May 2013, Volume 16, No.13 Abstracts

 Job Analysis-based Study on Human Resources of General Practitioner in Community Health Service Team

PENG Ying-chun, SU Ning. School of Health Management and Education,Capital Medical University,Beijing 100069,China

Abstract Objective To explore the current status of human resources of general practitioner (GP) so as to predict the number of GPs needed and provide problem-solving strategies.

Methods Eight GPs from the 8 community health service teams of a community health center in Beijing were included in the study. Job analysis methods including field observation, self recording, and structured interview analysis, combined with statistical analysis method were used to determine the quantitative work items, one-year workload, work time, and work saturation. One years working time was then calculated. The number of GP needed was predicted using the improved formula of health manpower demand.

Results This community health center should be equipped with 14 GPs. The personnel demand index was 0.57 based on the current 8 GPs.

Conclusion This community health center should be equipped with more GPs and should carry out relevant trainings among the current staff so as to narrow the personnel gap and improve the service capacity.

Key words Community health servicesGeneral practitionersManpower deploymentJob analysis

Evaluation Methods of Annual Public Health Work Objectives for Community Responsibility Doctor Team

GE Cheng-hui, SHAO Le-qin, ZHU Yue-wei, et al. Xiacheng District, Changqing Chaoming Street Community Health Service Center, Hangzhou 310003,China

Abstract Objective To design the quantitative assessment methods of annual public health work objectives for community responsibility doctor team, and investigate the impact of the methods on completion of the annual public health objectives.

Methods The work of annual evaluation and award was conducted based on the weighting coefficient formulated according to completion condition of various indicators of public health work signed in the target responsibility document by the community responsibility doctor team, in combination with the degree of work priority.

Results Since the implementation of quantitative assessment on annual public health work objectives of community responsibility doctor team, in the community health service center 69 864 new residential health records were built. The person-times of follow-up for patients with hypertension, diabetes mellitus, cancer, and severe mental disorders increased respectively from 29 589,5 409,270,and 568 in 2008 to 70 652,11 610,1 872 and 2 636 in 2011.The built rate of health records increased from 43.87% of 2008 to 89.76% of 2009.The standardized management rates for patients with hypertension, diabetes mellitus, cancer, and severe mental disorders increased respectively from 78.24%,83.26%,32.12% and 20.53% in 2008 to 93.52%,97.25%,77.84% and 89.78% in 2011.And resident satisfaction rates were respectively 80.37%,86.25%,92.13% and 95.56% in 2008-2011.

Conclusion The implementation of quantitative assessment on annual public health work objectives of community responsibility doctor team can improve the completion of objective tasks and raise the public health service quality and resident satisfaction.

Key words Community responsibility doctor team;Public health services;Target assessment

Setting Health Manager Position in Community Health Organizations: Meaning, Obstacle, and Strategy

GAO XiangYANG Hai-yanXUE Qiu-jiet al.Health Human Resources Development CenterMinistry of HealthBeijing 100097China

Abstract Objective To discuss the meaning, obstacle, and strategy of setting the position of health manager in community health organizations.

Methods SWOT analysis was used to analyze the strength, weakness, opportunity, and threaten in setting the health manager position in community health organizations.

Results Setting the health manager position in community health organizations is in accordance with the guiding principle of health system reform which is "ensuring basic medical services, strengthening grass-roots health care system, and establishing mechanism",and can promote the effective use of limited community health resources,transform the community service mode,and improve the capacity of service provision.However,the absence of macro-management policy,such as personnel training,organizing and reimbursement mechanism was seriously obstructing the career development of health managers.On-job training and qualification examination on health management among community health staff have been carried out in Minhang District of Shanghai.Family doctor service mode has provided valuable experience for developing health management in community health organizations.

Conclusion The community health organizations provide a broad space for the development of health management profession.Currently breakthroughs should be made in position setting,reimbursement mechanism,personnel training and professional title promotion.

