Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Primary medical institutions，with the characteristics of comprehensive，continuous，coordinated，convenient and economical，play an important role in the diagnosis and treatment of common and frequently#2; occurring children's diseases，planned immunization and child health management，and lay a solid foundation for children's health services. It is essential to improve the quality of child health services for children under the management of family doctor contract. There are regional differences in the ability of children's health services at primary institutions in China. Therefore， accurate evaluation of the quality of children's health services at primary institutions is helpful to find problems in time and promote the development of children's health services at a higher level. Objective To assess the quality of community children's health services for contracted children，analyze the quality problems and optimization strategies，and provide international vision and decision-making reference for further improving the quality. Methods Taking a district of Chengdu as a typical case，three community health service centers with stronger child health service ability in the district were selected as the sample institutions， and the parents of children contracted by the sample institutions were surveyed with the online questionnaire on the quality of community child health service by using the Chinese version of primary care assessment tool （PCAT）. Results Totally，3 631 parents of contracted children were investigated. The total PCAT score of community child health service quality in the sample centers was（58.72 ± 13.43）. The dimensions with relatively high PCAT scores of community child health service quality includes "continuity"，"community first consultation （service availability and service use）" and "comprehensive service （service provision）"，while the dimensions "children and family-Centered"，"comprehensive （available services）" and "coordination （referral）" had low scores. Conclusion It is suggested to strengthen the supply of diagnosis and treatment services for common pediatric diseases in the community，unblock the referral mechanism of Pediatrics，strengthen the awareness of parents of contracted children to be included in the contracted service team to participate in diagnosis and treatment decisions，and pay attention to the health services for children with non local registered residence.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-09-01 Cooperative journals: 《中国全科医学》
Abstract： Background Using discrete choice experiment（DCE） to study the employment preference of health personnel to choose jobs can provide scientific and efficient basis for the formulation of policies related to the attraction and retention of health personnel in rural and remote areas. Objective To review，summarize and generalize the researches on the application of DCE to the field of human resources for health，so as to provide reference for future research. Methods Web of Science，PubMed，CNKI，Wanfang and VIP were systematically searched for literature related to DCE application to the field of health human resources from February to April in 2022. The data of included studies such as study objectives，data analysis models，the choice item settings and results were extracted. Results A total of 44 papers published from 2000 to 2020 were finally included. The study objects were mainly health workers in service and students；six studies were labeled and others were unlabeled in the included papers；the number of working attributes ranged from 4 to 8；the number of levels of working attributes was predominantly 2 to 4（88.6%，39/44）. The teamwork of general practitioners and workload were used as working attributes in the studies in high-income countries；the most frequently selected working attribute in studies from low-and middle-income countries was housing（21 times），followed by essential equipment such as facilities and medications（19 times），and learning/training opportunities（16 times）. Income（salary） was incorporated into the working attributes across the literature. Furthermore，we formulated a framework of working attributes containing four aspects：social aspects，including the hospital volume，social support/respect，identification（establishment or becoming a permanent employee）；working aspects， including working location，working conditions，workload，working（management） atmosphere，teamwork，mentoring by supervisors（for primary health workers）；career development aspects，including years of promotion，training（continuing education） opportunities，academic and research opportunities；life aspects，including income，housing，traffic，and children's education. Mixed Logit Model was the frequently used analytical model（19 times），followed by Conditional Logit Model（9 times），Generalized Multinomial Logit Model（3 times）. Conclusion The heterogeneity of research findings in this field is large，making it difficult to draw uniform conclusions. Moreover，the application of DCE in the field of human resources for health still needs to be promoted globally. Relevant studies are very limited and the evidence obtained needs to be confirmed by further research.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-01
