Objective To investigate pre-hypertension in aspects of its incidence, accompanied cardiovascular risk factors, and difference between urban and rural areas in Chengdu. Methods By cluster random sampling method, a total of 2 011 patients aged 35-70 years from urban and rural communities in Chengdu were selected as respondents. The investigation was conducted through questionnaire, physical examination and laboratory tests, so as to find out the main cardiovascular risk factors of pre-hypertension. All data were dual input into computer by a specially-assigned person. SPSS 13.0 software was used for analysis, Chi-square test was adopted for categorical data, and Plt;0.05 was taken as an index for significant difference. Results a) The incidence rate of pre-hypertensive in Chengdu was 33.6%, and it was 45.67% and 46.31% in urban and rural areas, respectively. In rural area, more male (51.04%) were affected than female (42.83%). b) The smoking population with pre-hypertension were mainly the male, and the ratio of rural male was 60% (132/220), far higher than that of urban male which was 32.6% (59/181). c) The pre-hypertensive population accompanied with diabetes was higher in urban (27.97%) than rural (14.01%). d) The pre-hypertensive population accompanied with hypercholesterolemia or low HDL was 33.04% (150/454) in urban, as twice as that in rural which was 16.41% (76/471). e) The pre-hypertensive population accompanied with abdominal obesity was far higher in urban (28.41%) than rural (12.74%). Conclusion Smoking is the risk factor which needs to be primarily intervened for male hypertensive patients in rural area. Impaired glucose tolerance is the common risk factor for both urban and rural residents, and hyperlipidemia is the most primarily risk factor for urban pre-hypertensive patients, followed by diabetes, and abdominal obesity.
The shortage of health workforce in rural and remote areas has been commonly concerned by every country around the word. It is one of world health issues, challenging the aspirations of achieving equity. In this regard, WHO developed the Global Policy Recommendations to improve the accessibility of the health workforce in rural and remote areas through improved retention. This article focuses on the key steps of the policy guideline developed from evidence-based medicine methodology and from angle of guideline development, mainly about background, issues, evidence retrieval and selection, quality grading of evidence, and the forming of recommendation plan, in order to further explore how to correctly understand, obtain, evaluate and apply currently available research evidence, and how to use the GRADE system to make scientific and feasible recommendations in the decision-making process, emphasizing the importance of evidence and the GRADE system in the evidence-based health decision-making.
Objective To investigate the rural residents’ payment will for disease control and its influencing factors, so as to provide evidence for the government to make policy of combing disease control and New Rural Co-operative Medical system (NRCMS). Methods The self-designed questionnaire was adopted to investigate 1 117 rural residents from 156 villages, 44 towns, 19 counties (cities, districts) in Henan province. The frequency analysis and the multiple logistic regression analysis were conducted by using SPSS 11.5 software. Results On the basis of NRCMS payment, 68.3% of the rural residents were willing to pay extra for disease control, 62.3% of whom were willing to pay RMB 1.00 or more, and the average willing payment were RMB 3.01±7.66. The multiple logistic regression analysis revealed that the people willing to pay extra were as follows: self-employed, graduates from a secondary technical school, dink family, and the respondents who believed NRCMS had relieved their medical financial burden. Conclusion In practicing the rural public health policy of combining disease control and NRCMS, it is suggested to ask rural residents to pay a little extra money on the basis of current NRCMS payment. The foundation of bringing this policy into force is to keep practicing NRCMS well so as to relieve more financial burdens for rural residents. During the implementation, low income families should be taken into consideration according to their occupation, educational level and family structure.
Objective To investigate the satisfaction of participants in Wenjiang District of Chengdu regarding the New-style Rural Cooperative Medical Care (NRCMC), and to analyse its factors in order to help the decision makers optimize and improve the scheme in the future.Methods Three towns of Wenjiang District were selected for study by computer simple random sampling. Five percent of NRCMC participants were randomly selected in Wenjiang for a face-to-face interview using a questionnaire. Data entry and statistical analysis were completed by Epidata 3.0 and SPSS 11.5 respectively. Results A total of 2500 questionnaires were conducted for face-to-face interviews, and 2438 questionnaires were returned (response rate 97.6%); 58% participants were satisfied with NRCMC, and the results of stepwise multiple logistic regression analysis indicated that their desire to participation (partial regression coefficient B=-3.54, P=0.014) and the satisfaction with the present compensation proportion (partial regression coefficient B=-4.62, P=0.018) were the most important factors that influenced the total satisfaction with NRCMC.Conclusion It is of great significance to strengthen the promotion of NRCMC; reasonably establish the compensation mode and proportion; encourge voluntary participation for the sake of their benefits to improve the quality and performance of NRCMC.
Objective To investigate the spectrum of diseases and the current situation of antibiotic use in rural hospitals and community health service centers in Chengdu, so as to provide evidence for selecting essential medicines and promoting rational use of antibiotics. Method We selected 7 township/community health institutions, from which we collected inpatient and outpatient information. Information about antibiotic use was also collected, including categories, cost, and dosage. A standard questionnaire was used to investigate physicians’ prescription behavior for principal diseases. Result Urban and rural areas had different spectrums of diseases. The major diseases in urban areas included diabetes mellitus, hypertension, chronic obstructive pulmonary disease, and respiratory tract infection; while those in rural areas were infectious diseases of the respiratory system, digestive system, and urinary system. The physicians’ prescription behavior was mainly based on their personal experience. Antibiotics accounted for 30-50% of the total medicine cost. The top four types of antibiotics with the highest cost were cephalosporins, penicillin, quinolones, and macrolides. Conclusion Based on the different spectrums of diseases, essential drug lists and standard treatment guidelines appropriate for rural health care should be developed to improve the rational use of drugs. Factors such as the average cost of daily dose and the course of treatment should be taken into consideration to reduce the overall cost of medicine. An antimicrobial resistance monitoring system and special training courses on rational use of antibiotics should be utilized in the rural health institutions.
