Objective To investigate the current status of clinical and research developments in Lanzhou University in China, to provide reference data for establishing a coordinated, multi-sectional, research orientated and internationally competitive program in biomedical sciences. Methods Three types of questionnaire containing 57 items were designed for 8 secondary departments in clinical and basic sciences. Another type of questionnaire was distributed to 200 clinicians, researchers, lecturers, and administrators in both clinical and basic sciences from August to September 2005. We searched SCI, CSCD, CSTPCD, CBM and CNKI for research articles published by Lanzhou University, commercial development of research derived from the University, and general and competitiveness evaluations of the University. In addition, seminars, site visits, and expert interviews were also conducted.Results The response rates for the questionnaires were 100% and 91% respectively. The investigation included the identification and evaluation of research and clinical departments, human resources in the three branches of biomedical sciences (clinical, research and education), including academic title, educational background, age distribution, research area and funding (leading investigators included), and publication records. The numbers of undergraduate and graduate students and their CET-4 score (pass rate) were also analyzed. Based on the information obtained, six secondary databases were established and evaluated..Conclusions The merger of Lanzhou University and Lanzhou Medical College has created an opportunity for further development in biomedical research and clinical science. Facing new challenges and difficulties, we should take this responsibility to work together to make the University a national and international center of clinical, research and education in medical sciences.
Objective To provide evidence for the establishment of an essential medicines list, we investigated the institutional medicine supply in rural hospitals and community health service centers in Chengdu. Methods The trained investigators collected medicine sales records and information about the management of institutional pharmacies. Through in-depth interviews with the pharmaceutical personnel, we inquired into the drug supervision and supply networks in rural areas. Then we performed secondary research based on a comparative analysis of drug classification, administration and pharmacies in developed countries. Results Seven township hospitals/community health service centers had pharmacies, facilities, storage, and a clean environment. Three of them used electrical databases to manage medicine sales records. Five township hospitals and 5 village medical rooms purchased medicines from the drug supervision and supply networks every week. In this way, they ensured the quality and accessibility of drugs in rural areas. In the urban community health service centers, medicines were supplied based on the traditional commercial distribution system. Conclusion Rational allocation of health resources to set up institutional pharmacies and village medicine rooms is important. The supervision of village medical rooms must be stricter. We should expand the use of electrical databases and integrate the supervision and supply networks with the supply system of the essential medicines.
Objective To investigate the inpatient’s disease and cost constitution of the Third People’s Hospital of Chengdu in 2009, so as to provide baseline data for further research. Methods The case records of inpatients in the Third People’s Hospital of Chengdu in 2009 were collected, and based on the first diagnose, the diseases were classified according to the International Classification of Diseases (ICD-10). The data including general information of the inpatients, discharge diagnosis and hospitalization expense etc. were rearranged and analyzed using Excel software. Results a) The total number of inpatients was 1 220, and male was more than female. The disease spectrum included 12 categories. b) A total of 1 093 inpatients suffered from the top 3 systematic diseases as follows: trauma and toxicosis, musculoskeletal system and connective tissue disorders, and the factors affecting health and resulting from contact with health care institutions. Except the musculoskeletal system and connective tissue disorders, the other 2 systematic diseases were mostly seen in male rather than in female. c) According to ICD-10, the top 9 diseases of trauma and toxicosis were injuries to the wrist and hand, injuries to the hip and thigh, injuries to the knee and lower leg, injuries to the shoulder and upper arm, injuries to the lower back, lumbar spine and pelvis, injuries to the elbow and forearm, injuries to the thorax, injuries to the neck and injuries to the ankle and foot; the top 4 diseases in musculoskeletal system and connective tissue disorders were dorsopathies, soft tissue disorders, arthrosis, and osteopathies and chondropathies; among the factors affecting health and resulting from contact with health care institutions, removal of fracture fixation device. d) According to ICD-10 (list of three-digit catalogue and four-digit sub-catalogue), the top 5 single diseases in trauma and toxicosis were muscle and tendon injuries of the wrist and hand, intertrochanteric frature, fracture of the femoral neck, fracture of the tibia and fibula, and fracture of the lumbar spine; the top 5 single diseases in musculoskeletal system and connective tissue disorders were lumbar disc herniation, spondylosis, arthrosis of the knee, osteoporosis with pathological fracture, and osteonecrosis. e) The average hospital stay were 23.55 days, and the average cost per capita were 13 073.73 yuan which were constituted by material cost, drug cost including western and Chinese medicines, treatment expenses including blood transfusion fee, operation expenses including anesthetic