric encryption technology, hash algorithm, smart contract and other technical means, ensuring data ownership and on-demand, controllable, real-time and secure sharing of data. Since the operation of the platform in September 2021, as of October 2022, a tertiary hospital had accumulated 21 545 patient medical records on the chain. The overall operation of the platform was smooth, achieving reliable storage and secure sharing of patient electronic medical records, providing reference for further promoting the interconnection trusted sharing of electronic medical records in medical institutions in China.
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Objective:To construct a self-examination index system for hospital legal practice, and provide effective reference for the self-examination work of hospital practice in accordance with the law.Methods:From May 2021 to September 2022, a multi-dimensional and multi-level indicator system was initially constructed through literature review and expert interviews; Delphi expert consultation method was used to carry out a three-round questionnaire survey, experts were invited to assess the importance of indicators, and the weight values of indicators were processed by using analytic hierarchy process-fuzzy comprehensive evaluation method.Results:The Cs value of consulting experts′ familiarity with the survey content was 0.84, Ca value of judgment basis was 0.78, Cr value of authoritative evaluation was 0.81, and Kendall W value was 0.630. The index system of hospital self-examination included 5 first-level indexes, 19 second-level indexes, and 30 third-level indicators. The 5 first-level indicators included institutional practice, personnel practice, disinfection and prevention of infectious disease, online diagnosis and treatment, and anti-fraud insurance, with weights of 0.235, 0.186, 0.188, 0.185, and 0.206 respectively. Among the second-level indicators, the weights of rational use of medical insurance fund, internet hospital and internet diagnosis and treatment, organization qualification and practice behavior were the highest, with values of 0.206, 0.185, 0.122 and 0.113 respectively. Among the third-level indicators, the internet hospital physician qualification, whether the hospital had obtained the license to practice, cracking down on fraudulent insurance practices, real-name medical treatment, and reasonable and standardized use of health insurance costs had the highest weight, which were 0.185, 0.122, 0.076, 0.065, and 0.065, respectively. Conclusions:The self-examination index system of medical institutions is scientific, which could help the medical institutions to practice self-examination and ensure medical quality and safety.
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Objective:To translate the health literacy-sensitive communication scale into Chinese and examine its reliability and validity.Methods:Following Brislin′s translation principles, the HL-COM was translated and culturally adapted into Chinese. This cross-sectional study surveyed 434 outpatients and inpatients from three tertiary hospitals in Hubei Province using a questionnaire. Cronbach′s α coefficient and split half reliability were used to evaluate the reliability of the scale. Scale-level content validity index (S-CVI) and item-level content validity index (I-CVI) were used to evaluate the content validity. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity, while measurement equivalence across gender was examined.Results:The Chinese version of HL-COM contains 9 items, which was consistent with the original English version. Reliability of the scale: Cronbach′s ɑ Coefficient=0.938, Spearman-Brown half coefficient=0.926; Content validity: Scale-level content validity index (S-CVI)=0.926, Item-level content validity index (I-CVI) was 0.833-1.000; only one factor was extracted based on exploratory factor analysis, with a cumulative variance contribution rate of 68.541%. Confirmatory factor analysis indicated a good fit, with the fitting indexes of ?χ2/df=2.794, Normed Fit Index (NFI)=0.974, Standardized Root Mean Square Residual (SRMR)=0.025, Goodness-of-Fit Index (GFI)=0.962, Root Mean Square Error of Approximation (RMSEA)=0.089, Comparative Fit Index (CFI)=0.983. Multigroup confirmatory factor analysis indicated measurement invariance of the Chinese version of HL-COM across gender. Conclusion:The Chinese version of HL-COM demonstrates good reliability and validity, and serves as a valuable tool for assessing health literate in health care organization in China.
