Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
ObjectiveTo explore the quality of life (QOL) of rural cognitive function impaired elderly in Guangyuan city and analysis the influencing factors, in order to provide evidence for improving the QOL of rural cognitive function impaired elderly. MethodsBy stratified cluster sampling method, Mini-Mental State Examination (MMSE) was adopted in the cognitive function impaired screening in Guangyuan rural area of Sichuan province in 2012, then we used SF-12 questionnaire to evaluate the QOL of those rural elderly (more than 60 years old) whose cognitive function was impaired. ResultsA total of 270 rural cognitive function impaired elderly were selected from 735 old people. The results of QOL assessment showed that:the mean of physical component summary (PCS) was 37.93±11.55, and the mean of mental component summary (MCS) was 44.07±13.14. Gender, age, education levels, economic situation of the selfassessment, chronic disease, being engaging in physical labour and daily life care were correlated with the score of QOL. ConclusionIn order to improve their QOL, we should help the elderly with cognitive function impaired and focus on prevention and individual treatment; their special difficulties should be fully considered when making the policy of health care and social security.
ObjectivePublic health information collection is critical in improving the capacity of basic public health services. Our study took the "Wei Jian E Tong" APP as an example to evaluate the willingness and influencing factors of rural public health service personnel to continue using such APPs.MethodsWe applied exploratory sequential design in mixed-method research and chose Renshou county in Sichuan province as the representative region. Firstly, we used the personal in-depth interview to initially explore the status quo, applicability, continued willingness to use APP and other issues. Secondly, we used unified theory of acceptance and use of technology (UTAUT) and expectation confirmation theory (ECT) to construct a hypothetical model of influencing factors of user satisfaction. We then designed a structured questionnaire covering 7 measurement dimensions to survey all users of the APP at the survey site. Finally, we used structural equation model to verify the research hypothesis.ResultsA total of 21 individuals were interviewed in this survey, including leaders of township health centers, public health doctors, and rural doctors. Qualitative results showed the major defects were insufficient funds and policy support in the promotion and application, additionally lack of software functionalities and system incompatibility. A total of 593 valid questionnaires were collected from the quantitative survey on the satisfaction of township doctors and village doctors. Structural equation model results showed that seven direct hypotheses were established, of which compatibility had the largest effect value user satisfaction with a total effect value of 0.617, followed by facilitating condition (r=0.211), performance expectancy (r=0.137), effort expectancy (r=0.091) and social influence (r=0.068).ConclusionsTo promote the application of information collection apps in primary public health services and improve user satisfaction, the focus should be on solving software incompatibility and create interconnection among all levels of medical systems. At the same time, it is necessary to solve funding problems as a whole, optimize software functions, improve the performance evaluation system, and improve software training and promotion.
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.
【摘要】目的介紹華西醫院支援西部地區衛生工程項目的實踐和成效。方法過去5年間，華西醫院響應國家號召，通過各種幫扶形式，開展了一系列對口支援活動。結果華西醫院利用自身的資源優勢，通過各種幫扶形式，提高基層醫院的醫療救治水平和綜合服務能力，為建立城市支援農村衛生工作的長效機制進行了積極的實踐和探索，取得顯著成效。結論基層衛生事業與人民健康需求和現代醫學進步存在著相當的差距，醫療體制改革對部屬部管醫院的對口支援提出了更高的要求，對口支援的許多細節還需要我們去進一步完善。【Abstract】Objective To introduce the practice and progress of the supportive rural hygiene program of West China Hospital. Methods In the past five years, West China Hospital had made a lot of supportive rural hygiene practice. Results West China Hospital made good use of its own advantages in resources to develop the treatment level and the comprehensive service capability of primary hospital. West China Hospital did a lot of practice to establish the effective system of assistance of city medical care to rural areas, and had already achieved remarkable effects. Conclusionre is a lot of disparity between the basic public health or the requirement of people and the modern medicine progress. Many details for support should be further consummated.
ObjectiveTo evaluate the smoking environment, its related knowledge and difference between urban and rural areas in Chengdu. MethodsIn December 2010, we randomly sampled and investigated 60 dwellers aged from 35 to 70 from urban and rural communities, who were 1:1 paired by the age and sex. Questionnaires survey was used. ResultsThere were 48.3% (29/60) dwellers thought that smoking should be allowed freely at home, of which 30.0% (9/30)rural homes had no rules about smoking prohibited. There were 93.3% (28/30) urban dwellers supported male smoking. About 86.7%-98.3% urban dwellers realized that many diseases such as heart disease, stroke, and lung cancer may be due to smoking. And 16.7% urban dwellers also realized that cigarettes can result in diabetes mellitus, but none of rural dwellers did. The publicity of smoking cessation among urban dwellers (91.7%) by mass media was better than rural ones (0.0%). There were 95.0% dwellers denied any institution or organization for smoking control. ConclusionThe dwellers were short of cognition about restrictions of smoking environment and non-smoking knowledge. It's different between urban and rural area in tobacco advertisement and publicity of smoking cessation. We should continue enhancing public education, forbiding tobacco advertisement and providing institutions for smoking control.
Objective To understand the current situation of Chengdu primary health workers’ performance baseline, and to provide decision-making proof and policy recommendations for Chengdu Coordinated and Balanced Urban-rural Development as well as improve primary health workers’ performance in China. Method See the second study in this series. Result The number of the patients of the Chengdu seven Rural Hospitals / Centers showed a trend of slow increase, and all was higher than the national rural hospital average level except the 2 most remote rural hospitals(“Renhe” and “Bailu”). The seven Rural Hospitals / Centers could provide data about the “Six in One” work, and the performance was generally better than that of the world and the national average level , but showed a decreasing trend from the first circle to the third circle in Chengdu. The rate of patients’ satisfaction and very satisfaction for the Rural Hospitals / Centers “Six in One” work reached 65%-80%, but the rate of health workers’ job satisfaction and very satisfaction only reached 9%-46%, and also showed a decreasing trend from the first circle to the third circle. Conclusion The Chengdu primary health workers provide “Six in One” health service with a higher quality than the world and the national average levels. However, the number of the workers is less than enough; the human managerial structure is irrational; the educational and professional levels are low; their treatment and the work environment are poor. The distribution density , the academic qualification and the structure rationality of professional ranks of health personnel show a decreasing trend, and the difficulty of the service is gradually increasing from the first circle to the third circle, which causes the satisfaction rate of the workers’ job to decrease gradually from the first circle to the third circle. Suggestion: ① To make special performance assessment standard for special health institutions or personnel, and to give the continual oriented training chance for current health personnel. ② To integrate the regional health resources; to establish long-term and stable regional bilateral appointment help policy, technical and rational two-way referral system and indicator systems. ③ To take measures to solve the problems affecting the professional promotion and improvement of the grass-root health personnel.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
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 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.