The objective of this study was to examine the inpatient bed （IB） allocation equity and utilization in Chinese city commtmity health service centers （CHSCs）. The data were derived from the Baseline Survey of Natio...The objective of this study was to examine the inpatient bed （IB） allocation equity and utilization in Chinese city commtmity health service centers （CHSCs）. The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.展开更多
This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the me...This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.展开更多
Objective:Community health services are an emerging trend.We have found in practice that diagnosis and treatment of respiratory diseases in the community are distinct.The respiratory department’s daily work involves ...Objective:Community health services are an emerging trend.We have found in practice that diagnosis and treatment of respiratory diseases in the community are distinct.The respiratory department’s daily work involves a number of outpatient registration items and a vast workload.The routine manual operation is inefficient and it is not convenient to make effective statistical analysis of the outpatient data to identify the risk factors closely related to diseases.Therefore,it is imperative to process the outpatient information of patients with respiratory diseases effectively and efficiently in a unified manner by means of computer technology.Methods:The design and realization of the Community Health Service-oriented computerassisted Information System for Diagnosis and Treatment of Respiratory Diseases(CHS-DTRD)was completed as part of the community intervention study on bronchial asthma that was carried out jointly by the Nanjing First Hospital Affiliated to Nanjing Medical University and the Hospital of Nanjing University of Science&Technology,and based on 2 years of experience and the needs of an overall analysis.Results:The computer-assisted information system for diagnosis and treatment was developed using Java Server Page(JSP)technology and introducing the advanced Asynchronous JavaScript XML(AJAX)technique and MS-SQL Server was used in the background database.CHS-DTRD was composed of eight functional modules(outpatient data maintenance,outpatient appointment,intelligent analysis for disease risk factors,query and statistics,data dictionary maintenance,database manipulation,access control,and system configuration).CHS-DTRD featured a friendly interface,convenient operation,and stability and reliability.Conclusion:Community health-oriented diagnosis and treatment of respiratory diseases is simple,programmable,and intuitive,thus the workload of physicians is significantly reduced and the work efficiency is improved.This system facilitates an intelligent analysis of disease risk factors using data mining technology,and provides physicians with suggestions on intelligent analysis for diagnosis of disease and conclusion of disease causes.展开更多
Objective:The purpose of the current study was to determine the types of community health services selected by urban and suburban residents in Nanjing and the influencing factors in an ef-fort to improve the community...Objective:The purpose of the current study was to determine the types of community health services selected by urban and suburban residents in Nanjing and the influencing factors in an ef-fort to improve the community health services to better meet the residents’demands.Methods:Between 15 May 2013 and 15 June 2013,eight community health service centers from four districts in Nanjing(Gulou District and Baixia District in urban areas and Jiangning District and Pukou District in suburban areas;two centers from each district)were selected using a stratified random sampling method of investigation sites.After an intercept interview with 487 community residents,univariate and multivariate analyses were performed by means of logistic regression.Results:Among the 487 users of community health services,there were 241 residents from urban areas(49.5%)and 246 residents from suburban areas(50.5%).Among the respondents,there were 191(39.2%)who usually received medical treatment from community health service institutions,including 74(38.7%)from urban areas and 117(61.3%)from suburban areas.The analysis showed that the factors which influenced urban residents in Nanjing to choose community health services for medical treatment included income,payment terms of medical fees,reasonable prices,medical fees,and expenses for medications,while factors influencing suburban residents to choose community health services for medical treatment included income,level of education,carrier,medical institutions selected when feeling severely ill,availability of preventive health services,availability of health counseling services,medical fees,and expenses for medications.Based on an analysis of the results by means of unconditioned binary logistic stepwise regression,the factors influencing whether or not the urban residents chose community health services for medical treatment included gender,age,level of education,payment terms of medical fees,treat-ment environment,and expenses for medications,while the factors influencing suburban residents included availability of preventive health services and expenses for medications.Conclusion:There was a difference between the types of community health services selected by residents in urban and suburban areas of Nanjing and factors influencing the selection of ser-vices were different.Community health service institutions in different areas should strengthen their own service capability according to the local residents’health demands.展开更多
This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in ...This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenological-hermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.展开更多
基金The Baseline Survey of "The National Urban Community Health Service System Building Project" was funded by Ministry Of Health of China
文摘The objective of this study was to examine the inpatient bed （IB） allocation equity and utilization in Chinese city commtmity health service centers （CHSCs）. The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.
