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 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.
ObjectiveTo investigate the prevalence of impaired glucose regulation (IGR) and IGR combined with cardiovascular risk factors in rural areas of Chengdu City. MethodsFrom February to October 2010, we randomly sampled 1 016 patients in a rural community 100 kilometers away from the city center as the study subjects. The investigation was carried out by using questionnaire survey, physical examination and laboratory tests. The standard 75 g oral glucose tolerance test was used. ResultsA total of 1 016 subjects were investigated, among whom there were 431 males and 585 females with an average age of 56 years old. Of these subjects, 333 were diagnosed to have IGR with a rate of 32.77% (333/1 016). The age-adjusted standardized prevalence of pre-diabetes in rural areas in Chengdu was 32.52% (336/1 016), and the male and female prevalence were respectively 30.63% (132/431) and 34.36% (201/585) without significant difference (χ2=1.569，P=0.210). Impaired glucose tolerance (IGT) was the most common type of glycometabolism abnormality. Women had a significantly higher prevalence of IGT than men. In IGR population, major cardiovascular risk factors were overweight and obesity (40.8%), high low density lipoprotein cholesterol (38.4%), high triglyceride (30.3%), hypertension (23.7%), smoking (24.3%), and drinking alcohol (23.7%). The stratified analysis showed that the prevalence of overweight, obesity and low high density lipoprotein cholesterol in female was significantly higher than that in males, while the prevalence of smoking and drinking alcohol was significantly higher in males. ConclusionIn rural areas, the prevalence of pre-diabetes is high and complicated with multiple cardiovascular risk factors.
ObjectiveTo systematically review the implementation status, effectiveness and existing problems of nutrition improvement measures for vulnerable populations in rural areas of China. MethodsAll studies about the implementation status, effectiveness and existing problems of nutrition improvement measures for vulnerable populations in rural areas of China were electronically searched in VIP, CNKI, WanFang Data and CBM from inception to January 1st, 2014. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies, and then performed qualitative analysis in terms of implementation effectiveness and situation. ResultsA total of 79 studies were finally included. The results of qualitative analysis showed that:the earliest study was published in 1990; 38.0% of these studies were carried out in the southwest and northwest areas of China; 31.6% of these studies were financially supported, and most funds were provided by some international institutions; 90.0% of these research subjects focused on infants and children (under the age of 10); a variety of nutrition improvement measures had been taken, and 55.7% of these interventions measures were nutrition education which could be implemented easily; the implementation duration of 38.0% of these measures lasted less than half a year; 32.9% of these studies adopted the blood test to evaluate the outcomes of nutrition measures; all of the studies showed that nutrition levels of vulnerable populations in rural areas of China had been obviously improved by these measures. ConclusionThe nutrition improvement measures for vulnerable populations in rural areas of China have been implemented relatively earlier focusing on populations in West China where was less developed. However, an imbalance exists in the attention to target populations, especially to the elderly. Face to face nutrition education is most frequently taken; however, it could not directly reflect the changing of nutritional status. In addition, implementation duration is fairly short which indicates that more fund supports are needed from the government or institutions.
ObjectiveTo investigate the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) in Dayi County of Chengdu. MethodsRandomly cluster sampled residents between 40 and 70 years of age from two natural villages in the rural communities from February to December, 2010 were included in our study. We used questionnaire survey, physical examination and portable spirometry to collect data. Post-bronchodilator forced expiratory volume in 1 second/forced vital capacity of less than 70% was defined as the diagnostic criterion of COPD. Univariate analysis and logistic regression mode were used to define the risk factors. ResultsA total of 1 017 residents were enrolled in this survey, and 782 participants were valid for analysis, with a valid response rate of 76.89%. There were 330 males and 452 females, with an average age of (51.97±8.17) years old. The overall prevalence of COPD was 10.61%. After population standardization, the prevalence rate was 12.37%, and the overall prevalence increased with increment of age. The prevalence in male (13.33%) was higher than that in female (8.62%) with significant difference (P<0.01) and the prevalence increased with age. Univariate analysis showed that sex, age, education level, smoking and amount of smoking (pack-years) were the risk factors for COPD with significant difference. Logistic regression analysis showed that age, amount of smoking (pack-years) were the main risk factors for COPD. ConclusionCOPD is highly prevalent in Dayi County of Chengdu and it is important to prevent COPD by controlling smoking and improving education level.
ObjectiveTo understand the treatment status and economic burden of convulsive epilepsy patients in Hailin City, Heilongjiang Province, who had received an epilepsy management program that was terminated for 6 years, and to estimate the long-term effect of the epilepsy management program.MethodsFollow up the 234 patients in the program of epilepsy prevention and management in rural areas at the end of December 2011 by standardized questionnaire and interview.ResultsAmong the 234 patients who received antiepileptic drugs (AEDs) and follow-up management at the end of epilepsy prevention and management program in rural areas, 172 patients received Phenobarbitone (PB) and 62 patients received Sodium valproate (VPA). 86 patients completed the survey. Among them, 46 (53.49%) were still taking original drugs, 31 (36.05%) changed to other AEDs, 9(10.47%) gave up the treatment due to the closure of the program. The treatment costs of patients in adherence group were also lower than that of other patients, and the average cost was only 43.61% of that of the replace group. There were statistical significant differences in annual household income, drug costs, offset seizure frequency and current seizure frequency between the two groups.ConclusionThe epilepsy management program had remarkable long-term effects and short-term effects, it had advantages in treatment effect and reducing drug costs. It could be recommended throughout rural China.
