Objective To investigate the disease constitution of Yaqian Township Health Center (YQT) in Xiaoshan District of Zhejiang Province from 2008 to 2010, so as to provide baseline data for further study. Methods Questionnaire and focus interview were carried out to collect inpatients’ case records from 2008 to 2010. The first diagnoses were classified according to ICD-10, and the data of discharge diagnoses were rearranged and analyzed by using Excel 2003 and SPSS 13.0 software. Results a) The total numbers of inpatients were 182, 195 and 248 from 2008 to 2010, respectively; b) The disease spectrum included 9-14 categories, which accounted for 47.6%-66.7% of ICD-10; c) The top 6 systematic diseases accounted for 37.37%-75.39%, which included the circulatory, injury, digestive, respiratory, neoplasms and urinary and reproductive systematic diseases; d) A total of 8 of the top 15 single diseases were the same, including hypertension, great saphenous vein varices, redundant prepuce, lung cancer, fracture, superficial injuries, acute appendicitis, and inguinal hernia; and e) The constitution ratio of the chronic diseases, compared with the acute ones, was higher in 2008, but lower in 2009 and 2010. Conclusion a) In recent three years, the main systematic diseases seen in YQT have been circulatory, injury, digestive, respiratory, neoplasms, and urinary and reproductive systematic diseases. The newly increased diseases in 2010 were pregnancy, childbirth and puerperium. The acute diseases mainly are fracture and injure, while the chronic diseases mostly are hypertension; b) A total of 8 of the top 15 single diseases are the same, indicating the stability of the common inpatients’ diseases; and c) Attention should be paid in future to the chronic diseases management, women’s health and specialized subject construction.
ObjectiveTo investigate the epidemiological and economic burden of acute meningitis and encephalitis syndrome (AMES) in Jinan, so as to provide references for prevention and control of AMES. MethodsThe monitoring data of the AMES Special Reporting System of Jinan City from 2007 to 2014 was collected and the epidemiological characteristics of AMES were analyzed. A questionnaire survey was performed in AMES patients reported in 2013 to collect the basic information, prognosis, medical and non-medical expenses etc. of patients. The DALYs and economic burden of AMES were estimated by using SPSS 13.0 software. ResultsThe average incidence rate of AMES in Jinan was 8.49/100 000 through 2007 to 2014 and the mortality was 4.96‰. The total DALYs were 36 659.51 and the average DALY was 8.27.77.86% were aged less than 14 years old. The average direct economic burden of each case was 19.5 thousand RMB and the average indirect economic burden caused by DALYs was 69.1 thousand RMB. ConclusionThere's heavy burden from AMES, and measures should be made to reduce the incidence and economic burden.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
Objective To investigate the disease constitution and cost of inpatients in Gaozha Central Township Health Center (GzC) in Wuzhong City of Ningxia Hui Autonomous Region from 2008 to 2010, so as to provide baseline data for further research. Methods A questionnaire combined with a special interview was carried out, and case records and cost information of GzC inpatients in 2008, 2009 and 2010 (from January to November) were collected. The diseases in discharge record were classified according to International Classification of Diseases (ICD-10) based on the first diagnose and the cost was analyzed. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Results a) The total number of the inpatients was 1124, 642 and 747 in 2008, 2009 and 2010, respectively. The female was more than the male in both 2008 (59.34% vs. 40.66%) and 2009 (60.75% vs. 39.25%), and their disease spectrum included 17 categories, which accounted for 81% of ICD-10; b) The top six most commonly seen systematic diseases with a constituent ratio from 86.63% to 92.06% in recent three years were as follows: the respiratory system, digestive system, circulatory system, genitourinary system, injury and toxicosis, skeletal musculature and connective tissue disease. Except the injury and toxicosis, the other five systematic diseases were commonly seen in females rather than in males; c) The top 15 monopathies in recent three years were pulmonary infection, tracheitis or bronchitis, coronary heart disease, soft tissue injury, gastritis or chronic gastritis, upper respiratory infection, hypertension, urinary tract infection, prolapse of lumbar intervertebral disc, pelvic inflammation, fracture, pneumocardial diseases, superficial injury, chronic cholecystitis and arthritis; d) The main burdens of disease for inpatients focused on 35-54 age groups, then followed by the age groups above 55 in 2008 and 2009. