Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
Objective To investigate the health status of residents in rural areas of China as well as their needs for health service, and to explore the effective way to improve the health status of rural residents so as to provide a basis for the training of community healthcare professionals. Methods Using the method of stratified cluster random sampling, we investigated 4190 rural residents from 1200 families, which were sampled from 13 provinces of China according to the geographical distribution. Results The 2-week prevalence rate was 27.9%. 32.7% of the patients saw a doctor, and 20.5% did not take any measures. Among those who did not take any measures, 78.4% thought their illness was mild and did not need any treatment; and the second reason for no treatment was lack of money (accounting for 36.5%). The prevalence rate of chronic diseases during the past half year was 24.9%, among which lumbar and leg pain was the most prevalent (accounting for 7.8%), followed by hypertension (accounting for 5.5%). The rates of visiting a doctor were 43.9% and 61.5% in township level and village level health institutions, respectively, during the past one year. 70.0% of the patients looked for treatment, 8.4% chose to ignore, and 20.8% took medicine by themselves. Among those who visited a doctor, 61.0% preferred hospitals near their houses, and 34.0% preferred those with lower expenses. More than half of the residents (accounting for 57.3%) did not have any physical examination during the past 3 years, and 28.3% did have a check-up but not regularly. Among the rural residents investigated, 64.2% obtained health care knowledge from television, newspapers, books and radio broadcasting, and 67.3% were desirous of regular physical examination. 56.3% and 33.1% of the rural residents considered the skill of the healthcare professionals in town-level institutions to be acceptable and satisfactory, respectively; and 61.7% and 24.6% evaluated the skill of those in village-level institutions to be acceptable and satisfactory, respectively. Conclusion The health status of rural residents is not optimistic, and their health behaviors need to be correctly guided, and the medical facilities and healthcare service quality of primary healthcare institutions should be improved. It is suggested that the government and medical colleges take the responsibility to train healthcare professionals for the primary health care in rural areas.
Objective To provide the evidence for anti-epidemic command and developing response plan through investigation on prophlactical disinfection in Deyang, the worst-hit areas after Wenchuan earthquake. Methods We used convenient sampling together with the report forms and the self-made questionnaire to collect information from 107 villages and 17 settlement spots for the disaster victims in 25 towns in Deyang disaster area. Results There were a total of 6 kinds of disinfectant, including the chlorine disinfectant, 2 kinds of peroxide disinfectant and 2 other types of disinfectant, which were delivered the Deyang disaster area through the National amp; Province CDC system allocation or the None-Goverment Organization donation. From May 17 to June 9, the large-scale preventive disinfection was carried out in the disaster area, covering tap water, the restroom and the latrine pit, trash, environment and sewage. All personnel who conducted the disinfection for prevention and public health in the villages and towns received the technical training for disinfection. Conclusion Various disinfectant types and difference specifications cause trouble in the training of manpower and the use of disinfectant. Preventive disinfection in the most serious disaster areas is better than in serious disaster areas. The main channel of obtaining the disinfectant is through the National amp; Province CDC. The daily-report system of the disinfected areas may monitor the progress of disinfectant use. The suitable disinfection may prevent the public health secondary disaster and protect the environment effectively.