ObjectiveTo evaluate the disease characteristics,medical consultation model and barrier to get basic medical service rural patients with chronic obstructive pulmonary disease(COPD) in Chinese western. MethodsThe subjects were collected from a COPD epidemiology study conducted in Western rural district.The factors which were associated with disease characteristics,medical consultation model,and barrier to get basic medical service were analyzed by questionnaire,individual conversation,and laboratory tests. ResultsThis study enrolled 343 COPD patients confirmed by spirometry test.118 subjects consulted their doctors frequently because of apparent symptom.73(62%) subjects had symptom with 5 to 10 years,while 22(19%) subjects with more than 10 years.Among the symptomatic COPD subjects,only 2(2%) cases were diagnosed as COPD previously,15(13%) subjects with chronic bronchitis,and only 1(1%) subject underwent spirometry test.110(93%) subjects were prescribed as antibiotics,68(58%) subjects with theophylline,5(4%) subjects with ICS+LABA.COPD education was acceptable in most subjects(98%),however,the regular follow-up was acceptable in only 26% of subjects. ConclusionLack of disease information,inappropriate medical consultation model,and irregular COPD management in primary care are the major factors which influence diagnosis and treatment of COPD in Western rural area of China.
Objective To investigate the current status and needs of epilepsy management among patients and primary healthcare workers in rural Northwest China, providing data support for the development of an intelligent medical assistant tailored for rural epilepsy care. Methods A questionnaire survey was conducted from March 22 to April 22, 2025, targeting patients (or their caregivers) and healthcare workers in eight regions of the Shaanxi Rural Epilepsy Prevention and Management Project. The patient/caregiver questionnaire covered basic information, disease-related information, and functional needs; the healthcare worker questionnaire included basic information, job responsibilities, and functional suggestions. Questionnaires were distributed via the Wenjuanxing platform. Python was used for descriptive statistics and correlation analysis. Results A total of 1 154 valid patient/caregiver questionnaires (response rate 59.45%) and 337 valid healthcare worker questionnaires (response rate 100%) were collected. The main difficulties reported by patients/caregivers were psychological stress (58.75%), financial burden (47.05%), and lack of disease knowledge (38.82%). 87.09% of respondents expressed willingness to use an intelligent assistant, with the highest demand for psychological support (56.33%), medication reminders (52.51%), and condition monitoring (45.06%). The primary difficulties reported by healthcare workers were poor patient adherence (75.96%), insufficient professional training (62.62%), and ineffective communication (55.79%). 87.83% of healthcare workers were willing to use an intelligent assistant and expected it to feature patient information management (92.58%), remote follow-up (77.15%), and condition monitoring (74.48%) to improve work efficiency. Conclusion Patients and healthcare workers in rural Northwest China show high acceptance and clear demand for an intelligent medical assistant for epilepsy. Future development should prioritize core modules such as medication management, health education, and psychological support, adopting a minimalist design to enhance the accessibility and effectiveness of long-term epilepsy management.
Objective In light of problems related to the accessibility and affordability of healthcare, we aimed to investigate the status and causes for the shortage of qualified health human resources in the rural and primary health care setting, and to propose solutions to these problems at the level of health policy system. Methods The principles and methods of evidence-based medicine were applied. We developed the study selection criteria on the basis of the proposed questions, and identified relevant literature from biomedical databases and other additional sources. We graded eligible studies, extracted data, and summarized the data to draw conclusions. In addition, we conducted a survey to refine the proposed solutions. Results We identified 147studies from PubMed and CNKI, of which 30were in English. After summarizing the information, and using knowledge about the human resources for health in primary healthcare in China, we proposed a model of resident doctor aid healthcare. The survey that we conducted to assess such a model included interviewees of top level policy makers, medical students and staff in medical universities. Most of the interviewees (85%) thought it was feasible to develop an aid healthcare system. Among those who disagreed, the lack of corresponding policy was the most common factor. Conclusions It is suggested that the government develop relevant policies and make an attempt to practice the aid healthcare system. Emerging problems could be identified and addressed in practice.
ObjectiveTo biliometric analysis of the status quo of tracking rural health service quality, evaluation and supervision mechanism, in order to improve the quality of rural health service, optimize the allocation of resources and increase the quality and level of health service of rural medical staff. MethodsWe searched PubMed, The Cochrane Library (Issue 3, 2016), The Campbell Library, Web of Science, CBM, CNKI, and WanFang Data, as well as relevant websites up to March 2016. EndNote X7 software and Excel 2007 software were used for screening literature and analysis data. ResultsA total of 39 studies were included in the biliometric analysis. Eighteen studies were cross-sectional studies (46.2%), 18 were reviews (46.2%), 2 were cluster randomized trials (5.1%) and 1 was randomized controlled trial (2.6%). Thirteen studies were published in journals indexed by Science Citation Index, 3 were published in journals indexed by Chinese Science Citation Database, 18 were published on other peer-review journals, and 5 were thesis's. The involved theoretical models were as follows: 10 mechanisms (30.8%), 4 frameworks (18%), 11 systems (30.8%) and 12 methods (30.8%). The serviceable range included village clinics (n=3, 7.7%), town-level hospitals (n=3, 7.7%), and community (n=2, 5.1%). The research topics included public health (n=19, 48.7%), clinical care (n=16, 41%), medical insurance (n=4, 10.3%). ConclusionThe studies for rural health service quality tracking, research evaluation and supervision mechanism are still lack of systematic, pertinence and practicability, and the level of evidence is still low. We suggest pay attention and strengthen the rural health service quality tracking, research evaluation and supervision mechanism, and to provide effective evidence for effective evaluation and supervision to promote rural health service quality, and to promote the reasonable optimization the allocation of health resources in rural areas, and to greatly improve the quality and level of rural health service.