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males. Pulmonary infection focused on the age groups above 35; the onset of hypertension increased obviously and a sharp rise of hypertension existed in the 45-54 age groups in 2008, but the hypertention focused on 35-44 age groups in 2009; e) The total inpatients with top 15 monopathies accounted for 64.06% to 71.21%, including 8-9 chronic diseases ranking higher in 2010, and 6-7 acute diseases focusing on infection and injury; and f) The average costs of chronic diseases were higher than those of acute diseases. Conclusion a) There is a big gap between GzC and Yong’an Central Township Health Center (YaC) regarding the level of the regional economic development, the situation of disease burden and cost of inpatients. The former is demonstrated as general Central Township Health Center, while the latter as affluent Central Township Health Center in western China; b) In recent three years, the main systematic diseases are in respiratory, circulatory and digestive system; the inpatients suffer from more chronic diseases rather than acute diseases in their young age; the acute diseases mainly include infection and injury, and the pulmonary infection has ranked as the first during the past three years; c) The inpatients in 2008 and 2009 are mainly in ages of 35 to 54, and then are over 55 years old. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males; d) The patients’ average costs of chronic diseases for hospitalization and drug in 2010 were lower than those of YaC. Consideration on reasonable constitution of the cost for hospitalization should be paid attention to; and e) It is urgent to strengthen the construction of infrastructure and informatization in GzC.
ObjectiveTo investigate the guidance centers for promoting equalization of basic public health services in Sichuan province, in order to provide evidence for construction and development. MethodsBy questionnaire survey, we collected relevant information and data about the guidance centers at all levels in Sichuan province. The EpiData 3.0 was used to establish a database and the SPSS 16.0 was used to analyze data. ResultsA total of 202 guidance centers had been set up in Sichuan province. All disciplines of the basic public health services were covered by these centers. There were 2 020 technicians, whose average age was 41.37, more had college degree, and intermediate professional title. 54.5% of the guidance centers didn't work together, and there were 92.7% part-time technicians. Only 40% city and 20% county guidance centers got working funds. The average working funds of province, city and county were 890 000 yuan per year, 101 000 yuan per year and 89 000 yuan per year, respectively. ConclusionThe guidance centers of Sichuan province at all levels have effectively promoted the basic public health services project, but we should improve and perfect the management mechanism and guarantee mechanism.
Objective To investigate current situation of medical service and management in Gaozha Central Township Health Center (GzC), so as to provide baseline data for township health centers in both key techniques research and product development of drugs allocation and delivery. Methods A questionnaire combined with a special interview was carried out, which included the general information, human resources, medical service and management, and the practice of essential medicine list. Results a) The hardware condition of GzC was not good enough, and the economic status of the service recipients was lower than the average level of both Wuzhong City and China mainland; b) The constituent ratio of general practitioner (GP) and nurse, and GP and laboratorian were all lower than those of national level, while, the constituent ratio of GP and technician was a little bit higher. GzC was in short of medical technical personnel and, especially, the professional pharmacists. The logistics technical workers were as the same proportion as the nurses. The medical technical personnel without professional education background accounted for 3.4%, and about 38% of the staff members had no college degree, about 86.2% had at most primary profession titles. There was no personnel turnover of GzC in recently years; c) The bed utilization ratio was lower than national level (46.4% vs. 60.7%), while the average duration of stay and the in-patient and out-patient service workload of GP were longer or heavier than national level (8 vs. 4.8, 9 vs. 8.3, 4 vs. 1.3); d) The out-patient service in 2010 decreased 26.9% compared to 2009; and the in-patient service in 2010 decreased 42.4%; e) The average medical expense per outpatient and per inpatient increased 127.3% and 56.2%, respectively in 2010 compared to 2009; and f) Essential medicine list was put into practice in April 1st of 2010 and there was only 195 species available in GzC, which has not met the requirements of the national essential medicine list. Conclusion In order to meet the standards of general rural township health center in western China, GzC needs to cope with challenges of insufficient hardware conditions, short of staff, unreasonable personnel structure, low educational background and professional title of the staff, none human resources flow and low technical level of medical service. GzC dose well in drug expenses control, and the hospitalization costs are lower than those of the national level. However, it increases rapidly in 2010. The management of GzC may be influenced by zero-profit sale of the essential drugs, and appropriate subsidy and policy support are necessary to maintain its service quality. And it is required to complement the medicine based on the evidences, to carry out staff training and usage guidance of essential medicine, and to finally guarantee the safe and reasonable use of medicines.
