Analysis of Professional Quality Cultivation Strategies for Infant and Child Care Service Talents from the Perspective of Collaboration of Medical Care,Parenting,and Education,and Integration of Industry and Education

The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.

Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China

Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

Exploration on the Implementation of the Integration of Medical and Preventive Model in China’s Primary Health Care Institutions

Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.

Implementation Strategy of“Eight in One”of Integrated Medical and Care Service System in China:A Case Study of Anshan City of Liaoning

With the gradual intensification of aging in China,the issue of elderly care has become the primary issue that needs to be urgently solved in society.The construction of a reasonable and scientific integrated medical and care service system can not only efficiently allocate medical resources and services,but also better meet the needs of the elderly.Due to the involvement of multiple disciplines such as architecture,sociology,psychology,and behavioral science in the construction of the system,as well as the restriction of various objective factors such as medical capacity,spatial scale,and operating costs,the government and elderly care institutions have always been unable to find the best solution for how to scientifically and reasonably construct an integrated medical and care service system.This paper is based on Anshan City,Liaoning Province,which has prominent aging issues and distinct characteristics of the elderly population.Through extensive field research in elderly care institutions,and face-to-face communication with personnel from relevant government departments such as the Municipal Commission on Aging,the Civil Affairs Bureau,the Health Commission,the Medical Insurance Bureau,and the Human Resources and Social Security Bureau,it truly understands the problems that arise in the construction of the urban integrated medical and care service system.From three aspects:urban situation,institutional situation and the needs of the elderly,it is proposed to establish a clear departmental linkage mechanism with clear rights and responsibilities,a policy guarantee mechanism tailored to local conditions,a multi-measure operation mechanism,a technology first intelligent response mechanism,a warm and efficient service mechanism for the people,an overall layout mechanism,an evaluation and supervision mechanism for full process control,and a talent supply mechanism of external introduction and internal training.It aims to provide reference for the construction of an integrated medical and care service system in similar cities.

Exploration and Research on the Integrated Development of“Internet Plus Medical Treatment”

Objective To analyze the development of“internet plus medical treatment”and to explore advantages.Methods The literature of“internet plus medical treatment”was systematically combed and analyzed.Results and Conclusion After exploring the status quo of“internet plus hospitals”,smart pharmacy and web-assisted health management in China,we find that there are some problems in the medical service at present,such as the imperfect laws and regulations,the hidden dangers of information security and the obstacles of medical insurance payment.Therefore,we propose that the development of web-assisted medical service should be led by the government and relevant policies must be improved.Then,self-regulation should be strengthened,and industry standards should be enhanced.Three suggestions are made to improve medical insurance payment and benefit both hospitals and patients,which can provide reference for promoting the development of“internet plus medical treatment”in China.

Integration of Cervical Cancer Screening Services in the Routine Examinations Offered in the Kenyan Health Facilities: A Systematic Review

Cervical cancer is the second most common cancer among women and the leading cause of deaths among women worldwide. In Kenya, uptake of screening services is at 3.2% below the targeted of 70%. Therefore, there is need to study the factors that lead to low uptake of the screening services. One way of increasing the uptake of the screening services is its integration with other routine services, thus leading to a reduction in morbidity and mortality rates associated with the disease. The objective of this study was to review and examine the importance of integrating cervical cancer screening services in the routine examinations offered in the Kenyan health facilities. A retrospective study design was adopted by this study. The review of articles, journals, strategic plans was done from the year 2012 to 2017. Data sources included Medline, PMC, Library, Pubmed, Google scholar, cancer prevention plans and strategies. About 28 data sources were reviewed with 78.5% indicating that increased knowledge and creation of awareness on cervical cancer would greatly improve the utilization of the screening services. More than 87% of the information collected among published work in Kenya demonstrated that knowledge on importance cervical cancer screening is inadequate. The primary results of this study suggest that all women of reproductive age (WRA) should undergo cervical cancer screening as a routine service. An integration approach should be adopted, to enhance knowledge on cervical cancer and the importance of screening, causes, preventive and treatment options. The study recommends that, the Government of Kenya through the Ministry of health should include cervical cancer screening as a routine procedure for all WRA.

