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April 2013, Volume 16, No.10 Abstracts

 Efficiency of Community Health Service Based on Production Function

ZHANG An,ZHANG Tian-ye,XIA Wen, et al. Antai College of Economics & Management,Shanghai Jiaotong University,Shanghai 200030,China

Abstract Objective To investigate the efficiency and character of Community Health Services (CHS) in Shanghai.

Methods Ninety seven CHS centers of Shanghai were taken as the subjects in 2010.The production functions of CHS in Shanghai was established based on Cobb-Douglas function,and then analyzed by Weighted Least Squares Estimation.

Results A CHS production function in Shanghai was established: ln Y=0.750 + 0.596lnL + 0.239lnK +μ.The function showed that the marginal product of labor was 0.596,and the marginal product of capital was 0.239.The function also revealed a feature of decreasing returns to scale in CHS of Shanghai.

Conclusion The investment of manpower resource has more effect on output than capital.The manpower resource is a key factor for improving development of CHS of Shanghai.The Health Administrative Department needs to enlarge the investment to CHS;and at the same time,should further raise the managing levels of CHS centers and enhance the study on service model.

Key words Community health services;Production function;Efficiency

Study on Job-analysis-based Allocation of Public Health Manpower for Community Health Service Team

SU Ning,PENG Ying-chun.Beijing Centers for Diseases Control and Prevention,Business Management Office,Beijing 100013,China

Abstract Objective To predict the needed numbers of community public health personnel,investigate the existing problems of personnel allocation in community health service institutions,and put forward suggestions for improvement.

Methods All of the eight public health workers of all the 8 community health service teams in a community health service center in Beijing were recruited as the subjects.The field observation,self recording,and interview analysis of the methods of job analysis were used,in combination with statistical analysis,to determine the quantifiable work items,and workload,work time and work saturation in one year,and further to calculate one years working time.Then the improved formula of health manpower demand was applied to predict the public health personnel needed.

Results The community health service center should be equipped with 17 public health workers,and there are 8 now.The personnel demand index is 0.47.

Conclusion The numbers of community public health personnel in the community health service center are not enough,which can not meet the working need.It is necessary to fill in the gaps in public health personnel,at the same time,conduct training on relevant professional abilities,and enhance the level of service occupation,and thus,to a certain extent,to relieve the stress resulted from shortage of personnel quantity.

Key words Community health services;Public health;Manpower deployment;Job analysis

SWOT Analysis on Service of Sickbed at Home by Community Hospitals

LI Lin,WANG Yuan,WANG Wei,et al.Department of Health Statistics,School of Public Health,Tianjin Medical University,Tianjin 300070,China

Abstract Objective To learn the conditions of health care at home in community hospitals in Tianjin,and analyze the existing problems in implementation and the impacting factors so as to provide the basis for development of the service of sickbed at home.

Methods The purposive sampling was taken to choose eighteen hospital presidents of 18 community hospitals for a deep interview of development of the health care service at home.SWOT analysis was used to summarize the strengths,weaknesses,opportunities and threats in providing the service of sickbed at home.

Results Among the 18 investigated hospitals six have provided the service of sickbed at home,nine had ever provided the service before,and three never had.Nine of the presidents had worked on health care service at home and fourteen are willing to do the work.The main factors impacting development of the service at home were limitation of human resource,faultiness of strategies and measuresshortages of medical technologies and high medical risk.

Conclusion It is necessary to develop and standardize the administration rules for the service of sickbed at home,enhance the guidance of policies,speed up the training on general practitioners,and reasonably utilize the facilities of both software and hardware so as to raise the cognition degree from society.

Key words Hospital at home;Community health service institutions;SWOT analysis

Influence of Essential Medicine System on Community Health Centers in a District of Shanghai

ZONG Wen-hong,ZHOU Zhou,Mai Shu-peng,et al.Zhijiangxi Road Community Health Center,Zhabei District,Shanghai 200070,China

Abstract Objective To investigate the influence of essential medicines system (EMS) on the operation of community health centers (CHCs).

Methods The present status of outpatient visits,inpatient visits,fiscal compensation and personnel loss of medical institutions in Zhabei District after EMS implementation were evaluated through a combination of quantitative and qualitative approaches.

Results After the implementation of EMS,the outpatient visits,inpatient visits,drug proportion,and total income rise all decreased in CHCs.The year-on-year income increase of 4.82% was maintained mainly through outpatient income rise.Fifteen out of 45 (33%) general practitioners suggested decreased income,while no significant personnel loss was observed.

Conclusion The essential medicine list should be adjusted according to the changing needs.Doctors should be trained about the application of the drugs on the list to promote their use. Key words Essential medicine;Community health service centers;Outpatient visits;Pharmacy income;Fiscal compensation

Knowledge,Attitudes and Practices of Primary Doctors in Yantai on National Essential Drug System

HAN Wen-ting,QU Wei.Binzhou Medical University,Yantai 264003,China

Abstract Objective To investigate the Knowledge,Attitudes and Practices (KAP) of primary doctors in Yantai city on national essential drug system,in order to offer the relevant measures and advices to promote smooth implementation of the system.