Abstract： ABSTRACT: Objective To understand the differences in the demand for elderly care services between urban and rural residents in the Pearl River Delta (PRD), and to provide reference for promoting the balanced development of elderly care services in urban and rural areas. Methods Using multi-stage stratified random sampling method, we selected 7 community health service centers in 2 prefecture-level city in the PRD, and conducted a questionnaire survey on 1919 permanent residents aged 60 years and above who visited the centers. Results A total of 641 urban elderly people (33.4%) and 1278 rural elderly people (66.6%) were surveyed in the PRD. The proportion of elderly people with only children in urban areas is significantly higher than that in rural areas (22.2% vs 8.7%; p<0.001). The proportion of urban elderly people who purchase socialized elderly care services when needed is significantly higher than that of rural elderly people (30.0% vs 15.3%; p<0.001). The proportion of rural elderly people agreeing to the concept of raising children and preventing aging is higher than that of urban elderly people (76.1% vs 58.2%; p<0.001); 37.3% and 19.9% of urban and rural elderly people respectively stated that sudden public health incidents have an impact on their elderly care planning. The proportion of elderly people in rural areas who prefer family based elderly care is higher than that in urban areas (71.8% vs 57.1%; p<0.001). The proportion of urban elderly people clearly expressing their willingness to choose institutions for elderly care is significantly higher than that of rural elderly people (62.6% vs 44.0%; p<0.001). Taking family elderly care as a reference, among urban elderly people, the willingness to choose institutional elderly care is lower for those with "surplus" monthly household income and expenditure [OR (95% CI): 0.038 (0.006-0.246)] and "basically equal" [OR (95% CI): 0.072 (0.012-0.431)], and those who agree to the concept of raising children and preventing aging [OR (95% CI): 0.318 (0.110-0.923)]. Urban males [OR (95% CI): 1.544 (1.058-22.54)] and the elderly who purchase socialized elderly care services [OR (95% CI): 2.208 (1.213-4.020)] and those who believe that sudden public health events have an impact on their elderly care planning [OR (95% CI): 1.806 (1.183-2.757)] tend to prefer community based home-based elderly care. The rural elderly with local registered residence registration are more inclined to institutional pension [OR (95% CI): 4.237 (1.031-17.405)] and community home-based pension [OR (95% CI): 1.463 (1.057-2.024)], while those who have more than one child [OR (95% CI): 0.156 (0.050-0.482)], and the rural elderly who agree with the concept of raising children to prevent old age [OR (95% CI): 0.318 (0.110-0.923)] are less willing to choose community home-based pension, Rural elderly people who believe that sudden public health events have an impact on elderly care planning [OR (95% CI): 3.260 (1.002-10.600)] tend to prefer institutional elderly care. Conclusions There is a significant difference in the attitudes of elderly people in urban and rural areas towards the concept of raising children and preventing aging. Urban elderly people are more likely to accept socialized elderly care services compared to rural elderly people, and the impact of sudden public health events on elderly care planning is similar between urban and rural areas. It is suggested that in addition to strengthening the function of family elderly care, urban and rural elderly care resources should be reasonably allocated based on the differences between urban and rural areas.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-06-25 Cooperative journals: 《中国全科医学》
HUANG, Qixian
WEN, Yanting
HUANG, Jun
LI, Weibin
XU, Yongneng
LIN, Xiayi
WANG, Haoxiang
WENG, Fan
YANG, Lianping
Abstract： Background Dyslipidemia is the most important and causal independent risk factor for atherosclerotic cardiovascular disease（ASCVD）. The prevalence of dyslipidemia in elderly residents in Guangdong Province is high， and it is urgent to analyze the specific prevalence of dyslipidemia and its influencing factors among the elderly，and to carry out targeted preventive and control measures for dyslipidemia. Objective To investigate the epidemiological status of dyslipidemia and its risk factors among elderly residents included in the national basic public health service in Yuexiu District，Guangzhou. Methods A total of 41 469 elderly residents aged 65 years and above with complete important variables were selected as subjects from the information system of community health service center in Yuexiu District，Guangzhou City in 2020，the 2020 health checkup data was used to describe the epidemiological characteristics of the included patients such as basic information，BMI and blood lipid levels. Restricted cubic spline（RCS） fitting Logistic regression model was used to analyze the relationship between age，BMI and the prevalence of dyslipidemia. Results The prevalence of dyslipidemia in 41 469 elderly residents was 53.65%（22 247/41 469），with a standardized prevalence of 53.89%. The prevalence of hypercholesterolemia（HTC），hypertriglyceridemia（HTG）， mixed hyperlipidemia and low high-density lipoprotein cholesterol was 21.43%，16.50%，14.51% and 3.80%，with the standardized prevalence of 21.57%，16.53%，14.61%，3.78%，respectively. Multivariate Logistic regression analysis showed