The health status, health needs and demands as well as the concept of health itself have changes dramatically in the last one hundred years, the organizational and institutional evolutions of health system took place accordingly. To adapt the changes of health system, medical education has experienced three generations of major reform in the last century: the science-based curricula, problem-based instruction, system-based and competence-oriented education. At the same time the organization of medical education evolved from academic medicine to academic health center to academic health system. This article briefly describes the process of this evolution and presents author’s personal views on academic health system.
Objective To investigate the the status of Health manpower resources of rural hospitals, Health service, health personnel ’s reflection for the hospital’ current issues 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 the rural hospital staff’s self-evaluation of health services, the reflecting of the problems of the current hospitals ,the views of the future building, village health humen resources for health, etc. SPSS 17.0 sofewarewas used for data analysis. Result The following problems are existing in Xibaipo town hospitals. (1) The rural hospital infrastructure is poor: 14 beds, housing a total area of 832 square meters is far below the national average. (2) The quality of the health personnel in the rural hospital is low.The proportion of doctors and nurses (1׃0.75) is higher than the Ministry of Health’s standard (1׃1), less educated (only 2 person’s first degree is college), low-level professional titled (the proportion of health officer of no professional title is 42.86%), etc. (3) Health resources in village are scarce: the quality of rural doctors is low (90.91% are non-formal school graduation), village clinics is lack of facilities (16 villages have only a total of 10 village clinics, 5 beds). Conclusion The infrastructure of the rural hospital was poor,while the situation of the personnel allocation in the rural hospital was irrational ,and the integrated management of the hospital in town and village is not good . The health personnel proposed recommendation about construction of health personnel, departments, information technology , etc .The rural hospital should introduce equipment and personnel, improve health care services and strengthen the integrated management of the hospital in town and village .
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.
ObjectiveTo analysis the situation of health management service project for patients with hypertension in basic public health service project of Sichuan province from 2015 to 2016, and to provide enhancing suggestions for community prevention of hypertension.MethodsA total of 42 health clinics or community health service centers, 21 counties and 21 cities were extracted each year by method of multistage stratified random sampling from 2015 to 2016. In each institution, we sampled 10 residents, health records of hypertension. Telephone survey was used to judge the accuracy and standard ability of services the patients received according to the national basic public health service specifications, such as personal information, physical examing records, follow up information.The blood pressure of the last follow-up was recorded.ResultsRate of the managed hypertension was from 42.09% to 40.31% (χ2=115.33, P<0.05), rate of the records with accurate information was from 84.29% to 88.79% (χ2=1.94, P=0.16), and rate of the patients received normative services was from 69.49% to 72.33% (χ2=0.54, P=0.57). The control rate of blood pressure was from 82.66% to 85.37% (χ2=0.52, P=0.48). The standardization of the service could obviously improve blood pressure control rates (χ2=22.61, P<0.05).ConclusionProgress has been achieved in health management service of hypertension in Sichuan province from 2015 to 2016, however the standardization of the service is needed to be further enhanced.
The new coming era has brought great challenge to present health service model, and the development of new science and technology had improved the reconstruction of medical system and model. With the guidance of evidence-based management and participation of model technology, this paper provides an explanation of the new health service model containing new health management, clinical medicine, chronic disease management and elder care which cover the whole life cycle, so as to implement the " Health China” strategy and develop a whole life cycle health service system for all residents with necessary, high quality, and affordable prevention, treatment, rehabilitation and health promotion.
ObjectivesTo analyze the theoretical and practical research and effect evaluation of integrated care at home and abroad, so as to provide evidence for the development of integrated care in China.MethodsPubMed, CNKI and WanFang Data databases and government documents, research reports were searched to collect studies on integrated care, and then literature review was then performed.ResultsForeign integrated care was dominated at government level. The integration involved numerous departments such as hospital and insurance institutions. The degree of integration was high and funds were sufficient. The theoretical framework was studied from the macro, meso and micro perspectives, and people-centered, value-based integration was proposed. However, in China the integrated care was primarily guided by the government nationally. Local government was responsible for specific integration practices. The degree of integration was low and funds were insufficient. The theoretical research mostly focused on cooperation, interest mechanisms and so on. At home and abroad, researchers focused on the evaluation of health service and quality. Foreign countries paid more attention to medical costs, while in China, due to the imbalance of interest mechanisms, researchers paid more attention to medical expenses and performance evaluation.ConclusionThere is no unified theoretical framework and method for integrated medical care. Researchers and policy makers should combine the successful experience and characteristics at home and abroad, consider the complex health policy context of the country to implement integrated care.
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.