Methods Stratified random sampling method was used to investigate the cognition of 156 primary doctors from 5 Second-Level Grade-A Hospitals in Yantai city on National essential drug system of five hospitals through questionnaire survey on KAP.

Results The retrieval rate of the eligible questionnaires was 91.52% (151/165).Of which 52.98% (80/151) was male,and 47.02% (71/151) was female;the average age was 41.9±8.5 years,their education backgrounds were all college level or above,and 90.07% (136/151) had the middle professional title or above.Some 4.64% 7/151 were very familiar to the national essential drug system,32.45% 49/151 were familiar,and 50.99% (77/151) were generally known.Some 82.12% (124/151) supported the system and 71.52% (108/151) approved it.They were aware of the system by the way of professional training and media such as TV and newspaper,and 92.05% (139/151) wished to be further informed through professional training.in prescribing 92.72% (140/151) took the essential drugs as their first choice,80.79% (122/151) actively recommended the essential drugs to their patients,however,50.33% (76/151) expressed that the implementation of the system could reduce their personal incomes.

Conclusion The cognition of primary doctors in Yantai city on national essential drug system relatively good.Most of them approved the system,prescribed the essential drugs preferentially and advised the patients to select the drugs.Nevertheless,there are still some difficulties in spread of the national essential drugs system.It is necessary to take the related measures to promote the system,improve the reward mechanism,enhance professional training and media publication and raise the approval degree and compliance of the mass to the system,so as to promote the extensively implementation of the system.

Key words National essential drug systemPrimary care physicians; Recognition; Questionnaire survey

Status of Utilizing Essential Drugs in Basic Medical Institutions of Yancheng City

WU Hong-yan,LIU Jin-quan,YU Xiao-ling,et al.School of Pharmacy,Yancheng Institute of Health Science,Yancheng 224005,China

Abstract Objective To study the usage of the essential medicines in Yancheng city so as to provide a reference for improvement of the essential medicine system.

Methods A random sampling method was used to choose 12 basic medical institutions,including 8 community health centers and 4 Township hospitals as the subjects,from each of which 100 prescriptions made from May 2011 to May 2012 were selected for statistical analysis of such conditions as applying rate of the essential drugs and the cost.

Results The average applying rate of essential drugs was 66.91%,and the average cost of essential drugs accounted for 59.86% of the total prescription cost.

Conclusion The implementation of the essential drug system really brings about the great benefit to the mass,but the indexes like applying rate had not reached the requirement.So it is necessary to improve the supporting polities,and strengthen the supervision and popularization.

Key words Essential medicine;Basic medical institution;Use condition

Confirmatory Factor Analysis of Sub-health Measurement Scale Applied in Urban Residents

LU Yan,XU Hua-li,WEI Qian,et al.Department of Health Economy Administration,Nanfang Hospital,Southern Medical UniversityGuangzhou 510515,China

Abstract Objective To analyze the validity of Sub-Health Measuremen Scale-version 1.0 (SHMS V 1.0) for urban residents by Confirmatory Factor Analysis (CFA).

Methods The epidemiological survey was conducted among 1 000 sampled urban residents in Guangzhou,and AMOS 18.0 was used to do CFA.

Results For the first order model of dimensions,the goodness of fit index (GFI)=0.922 adjusted goodness of fit (AGFI) =0.906,and root mean square error of approximation (RMSEA) =0.040.For the second order model of dimensions and subscale,GFI=0.909, AGFI=0.895,and RMSEA=0.044.

Conclusion The first order model of dimensions and the second order model of dimensions and subscale are all up to the higher degree of adaptation which means theory model matches real data.The classification of dimensions and subscale for SHMS V 1.0 is reasonable, and SHMS V 1.0 has a higher construct validity in urban residents.

Key words Sub-health measurement scale;Urban residents;Validity;Confirmatory factor analysis

Changes in Artery Elastic Function in Young and Middle-aged Normal Body Mass Patients with Mild-moderate Hypertensive

WANG WeiCHANG LingLIU Hong-junet al.Medical Department of Beijing Jiaotong University HospitalBeijing 100044China

Abstract Objective To analyze changes of artery elastic function of young and middle aged patients with hypertension and with normal body mass and discuss the relationship between artery elastic function and indexes of blood pressure.

Methods HDI CV Profilor DO-2020 was used to measure large arterial compliance C1and small arterial compliance C2 of 159 hypertension patients with normal body mass and 137 non-hypertensive subjects randomly selected.Their systolic and diastolic blood pressures,fasting post blood glucose,blood lipid were tested at the same time.Multivariate correlation between the arterial elastic indexes and blood pressure indexes were analyzed.

