Objective To study and analyze the related data to emergent public health events in 2008 Wenchuan Earthquake and two years before and after the earthquake, to examine the emergent health control system of Sichuan in terms of organization, implement, current status and problems, so as to offer first-hand data and decision-making references to the perfection of the monitoring system and raising the effect of control and prevention of the emergent public health envents effect. Methods The report data were statistically analyzed by Excel, EpiInfo software. Results Between 2006 and 2010, the emergent public health events in Sichuan had reduced gradually year by year, and a wave trough was formed in 2008 when Wenchuan Earthquake attacked; the emergent public health events in each year mainly took place in two peaks, one was from April to June and the other was from September to November. Compared with the period between 2006 and 2010, five among six heavily afflicted cities and prefectures with 18 heavily damaged counties in 2008 had dropped in the listing of emergent public health events. Between 2006 and 2010, the emergent public health events happening in schools of Sichuan accounted for 75.00%, especially the township primary schools were on the top of each index as place, cause, morbidity and mortality, but there were no serious emergent public health events. Among nine types of emergent public health events, the contagious disease events accounted for 79.30% while the food poisoning events accounted for 14.33%; and the contagious disease events mainly were respiratory tract infection diseases such as chicken pox, mumps and measles, and hepatitis A which were all preventable with vaccine, and accounted for 82.93%. Conclusion The construction of Sichuan’s health emergency system is a good foundation for the handling of emergent public health events. The emergent public health events in the whole province get gradually reduced year by year between 2006 and 2010, and all kinds of emergent public health events have been handled properly. With the national support for the disaster relief of Wenchuan Earthquake, the provincial emergent public health events after the quake in 2008 have scored the lowest level in the history without severe epidemics after the earthquake; and the plan of no severe epidemics within three years after the earthquake has come true with partner assistance in health system. By improving the control of contagious disease, food poison and preventable diseases, the incidence of emergent public health events can be dramatically reduced with lower morbidity and mortality. Only by means of multi-departmental cooperation and social participation for jointly preventing and controlling school emergent public health events, especially for preventing and controlling the contagious diseases in countryside and township primary schools, can all kinds of emergent public health events be timely prevented and controlled with decreased hazard.
Objective To provide evidence for the construction of municipal public health system in Chengdu based on the existing problems. Method Using the priniple and method of evidence-based medicine, epicemiology and health care management, and the data searching, extraction and envaluation to analyse the current situation and problems of Chengdu’s public health system. also referring such research results from home and abroad with the hope of resolving such problems and make suggestions as to how to deal with this. Results There is a few literatures on the municipal public health system. The insufficient financial support, hardware and software condition deteriorated the serious situation of public health in Chengdu. Conclusions It is suggested that we should establish a managing committee of the public health system of Chengdu, make comprehensive plan to set up 6 professional centers, fund the research on main diseases and key techniques, increase financial appropriations by improving financing mechanism and establish a center for education and staff training.