ObjectiveTo understand the economic burden of disinfection supply to medical institutions in Yibin City, and explore the feasibility of establishing a regional centralized management model of disinfection supply center in Yibin City.MethodsFrom April to May 2018, 263 medical institutions in the eight counties and two districts of Yibin City were investigated by means of mobile phone application-designed questionnaire, to obtain the information of cost accounting and economic burden of disinfection supply.ResultsThere were 263 medical institutions involved in the survey, in which 61 (23.19%) had set up the central sterile supply department (CSSD), including 43 public hospitals and 18 private hospitals; 202 medical institutions were without CSSD, which were mainly secondary hospitals [195 (74.14%), including 120 public hospitals and 75 private hospitals]. The higher the hospital level was, the larger the average area of the CSSD was; the difference was statistically significant (χ2=40.009, P<0.001). The higher the hospital level was, the more full-time personnel were employed, and the difference was statistically significant (χ2=31.862, P<0.001), and the care staff were the majority (66.23%). The cost burden of CSSD was more than 1 million yuan in the tertiary hospitals, which was 100 000 yuan or above in 61.90% of the secondary hospitals, and was below 100 000 yuan in hospitals below secondary level. The higher the hospital level was, the higher the total cost burden became; the difference was statistically significant (χ2=37.995, P<0.001). ConclusionIn view of the heavy economic burden of CSSD in medical institutions and the unbalanced setting up of medical institutions below secondary level, the establishment of a regional CSSD centralized management model is a new direction, new trend, and new model for future development, which is conducive to improving the quality of disinfection and sterilization, reducing medical care costs, making rational use of health resources, effectively preventing hospital infections, and ensuring the medical safety.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
ObjectiveTo investigate on preoperative hand-washing for analyzing the underlying problems, in purpose of preventing operation-related infection via strengthening the standardization of surgical hand-washing and hand-disinfection. MethodsFrom July to September 2014, surveillance video of pre-operative hand-washing was studied and analyzed. We randomly selected 100 subjects, and assessment was performed based on the self-made surgical hand-washing and hand-disinfection protocol. Grading was done strictly. The passing score was 60 or higher; a score of 70-79 meant good; and a score of 80-100 indicated excellence. ResultsIn the survey, 91 in the 100 subjects were qualified. Among the qualified subjects, there were 53% of excellence and 20% of good. The major problems included erroneous methods, step omissions, time lacking, pollution, wrong flushing method or dry-hand method, and insufficient washing time. ConclusionBased on the survey, the administration department is advised to strengthen the regulatory supervision and education training based on standard surgical hand-washing and hand-disinfection criteria, especially training interns and new staff, in purpose of reducing the incidence of operation-related infection and improving hospitalization management qualities.
Objective To investigate evidence retrieval, appraisal, and reevaluation during evidence-based clinical decision making in China. Also, to analyze the related factors, so as to find the problems in the course of evidence-based clinical decision making and put forward corresponding solutions. Methods We searched Chinese Biomedical Literature Disc (CBM) and China Journal Full-text Database (Medical sciences) of the China National Knowledge Infrastructure (CNKI) to collect clinical evidence-based case reports. Relevant information was extracted from these reports by a selfdesigned investigation form.Then statistical analyses were performed. Results The search tools used in the course of evidence-based clinical decision making varied. The most frequently used were MEDLINE/PubMed (82.08%) and The Cochrane Library (60.38%). 30.63% of evidence-based case reports described the search strategy in detail, and 9.01% described how they modified their search strategy. All doctors evaluated the association between evidence and disease, but few of them integrated patient factors and relevant external factors when evaluating evidence. The scientific nature and validity of the evidence was evaluated in 74 evidence-based case reports (66.67%), and such evaluation was mainly based on the criteria of evidence grading (50.00%). Reevaluation was mentioned in 85.59% of evidence-based case reports. Conclusion In China, the application of evidence-based decision making varied in different clinical departments. Problems existed in the course of evidence retrieval, appraisal, and reevaluation. This revealed the low information diathesis level of doctors and their lack of evidence-based medicine knowledge. It is suggested that information education and evidence-based medicine education should be strengthened to improve doctors’ ability to use evidence-based clinical decision making. It is also recommended that the search tools, relevant search strategy, the modification of search strategy, and reevaluation on practice results of each case should be mentioned in evidence-based case reports.
Objective To learn the current status, publication standards, formats, and contents of medical advertisements published in journals in China, and to discuss the possibility of evidence-based evaluation and standards for advertisement publication. Methods We handsearched Issue One, 2008 of 222 core medical journals indexed by A Guide to the Core Journals of China (2004 version) and the most important databases to index top 20% academic journals to identify basic journal information and the content of their advertisements. The general and trade name of the drugs, and the advertisements and production license number of the drugs and devices were collected. We used EXCEL software for data input and SPSS 13.0 for statistical analyses. Results Two-hundred and eighteen journals were handsearched and evaluated. The other 4 journals were excluded because the print version could not be found. A total of 1,201 advertisements were published in 159 (72.9%) of the journals, with the average of 5.5 (range of 1-37) for each journal. Of the advertisements, 910 (75.8%) were related to medical drugs or devices, including 598 (49.8%) drug and 312 (26.0%) medical device advertisements. Most of them were published in clinical and special medical journals. There were 518 (86.6%) drug advertisements which had both advertisement license and production license number, but only 116 (36.1%) medical device advertisements stated the advertisement license and production license number. Conclusion The medical drug advertisements published in core medical journals in China lack sufficient publication standards, and medical device advertisements are even worse. We cannot conclude the efficacy, safety, and cost-effectiveness of advertisement production according to the current limited, unclear, and highly-commercialized advertisements.