Ontological Model for Cohesive Smart Health Services Management

Health care has become an essential social-economic concern for all stakeholders(e.g.,patients,doctors,hospitals etc.),health needs,private care and the elderly class of society.The massive increase in the usage of health care Internet of things(IoT)applications has great technological evolvement in human life.There are various smart health care services like remote patient monitoring,diagnostic,disease-specific remote treatments and telemedicine.These applications are available in a split fashion and provide solutions for variant diseases,medical resources and remote service management.The main objective of this research is to provide a management platform where all these services work as a single unit to facilitate the users.The ontological model of integrated healthcare services is proposed by getting requirements from various existing healthcare services.There were 26 smart health care services and 26 smart health care services to classify the knowledge-based ontological model.The proposed ontological model is derived from different classes,relationships,and constraints to integrate health care services.This model is developed using Protégébased on each interrelated/correlated health care service having different values.Semantic querying SPARQL protocol and RDF query language(SPARQL)were used for knowledge acquisition.The Pellet Reasoner is used to check the validity and relations coherency of the proposed ontology model.Comparative to other smart health care services integration systems,the proposed ontological model provides more cohesiveness.

Impact of the New Cooperative Medical Scheme on Health Care Service Utilization in Rural China

Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.

On Rural Medical Care and Health Undertaking Development during New Medical Reform

Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

The Pathway of China’s Integrated Delivery System:Based on the Analysis of the Medical Consortium Policies

With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery system,a medical consortium plays an important role in integrating public hospitals and primary care facilities.The first medical consortium policy issued after the COVID-19 pandemic apparently placed hope on accelerating the implementation of a medical consortium and tiered health-care delivery system.This paper illustrates the possible future pathway of China’s medical consortium through retrospection of the 10-year process,changes of the series of policies,and characteristics of the policy issued in 2020.We considered that a fully integrated medical consortium would be a major phenomenon in China's medical industry,which would lead to the formation of a dualistic care pattern in China.

Classification,prevalence and integrated care for neurodevelopmental and child mental health disorders:A brief overview for paediatricians

‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including autism spectrum disorder,attention deficit/hyperactivity disorder,tic disorder/Tourette’s syndrome,developmental language disorders and intellectual disability.Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability.Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm.Together these are referred to as neurodevelopmental,emotional,behavioural,and intellectual disorders(NDEBIDs)in this paper.Varying prevalence rates for NDEBID have been reported in developed countries,up to 15%,based on varying methodologies and definitions.NDEBIDs are commonly managed by either child health paediatricians or child/adolescent mental health(CAMH)professionals,working within multidisciplinary teams alongside social care,education,allied healthcare practitioners and voluntary sector.Fragmented services are common problems for children and young people with multi-morbidity,and often complicated by subthreshold diagnoses.Despite repeated reviews,limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research.The recently developed“Mental,Behavioural and Neurodevelopmental disorder”chapter of the International Classification of Diseases-11 offers a way forward.In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID,enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.

Evaluation and Analysis of Hospital Disaster Preparedness in Jeddah

Introduction: Disaster damage to health systems is a human and health tragedy, results in huge economic losses, deals devastating blows to development goals, and shakes social confidence. Hospital disaster preparedness presents complex clinical operation. It is difficult philosophical challenge. It is difficult to determine how much time, money, and effort should be spent in preparing for an event that may not occur. Health facilities whether hospitals or rural health clinics, should be a source of strength during emergencies and disasters. They should be ready to save lives and to continue providing essential emergencies and disasters. Jeddah has relatively a level of disaster risk which is attributable to its geographical location, climate variability, topography, etc. This study investigates the hospital disaster preparedness (HDP) in Jeddah. Methods: Questionnaire was designed according to five Likert scales. It was divided into eight fields of 33 indicators: structure, architectural and furnishings, lifeline facilities’ safety, hospital location, utilities maintenance, surge capacity, emergency and disaster plan, and control of communication and coordination. Sample of six hospitals participated in the study and rated to the extent of disaster preparedness for each hospital disaster preparedness indicators. Two hazard tools were used to find out the hazards for each hospital. An assessment tool was designed to monitor progress and effectiveness of the hospitals’ improvement. Weakness was found in HDP level in the surveyed hospitals. Disaster mitigation needs more action including: risk assessment, structural and non-structural prevention, and preparedness for contingency planning and warning and evacuation. Conclusion: The finding shows that hospitals included in this study have tools and indicators in hospital preparedness but with lack of training and management during disaster. So the research shed light on hospital disaster preparedness. Considering the importance of preparedness in disaster, it is necessary for hospitals to understand that most of hospital disaster preparedness is built in the hospital system.