Key words Health managerCommunity health service institutionPosition establishment

The Status Quo of Medical Care and Public Health Service Provided by General Practitioners in Beijing and Existing Problems

JIN Guang-huiLU Xiao-qinZHAO Ya-liet al.Department of Family MedicineSchool of Public Health and Family MedicineCapital Medical UniversityBeijing 100069China

Abstract Objective To investigate the status quo of medical care and public health services provided by general practitioners (GPs) in Beijing.

Methods Fifty-three GP trainees who attended the general practice job-transfer training and community faculty training in Beijing were surveyed in November 2012 using self-designed questionnaire.

Results The most frequently provided medical care services were diagnosis and treatment of common diseases (100.0%),referral (54.7%),home visit (45.3%),emergency care (39.6%),etc.Public health services provided by the investigated GPs in the past 2 weeks were management of health information (90.6%),management of chronic diseases (66.0%),geriatric care (54.7%),and health education (54.7%).Twenty-two out of 53 GPs undertook managerial work,such as statistical report and epidemiological survey.Inappropriate working time distribution (41/53,77.4%), unreasonable managerial responsibilities (26/53,49.1%),unclear scope of practice (52/53,98.1%),inappropriate division of labor in community health service team (50/53,94.3%) were the major problems raised by the GPs.Thirty-seven (74.0%) of the GPs thought family planning,management of psychiatric patients,and women health care should be undertaken by public health physicians,and 16 (30.2%) of the GPs thought management of health information should not be their responsibility.

Conclusion Therere no defined standards for medical care and public health service provided by GPs.The responsibility and labor division of health professionals in community health service team should be defined.The practice scope of GPs and standardization of service will be a critical research field in general practice.

Key words General practitionersScope of workQuestionnairesBeijing

Investigation on the Preparedness Status of Disaster Medical Rescue in Urban Community Health Service Centers of Jilin Province

LI Wen-tao,AN Li-bin,YIN Hui-ruet al.School of Public Health,Jilin University,Changchun 130021,China

Abstract Objective To investigate the preparedness status of disaster medical rescue in urban community health service centers so as to explore the role of urban community health service centers in disaster medical rescue.

Methods The stratified random sampling was taken to choose 20 urban community health service (CHS) centers from 9 cities/prefecture in Jilin province, and questionnaire survey and interview were used among 20 major leaders from each of the 20 centers.

Results Among all the 20 CHS centers there were only 9 (45%) where the disaster medical rescue drill had been conducted,6 (30%) where outdoor trauma rescue training conducted, and one (5%) where biological/chemical terrorist attack rescue training conducted. In all of the centers there were no relief material resources against biological/chemical terrorist attack.

Conclusion It is of impotent significance to strengthen the preparedness for disaster medical rescue in urban community health service centers. Now the preparation for disaster medical rescue in urban community health service centers in Jilin province is not good. It is necessary to enhance infrastructure and personnel training.

Key words Community health service centers;Disaster;Medical rescue

Satisfaction of Community Health Services Users in Dongguan City under the Mode of "Official Politics"

LI Jia-qi, WANG Pei-xi, LU Chu-hong. School of Public Health, Guangzhou Medical College, Guangzhou 510182,China

Abstract Objective To investigate the satisfaction status of the community health services (CHS) users and its influencing factors under the mode of "Official Politics" in Dongguan City.

Methods A CHS center in Dongguan City where "Official Politics" had been implemented was selected as the subject. The intercept survey method was taken to investigate the satisfaction of 360 people who applied the services in the CHS center with self-made satisfaction questionnaire constructed based on American Customer Satisfaction Index (ACSI).

Results The index of patients overall satisfaction on CHS was 74.18.Multivariate Logistic regression analysis showed that the main factors influencing the overall satisfaction were the perceived value, users expectations and perceived qualityOR=11.401,8.671,7.525.

