Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations.

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Analysis of inpatient bed allocation equity and utilization in the city community health service center of China.

The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city community health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms of IB allocation quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.

Exploring How Media Influence Preventive Behavior and Excessive Preventive Intention during the COVID-19 Pandemic in China.

In the context of global fighting against the unexpected COVID-19 pandemic, how to promote the public implementation of preventive behavior is the top priority of pandemic prevention and control. This study aimed at probing how the media would affect the public's preventive behavior and excessive preventive intention accordingly. Data were collected from 653 respondents in the Chinese mainland through online questionnaires and further analyzed by using partial least squares structural equation modeling (PLS-SEM). Taking risk perception, negative emotions, and subjective norms as mediators, this study explored the impact of mass media exposure and social networking services involvement on preventive behavior and excessive preventive intention. Based on differences in the severity of the pandemic, the samples were divided into the Wuhan group and other regions group for multi-group comparison. The results showed that mass media exposure had a significant positive impact on subjective norms; moreover, mass media exposure could significantly enhance preventive behavior through subjective norms, and social networking services involvement had a significant positive impact on negative emotions; meanwhile, social networking services involvement promoted excessive preventive intention through negative emotions.

The influence of health insurance towards accessing essential medicines: the experience from Shenzhen labor health insurance.

OBJECTIVES: Due to major problems of accessing essential medicines, this paper will evaluate the impact of the new Shenzhen labor health insurance on accessing essential medicines among migrant workers. METHODS: Medicines data and revenues-expenditures reports from 19 community health service centers in Shenzhen city were collected. Insurance indicators within two periods before and after 1st June 2006 were compared. Paired t-tests using month-values of indicators were performed. P value<0.05 considered statistically significant. RESULTS: The proportion of EMs in Medicine List of Shenzhen Labor health insurance is 88.5%. For each period, percentage costs of EM procured (Peem) was 43.1% and increased to 46.1%; costs of medicines per outpatient visit (Empv) was 24.94 RMB and decreased to 22.20 RMB; percentage costs of medicine per outpatient visit (Pe) were 49.1% and decreased to 45.9%; number of outpatient visits (Nov) was 428,328 and increased to 490,305. Values of t for differences in Peem, Empv, Pe and Nov between the two periods were -1.125 (P=0.285), 3.096 (P=0.010), 1.458 (P=0.173) and -2.069 (P=0.063), respectively. CONCLUSIONS: Shenzhen labor health insurance had improved accessibility to EMs for migrant workers, and ensured for them basic health services. Popularization of this insurance will benefit more people.

Comparative study of video-assisted thoracoscopic surgery ablation and radiofrequency catheter ablation on treating paroxysmal atrial fibrillation: a randomized, controlled short-term trial.

BACKGROUND: It is unclear whether the effect of video-assisted thoracoscopic surgery ablation is better than catheter ablation on paroxysmal atrial fibrillation (PAF) or not. This study aimed to compare the effects of catheter ablation and video-assisted thoracoscopic surgery ablation on PAF. METHODS: From March 2008 to March 2012, 138 consecutive patients with PAF were randomly assigned to receive either video-assisted thoracoscopic surgery ablation (thoracoscopy group, n = 66) or the traditional catheter ablation (catheter group, n = 72). RESULTS: No patient died during the study and all were successfully followed and included in analysis. There were no significant differences in clinical and echocardiographic characteristics between the two groups. All patients were evaluated at 1 week, 1 month, 3 months, 6 months, and 12 months after discharge by physical examination and related laboratory tests. Preoperative left atrium dimensions (LADs) of the recurrent AF were (47 ± 4) mm in the thoracoscopy group and (46 ± 8) mm in the catheter group, whereas the LADs were (40 ± 5) and (39 ± 9) mm, respectively, in non-recurrent PAF. CONCLUSIONS: The short-term outcome of video-assisted thoracoscopic surgery ablation is safe and effective; and the indications are wider than those for catheter ablation. The larger left atrium diameter is related to the recurrence of atrial fibrillation.

Changes in attitudes, knowledge and behavior associated with implementing a comprehensive school health program in a province of China.

After successful pilot projects, Zhejiang Province, China, decided to systematically scale-up health promoting schools (HPS) over the entire province of 47 million. This study describes the interventions and self-reported changes in attitudes, knowledge and behavior during the first phase of scaling-up. Group interviews were conducted with a sample of 191 participants (school administrators, teachers, students and parents) from nine schools with a total of approximately 15 200 students. Grounded theory guided data analysis. Schools implemented all HPS components (school health policy, physical school environment, psychosocial school environment, health education, health services, nutrition services, counseling/mental health, physical exercise, health promotion for staff and outreach to families and communities), adapted to local circumstances. Participants reported a range of changes in attitudes (paying more attention to health, attaining better 'psychological quality' and confidence, forming friendships between teachers and students and feeling more relaxed), knowledge and concepts (increasing knowledge about various health issues, developing a broader concept of health and gaining better understanding about the HPS concept) and behavior (actively participating, increasing physical activity, improving sanitary habits, reducing or quitting smoking, eating more nutritiously, increasing safety behavior, sustaining less injuries and improving parent-child communication). This qualitative study shows the feasibility and efficacy of implementing HPS in Zhejiang Province, China.