ABSTRACT
Objective To learn the status and equity of human resource allocation for health so as to provide evidence for health administrative department. Methods Descriptive analysis and annual percent changes (APC) were used to analyze the numbers and trends of human resource allocation for health from 2011 to 2015, and Gini coefficients were used for equity evaluation. Results In 2015, Hangzhou had the largest number (12.62) of medical personnel per 1000 persons while Jiaxing had the least amount (7.43) . Hangzhou had the largest number (10.32) of medical technical personnel per 1000 persons while Wenzhou had the least amount (6.23) . Hangzhou had the largest number (3.86) of licensed (assistant) doctors per 1000 persons while Jiaxing had the least amount (2.15) . Hangzhou had the largest number (4.23) of registered nurses per 1000 persons while Wenzhou had the least amount (2.42) . Jiaxing had 8.06 medical personnel, 7.03 medical technical personnel, 2.33 licensed (assistant) doctors and 2.86 registered nurses per square kilometer which were all the largest number while Lishui had 1.21 medical personnel, 1.00 medical technical personnel, 0.39 licensed (assistant) doctors and 0.38 registered nurses per square kilometer which were all the least. The doctor-to-nurse ratio was only 1:1.01 in 2015. Both numbers of human resources for health per 1000 persons and per square kilometer increased year by year from 2011 to 2015, and Gini coefficients of each index expressed by per 1000 persons were all under 0.2, while it ranged from 0.2 to 0.3 when they were expressed by per square kilometer. Conclusion Numbers of human resource allocation for health had an increasing trend and the allocation was fair, but the equity evaluated by service population was better than by service areas, and the research about accessibility of regional human resource allocation for health needs to be concerned.
ABSTRACT
Objective To learn the prevalence of chronic diseases and risk factors control among the elderly of community health management in Zhejiang Province.Methods The elderly residents over 60 years of urban areas in Zhejiang Province were investigated through multi-stage stratified sampling,and key health examination information in year 2015 of respondents was collected.The prevalence of chronic diseases and risk factors control were analyzed among the respondents who had accepted community elderly health management.Results Among 1 215 elderly who accepted community health management,self-reported prevalence rate of common chronic diseases was 84.36％,with hypertension 60.66％,cataract 21.32％ and diabetes 20.58％.The control rates of hypertension and diabetes were 64.04％ and 60.00％,respectively.The proportions of light weight,normal weight,overweight and obesity were 3.51％,50.04％,35.51％ and 10.94％ respectively.The prevalence rate of central obesity was 54.75％,female (59.00％) higher than male (48.47％) (P ＜ 0.001).The proportions of normal,borderline high and abnormal total cholesterol (TC) were 66.75 ％,23.95％ and 9.30％ respectively.The proportions of normal,borderline high and abnormal triglyceride (TG) were 65.73％,17.05％ and 17.22％ respectively.The proportions of normal TC and TG were both lower in female (both 61.94％) than those in male (TC:74.07％、TG:71.52％) (P ＜ 0.05).The prevalence rates of hypertension (OR =1.41,95％ CI:1.11-1.79),cataract (OR =2.19,95％ CI:1.65-2.91),coronary heart disease (OR =1.59,95％ CI:1.14-2.21)and cerehmvascular disease (OR =2.06,95 ％ CI:1.29-3.30)were significantly increased in the 75 years group than that in the 60-74 years group.The prevalence of cerehrovascular disease in elderly men in the age group of 60 -74 (OR =1.73,95％ CI:1.09-2.75) and chronic obstructive pulmonary disease (OR =2.41,95％ CI:1.04-5.59) were higher than that in female,while the prevalence of rheumatoid arthritis (OR =0.54,95％CI:0.35-0.84)were lower than that in male.Conclusion Among the elderly who accepted community health management,the prevalence rate of chronic diseases is similar with the general elderly population in Zhejiang Province.Female central obesity and blood lipids control should be strengthened in the community.
