The past two decades have witnessed the burgeoning of enormous digital technologies and data collected via countless channels.They are combined in numerous ways in different fields,including epidemiology,mHealth and m...The past two decades have witnessed the burgeoning of enormous digital technologies and data collected via countless channels.They are combined in numerous ways in different fields,including epidemiology,mHealth and modeling of health systems,with the intention to improve human health(e.g.,clinical decision support,electronic medical record management)[1-6].However,this is a new interdisciplinary area where no single scientific discipline knows how to take full advantage of these data and technologies to solve health problems[1].展开更多
Background To quantify the associations between the under-five mortality rate(U5MR)and measures of pediatric human resources,including pediatricians per thousand children(PPTC)and the geographical distribution of pedi...Background To quantify the associations between the under-five mortality rate(U5MR)and measures of pediatric human resources,including pediatricians per thousand children(PPTC)and the geographical distribution of pediatricians.Methods We analyzed data from a national survey in 2015-2016 in 2636 counties,accounting for 31 mainland provinces of China.We evaluated the associations between measures of pediatric human resources and the risk of a high U5MR(>18 deaths per 1000 live births)using logistic regression and restricted cubic spline regression models with adjustments for potential confounders.PPTC and pediatricians per 10,000 km^(2) were categorized into quartiles.The highest quartiles were used as reference.Results The median values of PPTC and pediatricians per 10,000 km^(2) were 0.35(0.20-0.70)and 150(50-500),respectively.Compared to the counties with the highest PPTC(≥0.7),those with the lowest PPTC(<0.2)had a 52% higher risk of a high U5MR,with an L-shaped relationship.An inverted J-shaped relationship was found that the risk of a high U5MR was 3.74[95%confidence interval(CI)2.55-5.48],3.07(95% CI 2.11-4.47),and 2.25 times(95% CI 1.52-3.31)higher in counties with<50,50-149,and 150-499 pediatricians per 10,000 km^(2),respectively,than in counties with≥500 physicians per 10,000 km^(2).The joint association analyses show a stronger association with the risk of a high U5MR in geographical pediatrician density than PPTC.Conclusion Both population and geographical pediatrician density should be considered when planning child health care services,even in areas with high numbers of PPTC.展开更多
基金funded in part by research grants from the USbased China Medical Board (16-262)the United Nations International Children’s Emergency Fund (2018-Nutrition-2.1.2.3)+2 种基金the National Natural Science Foundation of China (11771240, 91746205, 71673199)funding from Xi’an Jiaotong UniversityUniversity of Twente
文摘The past two decades have witnessed the burgeoning of enormous digital technologies and data collected via countless channels.They are combined in numerous ways in different fields,including epidemiology,mHealth and modeling of health systems,with the intention to improve human health(e.g.,clinical decision support,electronic medical record management)[1-6].However,this is a new interdisciplinary area where no single scientific discipline knows how to take full advantage of these data and technologies to solve health problems[1].
基金supported by the Shanghai Municipal Commission of Health and Family Planning(2016ZB0103).
文摘Background To quantify the associations between the under-five mortality rate(U5MR)and measures of pediatric human resources,including pediatricians per thousand children(PPTC)and the geographical distribution of pediatricians.Methods We analyzed data from a national survey in 2015-2016 in 2636 counties,accounting for 31 mainland provinces of China.We evaluated the associations between measures of pediatric human resources and the risk of a high U5MR(>18 deaths per 1000 live births)using logistic regression and restricted cubic spline regression models with adjustments for potential confounders.PPTC and pediatricians per 10,000 km^(2) were categorized into quartiles.The highest quartiles were used as reference.Results The median values of PPTC and pediatricians per 10,000 km^(2) were 0.35(0.20-0.70)and 150(50-500),respectively.Compared to the counties with the highest PPTC(≥0.7),those with the lowest PPTC(<0.2)had a 52% higher risk of a high U5MR,with an L-shaped relationship.An inverted J-shaped relationship was found that the risk of a high U5MR was 3.74[95%confidence interval(CI)2.55-5.48],3.07(95% CI 2.11-4.47),and 2.25 times(95% CI 1.52-3.31)higher in counties with<50,50-149,and 150-499 pediatricians per 10,000 km^(2),respectively,than in counties with≥500 physicians per 10,000 km^(2).The joint association analyses show a stronger association with the risk of a high U5MR in geographical pediatrician density than PPTC.Conclusion Both population and geographical pediatrician density should be considered when planning child health care services,even in areas with high numbers of PPTC.
