Objective To investigate current situation of medical service and management in Gaozha Central Township Health Center (GzC), so as to provide baseline data for township health centers in both key techniques research and product development of drugs allocation and delivery. Methods A questionnaire combined with a special interview was carried out, which included the general information, human resources, medical service and management, and the practice of essential medicine list. Results a) The hardware condition of GzC was not good enough, and the economic status of the service recipients was lower than the average level of both Wuzhong City and China mainland; b) The constituent ratio of general practitioner (GP) and nurse, and GP and laboratorian were all lower than those of national level, while, the constituent ratio of GP and technician was a little bit higher. GzC was in short of medical technical personnel and, especially, the professional pharmacists. The logistics technical workers were as the same proportion as the nurses. The medical technical personnel without professional education background accounted for 3.4%, and about 38% of the staff members had no college degree, about 86.2% had at most primary profession titles. There was no personnel turnover of GzC in recently years; c) The bed utilization ratio was lower than national level (46.4% vs. 60.7%), while the average duration of stay and the in-patient and out-patient service workload of GP were longer or heavier than national level (8 vs. 4.8, 9 vs. 8.3, 4 vs. 1.3); d) The out-patient service in 2010 decreased 26.9% compared to 2009; and the in-patient service in 2010 decreased 42.4%; e) The average medical expense per outpatient and per inpatient increased 127.3% and 56.2%, respectively in 2010 compared to 2009; and f) Essential medicine list was put into practice in April 1st of 2010 and there was only 195 species available in GzC, which has not met the requirements of the national essential medicine list. Conclusion In order to meet the standards of general rural township health center in western China, GzC needs to cope with challenges of insufficient hardware conditions, short of staff, unreasonable personnel structure, low educational background and professional title of the staff, none human resources flow and low technical level of medical service. GzC dose well in drug expenses control, and the hospitalization costs are lower than those of the national level. However, it increases rapidly in 2010. The management of GzC may be influenced by zero-profit sale of the essential drugs, and appropriate subsidy and policy support are necessary to maintain its service quality. And it is required to complement the medicine based on the evidences, to carry out staff training and usage guidance of essential medicine, and to finally guarantee the safe and reasonable use of medicines.
ObjectiveTo carry out health education to day surgery patients, assist the smoothness of their operation, promote early recovery of patients and improve the quality of nursing and patients' degree of satisfaction. MethodsA total of 1 888 operations from January to May, 2013 were chosen to be the control group; and 2 136 operations from January to May, 2014 were regarded as the trail group. Patients in the control group accepted routine nursing and health education, while patients in the trail group accepted health education before and after surgery, and through telephone during the follow-up period. ResultsThe rate of failure to keep the appointment, the readmission rates, and the satisfaction rate to the nursing work were 0.28%, 0.94% and 94.71% respectively in the trial group, while were 3.50%, 3.07%, and 90.20%, respectively in the control group. the differeces between the two groups were significant (P<0.05). ConclusionPersonalized health education can ensure the smooth operation of day surgery, advance wound healing of the patients, and improve the day surgery ward care quality and patient satisfaction.
The UK's National Institute for Health and Care Excellence (NICE) published guideline of mental wellbeing at work on March 2, 2022. The guideline covers how to create the right conditions for mental wellbeing in the workplace, with the aim of promoting supportive and inclusive workplace environments and helping people with or at potential risk of mental health problems. This review will interpret the guidelines in detail.
The purpose of evidence-based healthcare management is to prevent the overuse, underuse or misuse of some management measures, and to eliminate the gap between research and practice or the difference between best practices and conventional practices. Evidence-based healthcare management is still in an early stage of development. It also faces many challenges, which have aroused some criticism and even suspicion. This is closely related to the complexity of the management field itself and the lack of empirical research in the field. Considering the scarcity of high-quality health and medical resources in China, in order to improve the scientificalness of healthcare decision-making, we strongly appeal that promoting evidence-based healthcare management requires government-led, universal education, intensified research, scientific evaluation, technological innovation and integration.
Objectives To describe the mechanism of means testing used in health programs for targeting poor population and to describe how the authors have assessed effects of means testing approaches where applicable. Method We searched 24 electronic resources which included evidence-based, health, economic and social databases, 7 international institution websites, grey literature review resources and Google. Screening and data extraction were conducted by two reviewers separately, and the differences were discussed by the third person or a review group. We systematically analyzed the included studied by theme analysis method from different dimensions. We also described the evaluation outcomes by the authors. Result A total of 10244 records were searched, and 58 studies were included after screening by title, abstract and full texts. A total of 13 studies described verified means testing (VMT) conducted as a targeting method in the US; simple testing method (SMT) was conducted in 16 countries; 26 studies described how proxy means testing (PMT) was used in 14 countries; andmixed means testing (MA) was conducted in 14 countries. Means testing as a targeting method was widely used in four health programs which included health insurance, cash transfer, provision of free health service and fee structure. The target population was poor. Only few studies analyzed the outcomes of means testing; 3 studies analyzed under-coverage and 11studies analyzed leakage as their indicators. Scare cost information could be obtained from the included studies. Conclusion Means testing is widely used in various health programs for targeting the eligible population in distributing benefits, especially in developing countries. Targeting as a means for allocating health resources is particularly important in LMICs for their constraints in budgets available for health. Meanwhile, a universal coverage strategy has become a worldwide issue, and how current health resources can be used equitably and efficiently is a concern from the policy practice. Means testing, as one of the tools in targeting eligible population, would help in this process.
