Investigation and Analysis of Lung Cancer Risk Factors in the Health Check-Up Population

Objective: To investigate and analyze the risk factors of lung cancer in the population of health checkups. Methods: A total of 500 cases of the health check-up population were selected for data study. Surveyed showed that 19 cases of lung cancer were grouped as the lung cancer group and the remaining 481 cases made up the control group, and the risk factors were analyzed. Results: Among men, there was a significant proportion of individuals aged 60-69 years old, and women aged 30-39 years old. Additionally, individuals aged 60 and above were at increased risk of developing lung cancer. The results of the multifactorial analysis were that the risk factors affecting the detection of lung cancer in healthy people were smoking history, family history of lung cancer, secondhand smoke, history of respiratory diseases, psychosomatic factors, living environment, and kitchen fumes. Conclusion: People over 60 years of age were prone to early lung cancer, followed by individuals aged 30-39 years. It is important to identify the risk factors of lung cancer to strengthen the screening of high-risk groups for early detection and treatment.

Analysis of the Prevalence Characteristics of Lung Nodules and Their Influencing Factors in The Health Check-Up Population

Objective: To study the prevalence characteristics of pulmonary nodules and their influencing factors in the health check-up population. Methods: A total of 500 cases of health checkups were selected for the data study to analyze the detection and prevalence characteristics of pulmonary nodules. The influencing factors between the pulmonary nodules group and the no pulmonary nodules group were analyzed. Results: A total of 209 cases were detected, of which there were more males than females, and for female patients, the detection rate increased with age (P < 0.05). The distribution of gender, age, smoking, respiratory symptoms, and exposure to kitchen fumes between the two groups was compared (P < 0.05). The multifactorial analysis concluded that risk factors include, respiratory symptoms, older age, exposure to kitchen fumes, and smoking. In addition, patients who exercised more had a lower risk of developing lung nodules. Conclusion: The detection rate of pulmonary nodules was high in the health check-up population and the influencing factors analyzed involved the presence of respiratory symptoms, older age, kitchen fume exposure, and smoking, while the positive influencing factor was increased exercise.

Integration of Medical Care and Endowment: A New Exploration of Endowment Mode in the Context of Population Aging

China's aging pressure is increasingly serious. The elderly people are difficult to seek medical advice,the elderly dependency ratio is soaring,finance fails to bear such heavy load,and social endowment service pressure is also constantly increasing. Traditional endowment mode is already incapable of satisfying current endowment demands. On the basis of the population aging,this paper came up with the new endowment mode " hospital + nursing home" and analyzed its feasibility. Finally,it reached the conclusion that this endowment mode is helpful for solving problems of endowment and medical care,and alleviating the problem of population aging.

The Impact of Population Aging on the Expenditure of Medical Insurance Fund for Urban Workers in China

Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through analyzing the impact of the population aging,the income and accumulated balance of the medical insurance fund,and other related factors on the expenditure of the medical insurance fund,development status of the medical insurance fund for urban employees in China since 2003 was obtained.Stata 16.0 was used to perform multiple linear regression analysis on related factors to determine the correlation between population aging and the change in medical insurance expenditures.Results and Conclusion The factors that have a greater impact on the expenditure of the medical insurance fund are the amount of income from the medical insurance,followed by the number of people over the age of 65 in China and the urban retired employees participating in medical insurance.We should focus on the sustainable development of the urban employee medical insurance fund to deal with the threat of aging.

Development of Medication Literacy Scale for Pediatric Population with Nephrotic Syndrome and Assessment on Reliability and Validity