ObjectiveTo investigate scientific research situation of postgraduates in the West China School of Medicine of Sichuan University. MethodsA self-designed questionnaire was used in an investigation concerning scientific research situation among 352 medical postgraduates in the West China Medical School of Sichuan University. Then SPSS 15.1 software was used to analyze the data. ResultsMost experiments, that the postgraduates took, involved multiple technologies, of which, molecular techniques were the most widely-used (reaching 35.5%). Sixty-eight percent students maintained that clinical practice, teaching/learning and scientific research were very important. The most frequently-encountered problem were research design, experimental techniques and methods, the contact with laboratory, and statistical analysis. When encountering the problems, 51.1% postgraduates turned to tutors, and 40.1% dealt with it by themselves. ConclusionIt is suggested that, cultivating scientific research ability and awareness of medical postgraduates should be strengthened, and platforms should be set up for medical postgraduates to carry out research.
Objective To analyze the femoral head collapse and the operation of osteonecrosis of the femoral head (ONFH) in different Japanese Investigation Commitee (JIC) types, in order to summarize the prognostic rules of each type of ONFH, and explore the clinical significance of CT lateral subtypes based on reconstruction of necrotic area of C1 type and verify their clinical effect. Methods A total of 119 patients (155 hips) with ONFH between May 2004 and December 2016 were enrolled in the study. The total hips consisted of 34 hips in type A, 33 in type B, 57 in type C1, and 31 in type C2, respectively. There was no significant difference in age, gender, affected side, or type of ONFH of the patients with differenct JIC types (P>0.05). The 1-, 2-, and 5-year femoral head collapse and operation of different JIC types were analyzed, as well as the survival rate (with femoral head collapse as the end point) of hip joint between different JIC types, hormonal/non-hormonal ONFH, asymptomatic and symptomatic (pain duration >6 months or ≤6 months), and combined preserved angle (CPA) ≥118.725° and CPA<118.725°. JIC types with significant differences in subgroup surgery and collapse and with research value were selected. According to the location of the necrotic area on the surface of the femoral head, the JIC classification was divided into 5 subtypes in the lateral CT reconstruction, and the contour line of the necrotic area was extracted and matched to the standard femoral head model, and the necrosis of the five subtypes was presented by thermography. The 1-, 2-, and 5-year outcomes of femoral head collapse and operation in different lateral subtypes were analyzed, and the survival rates (with collapse of the femoral head as the end point) between CPA≥118.725° and CPA<118.725° hip in patients with this subtype were compared, as well as the survival rates of different lateral subtypes (with collapse and surgery as the end points, respectively). ResultsThe femoral head collapse rate and operation rate in the 1-, 2-, and 5-year were significantly higher in patients with JIC C2 type than in patients with other hip types (P<0.05), while in patients with JIC C1 type than in patients with JIC types A and B (P<0.05). The survival rate of patients with different JIC types was significantly different (P<0.05), and the survival rate of patients with JIC types A, B, C1, and C2 decreased gradually. The survival rate of asymptomatic hip was significantly higher than that of symptomatic hip, and the survival rate of CPA≥118.725° was significantly higher than that of CPA<118.725° (P<0.05). The lateral CT reconstruction of type C1 hip necrosis area was selected for further classification, including type 1 in 12 hips, type 2 in 20 hips, type 3 in 9 hips, type 4 in 9 hips, and type 5 in 7 hips. There were significant differences in the femoral head collapse rate and the operation rate among the subtypes after 5 years of follow-up (P<0.05). The collapse rate and operation rate of types 4 and 5 were 0; the collapse rate and operation rate of type 3 were the highest; the collapse rate of type 2 was high, but the operation rate was lower than that of type 3; the collapse rate of type 1 was high, but the operation rate was 0. In JIC type C1 patients, the survival rate of the hip joint with CPA≥118.725° was significantly higher than that with CPA<118.725° (P<0.05). In the follow-up with femoral head collapse as the end point, the survival rates of types 4 and 5 were all 100%, while the survival rates of types 1, 2, and 3 were all 0, and the difference was significant (P<0.05). The survival rate of types 1, 4, and 5 was 100%, of type 3 was 0, and of type 2 was 60%, showing significant difference (P<0.05). Conclusion JIC types A and B can be treated by non-surgical treatment, while type C2 can be treated by surgical treatment with hip preservation. Type C1 was classified into 5 subtypes by CT lateral classification, type 3 has the highest risk of femoral head collapse, types 4 and 5 have low risk of femoral head collapse and operation, type 1 has high femoral head collapse rate but low risk of operation; type 2 has high collapse rate, but the operation rate is close to the average of JIC type C1, which still needs to be further studied.