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
The purpose of this study was to construct the model of organization system,managemcnt,training and surveillance in healthcare-associated infection prevention and control(IC)of primary health care institutions and ide...The purpose of this study was to construct the model of organization system,managemcnt,training and surveillance in healthcare-associated infection prevention and control(IC)of primary health care institutions and identify its efleet on patient safety and decreasing economic burden by standardizing IC.A cross-sectional survey was conducted with questionnaires.Data were collected from 268 primary health care institutions in Hubei province,China.Hypotheses on the model of IC were analyzed by means of confirmatory factor analysis and structural equation modeling.The results showed that the fit indices of the hypothesized model of IC satisfied recommended levels:root mean square error of approximation(RMSEA)=0.071;comparative fit index(CFI)=0.965;tucker lewis index(TLI)=0.956:weighted root mean square residual(WRMR)=1.014.The model showed that organization system had a direct effect on management(β=0.311.P<0.01),and training(β=0.365,P<0.01).Management and training played an intermediary role that partially promoted organization system impact on surveillance.Results also showed that institutional factors such as the number of physicians、the ninnber of nurses,the designated capacity of beds,the actual number of open beds and surgery trips had positive impacts on management(β=0.050,P<0.01;β=0.181,P<0.01;β-0.111.P<0.01;β=0.064,P<0.01;β=0.084,P=0.04);nd training(β=0.21,P=0.03;β=0.050,P=0.02;β=0.586.P=0.01;0=0.995,P=0.02;β=0.223.P=0.03).In conclusion.the model of organization system,managemcnt,training and surveillancc in IC of primary health care institutions is valuable tor guiding IC practice.展开更多
Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs...Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs). Though there is some early evidence on the NEMPs’ effects on RUMs in China, the evidence is scarce, and conclusions vary. In the present study, we aimed to evaluate the impacts of the NEMPs of China on the RUMs in the primary health care institutions(PHCs). A cross-sectional survey was conducted in 2010. A total of 201 PHCs from six provinces of China were selected, and 39 181 prescriptions were extracted from January to June, 2010. Six indicators were used and tested by independent-samples T test. We found that the average number of drugs per prescription in PHCs with NEMP implementation(the treatment group) was significantly higher than that of the group without NEMP implementation(the control group)(3.37 vs. 2.83, P<0.01). There was no significant difference in the average cost per prescription(81.43 vs. 75.02). The percentage of prescriptions, including an antibiotic(53.40% vs. 36.48%, P<0.01) or an injection(40.54% vs. 27.94%, P<0.01), was higher in the treatment group, and the percentage of drugs prescribed by general name was significantly lower(83.71% vs. 93.11%, P<0.01). For the percentage of drugs prescribed from essential medicines list, the treatment group exhibited the higher ratio(76.12% vs. 53.45%, P<0.01). From this study, the NEMPs were not likely to have a positive impact on RUMs. China still needed efforts to improve the selection, the absence of physicians’ active involvement, and the patients’ habits of irrational medication use.展开更多
Objective To explore the current situation and problems of the pharmacy organization and pharmaceutical services in primary medical and health institutions so as to provide a reference for improving relevant policies....Objective To explore the current situation and problems of the pharmacy organization and pharmaceutical services in primary medical and health institutions so as to provide a reference for improving relevant policies.Methods Multi-stage stratified random sampling was used to collect questionnaires from primary medical and health institutions in 5 provinces,and 102 questionnaires were distributed.Then Excel 2016 and IBM SPSS 21.0 software were applied for descriptive statistical analysis,chi-square test and multiple response analysis.Results and Conclusion A total of 92 primary medical and health institutions participated in the survey,and 92 valid questionnaires were recovered.The survey shows that 54.1%of the institutions have established more than 8 pharmaceutical administration regulations.63.5%and 31.8%of the institutions have formulated pharmaceutical administration and pharmacotherapy team charters(or management systems).29.7%of institutions have pharmacy personnel in accordance with relevant regulations.The higher proportion of pharmacy services are prescription review and adjustment,medication guidance,collecting and reporting adverse reactions,medication errors and medication hazard information.Primary medical and health institutions still need to further improve their pharmaceutical administration system,organizational structure,pharmacy professional training and clinical pharmacy service.展开更多
目的系统梳理新一轮医药卫生体制改革以来农村基本医疗卫生服务综合评价指标体系,基于PHCPI概念框架(primary health care performance initiative conceptual framework)探寻目前评价指标普遍关注的内容和可能被忽略的评价内容,为后续...目的系统梳理新一轮医药卫生体制改革以来农村基本医疗卫生服务综合评价指标体系,基于PHCPI概念框架(primary health care performance initiative conceptual framework)探寻目前评价指标普遍关注的内容和可能被忽略的评价内容,为后续科学、全面地评价农村基本医疗卫生服务提供参考依据。方法通过中国知网、万方数据知识服务平台、维普中文科技期刊数据库检索2009—2019年有关农村基本医疗卫生服务综合评价指标体系的文献,基于SPIDER规范制定纳入排除标准,采用批判评估技术方案对纳入文献进行质量评价,运用框架合成法,选取PHCPI概念框架对纳入的文献进行归纳和总结。结果共纳入25篇文献,总体质量良好。评价体系中的指标可分为5个一级领域、16个二级领域、24个三级领域指标。综合对比各领域对应指标的文献数,卫生资金、效率等领域对应指标的文献数较多,均有20篇左右的文献,高于其他多数领域;投入、产出和结果的相应领域中,近85%的领域对应指标的文献在15篇及以上;服务提供的各领域中,仅18%左右的领域对应指标的文献达到15篇,40%以上领域对应指标的文献未超过5篇。结论农村基本医疗卫生服务综合评价体系对经济效益相关指标关注度较高,投入、产出和结果多数领域的指标重合度较高,评价体系对服务提供领域的关注度较低且内容分散。今后可加强对社会效益和服务提供相关指标的探索,以全面、综合地评价农村基本医疗卫生服务。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the National Natural Science Foundation of China(No.71473098).