Objective:To develop a medication literacy scale for the pediatric population with nephrotic syndrome(NS)in order to evaluate its reliability and validity.Methods:According to the medication belief scale,specific medication beliefs,and self-set dimensions,the NS pediatric population health literacy scale was designed to evaluate the medication literacy of 120 children with NS.Items,homogeneity,reliability,and validity of the scale were analyzed.Results:There were statistically significant differences in the Levene F test between the top 27%and the last 27%of the 22 items(P<0.001).The differences in the t-test were statistically significant(P<0.001).Content validity I-CVI:after deletion of item 4,the I-CVI of other items were all higher than 0.91.S-CVI was higher than 0.80,and S-CVI/AVE was higher than 0.90.The internal consistency coefficient(Cronbach'sα)was 0.868.Structural validity:KMO(Kaiser-Meyer-Olkin)statistical value was 0.862,and Bartlett's spherical test value was 1578.172(P<0.001).The extracted 6 common factors explain 70.21%of the variance variation.The loads of 22 items on their main factors are all greater than 0.427 except items 2 and 5.Conclusion:The medication literacy scale for the NS pediatric population has proved its good practicability,but some items of cognition need to be further explored.

Deep Forest-Based Fall Detection in Internet of Medical Things Environment

This article introduces a new medical internet of things(IoT)framework for intelligent fall detection system of senior people based on our proposed deep forest model.The cascade multi-layer structure of deep forest classifier allows to generate new features at each level with minimal hyperparameters compared to deep neural networks.Moreover,the optimal number of the deep forest layers is automatically estimated based on the early stopping criteria of validation accuracy value at each generated layer.The suggested forest classifier was successfully tested and evaluated using a public SmartFall dataset,which is acquired from three-axis accelerometer in a smartwatch.It includes 92781 training samples and 91025 testing samples with two labeled classes,namely non-fall and fall.Classification results of our deep forest classifier demonstrated a superior performance with the best accuracy score of 98.0%compared to three machine learning models,i.e.,K-nearest neighbors,decision trees and traditional random forest,and two deep learning models,which are dense neural networks and convolutional neural networks.By considering security and privacy aspects in the future work,our proposed medical IoT framework for fall detection of old people is valid for real-time healthcare application deployment.

Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Background: Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. Objective: The objective was to determine the diagnostic yield and cost-effectiveness of chest radiography during periodic medical check-ups of workers in Ngaoundere. Materials and Methods: A cross-sectional and descriptive study was carried out in Ngaoundere Regional Hospital from January to December 2018, concerning all persons coming to perform a systematic chest X-ray in the context of the periodic medical check-up having been consented to participate in the study. Posteroanterior (PA) chest radiographs were obtained from all workers during this periodic medical check-up. The variables studied were: age, sex, clinical manifestations, antecedents, job type, cost, and chest X-ray results. Statistical analysis was performed using the Sphinx Plus2-Lexica-V5 Edition software. Results: 753 workers were selected for this study, of whom 88.04% were men and 11.96% were women, a sex ratio H/F is of 7.4, the average age was 39 ± 7.89 years with extremes of 24 and 56 years, the most frequent job type was the administration (38.37%), the storekeepers (17.92) and the drivers (15.27%), most of them were asymptomatic (97.47%), some had cough (2.52%), chest pain (2.12%), dyspnea (0.26%) and fever (0.13%). History was dominated by lung infection (2.39%), pleurisy (1.06%) and tuberculosis (0.79%). 7.43% of workers occasionally smoked tobacco and consumed alcohol. 41 cases of pathologies (5.44%) were found on the chest X-ray, including 1 case (0.13%) of evolutionary pathology, 40 cases (5.31%) of sequelae pathologies. When the results of the chest X-ray are compared with the clinical signs and the pathological history of the workers, it is found that the only case with evolutionary abnormalities on the chest X-ray showed clinical signs and that the other cases with sequelae abnormalities had either clinical signs or antecedents related to these abnormalities. The cost of a chest X-ray at the time of our study was 5,000 FCFA ($8.59), for a total of 3,765,000 FCFA ($6473.74) for all the X-rays performed. Conclusion: In view of the low rate of abnormalities on the chest X-ray and the sequelae nature of the pathologies, it can be said that the routine X-ray of the chest during the periodic medical check-ups has a low diagnostic yield and a low cost-effectiveness ratio and is not profitable. It should be non-systematic and case-by-case based on the clinical context and background of workers.