Results 1Compared with the non-hypertensive group,the levels of C1〔(12.00±1.63ml/mm Hg×10 vs.13.50±2.95ml/mm Hg×10 and C2〔(5.82±1.70ml/mm Hg×100 vs.7.55±2.12ml/mm Hg×100 were significantly decreased in the hypertensive group P0.05.2 The systolic blood pressure and pulse pressure were negatively correlated with C1r=-0.488,-0.486,P0.01),but no correlation was found between C2 and various indexes.Diastolic blood pressure was not correlated with C1 and C2.

Conclusion The artery elastic function is obviously lower in young and middle aged patients with hypertension and with normal body mass.And C1 was negatively correlated with systolic blood pressure and pulse pressure.

Key words HypertensionArtery elasticBlood pressure

Impact of Quality of Life and Depression on Hypoglycemia in Patients with Type 2 Diabetes Mellitus

TU Chuan-faWANG Li-junJIN Duet al.Endocrine Departmentthe First Peoples Hospital of TaizhouTaizhou 318020China

Abstract Objective To explore the impact of quality of life and depression on hypoglycemia in patients with type 2 diabetes mellitusT2DM.

Methods A total of 458 patients were,according to whether they suffered from hypoglycemia within the past half year,divided into hypoglycemia group and non-hypoglycemia group.The single factor analysis was used ton investigate the differences between the two groups in scores of quality of life,depression,fasting blood sugar (FBG),glycosylated hemoglobin (HbA1c),and body mass index (BMI).Then the significant variables in single factor analysis were taken as the independent variables for multivariate regression analysis to explore the risk factors of hypoglycemia.

Results (1) The BMI in the hypoglycemia group was significantly higher than that in the non-hypoglycemia group 〔(24.8±1.9kg/m2 vs.24.2±1.8kg/m2 P0.05.2The total scores of physical health 〔(301.3±30.3 vs.312.8±31.2)〕 and psychological health 〔(304.0±30.8vs.316.1±31.4)〕 were significantly lower in the hypoglycemia group than the non-hypoglycemia group P0.01.The score of Depression Score of Patient Health Questionnaire (PHQ-9) was significantly higher in the hypoglycemia group than in the non-hypoglycemia group P0.05.3 The multivariate regression analysis revealed that the total scores of physical healthOR=0.911,95%CI0.8960.958,P=0.032 psychological health OR =0.835,95% CI0.7110.926,P=0.008 and PHQ-9OR =1.318,95% CI 1.115,1.481,P=0.022 were associated with hypoglycemia.

Conclusion The quality of life and depression are associated with hypoglycemia in patients with T2DM.

Key words Diabetes mellitus,type 2HypoglycemiaQuality of lifeDepression

Risk Factors for Fatty Liver Disease

CAO Nan,LIN Lian-jie,ZHENG Chang-qing,et al.Department of Gastroenterology,Shengjing Hospital of China Medical University,Shenyang 110004,China

Abstract Objective To investigate the risk factors for fatty liver disease.

Methods A total of 1 067 cases with complete information in our physical examination center between March 2011 and August 2011 were selected in this study.The age,gender,body mass index,blood pressure,fasting blood glucose,blood lipids,blood uric acid,liver function and routine blood examination results were compared between the fatty liver group and non-fatty liver group using questionnaire survey,physical examination,laboratory test,and abdominal ultrasound examination.

Results A total of 430 cases of fatty liver were detected out of 1 067 cases (40.30%) using abdominal ultrasound examination, including 274 male patients and 156 female patients.The prevalence of fatty liver disease was higher in males than in females (47.65% vs.31.71%) (χ2=28.018P0.01).The prevalence was higher in people with monthly earning 3 000 RMB 47.05%263/559 than in people with monthly earning 3 000 RMB (χ2=22.225P0.01).The prevalence varied in people with different occupations (χ2=55.260P0.05).Significant difference was observed between the two groups in diet and living habits,such as fatty food consumption,smoking,alcohol consumption,and exercise (P0.05).The prevalence of overweightobesityglucose metabolism disorderhypertensionhyperlipidemiaand hyperuricemia was higher in fatty liver group than in non-fatty liver group.Univariate analysis showed that the fatty liver group had significantly higher body mass indexsystolic blood pressure, diastolic blood pressure, and uric acid, but significantly lower high-density lipoprotein cholesterol and apolipoprotein A1 than the non-fatty liver group (P<0.001).Multiple regression analysis showed that agegenderbody mass index,systolic blood pressure,diastolic blood pressure,uric acid,apolipoprotein B,apolipoprotein A1,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglyceridesfasting-serum glucose level were risk factors for fatty liver disease (P<0.05).

Conclusion Unhealthy lifestyles like smoking, alcohol consumption, fatty food consumption, and lack of exercise,as well as overweight, obesity, hypertension, glucose metabolism disorder, dyslipidemia, and hyperuricemia increase the risks for fatty liver diseases.

Key words Fatty liver disease;Risk factors;Metabolic syndrome;Life style

Effect of Smoking on Postoperative Recovery of Men with Obstructive Sleep Apnea-hypopnea Syndrome and the Mechanism

WANG Ri-hong

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