ObjectiveTo investigate the human resources of village doctors for integrated management among township hospitals and village clinics in Xinjing county of Chengdu in 2010, so as to provide the evidence for optimal allocation of human resources in village level. MethodsThe information of village doctors in 2010, such as age, gender, educational level, professional license and work experience, were collected and analyzed using Microsoft Excel 2003 and SPSS 13.0. Resultsa) In Xinjin county, 213 village doctors were managed by 11 township hospitals (TH) in 2010 with the average of 19 village doctors in each TH; b) only 3 out of 11 THs achieved the national requirement of at least one village doctor per 1 000 rural population; to a greater or lesser extent, the shortage of village doctors existed in the rest 8 THs; c) Among the village doctors, the male-to-female ratio was 2.2 (68.5% vs. 31.5%). The village doctors younger than 45 years, 45 to 59 years, or no less than 60 years accounted for 42.8%, 18.8%, 38.5%, respectively. Those who graduated from secondary schools or elementary schools accounted for 90% (52.6% and 38%, respectively). d) Only 94.8% had the village doctor license. Among the 213 village doctors, only 1.4% and 3.6% were registered doctors or assistant doctors respectively. Those who worked longer than 30 years, 20-29 years, 10 to 19 years, and 5 to 9 years accounted for 44.6%, 12.2%, 29.6% and 6.1%, respectively. ConclusionThe quantity and quality of the village doctors in Xinjin county were insufficient to meet the requirement with aging teams, low education levels, and lack of professional qualifications. Therefore, the related policies should be implemented to maintain the stability of the village doctor teams, to improve the qualification and quality of service, and to promote the sustainable development of primary healthcare services.
Objective To analyze the benign-malignant outcomes of pulmonary nodules in surgical patients and their influencing factors, and provide evidence and ideas for optimizing and improving the integrated management model of pulmonary nodules. Methods From October to December 2023, a convenience sampling method was used to select patients who underwent lung surgery at West China Hospital, Sichuan University between July 2022 and June 2023 for this study. The malignancy rate of postoperative pathological results of pulmonary nodules and its influencing factors were analyzed using univariate analysis and multiple logistic regression. Results A total of 4600 surgical patients with pulmonary nodules were included, with a malignancy rate of 88.65% (4078/4600) and a benign rate of 11.35% (522/4600). Univariate analysis showed significant differences in malignancy rates among different genders, ages, methods of pulmonary nodule detection, and smoking histories (P<0.05); however, no significant difference was found regarding place of birth or family history of lung cancer (P>0.05). Multiple logistic regression analysis indicated that females [odds ratio (OR)=1.533, 95% confidence interval (CI) (1.271, 1.850)], older age groups [61-75 vs. ≤30 years: OR=1.640, 95%CI (1.021, 2.634); >75 vs. ≤30 years: OR=2.690, 95%CI (1.062, 6.814)], and pulmonary nodules detected during physical examinations [OR=1.286, 95%CI (1.064, 1.554)] were high-risk factors for malignancy, with statistical significance (P<0.05). Conclusion In the integrated management of pulmonary nodules, it is crucial not to overlook females or older patients, as they may be more significant influencing factors than smoking; furthermore, lung examinations are effective means of early detection of malignant lung tumors and are worth promoting and popularizing.
Lung cancer is the malignant tumor with the highest incidence and mortality rate in China. Early diagnosis and treatment are key to improving the survival rate and reducing the mortality rate for lung cancer patients. This article introduces the integrated management model for patients with pulmonary nodules/lung cancer developed by West China Hospital of Sichuan University based on “internet plus” and health service team of treatment, nursing, and care. The Integrated Care Management Center has established a multidisciplinary team, using internet platforms and artificial intelligence tools to develop a whole life cycle health service system for patients with pulmonary nodules/lung cancer, which is from the screening of high-risk population for lung cancer, the intelligent risk stratification and follow-up management of pulmonary nodules, the subsequent standardized diagnosis and treatment of lung cancer and comorbidity management, until the patient’s demise. After the implementation of this model, the malignancy rate in surgically treated patients with pulmonary nodules reached 85.08%, and the patient satisfaction score was 95.76. This model provides a new idea and reference for the innovation of chronic disease service model and the management of pulmonary nodules and lung cancer.