fee, examination expenses including radiation fee and laboratory fee, bed fee and others. The inpatient costs were mainly at patient’s own expense, nearly a half of those expenses were paid by social security, and public medical care only accounted for less than 3% of the total payment. Conclusion In 2009: a) The male inpatients were mainly the young and middle-aged, and the female were the elderly. The main 3 systematic diseases were trauma and toxicosis, musculoskeletal system and connective tissue disorders, and the factors affecting health and resulting from contact with health care institutions. Except the musculoskeletal system and connective tissue disorders, the other 2 systematic diseases were mostly seen in male rather than in female. b) The top 3 single diseases were lumbar disc herniation, muscle and tendon injuries of the wrist and hand, and intertrochanteric fracture. Except lumbar disc herniation, the other 2 single diseases were mostly seen in male rather than in female. c) The average hospital stay was 23.55 days. The overall costs were mainly constituted by material and drug cost (59.25%), with rationality worthy of attention. d) Inpatient costs were mainly at patient’s own expense or paid by social security, and the proportion of public medical care was low in the payment.
ObjectiveTo evaluate the current status of primary healthcare system reform in Xinjin county, in order to provide baseline data for improving the healthcare service system and population health in Chengdu. MethodsPrimary health care services and population health in Xinjin county were quantitatively described and compared. Resultsa) Eleven township hospitals (100%) and 89 village clinics (66.42%) were upgraded according to the national standards. The management of 60 village clinics were integrated with township hospitals. And 417 and 76 essential healthcare services were provided by township hospitals and village clinics, respectively. b) In 2010, the number of outpatients and inpatients in Xinjin county were increased by 24.2% and 46.3% respectively compared to those of 2009, while the costs per outpatient visit and inpatient discharge were reduced by 21.5% and 18.6% respectively. c) In 2010, health records of 98.2% of population in Xinjin county have been established; 96.3% of pregnant women were managed systematically; 98.8% of children immunization programs were implemented; 100% patients with severe mental disorders and about 78% with hypertension and diabetes were in follow-up and treatment; and 28.8% of total population got the free physical exams in 2010. d) The essential medicine accounted for 96.7% of total types of medicines and 97.8% of total expenditure of medicines in primarily healthcare institutions in Xinjin. The cost of medicine management was reduced from 8.5% to 4.2% while the medicine turnover rate was increased by 50%. e) Average life expectancy in Xinjin county was 77.97 years, infant mortality rate was 6.82‰ in 2010; and there was no maternal death in recent 8 years. f) The regional healthcare information system was established covering three-tier rural health care network spanning the county, township and village. Conclusiona) The primary healthcare system reform in Xinjin county improves the infrastructure of primary care system, the utilization of essential medical care, essential public health service, and essential medicines. b) Life expectancy, infant mortality rate and maternal mortality of Xinjin county are better than the average levels in Sichuan province and China. Xinjin county is a representative pilot county for healthcare service system reform in Chengdu city and a nice model to successfully promote healthcare system reform based on regional healthcare information system.
Objective To investigate the current situation, problems of medicinal biotechnology in China, and to provide the relevant countermeasures for its development. Methods We surveyed the units which could carry out medicinal biotechnology projects in 30 provinces except Tibet, and compared the results with that in America.Results The questionnaire were returned from 25 provinces (83.4%), and there were 1 477 medicinal biotechnology projects carried out by 149 units in the past 10 years. These projects ranged from basic biotechnology to regenerative medicine and stem cell researches. The basic research projects constituted quite large percentage among all the projects. But the development levels in different areas were imbalanced, cross correlation with the development levels of economy. An echelon team of talents has been developed, most of them were trained in China. The invested capital differed considerably among units, in general the amounts were insufficient. Most invested capital came from the government. The number of patent application for projects based on independent-developed technology was small. This showed that project principals had a poor understanding of patents. More than half of units did not have a Bioethics Committee. From the search result for documents, the number of articles on stem research of China was close to that in America; and the number of articles on gene treatment and tissue engineering has already exceeded that of America. However, research on gene diagnosis of China was lagging far behind America. Conclusions An echelon team of talents has been developed, most of them are trained in China.We should give full play to the advantage of the distribution of qualified personal resources in developed economical areas so as to promote the applicability and popularity of medicinal biotechnology in less developed areas.Regarding to applicability and development, we should first develop applied technology to form the core competetiveness of basic research, technology development and application; we should also strengthen the training in ethics and regulation to establish a set of scientific assessment of medicinal biotechnology and management system.