What does the development of medical tourism in Barbados hold for health equity?an exploratory qualitative case study

Background:Although the global growth of privatized health care services in the form of medical tourism appears to generate economic benefits,there is debate about medical tourism’s impacts on health equity in countries that receive medical tourists.Studies of the processes of economic globalization in relation to social determinants of health suggest that medical tourism’s impacts on health equity can be both direct and indirect.Barbados,a small Caribbean nation which has universal public health care,private sector health care and a strong tourism industry,is interested in developing an enhanced medical tourism sector.In order to appreciate Barbadians’understanding of how a medical tourism industry might impact health equity.Methods:We conducted 50 individual and small-group interviews in Barbados with stakeholders including government officials,business and health professionals.The interviews were coded and analyzed deductively using the schedule’s questions,and inductively for novel findings,and discussed by the authors.Results:The findings suggest that in spite of Barbados’universal health care and strong population health indicators,there is expressed concern for medical tourism’s impact on health equity.Informants pointed to the direct ways in which the domestic population might access more health care through medical tourism and how privately-provided medical tourism in Barbados could provide health benefits indirectly to the Barbadian populations.At the same time,they cautioned that these benefits may not materialize.For example,the transfer of public resources-health workers,money,infrastructure and equipment-to the private sector to support medical tourism with little to no return to government revenues could result in health inequity through reductions in access to and availability of health care for residents.Conclusions:In clarifying the direct and indirect pathways by which medical tourism can impact health equity,these findings have implications for health system stakeholders and decision-makers in Barbados and other countries attempting both to build a medical tourism industry and to protect health equity.

The Development Opportunities and Dilemmas of Telemedicine - Base on the Perspective of Medical Resource Distribution

Objective To discuss issues related to telemedicine in the context of the“Internet plus”and the prevention of novel coronavirus in early 2020,so as to provide some reference for the rapid development of Internet plus telemedicine.Methods Literature analysis method was used to summarize the current status of telemedicine at home and abroad.Descriptive statistical analysis and comparative analysis were also conducted to analyze the data of population and health in the“China Health Statistical Yearbook”and“China Statistical Yearbook”from 2009 to 2018.Results and Conclusion The distribution of medical demand and medical resources is uneven in 31 provinces,municipalities and autonomous regions,such problems are more serious between urban and rural areas in different regions.The population’s demand for medical care and the allocation of medical resources have the characteristics of positive correlation,large urban-rural differences and regional imbalance.Confronted with the situation that the uneven distribution of medical resources provides potential development opportunities for telemedicine and the difficulties in the further development of telemedicine,the government should formulate policies to improve the publicity of telemedicine,setting up a full coverage of telemedicine service system.Besides,hospitals should ensure the information security monitoring.

“苏适养老”服务高质量发展的优化策略研究

推进养老服务高质量发展是实施积极应对人口老龄化国家战略的重要议题。江苏省在积极推进“苏适养老”服务发展方面采取了一系列措施,然而与经济社会发展和老年人对高品质健康养老生活的美好期待相比,江苏省养老服务在有效供给、均衡发展、人才保障和智慧改造等方面还存在提升空间。江苏省持续擦亮“苏适养老”服务品牌,党的领导是根本保证,普惠是首要要求,农村是关键难点,医疗是核心需求,人才是重要基础,智慧是发展方向。因此,应持续加强党的统一领导,明确部门职责和分工,高位统筹推动养老服务现代化治理体系建设;完善兜底性、普惠型和多样化养老服务体系,满足老人多层次养老需求;加快补齐农村养老服务短板,推动养老服务资源在全省范围内的协调均衡发展;建设医养康养服务联合体,提升医养结合服务质量;加强专业化职业化人才队伍建设,激发养老服务人才动能;打造智慧健康养老新业态,推动银发经济发展壮大。

A population-based approach to the management of depression in a patient-centered medical home

Objective:This article describes the implementation of a population-based strategy to man-age depression in a patient-centered medical home.Methods:Review of English language articles;description of specific protocols utilized in one medical home.Results:Depression is a global concern estimated to affect 350 million people worldwide.Rates for depression vary between the United States and the Peoples’Republic of China,possibly due to significant factors in under diagnosis of this often hidden burden.Given the comorbidity of depres-sion with other health factors and the need for ongoing monitoring and care of this chronic illness,primary care has become a significant part of treatment interventions.Utilizing electronic health records(EHR),our strategy included the creation of a patient registry;selection of evidence-based treatment guidelines and protocols for point of care procedures;patient outreach and screening.Conclusion:The population-based program we outline is highly dependent on the EHR and the flexibility of roles and responsibilities of clinical staff.Further investigation is warranted into improved patient outcomes.