Conclusion The main factors influencing the overall satisfaction were the perceived value, users expectations and perceived quality. The CHS organization should focus on the factors influencing the CHS users satisfaction, try to improve the service level, and realize the function of "six in one".

Key words Community health services;" Office politics " mode;Satisfaction;American customer satisfaction index

Quality of Life for Colorectal Cancer Survivors in Medical Institutions-Community Service Model

ZHANG Zhi-guo,ZHAO Li-bo,ZHANG Ying,et al.Beijing Daxing District Peoples Hospital,Beijing 102600,China

Abstract Objective To investigate the impact of service model by both oncology specialists in tumor and community doctors on the quality of life for survivors with colorectal cancer.

Methods Sixty one survivors with colorectal cancer were divided as trial group (n=31) and control group (n=31).The patients in the trial group were given intervention and follow-up by community doctors under guidance of oncology specialists or medical institutions-community service model.And the patients in the control group were no intervention.The Quality of Life Questionnaire-C30 (QLQ-C30) in European Organization for Research and Treatment of Cancer (EORTC) was used to evaluate the quality of life of the patients in both groups at baseline and 3 months after the intervention.

Results After 3 months,the differences between the two groups in scores of emotion capacity (67.3 ± 12.5) vs. (56.7 ± 13.2),general health 〔(81.4±6.9 vs. 72.4±6.4)〕,insomnia 〔(23.7±16.9 vs. 50.3±30.1)〕,constipation 〔(20.8±11.7 vs. 36.3±17.2)〕,pain 〔(0.9±0.7 vs. 1.9±1.7)〕 were statistically significant P0.05.

Conclusion Under the medical institutions-community service model,the quality of life of colorectal cancer survivors can be effectively improved.

Key words Cancer survivor;Colorectal cancer;Quality of life;Medical institutions-community service model

Application and Evaluation of Digital Remote Medical Model in Community Eye Disease Screening

LIU Ju-hong,HAN Zheng-zheng,REN Xue-tao,et al.Desheng Community Health Center in Xicheng District,Beijing 100120,China

Abstract Objective To evaluate the effect of digital remote medical model in community eye disease screening.

Methods Cooperation platform between community health centers and specialist medical institutions was established with digital remote medical information technology.Residents 55 years old or above in Desheng Community,Xicheng District,Beijing were invited to participate voluntarily in eye disease screening using community bulletin.Staff of the community health center performed external and fundus photography with digital camera and uploaded the data.Diagnosis feedback was given to the subjects after grading by specialists.

Results From June 2009 to August 2012,9 798 residents were screened which accounted for 8.72% of the community population.Eye diseases (except cataract and retinal arteriosclerosis) were found in 21.32% 2 089/9 798of the subjects,including 690 cases (7.04%) of maculopathy,518 cases (5.29%) of glaucoma and suspected glaucoma,180 cases (1.84%) of diabetic retinopathy,and 44 cases (0.45%) of retinal vein obstruction.In addition,2 876 (29.35%) cases were diagnosed as cataract and 2 657 (27.12%) as retinal arteriosclerosis.The photographs of 344 (3.51%) subjects could not be graded.Diabetic retinopathy were detected in 8.93% (174/1 948) of the subjects with diabetes mellitus and retinal arteriosclerosis was detected in 36.09% 1 464/4 056of the patients with hypertension.

Conclusion Digital remote medical model is an effective method to screen eye disease in the community.This model can promote rational use of medical resources and early detection and prevention of eye diseases.

Key words Eye disease screening;Epidemiology;Remote consultation

Comparison of Pulmonary Artery Pressure Levels in Patients with Pulmonary Hypertension of Different Causes

GUO LuLIU Yue-jianXIE Zheng-lianget al.Department of Respiratory Disease ,Sichuan Provincial Academy of Medical Science & Sichuan Provincial People's HospitalChengdu 610072China

Abstract Objective To analyze and compare the levels of pulmonary artery pressure due to different causes in patients with pulmonary hypertension (PH).