Service Delivery Factors That Influence Utilization of HIV Integrated Primary Health Care Programme in Embu Referral Hospital, Kenya

Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served;they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.

Insights into the Social Determinants of Health in Older Adults

In this paper, we review the social determinants of health in older adults and their complex interrelationship with medical diseases. Also, we provide recommendations to address these determinants in the integrated healthcare plan. The social determinants in older adults and its influence in health outcomes have been studied for decades. There is solid evidence for the interrelationship between social factors and the health of individuals and populations;however, these studies are unable to define their complex interrelatedness. Health is quite variable and depends on multiple biological and social factors such as genetics, country of origin, migrant status, etc. On the other hand, health status can affect social factors such as job or education. Addressing social determinants of health in the integrated healthcare plan is important for improving health outcomes and decreasing existing disparities in older adult health. We recommend a person-centered approach in which individualized interventions should be adopted by organizations to improve the health status of older adults at the national and global level. Some of our practical recommendations to better address the social determinants of health in clinical practice are EHR documentation strategies, screening tools, and the development of linkages to the world outside of the clinic and health system, including social services, community activities, collaborative work, and roles for insurance companies.

The Prevention and Control Measures of COVID-19 in the People’s Hospital of Pingchang County

COVID-19 (COVID-19) or COVID-19 is pneumonia caused by the novel coronavirus infection in patients in 2019. COVID-19 pneumonia epidemic is widespread, wide, and deep. To effectively combat the further spread of COVID-19: the overall protocol of the hospital: “three lines of defense” of community prevention and control, fever clinic and face-to-face treatment;grasp the good three-time limits: “2 hours, 12 hours and 24 hours”;do a good job of three key points: key areas and places and groups;carry out four early prevention and control measures: early detection, early reporting, early isolation and early treatment;management of confirmed, suspected, fever, close contact “four types of personnel”;implement l responsibility system;doing all receivable, should be treated, should be checked, should be separated by “four should be”;do investigation, control, supervision, education, and care “five in place”. Through the above methods, the People’s Hospital of Pingchang County has effectively controlled COVID-19.

Financial Sustainability of a Public or Private Health System,a Condition for a Romania With a Healthy Population

Can Romania have a sustainable health system,so that the population can choose medical services at a state hospital or at a private hospital?A healthy state,with a healthy population,can ensure a viable balance with a secure future.Each country ensures its health system through levers,policies,and well-defined sources of funding,determined by demographics,geographical position,culture,nationality,has the necessary sources to implement its own health system,whether it is public or private.The programs that can be implemented in the health system start from the quality of medical services,which must be provided so that each patient can be sure that medical needs are achievable.We have a people with diverse traditions,a beautiful culture,specialized doctors and yet the medical system is still fragile.Funding programs must help us start this health system,build many private hospitals,so from prevention to services specialized,surgical,to be able to bring in the country specialized medical staff to us but gone to many states of the world.Any change can lead us to what we want,the health of our population in the village,the city,the majority of the population,the identification of possibilities to revive the health system.The market of private health systems,diversified by international players,bank brokers,manages to bring important changes in the health system.From a technical point of view,health insurance has its originality in the impossibility of being able to predict the insured’s illness and the costs necessary for recovery.Any risk related to personal injury,illness,temporary incapacity for work,can be identified,assessed in the form of medical expenses,loss of income,as a result,disability,borne by both the individual and the family,due to the inability to insure a normal activity,daily existence.Insurance can be considered as a method of controlling the health risk.The current situation regarding the disease of the population whit COVID often makes us understand that we must be prepared at all times.The situation of the pandemic SARS-COV 19 found a timely solution through the private health system.