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。

人口老龄化背景下辽宁省实施智慧医养服务有效路径分析

随着全球人口老龄化程度的加深,我国迎来了“银发时代”,养老问题在面临严峻挑战的同时也衍生出了新的机遇.目前,辽宁省已经进入深度老龄化社会,随着人们养老需求的增加及电子信息技术的飞速发展,智慧医养成为老龄化时代的必然产物.通过对国家统计局、中国互联网络信息中心、智慧医养等相关平台发布的数据进行统计、对比分析,发现辽宁省实施智慧医养服务面临着在老年群体中推广度较低、覆盖面不全、基础有待提升、网络信息平台存在安全隐患等困境,最终从4个方面提出针对辽宁省实施智慧医养服务的有效实施路径,希望能够以此促进辽宁省智慧医养服务高质量发展,对辽宁经济的发展及健康中国战略的实施起到一定的推动作用.

北京市医药分开、医耗联动综合改革前后老年人群医疗机构治疗费用流向研究

目的通过研究北京市医药分开、医耗联动综合改革前后老年人群医疗机构治疗费用流向变化,为优化老年患者就诊流向提供数据参考。方法采用多阶段分层整群抽样方法获取样本,基于《卫生费用核算体系2011》核算老年人群的治疗费用。结果2016—2019年北京市老年人群医疗机构治疗费用由604.57亿元增长至797.54亿元,年均增速为6.83%,其中社区卫生服务中心治疗费用增长最快,增速达24.04%,治疗费用占比由11.31%增长至17.71%,三级医院治疗费用占比下降4.39个百分点。门诊患者治疗费用流向优化明显,低龄老年门诊患者更愿意在社区就诊,但高龄老年患者门诊流向优化更明显。内分泌、营养和代谢疾病,神经系统疾病等慢性病老年门诊患者治疗费用大幅度流向社区卫生服务中心。结论改革对不同年龄和疾病的老年患者就诊影响不同,建议加强基层医疗卫生机构服务能力建设,凸显二级医院发展特色,精准完善老年患者分级诊疗体系。

我国养老产业发展“拐点”研判——基于多案例研究的典型事实

随着人口老龄化进程加速,我国的养老需求结构正在从生存型向发展型转变,这将为养老产业的发展带来广阔的市场空间,但当前我国养老产业发展相对滞后,仍面临严重的发展困境。我国养老产业发展的“拐点”何时到来?为回答好这个问题,本文以案例研究和实证分析相结合的研究框架,首先,以法、德、日、美四国为例,系统梳理其养老产业发展历程,总结归纳出养老产业发展“拐点”出现的共性特征;其次,聚焦日本养老产业发展轨迹,重点关注其介护险实施前后养老产业相关重要指标变化;最后,选取九个养老产业相关指标,基于指数平滑、灰色模型等方法对中国养老产业未来情况进行预测,并与日本可比时期指标情况进行比较,判断中国养老产业“拐点”出现的可能时间。研究发现:养老产业发展“拐点”的出现具有四个共性特征,分别是三支柱养老金体系改革、长护险制度全面实施、多元化服务助推医养结合、代际转换背后的产业增量机会,而中国养老产业发展“拐点”可能出现的窗口期将在2026—2030年间。

