[Analysis of the difference in free influenza vaccination rates between old people in urban and rural areas in Beijing].

OBJECTIVE: To assess the status of free influenza vaccination rates for the elderly in Beijing. METHODS: A questionnaire survey was carried out among 1 000 old people in Beijing. Random sampling method was employed. Descriptive analysis and Chi square test were used for statistical analysis, and Logistic regression model was used to analyze the difference in free influenza vaccination rates between the urban and rural areas. RESULTS: The continuous influenza vaccination rate of the elderly from 2007 to 2010 was 46.4%, which was higher in the rural (70.9%) than in the urban (38.3%). The vaccination rate in the rural was 3.859 times that in the urban, after other variables were controlled. CONCLUSION: The vaccination rate among the elderly in Beijing has been raised after the implementation of free influenza vaccination policy in 2007, especially for the rural people. In the urban areas, concerning about the safety of the vaccine is one of the reasons why people chose not to take free influenza vaccination; while in the rural, the insufficient knowledge about the flu and influenza vaccine plays an important role.

Clinical predictors for diagnosing pandemic (H1N1) 2009 and seasonal influenza (H3N2) in fever clinics in Beijing, China.

OBJECTIVE: Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic (H1N1) 2009 and seasonal influenza (H3N2) in patients attending fever clinics. METHODS: From 1 May 2009 to 1 January 2010, all adult patients admitted to fever clinics for suspected influenza, confirmed by real time RT-PCR, were enrolled. Predictors of influenza virus infection were selected with logistic regression models. Measures of sensitivity, specificity, positive and negative likelihood ratios (LRs) were calculated to identify the best predictors. RESULTS: The clinical features and routine blood test results of influenza (H1N1) 2009 and seasonal influenza were similar. The positive and negative LRs of current US CDC influenza-like illness (ILI) criteria were modest in predicting influenza infection. Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic (H1N1) 2009 and seasonal influenza. The revised criteria are: fever >38 °C accompanied by at least one of the following-cough, arthralgia or relative lymphopenia. CONCLUSION: Patients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate. In addition, physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza.

[Relation between social capital factors and self-rated health among Chinese adults].

OBJECTIVE: To examine the relations between factors of social capital and self-rated health among Chinese adults. METHODS: Univariate and multivariate analyses were used, based on 33 610 respondents in cross-sectional data of Chinese Family Panel Studies implemented by Institute of Social Science Survey, Peking University. RESULTS: In the study, 47.4% of the respondents reported "good" in self-rated health. The result of univariate analysis showed that those who took part in any organizations (P<0.001) or had frequent interaction with others (P<0.001) tended to report relatively higher level on self-rated health. After controlling the physical health and demographic factors, the social participation (P<0.01), social interaction (P<0.001) and perceived social equity (P<0.001) were all the correlates of self-rated health among Chinese residents. CONCLUSION: Factors of social capital are important correlates of self-rated health in China, controlling the physical health and demographic factors. self-rated health can indicate people's social health to certain extent.

[Comparative analysis of applying patient experience and satisfaction survey (VPSM) tool in Chinese hospitals].

OBJECTIVE: Patient experience and satisfaction survey has been regarded as an important method of collecting patients' opinions on medical services and improving the quality of management. From 2005 to 2009, Australia Victorian patient satisfaction monitoring, VPSM, was introduced, localized and adopted by over 50 Chinese hospitals. To compare and analyze each localized applications of VPSM and submit suggestions for further applications. METHODS: The paper adopted the way of document research. The researchers collected all of the published and unpublished investigation plans and monitoring reports during these five years, compared the operations and the results of investigations and indicated the advantages and weaknesses. RESULTS: In respect of methods, they were similar but showed some small differences in details such as the questionnaire structure, the reminding letter and the organization of data acquisition and analysis. The localized VPSM was gradually moving towards standardization. The monitoring was able to find the changing of medical services and provided the referential information for management. CONCLUSION: The localization of VPSM is still on its way and it needs improving by means of extending application.

[Determinants of self-rated health in old people].