ABSTRACT
Objective To explore regional variations of basic public health services implementation in Zhejiang Province at prefectural,county and township level,respectively.To find key problems which obstacle the equalization of basic public health services in Zhejiang Province.Methods Descriptive analysis was made on surveillance data of basic public health services in Zhejiang Province,2014.Gini coefficient of key indicators was calculated at prefectural,county and township level,respectively.To the key indicator with higher Gini coefficient,Lorenz curve was plotted and Gini coefficient of each prefectural-level city was calculated.Results An increasing tendency from prefectural to township level was showed in Gini coefficient of all twenty-five analyzed indicators.The Gini coefficient at township level was 0.497 for the average financial fund per migrant person,and the highest prefectural -level cities were Taizhou (0.709 ),Lishui (0.838 ), Quzhou(0.918).The Gini coefficient at township level of other indicators were 0.314 and 0.235 for the children and elderly health management of traditional Chinese medicine,and lower than 0.05 for maternal &children health care, immunization,and coverage rate of electronic health record,and between 0.066 to 0.179 for health management of chronic disease and severe mental illness patients.Conclusion Average financial fund per migrant person and health management of traditional Chinese medicine are current major problems which obstacle the equalization of basic public health services in Zhejiang Province.
ABSTRACT
Objective Estimate type I and type II error probability (α,β)of sampling deduction,using sample size set in national basic public health services supervision.Methods Assuming a series of population indicator value of supervised area,αand βwas calculated based on binomial & hypergeometric distribution theory according to the sample size and indicator requirements set in supervision plan.Results When the population indicator value of supervised area was just equal to indicator requirements,probability of type I error was as follows,health record utilization rate(0.41 ),health record qualification rate(0.26),children systematic management rate(0.32),postpartum visit rate(0.32),the elderly health examination form completion rate (0.35 ),standard administration rate of patients with hypertension or diabetes (0.37),control rate of blood pressure of hypertension patients(0.34),control rate of blood glucose of diabetes patients (0.43),standard administration rate of severe mental illness patients(0.50).When the population indicator value of supervised area was 0.05 lower than indicator requirements,probability of type II error of those indicator was as follows, 0.41,0.54,0.53,0.53,0.51,0.50,0.57,0.47,0.38.Conclusion Current sample sizes of all indicators result in weak sensitivity of unqualified area detection.In order to avoid mistake,the sample size should be improved.
ABSTRACT
Objective To develop appropriate evaluation methods of local basic public health services which are suitable to county level and above.Methods Data on basic public health services of 1 1 cities in Zhejiang province in 201 2 was evaluated by different evaluation methods including weighted synthetic scored method,weighted synthetic index method, Weighted Technique for Order Preference by Similarity to Ideal Solution (Topsis ) and Weighted Rank -Sum Ratio (RSR).The consistency of evaluation results were tested by Kendall's coefficient of concordance W test.Combination evaluation was conducted to evaluate four single synthetic evaluation results through average method,weighted average combination evaluation method and hierarchical clustering analysis.Results Different synthetic evaluation methods had different evaluation results.However,in the order,the top two were all Hangzhou and Ningbo.Kendall's W test showed good consistence of four evaluation results.Rank of 1 1 cities were Hangzhou,Ningbo,Shaoxing,Jiaxing,Huzhou, Taizhou,Jinhua,Zhoushan,Lishui,Wenzhou and Quzhou based on combination evaluation value by average method, which was the same to the rank based on weighted average combination evaluation result.Eleven cities could be classified into four categories by hierarchical clustering analysis with statistical significance (P <0.01 ):Excellent (Hangzhou, Ningbo),Good (Huzhou,Jiaxing,Shaoxing),Middle (Zhoushan,Jinhua,Taizhou)and Poor (Wenzhou,Quzhou, Lishui).Conclusion These four synthetic evaluation methods used in this study are all suitable to county level and above in basic public health services evaluation.Various synthetic evaluation methods could be used in practice with combination evaluation of various evaluation results.Average method which is convenient and accurate is preferred when consistency of various synthetic evaluation results was testified.Hierarchical clustering analysis could be used for combination evaluation when no precise rank is needed.
ABSTRACT
<p><b>OBJECTIVE</b>To discuss the clustering of Yunnan unexplained sudden death (YUSD) in household and village.</p><p><b>METHODS</b>Fifty-two cases were found by YUSD surveillance system in 2005. Poisson distribution and beta-binomial distribution (BBD) were employed in studying the household distribution of the disease. Poisson distribution and negative binomial distribution (NBD) were employed in studying the village distribution of the disease.</p><p><b>RESULTS</b>BBD were fitted household distribution of YUSD very well (chi(2) = 0.25, P = 0.62), while Poisson distribution was consistent with it (chi(2) = 46.01, P < 0.001). And NBD were fitted village distribution of YUSD very well (chi(2) = 0.05, P = 0.58), however the consistency in Poisson distribution was not observed (chi(2) = 110.57, P < 0.001).</p><p><b>CONCLUSION</b>Household and village clustering of YUSD does exist.</p>