Objective To describe the criteria and procedure for defining an essential healthcare package in the developed and developing countries. Method Search words were chosen by both health policy experts and search coordinators after discussion and pilot. We searched electronic databases, websites of health institutions and governments and search engine Google. Any reports of implemented strategy to develope an essential healthcare package were included. Pre-designed data extraction form was used for collecting strategies and study method of included studies. Then the extracted information was analyzed and described. Result One hundred and sixty-six studies covering 72 countries were included, most of which were studies in the middle and low Countries. In terms of study objective,160 articles aimed to describe strategies, 6 articles aimed to evaluate effectiveness of strategies.Five studies evaluating effectiveness were cross-sectionnary data, and one study was time series. Conclusion An appropriate package should be defined according to both technique criteria and social welfare criteria, considering each country’s healthcare system and market structure, characteristics of the demander and provider, capacity of government’s regulation. The experience in transition countries gives us more high lights.
Objectives To describe background, measures and impacts of building essential healthcare system in the developed and developing countries aboard. Methods Search words were chosen by both health policy experts and search coordinators after discussion and pilot. The resources we searched included electronic databases, websites of health institutions and governments and search engine Google. Any reports of implemented strategy to develop an essential healthcare package were included. Pre-designed data extraction form was used for collecting strategies and study method of included studies. Then the extracted information was analyzed and described. Result 166 studies covering 72 countries were included, most of which were studies in the middle and low Countries. In terms of study objectives, many studies (160 articles) aimed to describe strategies, while few studies(6 articles) were to evaluate effectiveness of strategies. Most of studies evaluating effectiveness were cross-sectionnary data, Except one time cohort study with intervention. Conclusions Strategies to implement essential healthcare system varies in the different country because of diversity of political, culture and economic background and different goals. The experience in transition countries gives us more high lights.
ObjectivesTo understand the current situation of the nosocomial infection management system in maternal and child health care institutions at all levels in Sichuan province, and provide a feasible policy basis for strengthening the nosocomial infection management.MethodsThe expert group members of Sichuan Maternal and Child Health Association Academy Association designed a unified questionnaire, and distributed the questionnaire through “Questionnaire Star” to carry out on-site online survey.ResultsA total of 159 maternal and child health care institutions participated in the survey. Most secondary and below maternal and child health care institutions had not set up professional hospital infection monitoring system. A few secondary and below maternal and child health care institutions did not independently set up a hospital infection management committee, hospital infection management department, full-time hospital infection department head, the inspection team of infection control, monitoring system, and nosocomial infection management system and special supervision had not been established in special departments. There were statistical differences in some jobs in the construction of nosocomial infection management system in different levels of maternal and child health care institutions (P<0.05).ConclusionsThe organizational system construction of hospital infection managemen are at a low level in the second level and below maternal and child health care institutions in Sichuan province. The tertiary maternal and child health care institutions should give full play to the leading role in promoting the standard construction of nosocomial infection management system of maternal and child health care institutions in Sichuan province, and carry out nosocomial infection management of maternal and child health care institutions orderly.
Objective To investigate the situation of human resources of primary health care institutions in Chengdu and provide references for rational allocation of health personnel in primary health care. Methods From October to November 2016, self-administered questionnaire was used to investigate the situation of the human resources of health workers in a total of 390 primary health care institutions in the three circles of Chengdu (including the subsidiary counties, towns, and districts) during 2015. The Health Resources Density Index (HRDI) was calculated and its equilibrium was analyzed. Frequency and constituent ratio were used for descriptive analysis. Results Three hundred and seventy valid questionnaires were recovered. The number of clinical doctors, general practitioners, and registered nurses per 10 000 residents in Chengdu was 5.32, 1.38, and 4.32, respectively. Doctors’ and nurses’ HRDI was 0.52 and 0.42 respectively. The number of intermediate and junior professional titles accounted for 15.91% and 52.13% respectively. The ratio of doctors to nurses was 1∶0.81, and the ratio of general practitioners to nurses was 0.32∶1. Structure rationality of distribution density and professional titles of healthcare personnel showed a decreasing trend from the first circle to the third circle. Conclusions The personnel troop of primary health care service in Chengdu has been formed. However, the professional title structure and the distribution of professional categories still need to be improved. The situation of primary health workers in the third circle is relatively backward compared with other circles in Chengdu. It is suggested that the number of nurses and general practitioners should increase properly, and rational intervation should be carryed out in the distribution of primary health workers, so as to balance and develop the grass-root health personnel in the three circles of Chengdu.