OBJECTIVE: To describe the status of self-rated health (SRH) among the elderly and find out the relationship between SRH and other health measures such as two weeks prevalence and chronic disease prevalence. METHODS: The data used was generated from cross-sectional household health survey conducted in the year of 2009 in Shunyi district, Beijing. SPSS software was used to conduct univariate and multivariate liner regression analysis with self-rated health. RESULTS: The average score of self-rated health among the elderly is 72.49. Univariate analyses suggest that are age, sex, marital status, income level, education, employment, medical insurance type, self-perceived anxious or depression, disease state are all associated with poor SRH score. Multiple liner regression model shows that age, job, medical insurance, self-perceived anxious or depression, suffer from two-week illness and chronic disease had effects on SRH of the elderly. CONCLUSION: Physical and psychological unhealthy are independent risk factors of SRH among the elderly, disease status is the most influential predictor on SRH score. Thus, a single measurement of SRH question can be used in health status assessment of the elderly.

[Influence of patients' attitude on doctors' satisfaction with the doctor-patient relationship].

OBJECTIVE: To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients, gathering evidence to improve the doctor-patient relationship. METHODS: This study was a cross-sectional study, in which doctors and nurses in 10 hospitals of Beijing, Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews. RESULTS: The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97, which was much lower than the patients'. The patients' socio-demographic characteristics, social economic status (SES) and behavior characteristics influence the interaction of the doctors and the patients. The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust. CONCLUSION: The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship. The patients' characteristics have important influence on the doctor-patient relationship. It's necessary to take action on the patients to improve the doctor-patient relationship.

[Epidemiologic study of admitted children with Kawasaki disease in Beijing from 1995 to 1999].

OBJECTIVE: To evaluate the epidemiologic picture of Kawasaki disease (KD) in Beijing and its suburbs. METHODS: A questionnaire form and diagnostic guideline for KD were sent to all hospitals with pediatric inpatient beds throughout Beijing and its suburbs. Pediatricians were asked to review the medical records and report all patients with KD diagnosed during the 5-year period from January, 1995, to December, 1999. RESULTS: A total of 710 patients with KD were reported from 37 (95%) of 39 hospitals with pediatric inpatient beds. The incidence rates of KD were 18.2 (1995), 21.1 (1996), 18.6 (1997), 30.6 (1998) and 27.8 (1999) per 100,000 children < 5 years of age. The male:female ratio was 1.7:1. The age at onset ranged from 1 month to 13.4 years (with median of 2.3 years), with 85.2% < 5 years old. The disease occurred more frequently in spring and summer and less frequently in autumn and early winter. Lymph node enlargement was the least common clinical sign, and its incidence decreased from 1995 to 1999. Cardiac abnormalities were found in 21.5% of patients and were more prevalent in patients diagnosed 10 days or longer after the onset. No patients died in the acute stage. CONCLUSIONS: The incidence of KD in Beijing is lower than that reported in Japan, similar to the incidence in the United States and higher than in those other Western countries. The age and gender distribution and increasing trend in incidence are similar to those in previous reports, but seasonal distribution is unique.

Epidemiologic pictures of Kawasaki disease in Shanghai from 1998 through 2002.

BACKGROUND: Epidemiologic features of Kawasaki disease in China is still not clear. METHODS: A questionnaire form and diagnostic guidelines for Kawasaki disease were sent to hospitals in Shanghai, which provided with pediatric medical care. All patients with Kawasaki disease diagnosed during January 1998 through December 2002 were recruited in this study. RESULTS: A total of 768 patients with Kawasaki disease were reported. The incidence rates of Kawasaki disease for each year were 16.79 (1998), 25.65 (1999), 28.16 (2000), 28.05 (2001), and 36.76 (2002) per 100,000 children under 5 years of age. The male/female ratio was 1.83:1. The age at onset ranged from 1 month to 18.8 years (median: 1.8 years). The disease occurred more frequently in spring and summer. Fever was the most common clinical symptom, followed by oral changes, extremities desquamate, rash, conjunctive congestion, lymphadenopathy, extremities swelling, and crissum desquamate. Cardiac abnormalities were found in 24.3% of patients. The most common cardiac abnormality was coronary artery lesions including dilatation (68%) and aneurysm (10%). The case-fatality rate at acute stage of the disease was 0.26%. A second onset of the disease occurred in 1.82% of patients. CONCLUSIONS: The incidence rate of Kawasaki disease in Shanghai is lower than that reported in Japan, but higher than those in western countries. The increasing trend in incidence, sex distribution and cardiac abnormalities are similar to those in previous reports. The seasonal distribution is similar to the report from Beijing and different from other reports.