ObjectivesTo investigate the awareness and knowledge of Chinese guideline developers on the patient version of guidelines (PVG).MethodsA questionnaire was developed and distributed to participants of the guideline development workshop on the " 2017 Chinese Medical Doctor Association Annual Conference on Evidence-Based Medicine & Gansu Medical Doctor Association/ Gansu Medical Association Annual Conference on Evidence-Based Medicine”, and guideline developers in Shenzhen, Guangzhou, Xi’an, Beijing and other places were investigated through field surveys. The questionnaire included ten questions centred on respondents’ awareness and their views on the development of PVG. After the invalid questionnaire was excluded, Excel 2013 software was used for data entry, and SPSS 19.0 software was used for data analysis.Results150 questionnaires were distributed and 107 (71.3%) were collected, from which 90 (60.0%) questionnaires with complete response were analyzed. For the awareness of PVG: 30.0% of respondents chose " just know it without more knowledge”, 34.4% chose " never heard of”. The awareness was not associated with educational or departmental background, majors and regions (P>0.05). For opinions on PVG and its development process: 86.7% of the respondents thought PVG is necessary, 90% thought the presentation of PVG needs to follow reporting standards, and 45.6% thought the primary barrier of the development of PVG is lack of cognition.ConclusionsResearch work on PVGs is at an initial stage in China. The awareness among Chinese guideline developers and relevant researchers is lacking and the development methodology requires further exploration. Carrying out research relevant to PVG can promote its development and application in China, so as to improve the clinical practice.
Objective To investigate the situation and problems of medical evidence-based medicine （EBM） teaching in China. Methods One hundred and four participants from different hospitals or universities of China in 2005 “Evidence-Based Medicine Teachers Advanced Training Workshop Ⅱ of Ministry of Education” were investigated. A selfcomplete questionnaire on EBM teaching was given at the registration. Results Seventy five questionaires from responders who came from 50 medical institutions of 18 provinces and 25 cities were available for analysis, representing a response rate of 72%. The average age of responders were 38 years old, and 61.3% were graduates. And 14 hospitals or universities have given EBM courses. Namely, for the postgraduates in 9 universities, undergraduates in 2 universities, physicians, nurses and medical managers in 2 hospitals. The lectures lasted from 8 to 36 hours in different units. Di~culties were：lack of EBM teachers, and better understanding the concept and approach of EBM, less paid attention by policy makers, and too busy in specialty. Conclusion EBM teaching is blooming in medical universities in China. It is needed for us to train high qualified EBM teachers.