文摘The purpose of this study was to construct the model of organization system,managemcnt,training and surveillance in healthcare-associated infection prevention and control(IC)of primary health care institutions and identify its efleet on patient safety and decreasing economic burden by standardizing IC.A cross-sectional survey was conducted with questionnaires.Data were collected from 268 primary health care institutions in Hubei province,China.Hypotheses on the model of IC were analyzed by means of confirmatory factor analysis and structural equation modeling.The results showed that the fit indices of the hypothesized model of IC satisfied recommended levels:root mean square error of approximation(RMSEA)=0.071;comparative fit index(CFI)=0.965;tucker lewis index(TLI)=0.956:weighted root mean square residual(WRMR)=1.014.The model showed that organization system had a direct effect on management(β=0.311.P<0.01),and training(β=0.365,P<0.01).Management and training played an intermediary role that partially promoted organization system impact on surveillance.Results also showed that institutional factors such as the number of physicians、the ninnber of nurses,the designated capacity of beds,the actual number of open beds and surgery trips had positive impacts on management(β=0.050,P<0.01;β=0.181,P<0.01;β-0.111.P<0.01;β=0.064,P<0.01;β=0.084,P=0.04);nd training(β=0.21,P=0.03;β=0.050,P=0.02;β=0.586.P=0.01;0=0.995,P=0.02;β=0.223.P=0.03).In conclusion.the model of organization system,managemcnt,training and surveillancc in IC of primary health care institutions is valuable tor guiding IC practice.
基金National Natural Science Foundation of China(Grant No.71303011,71774005)
文摘Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs). Though there is some early evidence on the NEMPs’ effects on RUMs in China, the evidence is scarce, and conclusions vary. In the present study, we aimed to evaluate the impacts of the NEMPs of China on the RUMs in the primary health care institutions(PHCs). A cross-sectional survey was conducted in 2010. A total of 201 PHCs from six provinces of China were selected, and 39 181 prescriptions were extracted from January to June, 2010. Six indicators were used and tested by independent-samples T test. We found that the average number of drugs per prescription in PHCs with NEMP implementation(the treatment group) was significantly higher than that of the group without NEMP implementation(the control group)(3.37 vs. 2.83, P<0.01). There was no significant difference in the average cost per prescription(81.43 vs. 75.02). The percentage of prescriptions, including an antibiotic(53.40% vs. 36.48%, P<0.01) or an injection(40.54% vs. 27.94%, P<0.01), was higher in the treatment group, and the percentage of drugs prescribed by general name was significantly lower(83.71% vs. 93.11%, P<0.01). For the percentage of drugs prescribed from essential medicines list, the treatment group exhibited the higher ratio(76.12% vs. 53.45%, P<0.01). From this study, the NEMPs were not likely to have a positive impact on RUMs. China still needed efforts to improve the selection, the absence of physicians’ active involvement, and the patients’ habits of irrational medication use.
文摘Objective To explore the current situation and problems of the pharmacy organization and pharmaceutical services in primary medical and health institutions so as to provide a reference for improving relevant policies.Methods Multi-stage stratified random sampling was used to collect questionnaires from primary medical and health institutions in 5 provinces,and 102 questionnaires were distributed.Then Excel 2016 and IBM SPSS 21.0 software were applied for descriptive statistical analysis,chi-square test and multiple response analysis.Results and Conclusion A total of 92 primary medical and health institutions participated in the survey,and 92 valid questionnaires were recovered.The survey shows that 54.1%of the institutions have established more than 8 pharmaceutical administration regulations.63.5%and 31.8%of the institutions have formulated pharmaceutical administration and pharmacotherapy team charters(or management systems).29.7%of institutions have pharmacy personnel in accordance with relevant regulations.The higher proportion of pharmacy services are prescription review and adjustment,medication guidance,collecting and reporting adverse reactions,medication errors and medication hazard information.Primary medical and health institutions still need to further improve their pharmaceutical administration system,organizational structure,pharmacy professional training and clinical pharmacy service.
文摘目的系统梳理新一轮医药卫生体制改革以来农村基本医疗卫生服务综合评价指标体系,基于PHCPI概念框架(primary health care performance initiative conceptual framework)探寻目前评价指标普遍关注的内容和可能被忽略的评价内容,为后续科学、全面地评价农村基本医疗卫生服务提供参考依据。方法通过中国知网、万方数据知识服务平台、维普中文科技期刊数据库检索2009—2019年有关农村基本医疗卫生服务综合评价指标体系的文献,基于SPIDER规范制定纳入排除标准,采用批判评估技术方案对纳入文献进行质量评价,运用框架合成法,选取PHCPI概念框架对纳入的文献进行归纳和总结。结果共纳入25篇文献,总体质量良好。评价体系中的指标可分为5个一级领域、16个二级领域、24个三级领域指标。综合对比各领域对应指标的文献数,卫生资金、效率等领域对应指标的文献数较多,均有20篇左右的文献,高于其他多数领域;投入、产出和结果的相应领域中,近85%的领域对应指标的文献在15篇及以上;服务提供的各领域中,仅18%左右的领域对应指标的文献达到15篇,40%以上领域对应指标的文献未超过5篇。结论农村基本医疗卫生服务综合评价体系对经济效益相关指标关注度较高,投入、产出和结果多数领域的指标重合度较高,评价体系对服务提供领域的关注度较低且内容分散。今后可加强对社会效益和服务提供相关指标的探索,以全面、综合地评价农村基本医疗卫生服务。