Objective To summarize the research progress of health care transition (HCT) for pediatric liver transplant recipients. Method The literatures of HCT for pediatric liver transplant recipients were reviewed, and the concept, related factors, interventions and methods of health care transition were summarized. ResultsHCT is the process of moving from a child/family-centered model of care to an adult or patient-centered model of health care, and influenced by health care provider, child and caregivers, and other factors such as medical policy and economic level. Personalized transition program has more benefits for improving the experience and health outcomes of patients. Conclusion problem-oriented and demand-oriented transition program is recommended, early intervention to improve self-management abilities of children, information construction of pediatric medical system and multidisciplinary team building are important for improving health outcomes of patients.
ObjectiveTo systematically review the willingness rate of the first consultation in primary health care institutions among Chinese residents.MethodsCNKI, WanFang Data, VIP, PubMed, Web of Science and EMbase databases were electronically searched to collect cross-sectional studies on the willingness rate of the first consultation in primary health care institutions of residents in China from January 2006 to November 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; meta-analysis was then performed using Stata 14.1 software.ResultsA total of 26 cross-sectional studies involving 36 430 subjects were included. The results of meta-analysis showed that the willingness rate of Chinese residents for the first consultation in primary health care institutions was 61.4% (95%CI 54.5% to 68.3%). The results of subgroup analysis showed that for the willingness rates of the first treatment at the grassroots level in male and female residents were 65.6% and 64.9%; urban and rural residents were 49.9% and 58.9%; <60 and ≥60 years old residents were 60.5% and 71.6%; primary school and below, junior high school, high school or technical secondary school, junior college or above educational level residents were 72.8%, 68.1%, 64.2%, and 52.8%; employees, residents, and other types of insurance residents were 74.1%, 75.9%, and 64.4%; residents with monthly income <3 000, 3 000-5 000, and >5 000 yuan were 65.8%, 65.3%, and 58.5%; high, medium, and poor levels of health status residents were 56.8%, 52.6%, and 48.8%; with and without chronic diseases residents were 61.0% and 56.9%; with and without spouse residents were 63.9% and 64.6%; with and without contracted family doctor residents were 87.1% and 62.6%; on duty, retired, and other employment status residents were 70.7%, 69.9% and 71.5%; primary medical institutions residents those were satisfied, average, and dissatisfied were 77.3%, 60.7%, and 49.4%.ConclusionsCurrent evidence suggests that it remains room for improvement in the level of willingness of Chinese residents for first consultation in primary health care institutions. Residence, age, educational level, type of medical insurance, income level, health level, family doctors contracted status, and satisfaction with primary medical institutions have an impact on residents' willingness to receive first treatment at primary hospitals. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
Objective To systematically review the current situation, dilemmas and countermeasures of the regulation of health care integration services in China, and provide reference for the research on the regulation of health care integration services in China. Methods Studies and policies on the regulation of health care integration services were systematically searched from the inception of the databases to October 2022, and the included studies and policies were coded and analyzed by using the qualitative analysis software NVivo12. Results A total of 12 research articles and 15 policy announcements were included. The theoretical framework, regulatory dilemmas and regulatory countermeasures for the regulation of health care integration services were obtained through open coding, axial coding and selective coding. The regulatory framework of health care integration services was divided into five aspects: regulatory basis, regulatory subject, regulatory object, regulatory content and regulatory methods. The lack of regulatory basis led to dilemmas in the remaining aspects accordingly. Conclusion The regulation of health care integration services needs to start from the regulatory basis, introduce and improve the health care integration laws and policies, and gradually form a health care integration service regulatory model with institutional self-regulation as the priority, government regulation as the main body, and the public, third parties and other social regulation as the auxiliary.
Objective To investigate the influencing factors in the service volume of primary health care institutions in Chengdu, and provide references for promoting the hierarchical diagnosis and treatment. Methods A self-administered questionnaire was used to investigate the service volume of a total of 390 primary health care institutions (including community health service centers and township hospitals) across 22 districts and counties of Chengdu from October to November 2016. Rank sum test, rank correlation analysis and multiple linear regression model were used to analyze the influencing factors of outpatient visits in the institutions. Results The median annual amount of outpatient visits was 60 493 in community health service centers and 31 374 in township hospitals. Between community health service centers and township hospitals, the difference in median daily visits per doctor was not significant (14.41 vs. 13.29), but the median daily visits per doctor in general practitioners (12.22 vs. 8.16), rehabilitation physicians (10.10 vs. 6.34) and traditional Chinese medical doctors (4.82 vs. 6.17) varied considerably. Multiple linear regression analysis showed that the amount of outpatient visits in community health service centers was related to the amount of intermediate physicians, while the amount of outpatient visits in township hospitals was related to the setup of dental clinics, the amount of primary physicians, the amount of beds and population to be served (P<0.05). Conclusions Differences exist in the service volume among primary health care institutions in Chengdu. It’s necessary to make proper plans for the management of administrative offices and the allocation of personnel, so as to improve medical services of primary health care institutions.
Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.