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 interview...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.展开更多
Background:Primary health care system is a critical component of diabetes care and management.This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions(PHIs)in China,and t...Background:Primary health care system is a critical component of diabetes care and management.This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions(PHIs)in China,and to explore the relationship between availability of glucose-lowering drugs and medication adherence among type 2 diabetes mellitus(T2DM)patients.Methods:This cross-sectional study conducted in Shandong Province,eastern China(hereafter referred to as Shandong),between August and December 2017.In total,2520 community-managed T2DM patients were selected from 68 PHIs in Shandong,including 62 village-level and 6 township-level PHIs.The self-developed questionnaire was used to survey the availability of glucose-lowering drugs in PHIs.Patients’medication adherence was assessed by four self-reported questions,and was classified as either adherent or non-adherent.Descriptive statistics was used to analyze the availability of glucose-lowering drugs in PHIs and the medication adherence among the T2DM patients.Multilevel logistic regression models were used to explore the relationship between the availability of glucose-lowering drugs in PHIs and patients’medication adherence.Results:A total of 1866 T2DM patients prescribed with at least one glucose-lowering drug were included in analysis.Among them,58.5%patients followed their antidiabetic treatment well.In village-level PHIs,the patient’s adherence rate was lower than in township-level PHIs(55.9%vs.61.1%,P<0.05).Among the 68 PHIs,average(2.53±0.97)glucose-lowering products(generic names)were available,which in village-level PHIs were less than in township-level PHIs(2.47 vs.3.17,P<0.05).And the number of available glucose-lowering products in PHIs was associated with the adherence of T2DM patients.Conclusion:Poor availability of glucose-lowering products was found in PHIs in Shandong.The availability of glucose-lowering products in PHIs was positively associated with patients’medication adherence,and could be enhanced to improve the control of diabetes in primary care settings.展开更多
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. Result...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.展开更多
基金Source of the project:the Social Science Planning Fund Project of Liaoning Province(L19BG034)the Philosophy and Social Science Planning Key Project of Shenyang City(SZ202001L)the Key Project of Shenyang Social Science Funding(SYSK2020-04-01).
文摘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.
基金funded by the Key Research and Development Program of Shandong Province(Grant No.2018GSF118184).
文摘Background:Primary health care system is a critical component of diabetes care and management.This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions(PHIs)in China,and to explore the relationship between availability of glucose-lowering drugs and medication adherence among type 2 diabetes mellitus(T2DM)patients.Methods:This cross-sectional study conducted in Shandong Province,eastern China(hereafter referred to as Shandong),between August and December 2017.In total,2520 community-managed T2DM patients were selected from 68 PHIs in Shandong,including 62 village-level and 6 township-level PHIs.The self-developed questionnaire was used to survey the availability of glucose-lowering drugs in PHIs.Patients’medication adherence was assessed by four self-reported questions,and was classified as either adherent or non-adherent.Descriptive statistics was used to analyze the availability of glucose-lowering drugs in PHIs and the medication adherence among the T2DM patients.Multilevel logistic regression models were used to explore the relationship between the availability of glucose-lowering drugs in PHIs and patients’medication adherence.Results:A total of 1866 T2DM patients prescribed with at least one glucose-lowering drug were included in analysis.Among them,58.5%patients followed their antidiabetic treatment well.In village-level PHIs,the patient’s adherence rate was lower than in township-level PHIs(55.9%vs.61.1%,P<0.05).Among the 68 PHIs,average(2.53±0.97)glucose-lowering products(generic names)were available,which in village-level PHIs were less than in township-level PHIs(2.47 vs.3.17,P<0.05).And the number of available glucose-lowering products in PHIs was associated with the adherence of T2DM patients.Conclusion:Poor availability of glucose-lowering products was found in PHIs in Shandong.The availability of glucose-lowering products in PHIs was positively associated with patients’medication adherence,and could be enhanced to improve the control of diabetes in primary care settings.
基金Supported by Humanities and Social Science Research Project of the Ministry of Education in 2010 (10YJC840088)
文摘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.
