ObjectiveTo evaluate the smoking environment, its related knowledge and difference between urban and rural areas in Chengdu. MethodsIn December 2010, we randomly sampled and investigated 60 dwellers aged from 35 to 70 from urban and rural communities, who were 1:1 paired by the age and sex. Questionnaires survey was used. ResultsThere were 48.3% (29/60) dwellers thought that smoking should be allowed freely at home, of which 30.0% (9/30)rural homes had no rules about smoking prohibited. There were 93.3% (28/30) urban dwellers supported male smoking. About 86.7%-98.3% urban dwellers realized that many diseases such as heart disease, stroke, and lung cancer may be due to smoking. And 16.7% urban dwellers also realized that cigarettes can result in diabetes mellitus, but none of rural dwellers did. The publicity of smoking cessation among urban dwellers (91.7%) by mass media was better than rural ones (0.0%). There were 95.0% dwellers denied any institution or organization for smoking control. ConclusionThe dwellers were short of cognition about restrictions of smoking environment and non-smoking knowledge. It's different between urban and rural area in tobacco advertisement and publicity of smoking cessation. We should continue enhancing public education, forbiding tobacco advertisement and providing institutions for smoking control.
ObjectiveTo explore the quality of life (QOL) of rural cognitive function impaired elderly in Guangyuan city and analysis the influencing factors, in order to provide evidence for improving the QOL of rural cognitive function impaired elderly. MethodsBy stratified cluster sampling method, Mini-Mental State Examination (MMSE) was adopted in the cognitive function impaired screening in Guangyuan rural area of Sichuan province in 2012, then we used SF-12 questionnaire to evaluate the QOL of those rural elderly (more than 60 years old) whose cognitive function was impaired. ResultsA total of 270 rural cognitive function impaired elderly were selected from 735 old people. The results of QOL assessment showed that:the mean of physical component summary (PCS) was 37.93±11.55, and the mean of mental component summary (MCS) was 44.07±13.14. Gender, age, education levels, economic situation of the selfassessment, chronic disease, being engaging in physical labour and daily life care were correlated with the score of QOL. ConclusionIn order to improve their QOL, we should help the elderly with cognitive function impaired and focus on prevention and individual treatment; their special difficulties should be fully considered when making the policy of health care and social security.
Objective To provide baseline data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development in Chengdu. Methods We selected 7 township/community health institutions and 6 village health posts /street clinics using stratified sampling to take account of the levels of economic development and the distance from the centre of Chengdu We then performed on-site surveys and secondary research. Data were analyzed by using Epidata or Excel. Results The utilization of health institutions was generally good. The number of visits and number of inpatients in medical institutions increased steadily. The utilization rate of hospital beds and doctors’ workload were higher than the national average. The average medical expense per outpatient /inpatient was far lower than the national level. The overall condition of the health institutions that close to the centre of Chengdu was better. Conclusion We should persist in taking advantage of the rural hospitals’ construction to improve village health posts /street clinics and strengthen the national and governmental compensating mechanism for township /community health organizations (village health posts /street clinics), so as to make the basic condition of current township/ community health organizations (village health posts /street clinics) better.
Objective To investigate the spectrum of diseases and the current situation of antibiotic use in rural hospitals and community health service centers in Chengdu, so as to provide evidence for selecting essential medicines and promoting rational use of antibiotics. Method We selected 7 township/community health institutions, from which we collected inpatient and outpatient information. Information about antibiotic use was also collected, including categories, cost, and dosage. A standard questionnaire was used to investigate physicians’ prescription behavior for principal diseases. Result Urban and rural areas had different spectrums of diseases. The major diseases in urban areas included diabetes mellitus, hypertension, chronic obstructive pulmonary disease, and respiratory tract infection; while those in rural areas were infectious diseases of the respiratory system, digestive system, and urinary system. The physicians’ prescription behavior was mainly based on their personal experience. Antibiotics accounted for 30-50% of the total medicine cost. The top four types of antibiotics with the highest cost were cephalosporins, penicillin, quinolones, and macrolides. Conclusion Based on the different spectrums of diseases, essential drug lists and standard treatment guidelines appropriate for rural health care should be developed to improve the rational use of drugs. Factors such as the average cost of daily dose and the course of treatment should be taken into consideration to reduce the overall cost of medicine. An antimicrobial resistance monitoring system and special training courses on rational use of antibiotics should be utilized in the rural health institutions.
【摘要】目的介绍华西医院支援西部地区卫生工程项目的实践和成效。方法过去5年间，华西医院响应国家号召，通过各种帮扶形式，开展了一系列对口支援活动。结果华西医院利用自身的资源优势，通过各种帮扶形式，提高基层医院的医疗救治水平和综合服务能力，为建立城市支援农村卫生工作的长效机制进行了积极的实践和探索，取得显著成效。结论基层卫生事业与人民健康需求和现代医学进步存在着相当的差距，医疗体制改革对部属部管医院的对口支援提出了更高的要求，对口支援的许多细节还需要我们去进一步完善。【Abstract】Objective To introduce the practice and progress of the supportive rural hygiene program of West China Hospital. Methods In the past five years, West China Hospital had made a lot of supportive rural hygiene practice. Results West China Hospital made good use of its own advantages in resources to develop the treatment level and the comprehensive service capability of primary hospital. West China Hospital did a lot of practice to establish the effective system of assistance of city medical care to rural areas, and had already achieved remarkable effects. Conclusionre is a lot of disparity between the basic public health or the requirement of people and the modern medicine progress. Many details for support should be further consummated.