Objective To systematically review and conclude the healthcare reform policy in rural China throughout the past 62 years. Methods This study was applied with PICOS structure to formulate research issues. National/ministry policies and documents on healthcare reform in rural China were systematically collected. The primary healthcare issues and healthcare reform measures carried out at each stage were studied, and, the criteria as population healthcare indicators, indicators for healthcare workforce and infrastructure in rural areas, healthcare expenditure indicators, and the results of national surveys for healthcare service were used to evaluate the reform performance achieved at each stage. Results A total 396 national policies on healthcare reform in rural China were included through comprehensive search. In accordance with the results of quantitative analysis on literatures, characteristics of economy system reform at each stage as well as actual advancement on healthcare reform, the reform courses of healthcare system in rural China in this study were divided into six periods as follows: national economy recovery and adjustment period, cultural revolution period, early stage of economy system transition, initial stage of healthcare reform, middle stage of healthcare reform, and implement stage for new rural cooperative medical system (NRCMS). The average policies of each period increased year by year, which generally showed as features as laying more emphasis on medical services than medicine, and thinking little of medical insurance. The population health indicators, sickbeds per thousand rural population and medical practitioners kept improving gradually. Yet the import of market mechanism and influence of international economy condition led to the decline in public welfare of healthcare system, increase of personal expenditure proportion among general healthcare cost, and duplicate content among some polices.Conclusion Commonwealth orientation is the fundamental principal to fulfill healthcare service system, thus performance on policies should be concluded in combination with the present national conditions, future requirements as well as evidence-based policy-making, and additionally, such performance should be improved during implementation.
Objective Through investigating and analyzing the training status quo of rural doctors in Liangshan Yi Autonomous Prefecture of Sichuan province, to find out problems existing in the training. Methods In October 2010, the on-site questionnaires were distributed to 300 rural doctors from 13 counties who were studying at medical schools of Liangshan Prefecture. The data of their training status were recorded with Epidata 3.0 software and then analyzed with SPSS 16.0 software. Results Among the total 300 questionnaires distributed, 279 were valid with the response rate of 93%. The results showed that: rural doctors in Liangshan Prefecture were generally low in education background and short of knowledge and skills, and took over the burden of the training tuition; and the training content was not fully correlated with theirs actual demands. Conclusion This paper suggests, the in-service training should be conducted on the following bases: the actual situation of Liangshan Prefecture, the adequate consideration of characters of minority region, the improvement of training quality, and the formulation of supporting policies and implementing methods.
Objective To investigate the basic condition and psychological health status of children in rural areas of Xibaipo town in Hebei province, learn the psychological problems of the leftover children and their influencing factors, and provide scientific basis for the school and family education for the leftover children. Methods A questionnaire survey was performed on 446 middle and primary school students in Xibaipo town, and the self-designed questionnaire was applied to collect the basic condition, family condition and psychological health status of the children. EpiData 3.0 and SPSS 17.0 were used to perform data entry and data analyses, respectively. Results The survey displayed that the leftover children accounted for 43.5% of the total number of students. The negative emotion of leftover children was significantly ber than that of non-leftover children (χ2=12.484, Plt;0.001), especially for children with both parents living far away. The main factors affecting children’s emotion were their academic performance and whether they were left behind by their parents. Conclusion The psychological health status of the leftover children is poorer than that of non-leftover children, especially for children with both parents working outside and mothers working outside. Being left over and the academic performance are the factors affecting children’s mental condition. More attention should be paid to the physical and mental development of leftover children and vigorous efforts should be exerted to formulate corresponding policies and take countermeasures so as to promote healthy growth of children.
Objective To investigate the the status of Health manpower resources of rural hospitals, Health service, health personnel ’s reflection for the hospital’ current issues 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 the rural hospital staff’s self-evaluation of health services, the reflecting of the problems of the current hospitals ,the views of the future building, village health humen resources for health, etc. SPSS 17.0 sofewarewas used for data analysis. Result The following problems are existing in Xibaipo town hospitals. (1) The rural hospital infrastructure is poor: 14 beds, housing a total area of 832 square meters is far below the national average. (2) The quality of the health personnel in the rural hospital is low.The proportion of doctors and nurses (1׃0.75) is higher than the Ministry of Health’s standard (1׃1), less educated (only 2 person’s first degree is college), low-level professional titled (the proportion of health officer of no professional title is 42.86%), etc. (3) Health resources in village are scarce: the quality of rural doctors is low (90.91% are non-formal school graduation), village clinics is lack of facilities (16 villages have only a total of 10 village clinics, 5 beds). Conclusion The infrastructure of the rural hospital was poor,while the situation of the personnel allocation in the rural hospital was irrational ,and the integrated management of the hospital in town and village is not good . The health personnel proposed recommendation about construction of health personnel, departments, information technology , etc .The rural hospital should introduce equipment and personnel, improve health care services and strengthen the integrated management of the hospital in town and village .
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.