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Objective:To discuss the role of rural-order tuition-waived medical students in grass-roots public health, and put forward pertinent suggestions for further improving the effectiveness of rural directional general practitioner training programs.Methods:Through interviews with 63 graduated rural-order tuition-waived medical undergraduates from rural primary medical institutions in Sichuan Province, the standard procedures of spindle encoding and content analysis were used to analyze the influence of the training effect of rural-order tuition-waived medical students on grass-roots public health services.Results:The results showed that the training effect of rural-order tuition-waived medical students mainly reflected in theoretical learning, practical work ability, future career planning and post-graduation education, among which the training effect of theoretical learning and practical work ability was better. Rural-order tuition-waived medical students played a positive role in grass-roots public health services, mainly in the protection of key populations, home prevention and management of the elderly and chronic diseases patients, and home prevention and management of children and pregnant women.Conclusion:The measures for rural-order tuition-waived medical students to provide grass-roots public health services should include that the supporting policies of the state and schools can be continuously improved and implemented, college teachers should pay more attention to the guidance of the humanistic spirit of general medical students, and the curriculum system construction of rural-order tuition-waived medical students should highlight the courses related to grass-roots and general medicine. In the process of student training, we should construct effective practical methods and strengthen post-employment continuing education.
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【Objective:】 To preliminary construct a scientific, systematic and applicable evaluation index system of the interest conflict for medical institutions ethics committee. 【Methods:】 Literature retrieval, interpretation of laws and regulations, expert group discussion and Delphi expert letter inquiry were used to screen indicators and determine the evaluation index system of interest conflict and the weight of various indicators. 【Results:】 The response rates of the two rounds of correspondence questionnaire were both 100%, the authority coefficient Cr values of the two rounds were 0.855 and 0.865, and the coordination coefficient W values of the two rounds were 0.817 and 0.826, which were statistically significant (P<0.05). The final formed system included 3 first-level indicators, 10 second-level indicators and 25 third-level indicators. 【Conclusion:】 The evaluation index system of interest conflict for medical institution ethics committee is scientific and reliable.
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Objective@#To investigate the detection of HIV/AIDS cases in medical institutions in Tianjin Municipality from 2005 to 2021, so as to provide insights into optimization of HIV antibody testing strategies in medical institutions.@*Methods@#All data pertaining to individuals receiving HIV antibody tests in medical institutions in Tianjin Municipality from 2005 to 2021 were collected from the information systems in medical institutions and the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. The positive rate of HIV antibody and epidemiological characteristics of HIV/AIDS cases in medical institutions were analyzed.@*Results@#The number of HIV antibody tests increased from 86 102 person-times in 2005 to 1 369 345 person-times in 2021 in medical institutions in Tianjin Municipality, with annual increase by 18.88%. The positive rate of HIV antibody increased from 2.44/104 to 2.85/104 (P<0.05), with annual increase by 2.79/104. Both the proportion of the number of HIV antibody tests and the number of HIV/AIDS cases detected by medical institutions in the whole city appeared a tendency towards a rise (P<0.05). A high positive rate of HIV antibody was seen in sexually transmitted disease clinics (53.69/104) and other testing services (12.25/104), and the highest positive rate of HIV antibody was seen in individuals at ages of 20 to 39 years (5.40/104), while the positive rate of HIV antibody was higher in men (5.84/104) than in women (0.53/104) (P<0.05). A total of 3 610 HIV/AIDS cases were detected in medical institutions in Tianjin Municipality from 2005 to 2021, with a median age of 38 (interquartile range, 24) years. Of all HIV/AIDS patients, there were 3 277 men (90.78%), and men who have sex with men was the predominant transmission route (63.46%), while the proportion of late identification of HIV/AIDS cases was 65.60%. In addition, the proportion of timely detection for the first CD4+T lymphocyte count testing increased from 23.81% in 2005 to 71.54% in 2021 (P<0.05).@*Conclusions@#The number of HIV antibody tests and positive rate of HIV antibody appeared a tendency towards a rise in medical institutions in Tianjin Municipality from 2005 to 2021. The HIV/AIDS cases were predominantly identified in sexually transmitted disease clinics and other testing services, and were predominantly men.