ObjectiveTo comprehensively evaluate the essential public health service in Xinjin county of Chengdu from 2009 to April 2011, so as to provide evidence for improving primary healthcare system reform in Chengdu city. MethodsThe data was collected from the Xinjin county-wide health information system. The electronic health records, chronic disease management, childbirth management and mental health were quantitatively described and compared. Resultsa) In 2010, 88 772 residents had the physical examination and health assessment, among which, 14 497 (16%) were detected with some health problems. The average cost per positive detection was RMB 122.5 yuan. b) Up to April 2011, 98.2% of people in Xinjin county have their health records but the proportions were ranged from 68.08% to 109.02% in different primary healthcare providers. The details of the most health records were incomplete. c) 7 318 patients with hypertension and 2 187 diabetes mellitus were detected, and among them, 90.1% of patients with hypertension and 95.1% of patients with diabetes had their health records for chronic diseases management. d) The rate of stillbirth or neonatal mortality was lower than 4‰. There was no maternal death in the 8 years. But the cesarean section rate was about 61%. e) 97.3% of the patients with mental disorders were supervised in 2010, which was reduced by 2.7% compared to 2009. Conclusionsa) There is low proportion of all the residents in Xinjin having physical examination and health assessment and the rate of diseases detection is low as well. b) There is very wide coverage of health records for residents in Xinjin county, nearly universal coverage. c) The health records for the chronic disease patients were well-established, but the early detection rate of the chronic diseases is low. d) High proportion of the patients with mental disorders is supervised. e) The strategy that only county-level hospitals could provide obstetrical service instead of township hospitals is successful to reduce the neonatal mortality and maternal mortality. However, the cesarean section rate is high. f) It acts, to some extent, as a model to successfully improve the essential public health service and management based on the conuty-wide healthcare information system. However, the data quality, data mining and data utilization should be further improved
ObjectiveTo get known of the knowing and utilization of essential public health services among community residents for clinical visits in Nanchang city, and to provide evidence for promoting the effective use of public health services. MethodsA total of 20 community health services (CHS) organizations were finally selected by stratified random sampling method from 5 administrative regions in Nanchang city. Questionnaire survey about the knowing and utilization of public health services was performed to the 500 residents. We used EpiData 3.0 software to establish the database and SPSS 17.0 software for statistical analysis. ResultsThe awareness rate about essential public health services among them was 77.6% in Nanchang, which was highest to 91.0% in Wanli district and lowest to 47.0% in Xihu district. The differences between the administrative regions were significant (χ2=75.893, P=0.000). The archiving rate in CHS organizations among visits was 59.2%, which was up to 84.0% in Wanli district and lowest to 40.0% in Qingshanhu district. It also showed statistical significance between the regions (χ2=110.493, P=0.000). The total utilization rate about essential public health services was 95.8% in the population, which was no significant difference between the regions (χ2=7.772, P=0.100). However, the utilization rate in different populations was statistically significant (P < 0.05). ConclusionThe awareness rate and archiving rate about essential public health services among the residents in CHS organizations in Nanchang was not high, but the utilization rate was much higher, which was different among the administrative regions. The CHS organizations should strengthen the publicizing of essential public health services knowledge for the people in different regions to improve the co-development of the regions. In addition, it is also necessary to improve the use of community health services among the populations to achieve the goal about the equalization of essential public health services.
ObjectiveTo investigate the guidance centers for promoting equalization of basic public health services in Sichuan province, in order to provide evidence for construction and development. MethodsBy questionnaire survey, we collected relevant information and data about the guidance centers at all levels in Sichuan province. The EpiData 3.0 was used to establish a database and the SPSS 16.0 was used to analyze data. ResultsA total of 202 guidance centers had been set up in Sichuan province. All disciplines of the basic public health services were covered by these centers. There were 2 020 technicians, whose average age was 41.37, more had college degree, and intermediate professional title. 54.5% of the guidance centers didn't work together, and there were 92.7% part-time technicians. Only 40% city and 20% county guidance centers got working funds. The average working funds of province, city and county were 890 000 yuan per year, 101 000 yuan per year and 89 000 yuan per year, respectively. ConclusionThe guidance centers of Sichuan province at all levels have effectively promoted the basic public health services project, but we should improve and perfect the management mechanism and guarantee mechanism.
ObjectiveTo provide recommendations for the management of intensive care unit patients without novel coronavirus disease 2019 (COVID-19).MethodsWe set up a focus group urgently and identified five key clinical issues through discussion. Total 23 databases or websites including PubMed, National Guideline Clearing-House, Chinese Center for Disease Control and Prevention and so on were searched from construction of the library until February 28, 2020. After group discussion and collecting information, we used GRADE system to classify the evidence and give recommendations. Then we apply the recommendations to manage pediatric intensive care unit in the department of critical care medicine in our hospital. ResultsWe searched 13 321 articles and finally identified 21 liteteratures. We discussed twice, and five recommendations were proposed: (1) Patients should wear medical surgical masks; (2) Family members are not allowed to visit the ward and video visitation are used; (3) It doesn’t need to increase the frequency of environmental disinfection; (4) We should provide proper health education about the disease to non-medical staff (workers, cleaners); (5) Medical staff do not need wear protective clothing. We used these recommendations in intensive care unit management for 35 days and there was no novel coronavirus infection in patients, medical staff or non-medical staff. ConclusionThe use of evidence-based medicine for emergency recommendation is helpful for the scientific and efficient management of wards, and is also suitable for the management of general intensive care units in emergent public health events.
