Objective To systematically review the prevalence of depression in rural Chinese population aged 60 and above from 2010 to 2023. MethodsThe CNKI、WanFang Data、VIP、CBM、PubMed、Embase and Cochrane Library databases were electronically searched to collect cross-sectional studies on the prevalence of depression of elderly populations in rural China from January 2010 to March 2023. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 17.0 software. ResultsA total of 23 cross-sectional studies with a total sample of 34 916 cases and 11 308 depression patients were included. The meta-analysis results showed that the prevalence of depression in rural Chinese population was 31.02% (95%CI 26.10% to 36.16%). Subgroup analysis showed that the prevalence was higher among females than males; the GDS-30 scale had the highest detection rate, followed by the CES-D-10 and GDS-15 scales; the prevalence was higher in the Midwest than in the East; and the prevalence was higher in surveys conducted after 2015 than in 2015 and before. In addition, the prevalence of depression was higher in the rural elderly population aged 70 and above, non-married, illiterate or semi-literate, with poor self-rated health status, living alone, in poor economic status, with chronic diseases, and with low social activity. ConclusionThe prevalence of depression is high among the rural elderly population in China, and there are significant disparities in the prevalence of different characteristics of the elderly. These differences should be given more attention to improve the mental health of the rural elderly population. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To provide basic data for further application of national essential medicine list (EML) in Chengdu, through a survey of key-workers or persons, who attended the lecture of EML, in charge of village town hospitals or community medical service centers, and to find out their awareness of and attitudes to the essential medicine and requirements and suggestions for EML training. Methods Based on principles and methods of modern cognitive psychology, we designed the questionnaire and carried out the survey face to face. Two people input the data independently and verified them. Proportions were used to analyze the data through the Excel software. Results (1) The proportions ofcorrect answers to the questions of essential medicine conception, use range of EML and the relationship between EML and essential insurance medicines list were 89%, 91% and 87%, respectively. (2) 46% of the persons investigated (117 persons) chose “always consider preferentially using the essential medicine when prescribing”, 31% (81 persons) “consider using the essential medicine in most cases”. (3) 41% of the persons investigated (103 persons) chose “comparatively welcome” for the EML. (4) Problems of implementing EML in village town hospitals or community medical service centers, in the order of importance decreasing, were: “income and compensation”, “awareness of the essential medicine and prescribing habit of the doctor”, “patient’s cognition of essential medicine and preference to drug use”, “safety and effectiveness of the essential medicine”, “the applicability of essential medicine ” and “the purchase and delivery of essential medicine”, respectively. (5) The ways of getting information of essential medicine were 19.6% (187 person-time) through documents, 18.6% (177 persontime) through conferences and 15.3% (146 person-time) through lectures. (6) 60% of the persons investigated (154 persons) attended training of the essential medicine once or twice. (7) 77% of the persons investigated (196 persons) were trained for less than one week for essential medicine. (8) Requirements and suggestions on the training of essential medicine: 42% (71 person-time) enlarging the targeted people, 22% (38 person-time) increasing the training time,16% (27 person-time) improving practicability and specificity of training contents, 11% (18 person-time) diversifying training ways, 9% (15 persontime) requiring “training according to needs ” which addresses specific problems after investigation. Conclusion Training of essential medicine should be strengthened for medical workers in the village town hospitals or community medical service centers, and researches should be carried out on evaluation of EML applicability, performance of EML implementation, financial aiding, income of medical worker, procurement and reimburse, etc.
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 provide baseline data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development in Chengdu. Methods We selected 7 township/community health institutions and 6 village health posts /street clinics using stratified sampling to take account of the levels of economic development and the distance from the centre of Chengdu We then performed on-site surveys and secondary research. Data were analyzed by using Epidata or Excel. Results The utilization of health institutions was generally good. The number of visits and number of inpatients in medical institutions increased steadily. The utilization rate of hospital beds and doctors’ workload were higher than the national average. The average medical expense per outpatient /inpatient was far lower than the national level. The overall condition of the health institutions that close to the centre of Chengdu was better. Conclusion We should persist in taking advantage of the rural hospitals’ construction to improve village health posts /street clinics and strengthen the national and governmental compensating mechanism for township /community health organizations (village health posts /street clinics), so as to make the basic condition of current township/ community health organizations (village health posts /street clinics) better.