Methods The data of 2 240 patients diagnosed with PH were retrospectively analyzed from outpatient department,emergency center and inpatient department of Sichuan provincial peoples hospital from January 2006 to December 2010.The levels of pulmonary artery systolic pressure PASP were analyzed and compared for these patients with different causes.

Results The proportion of mild,moderate and severe degree of PASP among the 2 240 patients was 43.79% 981/2 240,37.41% 838/2 240 and 18.80%421/2 240 respectively.The level of mean PASP in patients with PH due to pulmonary arterial hypertension,left heart disease,chronic lung disease and/or hypoxia,chronic thromboembolic pulmonary hypertension and miscellaneous factors were respectively 60±19mm Hg,52±17mm Hg,50±13mm Hg,61±13mm Hg and56±14mm Hg,with a statistically significant difference by analysis of variance P0.05.The top 3 subtypes of PH which possessed the highest level of PASP were persistent pulmonary hypertension of the newborn being 97±6mm Hg,pulmonary hypertension due to congenital heart diseases being 72±28mm Hg,and idiopathic pulmonary arterial hypertension being67±14mm Hg respectively,with significant difference as compared with other subtypes P0.05.And the subtypes with lowest level of PASP were PH due to portal hypertension and sleep-disordered breathing,being respectively 35±15 mm Hg and 35±16mm Hg,with significant difference as compared with other subtypes P0.05.

Conclusion The degree of pulmonary artery pressure is generally mild to moderate in patients with pulmonary hypertension.The highest-leveled subtypes of PH are persistent pulmonary hypertension of the newborn,pulmonary hypertension due to congenital heart diseases and idiopathic pulmonary hypertension respectively.So the patients with these types of PH should be paid more attention.

Key words Hypertension,pulmonaryPulmonary artery pressureCauseCharacteristic

Bone Mineral Density in Patients with Type 1 Diabetes Mellitus and Its Associated Factors

DUAN Peng,TU Ping,WU He-ping,et al.Department of Endocrine and Metabolic Diseases,the Third Hospital of Nanchang,Nanchang Key Laboratory of Diabetes,Nanchang 330009,China

Abstract Objective To explore the bone mineral density (BMD) in patients with type 1 diabetes mellitus and its associated factors.

Methods Forty-seven patients with type 1 diabetes mellitus treated in our hospital were assigned as the study group,and 40 healthy people as the control group.Waist-to-hip ratio (WHR) and body mass index (BMI) were calculated according to physical examination results.Fasting plasma glucose (FPG) and 2 hour postprandial glucose (2 hPG) were detected by glucose oxidase method,HbA1c was tested by high efficiency liquid chromatography,fasting C-peptide(FCP) and 2 hour postprandial C-peptide (2 hCP) levels by radio immunoassay,and BMD of lumbar (L2-L4) and left femoral neck by DXA.

Results No difference in age was observed between the two groupsP0.05.The study group was lower in BMI,WHR,FCP,2 hCP,and BMD of lumbar and left femoral neck,but higher in FPG,2 hPG,and HbA1c than the control group P0.05.The disease course and HbA1c were negatively,while FCP and 2 hCP were positively correlated with BMD of lumbar and left femoral neck (P0.05.Multiple regression analysis showed correlation of the diabetes course,HbA1c,FCP, and 2 hCP with BMD of lumbar and left femoral neckP0.05.

Conclusion BMD of patients with type 1 diabetes mellitus is lower than that of healthy people.The disease course,HbA1c, FCP, and 2 hCP are correlated with BMD of lumbar and left femoral neck in patients with type 1 diabetes mellitus.

Key words Diabetes mellitus,type 1;Bone mineral density;Influencing factors

Influencing Factors of Sleep Quality Among Patients with Reflux Esophagitis


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