文摘This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.
基金National Natural Science Foundation of China[grant No.61373062]The Fundamental Research Funds for the Central Universities[grant No.30920130111010]Social Development Project of Wujiang City,[grant No.WS201217].
文摘Objective:Community health services are an emerging trend.We have found in practice that diagnosis and treatment of respiratory diseases in the community are distinct.The respiratory department’s daily work involves a number of outpatient registration items and a vast workload.The routine manual operation is inefficient and it is not convenient to make effective statistical analysis of the outpatient data to identify the risk factors closely related to diseases.Therefore,it is imperative to process the outpatient information of patients with respiratory diseases effectively and efficiently in a unified manner by means of computer technology.Methods:The design and realization of the Community Health Service-oriented computerassisted Information System for Diagnosis and Treatment of Respiratory Diseases(CHS-DTRD)was completed as part of the community intervention study on bronchial asthma that was carried out jointly by the Nanjing First Hospital Affiliated to Nanjing Medical University and the Hospital of Nanjing University of Science&Technology,and based on 2 years of experience and the needs of an overall analysis.Results:The computer-assisted information system for diagnosis and treatment was developed using Java Server Page(JSP)technology and introducing the advanced Asynchronous JavaScript XML(AJAX)technique and MS-SQL Server was used in the background database.CHS-DTRD was composed of eight functional modules(outpatient data maintenance,outpatient appointment,intelligent analysis for disease risk factors,query and statistics,data dictionary maintenance,database manipulation,access control,and system configuration).CHS-DTRD featured a friendly interface,convenient operation,and stability and reliability.Conclusion:Community health-oriented diagnosis and treatment of respiratory diseases is simple,programmable,and intuitive,thus the workload of physicians is significantly reduced and the work efficiency is improved.This system facilitates an intelligent analysis of disease risk factors using data mining technology,and provides physicians with suggestions on intelligent analysis for diagnosis of disease and conclusion of disease causes.
基金Philosophy and Social Science Fund Project in Jiangsu Province:“Research on Evaluation Index System of Excessive Medical Behavior in Jiangsu Provincial Public Hospitals”[2011SJB630042]Philosophy and Social Science Special Fund Project in Nanjing Medical University:“Establishment of Rating Scale for Doctor’s Professional Behavior in Chinese Public Hospital under the New Health Care Reform”[2013NJZS02]Project Supporting for Training Talents in“Jiangsu Provincial Advantageous Discipline”[JX10331801].
文摘Objective:The purpose of the current study was to determine the types of community health services selected by urban and suburban residents in Nanjing and the influencing factors in an ef-fort to improve the community health services to better meet the residents’demands.Methods:Between 15 May 2013 and 15 June 2013,eight community health service centers from four districts in Nanjing(Gulou District and Baixia District in urban areas and Jiangning District and Pukou District in suburban areas;two centers from each district)were selected using a stratified random sampling method of investigation sites.After an intercept interview with 487 community residents,univariate and multivariate analyses were performed by means of logistic regression.Results:Among the 487 users of community health services,there were 241 residents from urban areas(49.5%)and 246 residents from suburban areas(50.5%).Among the respondents,there were 191(39.2%)who usually received medical treatment from community health service institutions,including 74(38.7%)from urban areas and 117(61.3%)from suburban areas.The analysis showed that the factors which influenced urban residents in Nanjing to choose community health services for medical treatment included income,payment terms of medical fees,reasonable prices,medical fees,and expenses for medications,while factors influencing suburban residents to choose community health services for medical treatment included income,level of education,carrier,medical institutions selected when feeling severely ill,availability of preventive health services,availability of health counseling services,medical fees,and expenses for medications.Based on an analysis of the results by means of unconditioned binary logistic stepwise regression,the factors influencing whether or not the urban residents chose community health services for medical treatment included gender,age,level of education,payment terms of medical fees,treat-ment environment,and expenses for medications,while the factors influencing suburban residents included availability of preventive health services and expenses for medications.Conclusion:There was a difference between the types of community health services selected by residents in urban and suburban areas of Nanjing and factors influencing the selection of ser-vices were different.Community health service institutions in different areas should strengthen their own service capability according to the local residents’health demands.
基金Kristianstad University The Research Board Kristianstad University
文摘This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenological-hermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.