医防融合的关键问题、机制创新与实现路径

我国医疗服务与公共卫生服务相互割裂的问题由来已久,医防融合是新时代背景下实现健康中国战略的重要举措。当前,在医防融合试点实践中,存在医疗卫生服务体系多头管理、紧密型医联体尚未真正形成、医院“重医轻防”理念仍未转变、医防信息不能互联互通等问题。对此,可以借鉴宿迁的经验,从组织管理、医防服务供给、卫生筹资、医防人才与医防信息等方面入手,实现医防融合的机制创新,在此基础上,将医防融合作为常态化制度持续向纵深推进。

中国基层医疗服务发展对老年人健康的影响

实现健康老龄化是我国积极应对人口老龄化的一项重要战略任务。老年人的健康状况和医疗服务需求特点决定了基层医疗服务在促进老年健康中的重要地位。基层医疗服务发展对老年人健康具有重要影响。分析评估我国基层医疗服务发展的成就和不足,更好地发挥基层医疗服务在促进健康老龄化和建设健康中国中的作用具有重要的现实意义。本文从老年人感知的基层医疗服务可及性、服务可得性和服务适配性三个维度构建反映基层医疗服务发展水平的综合指标,利用2015年和2018年中国健康与养老追踪调查(CHARLS)数据,实证检验和分析我国基层医疗服务发展水平对老年人健康的影响及其作用机制。研究发现老年人感知的基层医疗服务发展水平越高,自评健康水平就越高,自评健康改善状况也越好,说明基层医疗服务发展对老年人健康具有积极作用,且结论具有稳健性。基层医疗服务发展会改善医疗服务便利性,降低医疗服务费用,促进老年人的医疗服务利用,降低老年人医疗服务需求未满足的程度;基层医疗服务还担负着向辖区居民开展疾病预防与控制、健康教育、居民健康档案管理、慢性病患者健康管理、老年健康与医养结合服务等初级卫生保健服务的职责,可以改善老年人健康管理水平;基层医疗服务发展能够提高老年人健康素养,有助于培养健康生活方式与行为,最大限度消除健康危险因素,从而促进老年人健康。机制检验发现医疗服务需求满足程度、健康管理状况、健康素养与行为在基层医疗服务发展影响老年人健康过程中发挥了部分中介作用。异质性分析结果表明基层医疗服务发展对老年健康的影响在不同地区、不同年龄阶段、不同收入水平和健康状况的老年群体之间存在显著差异。中西部地区和农村地区老人、中低龄老人、低收入老人和罹患慢性病的老人从基层医疗服务发展中受益更大。政府应进一步优化基层医疗资源配置,增强基层医疗服务能力,增加服务供给,在提高老年人医疗服务需求满足程度的同时提高老年人健康管理水平,提升老年人健康素养,培养健康行为方式,更好地发挥基层医疗服务促进老年人健康的作用。

人口老龄化背景下体育消费的健康效应——基于全国消费大数据的实证证据

基于健康资本需求理论将体育消费视作一种健康投资,提出个体体育消费的增长可降低其医疗消费支出的假设;采用2018—2021年全国消费大数据,实证检验个体体育消费的健康效应。结果显示,体育消费占个体年度总消费的比例每提高1个单位,医疗消费占个体年度总消费的比例降低0.203个单位。新冠病毒感染疫情对体育消费的健康效应有所抑制但依然显著。进一步分析表明,体育消费的健康效应对35岁及以上人群的影响会随着年龄的增长明显增强,对65岁及以上老龄人口的影响效果最为突出。认为:在应对人口老龄化和医疗负担增加等重大挑战时,需要加快普及对体育消费的健康效应认知,大力促进全人群体育消费。

中国社会医疗保险制度未来发展的挑战与创新建议

中国社会医疗保险制度发展至今,已覆盖了95%以上的人口,筹资和报销待遇都达到了与国民经济所处的中等收入国家地位相称的水平,但也存在不同人群待遇相差悬殊、医保基金使用效率不高的问题。未来需要从实现公平的国民待遇、进行科学的医保筹资规划、制定统一的医疗服务价格、设计合理的医保报销政策、明确划分中央与地方政府的职责等方面,正视挑战,创新发展,避免医保制度发展的中等收入陷阱。