基于Fairlie分解的流动人口灾难性医疗支出的城乡差异及影响因素分析

目的:分析流动人口灾难性医疗支出的城乡差异及影响因素,为促进城乡流动人口健康公平提供建议参考。方法:基于2018年全国流动人口动态监测调查,运用卡方检验探究城乡流动人口特征分布差异,利用基于logistic回归的Fairlie分解法分析流动人口灾难性医疗支出的城乡差异及影响因素。结果:流动人口灾难性医疗支出发生率为24.25%,其中城镇发生率显著低于农村(P<0.05);Fairlie分解显示流动人口灾难性医疗支出的城乡差异中特征效应占95.53%,系数效应占4.47%,收入水平、健康状况、婚姻情况、医保报销情况及是否接受健康教育对该差异产生作用(P<0.05)。结论:农村流动人口的灾难性医疗支出风险高于城镇,收入水平和健康状况差异起主要作用。应加强农村流动人口的健康教育与劳动保障,提高城乡健康公平性,通过改进医保报销机制缩小流动人口灾难性医疗支出的城乡差异。

老年友善医院建设需求研究和对策建议

人口老龄化是社会发展的必然趋势,也是今后较长一段时期我国的基本国情,如何基于适老性原则开展老年友善医院的统一规划和建设,医疗机构亟待进行“适老化”的友善服务改善,促进医院为老年患者创造安全、友善、适宜的就医环境,不断提高老年患者就医质量。笔者通过对老年友善医院建设的现状、面临的难点问题和老年患者需求等进行分析研究,并提出对策建议,从而建立老年人保健服务机制,推动我国老年医学发展,更好地满足老年人保健。

人口老龄化背景下辽宁省实施智慧医养服务有效路径分析

随着全球人口老龄化程度的加深,我国迎来了“银发时代”,养老问题在面临严峻挑战的同时也衍生出了新的机遇。目前,辽宁省已经进入深度老龄化社会,随着人们养老需求的增加及电子信息技术的飞速发展,智慧医养成为老龄化时代的必然产物。通过对国家统计局、中国互联网络信息中心、智慧医养等相关平台发布的数据进行统计、对比分析,发现辽宁省实施智慧医养服务面临着在老年群体中推广度较低、覆盖面不全、基础有待提升、网络信息平台存在安全隐患等困境,最终从4个方面提出针对辽宁省实施智慧医养服务的有效实施路径,希望能够以此促进辽宁省智慧医养服务高质量发展,对辽宁经济的发展及健康中国战略的实施起到一定的推动作用。

低收入人口疾病返贫风险与医疗保障现状研究--基于Z县的实证分析

本文通过对西南地区Z县的实证分析,揭示了低收入人口的实际医疗费用支出及保障效果。研究发现,尽管三重保障在减轻低收入患者医疗负担方面发挥了积极作用,但是大病患者仍面临较高返贫风险。Z县医疗支出数据表明,低收入大病患者的名义报销比例处于较高水平,但实际报销比例相对较低,自付费用较高;另外,大病保险报销具有“雨露均沾”倾向,未能集中将有限资源向重特大病患者倾斜,难以减轻患者大额医疗费用支出负担。建议扩大城乡居民基本医保报销目录,降低患者政策报销范围外的支出压力;完善大病保险机制,增强精准保障能力,优化报销结构;构建多元保障体系,进一步降低大病患者的返贫风险。通过上述措施的优化,或可在共同富裕背景下有效提升低收入人口的医疗保障水平,促进健康公平。

基于农村空巢老人健康需求状况的医疗服务可及性研究

实施积极应对人口老龄化国家战略,提高农村社区医疗服务可及性,为老年人提供高质量的老年健康服务,是我国坚持以人民为中心发展思想的重要体现。文章基于中国老年健康影响因素跟踪调查(CLHLS)数据,探究医疗服务可及性与农村空巢老人健康需求的关系;以农村空巢老人为研究对象,运用二元logistic回归分析,分析农村空巢老人健康需求的影响因素,以论证医疗服务的有效供给如何满足农村空巢老人健康需求。结果显示,医疗服务供给可及性对农村空巢老人的健康需求存在较为显著的影响,医疗服务可及性是影响农村空巢老人健康需求的重要因素。因此,完善农村社区基本医疗服务,增强农村医疗卫生资源的供给能力,是改善农村空巢老人健康行为方式的必要路径。政府可通过互联网远程医疗提高农村社区的医疗服务可及性,满足农村空巢老人多元化的健康需求,增进农村空巢老人的健康福祉。