Abstract Objective To investigate the disease constitution and hospitalization expenses in Songqiao Central Township Health Center (SqC) in Gaoyou City of Jiangsu Province in 2010, so as to provide the baseline data of disease burden for further study. Methods The inpatient records of SqC in 2010 were collected. The first discharge diagnoses were classified according to the International Classification of Disease 10 (ICD-10). The general information of the inpatients, discharge diagnosis, hospitalization expenses, disease category, age, gender, and reimbursement of expenses were described and analyzed by using Microsoft Excel 2003 and SPSS 13.0 software. Results a) The total number of inpatients was 1036 in 2010, and the gender ratio was about 1.0 (50.7% vs. 49.3%); b) The disease spectrum included 17 categories. The cumulative percents of the top 5 systematic diseases were 81.2%, including the respiratory, digestive, neoplasm, circulatory diseases, and injury, poisoning amp; external causes; c) The top 15 diseases were pneumonia, fracture, malignant neoplasm, benign neoplasm, acute bronchitis, cerebral infarction, hypertension, acute appendicitis, emphysema, cholecystolithias accompanied with cholecystitis, inguinal hernia, coronary heart disease, diabetes mellitus, chronic bronchitis and superficial injury; d) The patients suffering from pneumonia and acute bronchitis were mainly over 65 years old and younger than 5; e) The number of chronic diseases significantly increased with age, especially after the age of 35 years old, and reached the peak at the age over 65 years old; while the acute diseases were mainly distributed at the age younger than 15 yeas old and older than 65 years old. The average length of stay, the total hospitalization and out-of-pocket expenses per capita of the chronic diseases were more than those of the acute ones (13.8 days vs. 9.9 days, ? 3 082 vs. ? 2 615; ? 417 vs. ? 371, respectively); f)The length of stay and total hospitalization per capita were quite higher than the other township health centers (11.6 days vs. 5.2 days, ? 3 001.4 vs. ? 1 004.6); and g) Both of the total reimbursement and out-of-pocket expenses per capita accounted for 44%-57% of the total hospitalization expenses. Among the total reimbursement, the payment from New Cooperative Medical Scheme (NCMS) accounted for over 99%, while that from Medical Aid Scheme only accounted for less than 2%. Conclusion a) The top 3 systematic diseases of SqC are seen in respiratory system, digestive system and neoplasm. The acute diseases are mainly pneumonia and fracture; b) The number of acute or chronic diseases increases significantly with age, especially after 35 years old. Both adolescents and the aged suffer from the heaviest burden of diseases; c) The average length of stay and hospitalization expenses pre capita of SqC are much higher than those of the other township health centers; and d) NCMS is the major source of reimbursement. However, the proportion of out-of-pocket expenses and the burden of diseases are still very high and heavy. Thus the policy of NCMS needs to be adjusted step by step in future.
Objective To investigate the performance of Essential Medicine List (EML) policy over the past one year in Xintian Township Health Center (XTHC), so as to provide references for the delivery, storage and compensation mechanism of essential medicine for township hospitals. Methods Focus interview combined with a questionnaire was carried out to investigate the supply and usage of EML, the situation of both diagnosis-treatment services and the income-expenditure change before and after EML policy. Results a) It showed that there was an increasing trend with the preparation rate of EML from 62.2% before implementation to 87.3% after, and the proportion of EML income to total medicine expenses increased from 39.3% to 90.6% in XTHC. But problems still existed such as incomplete and old variety of medicine; b) The numbers of outpatient-time and inpatient-time kept growing, while medical cost for both average clinic cost and average hospitalization cost decreased to different extent; c) Although the gross income increased slightly, this center was still running in the red with the limited amount of financial assistance; and d) The proportion of medical care and drug kept decreasing while the proportion of drug cost and examination cost kept increasing. Compared with the situation in 2009, the proportion of examination cost from 2010 to 2011 had increased by 30%, and it still remained at the previous level after EML implementation. Conclusion The implementation of EML does not completely change the predicament of “Make compensation for doctors by selling drugs” in township health center. Owing to the sale policy of zero price difference and the poor performance of compensation for township health centers, XTHC is still running under deficit. Evidence-based medicine selection and research on compensation mechanism for underdeveloped areas are urgently needed.
Objective To study the distribution of HIV/AIDS high-risk population, HIV infection and the main risk factors for developing HIV/AIDS’ controllable measures and exploring appropriate health education and behavior intervention models. Methods A total of 360 commercial sex workers (CSW) joined together through convenience sampling and 360 drug users (DU) joined together through convenience sampling or snow-balling sampling whose relevant behavior factors were investigated by questionnaires. Results The general rate of knowing knowledge about AIDS was 75.2% among 360 CSW, 67.8% CSW used condom in commercial sex activities; none of 149 CSW blood samples was detected HIV or syphilis antibody positive. The general rate of knowing knowledge about AIDS was 83.7% among 360 DU who injected drugs last month, the rate of sharing needles was 47.6% and the low rate of condom used; 1 HIV antibody and 5 syphilis antibodies positive were found among 198 DU blood samples, so HIV and syphilis infection rate were 0.51%and 2.53%, respectively. Conclusion The rate of HIV infection is a very low level and there are many risk factors among CSW and DU. A good job should be done to integrate AIDS health education with behavioral intervention and the monitoring system for the AIDS/HIV high-risk population should be improved.