Objective To understand the current situation of Chengdu primary health workers’ performance baseline, and to provide decision-making proof and policy recommendations for Chengdu Coordinated and Balanced Urban-rural Development as well as improve primary health workers’ performance in China. Method See the second study in this series. Result The number of the patients of the Chengdu seven Rural Hospitals / Centers showed a trend of slow increase, and all was higher than the national rural hospital average level except the 2 most remote rural hospitals(“Renhe” and “Bailu”). The seven Rural Hospitals / Centers could provide data about the “Six in One” work, and the performance was generally better than that of the world and the national average level , but showed a decreasing trend from the first circle to the third circle in Chengdu. The rate of patients’ satisfaction and very satisfaction for the Rural Hospitals / Centers “Six in One” work reached 65%-80%, but the rate of health workers’ job satisfaction and very satisfaction only reached 9%-46%, and also showed a decreasing trend from the first circle to the third circle. Conclusion The Chengdu primary health workers provide “Six in One” health service with a higher quality than the world and the national average levels. However, the number of the workers is less than enough; the human managerial structure is irrational; the educational and professional levels are low; their treatment and the work environment are poor. The distribution density , the academic qualification and the structure rationality of professional ranks of health personnel show a decreasing trend, and the difficulty of the service is gradually increasing from the first circle to the third circle, which causes the satisfaction rate of the workers’ job to decrease gradually from the first circle to the third circle. Suggestion: ① To make special performance assessment standard for special health institutions or personnel, and to give the continual oriented training chance for current health personnel. ② To integrate the regional health resources; to establish long-term and stable regional bilateral appointment help policy, technical and rational two-way referral system and indicator systems. ③ To take measures to solve the problems affecting the professional promotion and improvement of the grass-root health personnel.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
ObjectiveTo investigate the health technologies on diabetes prevention and management used in rural China and the assessment results of these health technologies, and to provide references for the selection and using of health technologies on diabetes prevention and management in rural China. MethodsWe searched VIP, CNKI, CBM and WanFang Data to collect survey studies and assessment reports of health technologies on diabetes prevention and management in rural China. The search date was up to July 15th, 2014. Two reviewers independently screened literature, and then the qualitative analysis was performed for the included studies. ResultsA total of 15 studies were included. The results of qualitative analysis showed that:the targeted populations were patients and ordinary villagers who had received the service or treatment of diabetes health technology in rural, as well as the grassroots medical technical personnel and promotion staffs who had developed the health technologies. Diabetes health technology studies in rural mainly included medical personnel health technology related knowledge training. The contents of health technology assessment involved effectiveness, acceptability, economic characteristics, requirements and technical specific property. ConclusionThere was limited researches on the investigation and analysis of health technologies on diabetes prevention and management in rural China, and evaluation content remains insufficient.
The shortage of health workforce in rural and remote areas has been commonly concerned by every country around the word. It is one of world health issues, challenging the aspirations of achieving equity. In this regard, WHO developed the Global Policy Recommendations to improve the accessibility of the health workforce in rural and remote areas through improved retention. This article focuses on the key steps of the policy guideline developed from evidence-based medicine methodology and from angle of guideline development, mainly about background, issues, evidence retrieval and selection, quality grading of evidence, and the forming of recommendation plan, in order to further explore how to correctly understand, obtain, evaluate and apply currently available research evidence, and how to use the GRADE system to make scientific and feasible recommendations in the decision-making process, emphasizing the importance of evidence and the GRADE system in the evidence-based health decision-making.
Objective To investigate the residents’ needs, demand and utilizations of health service in Pingshan Xibaipo town in Hebei province, so as to provide baseline data for the establishment of a rural hospital’s comprehensive model. Method We conducted the survey which using questionnaires to collect the information of all residents in 16 villages of Xibaipo town. The contents of the survey was residents’ spectrum of disease, health service needs, demand and utilization, the cost and Evaluation of medical services, etc. SPSS 17.0 software was used for descriptive analysis. Result The local health services situation was ‘high need, low-use’. The participation rate of the new rural cooperative medical care (NCMS) was 98.06%. Most residents choose rural hospital as the hospital to visits and hospitalization. The evaluation of the equipment and the reasonableness of the charges was lowest. There was a great demand for periodic physical examination and health education. Conclusion The proportion of Health service needs Converse to health services use is low. The health services of major diseases such as hypertension, cerebrovascular diseases need to focus on strengthening. The government should increase financial investment and strengthen basic health resources, strive to do a good work of the residents’ health education and physical examination.