Objective To explore the effect of kidney transplantation on chronic prostatitis-like symptoms. Methods A total of 300 male renal transplant recipients between January 2015 and January 2017 were collected in the study. All recipients received the questionnaire survey of the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) preoperatively and at 3 months after transplantation. The score and relevant risk factors were statistically analyzed. Results A total of 210 recipients (70.0%) completed questionnaire effectively, in whom 150 (71.4%) had preoperative and 90 (42.9%) had postoperative chronic prostatitis-like symptoms, respectively. In the 210 patients, the preoperative and postoperative pain score was 6.57±3.12 vs. 3.57±3.16 (P<0.001), voiding score was 3.71±2.38vs. 3.29±2.66 (P=0.116), quality of life score was 7.57±1.60 vs. 5.14±2.75 (P<0.001), and the total NIH-CPSI score was 17.86±3.81vs. 12.00±6.65 (P<0.001), respectively. The severity of chronic prostatitis-like symptoms was alleviated significantly after kidney transplantation. Conclusion Kidney transplantation can alleviate the chronic prostatitis-like symptoms significantly, and improve the quality of life in uremia patients.
Objective To investigate and compare the demands of dosage forms and specifications of essential medicine for children in different levels of medical institutions, so as to provide references for selection of essential medicines for children by levels of medical institutions. Methods In 13 provinces or municipalities, 104 medical institutions, including tertiary, secondary and primacy medical institutions, were investigated by questionnaires. Kinds of drugs, dosage forms, requirement types and requirement levels of drugs were analyzed and compared in different levels of medical institutions. Results Tertiary medical institutions had higher demands than other levels of medical institutions for the number of drugs types, dosage forms and level of demand on each drug (P < 0.05), secondary medical institutions were higher than primacy medical institutions (P < 0.05), but community health service centers were the same as township health centers. Conclusion The demands of dosage forms and specifications of essential medicine for children in different levels of medical institutions are different. So future studies should develop the essential medicines list for children depend on different levels of care.
Objective To survey the current status of residents’ health examination in township medical units in Shuangliu county, so as to provide references for exploring the residents’ health examination mode suitable for the well-off rural hospitals, and for improving the effects of physical examination. Methods The self-designed questionnaires were made to survey the current situation of health examination for the residents in 24 township medical units in Shuangliu County, including 3 central township hospitals, 3 community health centers and 18 general township hospitals; and the outline was designed to interview the people responsible for managing and implementing the resident’s examination work. The Epidate 3.1 was used for data input, the SPSS 17.0 was used for descriptive statistics and stratified analysis, and the classification method was adopted for qualitative research of personal interview data. Results The number of primary health care units for carrying out residents’ health examination got gradually increased year by year from 2008 to 2010; and all 24 township-level medical units had already carried out that examination by 2010. But some issues still existed such as lower participation rate and ineffective utilization of the archives. Conclusion a) It is necessary to prepare well, enhance organizing, expand publicity, and increase participation rate when primary health care units carry out the health examination for residents; b) It is necessary requires to fasten the informatization construction of health archives, and to quicken the process and analysis of examination information; and c) It is advisable to constantly optimize the examination items according to exam information, to improve the qualification of medical staffs, and to fasten the construction of exam team.
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.