ObjectivePublic health information collection is critical in improving the capacity of basic public health services. Our study took the "Wei Jian E Tong" APP as an example to evaluate the willingness and influencing factors of rural public health service personnel to continue using such APPs.MethodsWe applied exploratory sequential design in mixed-method research and chose Renshou county in Sichuan province as the representative region. Firstly, we used the personal in-depth interview to initially explore the status quo, applicability, continued willingness to use APP and other issues. Secondly, we used unified theory of acceptance and use of technology (UTAUT) and expectation confirmation theory (ECT) to construct a hypothetical model of influencing factors of user satisfaction. We then designed a structured questionnaire covering 7 measurement dimensions to survey all users of the APP at the survey site. Finally, we used structural equation model to verify the research hypothesis.ResultsA total of 21 individuals were interviewed in this survey, including leaders of township health centers, public health doctors, and rural doctors. Qualitative results showed the major defects were insufficient funds and policy support in the promotion and application, additionally lack of software functionalities and system incompatibility. A total of 593 valid questionnaires were collected from the quantitative survey on the satisfaction of township doctors and village doctors. Structural equation model results showed that seven direct hypotheses were established, of which compatibility had the largest effect value user satisfaction with a total effect value of 0.617, followed by facilitating condition (r=0.211), performance expectancy (r=0.137), effort expectancy (r=0.091) and social influence (r=0.068).ConclusionsTo promote the application of information collection apps in primary public health services and improve user satisfaction, the focus should be on solving software incompatibility and create interconnection among all levels of medical systems. At the same time, it is necessary to solve funding problems as a whole, optimize software functions, improve the performance evaluation system, and improve software training and promotion.
ObjectiveTo establish a hypertension prediction model for middle-aged and elderly people in China and to use the basic public health service database for performance validation. MethodsThe literature related to hypertension was retrieved from the internet. Using meta-analysis to assess the effect value of influencing factors. Statistically significant factors, which were also combined in the database, were extracted as the predictors of the models. The predictors’ effect values were logarithmarithm-transformed as the parameters of the Logit function model and the risk score model. Participants who were never diagnosed with hypertension at the physical examination of health service project of Hongguang Town Health Center in Pidu District of Chengdu from January 1, 2017, to January 1, 2022, were considered as the external validation group. ResultsA total of 15 original studies were involved in the meta-analysis and 11 statistically significant influencing factors for hypertension were identified, including age, female, systolic blood pressure, diastolic blood pressure, BMI, central obesity, triglyceride, smoking, drinking, history of diabetes and family history of hypertension. Of 4997 qualified participants, 684 individuals were identified with hypertension during the five-years follow-up. External validation indicated an AUC of 0.571 for the Logit function model and an AUC of 0.657 for the risk score model. ConclusionIn this study, we developed two different prediction models based on the results of meta-analysis. National basic public health service database is used to verify the models. The risk score model has a better prediction performance, which may help quickly stratify the risk class of the community crowd and strengthen the primary-level assistance system.
Cancer prevention and control is an important healthcare task towards major diseases of the Chinese people and an important part of the “Healthy China 2030” plan outline. This article summarizes and introduces the current status and practical experience of subnational cancer prevention and treatment status in Yibin City and Ya’an City of Sichuan Province. Lung cancer, digestive system cancers, and cervical and breast cancers compose of the majority of cancers with high incidence. In the aspect of cancer epidemiology, there are certain disparities among cities and between urban and rural areas, among which the mortality risk of cancer in rural areas is higher. In Yibin and Ya’an cities, the specialized agencies and governance system for subnational cancer prevention and control are still in the early stage of development, and the background data such as cancer-specific survival rate, public awareness of core knowledge on cancer prevention and control, quality control of key techniques, and healthcare resources in subnational areas are still unclear. Therefore, all levels of cancer prevention and control need further strengthening the organizational leadership and system construction, and promoting the hierarchic healthcare and balanced development.