ObjectiveTo identify primary osteoporosis patients’ function and environment status based on International Classification of Functioning, Disability and Health (ICF) and provide evidence to clinical treatment, rehabilitation therapy and rehabilitation nursing.MethodsA questionnaire survey was conducted among osteoporosis patients hospitalized in the Center of rehabilitation Medicine of West China Hospital of SiChuan University, from May 2017 to December 2019. The research design was based on a cross-sectional survey. ICF was applied to simplify the core classification set, and a convenient sampling method was adopted.ResultsA total of 240 patients were investigated. All of the patients’ function showed limitation but different level. Meanwhile, including Walking (D450), Sensation of pain(B280), Structure of trunk (S760), Lifting and carrying objects (D430), Mobility of joint function (B710), the proportion of injuries were more than 90%, most of which the limitation level were light and moderate injuries indicating 5%-49% injuries; more than 50% pointed the three parts of environment factors were facilitative factors including Products or substances for personal consumption (E110), Health professionals (E355), Health services, systems and policies (E580), of which the proportion of Health services, systems and policies (E580) were highest.ConclusionOsteoporosis has a significant effect on patients’ function, we should develop clinical treatment, rehabilitation therapy, rehabilitation nursing based on the current evaluation of function.
Interpretation of the complete scientific connotation of functional foods accurately prior to approval and registration based on animal tests and small sample size human food tests is challenging. Further technical evaluation after market introduction should be carried out on safety, health function and other aspects of those widely used commercial scale production products. According to the analysis report on the consumption situation of post-marketing population submitted when applying for product registration extension since the implementation of the functional food registration and filing management measures more than 3 years ago, the post-marketing evaluation report of functional food still lacks systematic and perfect evidence support. Based on the successful experience of evidence-based medicine and post-marketing evaluation evidence, this paper analyzes the post-marketing evaluation content, evidence source construction, evidence classification and classification of functional food, and puts forward the preliminary idea of constructing post-marketing evaluation evidence body of functional food safety and health function technology from multiple view points, so as to provide insights into evidence system research in this field in the future.
Objective Review the status of the direct health cost of nonsmall-cell lung cancer , and to put forward policy recommendations. Methods Database including PubMed, Cochrane Library and Chinese BioMed were searched, and studies literatures about the direct health cost of nonsmall-cell lung cancer. Results Twenty two studies were analyzed in this paper including 20 foreign studies. Normally, international researches about direct medical cost of treating the nonsmall-cell lung cancer investigate total cost from the first diagnosis until several years later. The discrepancy in the results could be explained by different payments, treatment patterns and research methods in different countries. The direct medical cost of nonsmall-cell lung cancer is expensive especially the cost of in-patient. It’s increase with the time of therapy. Most of the researches in China about direct medical cost of nonsmall-cell lung cancer focus on per in-patient fees. Conclusion Facing the increasingly heavy economic burden of nonsmall-cell lung cancer, to lower the incidence of this disease and to reduce the treatment related cost should be taken into account., the prevention of nonsmall-cell lung cancer carcinoma should be enhanced, Such as tobacco control, environment improvement, etc. A proper incentive mechanism should be established.
Objective To explore the evaluation index and appointment mechanism of healthy professional titles. Methods We collected the data of people evaluated and appointed as advanced professional titles, and the evaluation and appointment documents in West China Hospital. We analyzed the evaluation index and appointment mechanism. Results A total of 400 people gained senior title promotion. The evaluation indexes focused on academic degrees, papers, research projects, patents, as well as awards and honors. The research achievements reduced of 80% people who had gained senior titles. Conclusion Current evaluation indexes prefer to inflexible index and ignore flexible index. The appointment mechanism lacks outcome evaluation, and the professional title will not be eliminated once appointed. In the future, we should improve the evaluation index and appointment mechanism focusing on the specific characteristics of healthy professional titles.
Avoidable mortality (AM) is an important indicator of health system performance. It is also an effective tool for evaluating the effectiveness of health measures and allocation of health resources. The concept development, analytical methods, and research contents of avoidable mortality are introduced in this study. This study investigated the applicability of avoidable mortality analysis in determining priority health-service intervention areas, determining priority health-service intervention populations and evaluating the quality of those services. This paper also discussed the significance and limitations of avoidable mortality analysis. The investigation provided references for further research and application of avoidable mortality analysis.