that gender，age，education level，exercise status，and BMI were all influencing factors for dyslipidemia in elderly residents，among which female，low age group，and high BMI were risk factors for dyslipidemia in elderly residents（P<0.05）. The results of RCS fitting showed a non-linear relationship between age，BMI and the prevalence of dyslipidemia in elderly residents. The overall prevalence of dyslipidemia in elderly residents showed a decreasing trend with the increase of age. The risk of dyslipidemia showed a increasing and then decreasing trend with the increase of BMI，the OR increased significantly at low BMI，while decreased at high BMI. Conclusion The prevalence of dyslipidemia is relative high among elderly residents aged 65 years and above included in the national basic public health services in Yuexiu District，Guangzhou. The prevalence of dyslipidemia in the elderly group tends to decrease with the increase of age，and the risk of dyslipidemia prevalence tends to increase and then decrease with the increase of BMI，suggesting special features in the management of dyslipidemia among the elderly，the analysis of risk factors for dyslipidemia in the elderly should be focused on and early preventive and control measures should be carried out.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-11-23 Cooperative journals: 《中国全科医学》
Abstract：
Background Dyslipidemia is the most important and causally independent risk factor for atherosclerotic cardiovascular disease(ASCVD）, and the prevalence of dyslipidemia in elderly residents in Guangdong Province is high, It is necessary to pay attention to the prevalence of dyslipidemia in the elderly and its influencing factors, and to prevent and control dyslipidemia in a targeted manner. Objective To investigate the epidemiological status of dyslipidemia and its risk factors among elderly residents in Yuexiu District, Guangzhou, who were included in the national basic public health service. Methods Using the method of cross-sectional study, we selected 65-year-old elderly residents in Yuexiu District, Guangzhou City, who were enrolled in the national basic public health services in 2020, and used the 2020 health examination data to describe the epidemiological characteristics of patients' basic conditions, BMI and lipid levels, and used restricted cubic spline (RCS) fitted logistic regression models To analyze the changing relationship between age, BMI and the prevalence of dyslipidemia. Results A total of 18,891 elderly residents were included, and the prevalence of dyslipidemia was 53.65%, with a standardized prevalence of 53.89%.The prevalence of hypercholesterolemia(HTC), hypertriglyceridemia(HTG), mixed hyperlipidemia and low high-density lipoprotein cholesterol were 21.43%, 16.50%, 14.51% and 3.80%, respectively, and the standardized prevalence was21.57%,16.53%,14.61%,3.78%, respectively. Single Factor Analysis of chi-square analysis showed that gender, age, education and BMI were the influencing factors for the prevalence of dyslipidemia (P <0.05); Multifactorial Logistic regression analysis showed that female (OR=1.72，95%CI 1.65~1.79), BMI (OR=1.04，95%CI 1.04~1.05) Age (OR=0.97, 95% CI 0.97-0.98) was a protective factor for the occurrence of dyslipidemia, and there was a cholesterol paradox phenomenon for age. Age, BMI and the prevalence of dyslipidemia in elderly residents over 65 years old showed a non-linear relationship, and age and the prevalence of dyslipidemia showed a fluctuating downtrend; as the BMI level increased the risk of dyslipidemia prevalence showed a trend of increasing and then decreasing, and the OR increased significantly under low BMI, while under high BMI, the OR decreased, and the increase without fluctuation was not statistically significant. Conclusion The prevalence of dyslipidemia was high among elderly residents aged 65 years who were included in the national basic public health services in Yuexiu District, Guangzhou. The prevalence of dyslipidemia in this elderly group decreased with increasing age, and the risk of dyslipidemia prevalence showed a trend of rising and then decreasing with increasing BMI level. It suggests that there are some special features in the management of dyslipidemia in the elderly has some special characteristics, and the analysis of risk factors for dyslipidemia in the elderly group should be focused on and early prevention and control should be carried out.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-10-13 Cooperative journals: 《中国全科医学》
Abstract： This review explored the studies using Discrete Choice Experiments in the field of human resources for health published in English from 2000 to 2020，searches were conducted through Web of Science、PubMed、Baidu Scholar, a total of 44 studies were identified. We synthesized roundly the data of the research including respondents, analysis model and results，etc., furthermore， we formulated a framework of work attributes. We found that there was heterogeneity across these studies, and more research should be conducted to provide evidence in this field. Meanwhile, suggestions on the experiment design were also offered, aiming to inform future researchers，for example, iteration methods could be tried in qualitative studies and the levels of job attributes may be described quantitatively.
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