Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-01 Cooperative journals: 《中国全科医学》
SU Jin
SHOU Juan
GU Wenqin
YI Chuntao
XU Liping
CHENG Lili
DING Hongjuan
ZHOU Peng
WU Yinghua
QIN Jie
XUE Bin
WEI Baichuan
WANG Qian
PENG Yan
CHENG Yimin
YANG Lan
WEI Yangyang
WANG Lei
QI Jinlin
SHAO Ying
Abstract： Background With the gradual deepening of the comprehensive reform of community health services，the prevention and control of single diseases for the entire population in the community is also constantly being optimized，However，there is still a lack of appropriate evaluation methods in the community to reflect its prevention and control effectiveness evaluation. Objective By analyzing and exploring the cost effect of the existing whole-population prevention and control measures of osteoporosis in Fenglin community，from2016 to 2022，this paper answers the initial results and possible problems of the whole population prevention and control of single disease in the community. Methods This study conducted a cost-effectiveness analysis on 4293 community residents who received osteoporosis prevention and treatment in Fenglin Community from 2016 to 2022. Divide the research object into three states based on bone density values: healthy，low bone mass，and osteoporosis，and construct a Markov model to analyze the influencing factors of different state transitions. And based on the predicted values of the Markov model combined with quality adjusted life years （QALY），the increment of quality adjusted life years（QALY） is calculated. All costs invested in prevention and control work from 2016 to 2022 are counted，and the effectiveness of prevention and control is evaluated by the cost/quality adjusted life year increment ratio. Quality adjusted life years （QALY）are obtained by calculating the health utility value and expected life determined through literature search. Results The total cost of osteoporosis prevention and treatment in Fenglin community was 33，814，102.15 yuan. The total quality-adjusted life years of 4293 community osteoporosis prevention and treatment population were 77098.2889 at the first diagnosis，the average per capita was 17.959，and the standard deviation was 9.34. At the second diagnosis，the total quality-adjusted life years were 79616.9361，the mean per capita was 18.546，the standard deviation was 9.342，and the difference between the two diagnoses was 2，518.6472. The incremental cost-effectiveness ratio （ICER） is 2，132.9070 yuan /QALY，and the incremental cost#2;effectiveness ratio （ICER） is less than 1 times （66，965.10 yuan） per capita GDP，indicating that the intervention scheme is fully cost-effective. Conclusion This study combined Markov model and quality-adjusted life years （QALY） to make a preliminary evaluation of the prevention and treatment effect of osteoporosis in Fenglin community. The results showed that the intervention program of osteoporosis prevention and treatment in Fenglin community was worth investing， and provided a certain basis for the accurate prevention and treatment decision of osteoporosis in the future.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-26 Cooperative journals: 《中国全科医学》
Abstract： Background The level and quality of diagnosis and treatment of Helicobacter pylori（Hp）infections in Shanghai's community health service Institutions is unclear，and there is a lack of systematic evaluation and monitoring. Objective To understand the current status of diagnosis，treatment and management of Helicobacter pylori（Hp）infection in community health centers in Shanghai，to evaluate the quality of diagnosis and treatment，and to explore the problems and improvement measures. Method A questionnaire was distributed to a total of 249 community health centers in 16 administrative districts of Shanghai and 3 875 general practitioners（GPs）working in the community health centers from May to June 2022 to investigate the standardization of prescriptions for the eradication of Hp infections in the community health centers，the detection of Hp infections，the provision of drugs for the eradication of Hp infections，the management of Hp infections，the difficulties of Hp infections in the treatment of Hp infections，as well as the knowledge of community-based GPs on the diagnosis and treatment of Hp infections. Result The result of the prescription eradication program for Hp infection in primary health care facilities in Shanghai was only 32.0 percent correct. The proportion of health service centers with the ability to conduct Hp infection testing in primary healthcare institutions in Shanghai is high，nearly 80%. Most of the community health service centers were able to equip the basic medicines needed for the eradication of Hp，but the rate of bismuth equipment was low，54.6%. The rate of Hp diagnosis and treatment standard supervision was 80.0%. The demand for the training of standardized diagnosis and treatment of Hp infections was high，accounting for 66.7%. The main difficulties in Hp infection diagnosis and treatment were incomplete drug provision，insufficient doctor's diagnosis and treatment ability and insufficient equipment. Community general practitioners do not have enough basic knowledge about the diagnosis and treatment of Hp infection. Conclusion The capacity to conduct Hp testing needs to be further strengthened in primary care organizations in Shanghai，especially in remote community health service centers，including the purchase of more Hp-related testing equipment and reagents，and the completion of related medications needed for the eradication of Hp. In addition，it is necessary to further strengthen the standardized diagnosis and treatment training of Hp infection for community health centers，improve the diagnosis and treatment ability of general practitioners on Hp infection，and at the same time，strengthen the supervision of Hp diagnosis and treatment standardization，so as to further improve the diagnosis and treatment ability of community general practitioners on Hp infection.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-01-31 Cooperative journals: 《中国全科医学》
Abstract： The primary entities in community medical activities are the community health service centers. Amidst the backdrop of new medical reforms，the community health service centers have continuously sought appropriate development strategies. The Fenglin Street Community Health Service Center in Xuhui District，Shanghai，has pioneered the "combination of general and specialized disciplines" model，merging general medicine with specialized disease management，which has significantly contributed to the advancement of core disciplinary areas and the enhancement of medical service standards. This paper provides a comprehensive summary of the "combination of general and specialized disciplines" practice in Fenglin，with the aim of offering insights and guidance to related grassroots medical institutions based on the findings.
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