Objective To systematically review indicators and methods of quality assessment for primary health care, to provide empirical evidence for quality improvement in this area. Methods We electronically searched databases including Proquest Dissertations and Theses, ISI Web of Knowledge, PubMed, EMbase, IDEAS, Jstor, SSRN, Popline and The Cochrane Library (Issue 4, 2014) and network resources on World Bank, World Health Organization and Google from inception to April 2014. Empirical studies about quality assessment of primary care system, organization and personnel were collected. Data was extracted using pre-designed form for qualitative analysis and description. Results A total of 59 studies were included. The quality assessment for primary health care in practice was mainly from four dimensions: (1) emphasize on the implementation of such basic characteristics of primary health care as first contact, coordination, comprehensiveness and continuous; (2) focus on the evaluation of primary care contents, such as basic medical care, preventive care, chronic diseases, etc.; (3) based on the structure, process and outcome quality proposed by Donabedian; (4) emphasize on patients’ perceived quality. Seven relevant tools were widely used in the process of quality assessment in practice. Conclusion The majority of included studies were from developed countries while such empirical studies lacked in developing countries. Included studies varied in the connotation and angel of the primary health care quality, among which, the GPAS (General Practice Assessment Survey) used for evaluating pati ent perceived quality and PCAT (Primary Care Assessment Tools) used for evaluating the basic characteristics of primary care were widely used.
This paper introduces the development and changes of clinical practice guidelines based on the enlightenment of the Reporting Items for Practice Guidelines in Health Care (RIGHT), and provides policy recommendations.
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.
ObjectivesTo investigate residents’ sensitivity towards basic public health services in Sichuan province, so as to provide advice on future improvement.MethodsUsing multistage stratified sampling and through consultation of the Sichuan province's basic public health service regulatory platform to select 40 equidistant samples from the five key population groups. Specifically, 200 individuals from each of the 21 cities were enrolled. Telephone survey was conducted to acquire residents’ awareness rate, satisfaction and compliance. Technique for order preference by similarity to an ideal solution (TOPSIS) was applied to comprehensively evaluate residents’ sensitivity of basic public health services.ResultsA total of 4 200 community residents who have accepted health managements in basic health care institutions were enrolled. The mean Cj value was 0.523 6. The No.4 city had the highest Cj value of 0.751 9, and the No.10 city had the lowest value of 0.276 3.ConclusionsThe residents’ sensitivity to basic public health services varies in 21 cities of Sichuan province. We should improve the quality of medical services in primary health care institutions and provide wide publicity to enhance the well-being and satisfaction of community residents. Government should improve the quality of medical services in primary health care institutions, and narrow the gap between different cities, so as to improve residents’ experience.
To conduct a comprehensive review of the current research status and related influencing factors of adolescents with epilepsy participating in transitional care, providing references for future research and clinical practice. Guided by the methodology of the JBI scope review Guidelines, relevant studies in PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang Database, VIP Database, and Chinese Biomedical Literature Database were systematically retrieved The search period was from the establishment of the database to July 20, 2025, and the included literature was summarized and analyzed. 13 literatures were included, and 18 related factors influencing the participation of adolescents with epilepsy in health care were sorted out. The influencing factors can be summarized into five themes, namely internal individual factors, disease-related factors, psychological and cognitive factors, family system factors, and social support factors. The influencing factors for adolescents with epilepsy to participate in transitional care are diverse. In the future, under the guidance of relevant influencing factors, it is necessary to deeply explore the individual characteristics and needs of adolescents with epilepsy participating in transitional care, provide them with personalized transitional health care services, and enhance their ability to participate in transitional care and disease management.
Chris Silagy is the Chair of The Cochrane Collaboration between 1996 and 1998, and the founder as well as the first Director of the Australasian Cochrane Centre. He helped to establish the Chinese Cochrane Centre. He has made great contributions to the establishment and development of The Cochrane Collaboration to which he devoted his whole life. Though he died at the early age of 41, his optimism, great energy and b responsibility have left deep impression and inspiration to every one around him.
Objective To understand current situation of medical service and management in Yong’an Central Township Health Center (YaC) through on-the-spot investigation, in order to provide references for personal employment and essential medicines list implement in township health centers. Methods Questionnaire and focus interview were carried out, which included the general information, human resources, medical service and management, and the practice of essential medicines list. Results The hardware equipments of YaC were fine, and the target population had fairly good health and economy status. The ratio of General Practitioner (GP)/ nurse and GP/ pharmacist were all above the national average level. The members with college degree and above accounted for 61.6%, and about 88% staffs were with or below primary profession titles. There was a balance between personnel flow out and in. The drug income accounted for 53.6% of the whole in 2009 and the medical expenses increased compared to 2008. Essential medicines list was put into practice in April 1st of 2010 with no relevant technical documents as correspondence. Conclusion YaC, as a good representative of fairly well-off rural Township Health Center in western China, needs to cope with challenges of irrational personnel structure, low educational background and professional title of the staff and human resources flow, and requires developing policy and adopting measures step by step. The management of YaC may be influenced by zero-profit price of the essential medicine, and appropriate subsidy and policy support are necessary to maintain current service quality.
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 understand the current situation of medical service and management in Luxi township health center (LxC) in Yongxin county of Jiangxi province, so as to provide baseline data about drug allocation, logistic key techniques research and products development for township health centers. Methods By means of questionnaire and focus interview, the LxC was investigated from the following aspects: general information, human resources, medicine list, basic device configuration, medical service and management, as well as service efficiency. Results a) Yongxin county including 13 village committees covers an area of 86 km2, with the population of 22 300 in 2009, and it pertains to a backward area with the annual per capita income of RMB 4 100 yuan; b) Among the total 28 staffs in LxC, 78.6% were health workers; the general practitioner (GP)/nurse ratio was about 1?0.58; the proportion of GP, nurses, medical technicians, other staffs was 54.55%, 31.82%, 9.09% and 4.54%, respectively; the proportion of bachelor degree, junior college graduation and secondary technical school graduation was 9.1%, 13.6%, and 77.3%, respectively; and the ratio of elementary, middle, and high professional title of health workers was 15?5?1; c) There were 625 species of drugs in LxC in 2009, and the hospital beds approved by government were 0.69 per thousand agricultural persons, which, however, were 1.15 in fact. The rate of 51 basic equipments shown in national regulation was actually 76.5%, and the readiness and utilization rate of existing 40 equipments was 92.5%; and d) In 2009, the outpatients were 12 150 person-time, with the average cost of RMB 29.39 yuan; the hospital discharge was 1 589 person-time, with the average stay of 12 days and the average cost of RMB 490.05 yuan; the vaccine inoculations were 5 053 person-time; among the total income, the medical service income accounted for 73.2%, while the drug income accounted for 53.7%; the personnel expenditure was 31.0% of the total, and the balance of income and expenditure was RMB –263 500 yuan. Conclusion The hardware condition of LxC is not so good owing to the financial difficulties of Yongxin county and Jiangxi provincial government. In comparison with the whole country, although the professional title structure is ok, health workers are still not enough, with unreasonable specialty structure and low educational background. The rate of basic equipments and the approved hospital beds per thousand agricultural persons are low. There are 625 species of drugs, containing 218 species shown in 2009 national essential medicine list. And the other conditions are as follows: no information system, lack of public health service, short of financial input, high ratio of “running hospital by selling drugs”, and low efficiency of medical service. So the top priority of LxC construction should be figuring out all of the above issues, and better serving the people.