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Objective:To understand the current situation and problems of the supervision of individual clinics in China , and put forward some reform suggestions .Methods:Two cities were selected from typical provinces in east-ern, central and western regions by typical sampling .The investigation was conducted by semi-structured interviews and typical clinic participant observation method .Results:There were serious problems in the regulation of the pri-vate clinics and it was necessary to build efficient regulation mechanism .Conclusions:We should strengthen the su-pervision of private clinics .In the future , we should improve the access threshold for the private clinic; strengthen inter-sector cooperation and joint law enforcement; promote information exchange and information network construc-tion;use economic incentives and punitive measures at the same time and make the association itself and social su -pervision work .
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BACKGROUND: Both MRI and transcranial Doppler can be used for ultra-early assessment of acute cerebral infarction (ACI), the former is considered as a reliable diagnostic means mainly for the morphological changes of ACI, however the latter is often used before obvious morphological changes appeared, but their combined diagnostic value is still uncertain. OBJECrIVE: To investigate the value of combined MRI and transcranial Doppler in ultra-early assessment of highly suspected ACI.DESIGN: Case analysis and double-blind design.SETTING: MRI Department of Daqing Oil-field General Hospital and Department of Clinical Epidemiology of West China School, and Medical-Economic Department of Public Health College, Sichuan University.PARTICIPANTS: From May 2000 to July 2001, totally 225 highly suspected ACI patients with stoke-like onset, 121 males and 104 females,aged of 33-86 years old with the means of (62±12), within 12 hours after onset, informed of the experiment, were selected from Daqing Oil-field General Hospital.METHODS: All cases subjected to transcranial Dopller examination and following MRI examination with interval of no more than 1 hour, then received follow-up MRI examination at 15 days later (as golden diagnostic standards for CI). MRI was performed to detect the position, morphology,size and signal of pathological changes. Transcranial Doppler was used to determine the blood flow velocity, peak value of systolic and diastolic stage, frequency spectrum and sound spectrum of blood flow of bilateral cerebral anterior, middle and posterior arteries, internal carotid artery and basal vertebral artery.MAIN OUTCOME MEASURES: The sensitivity, specificity and accuracy in the diagnosis of ACI with MRI, transcranial Doppler and the combination of MRI and transcranial Doppler.RESULTS: Totally 225 cases were selected, and 5 excluded for not accordant to the inclusion standards, finally 220 statistical analyzed. The diagnostic sensitivity of MRI was 79.3%,. specificity of 98.4% and accuracy of 90.5%, comparing to corresponding 80.4%, 81.3% and 80.9% of transcranial Doppler, and 96.7%, 80.5%, 87.3% of the combination of MRI and transcranial Doppler.CONCLUSION: The combination of MRI and transcranial Doppler can be used to make rapid and accurate assessment of ACI due to higher sensitivity and specificity.
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<p><b>OBJECTIVE</b>To determine the economic effects on the prevention of dental fear (DF) by pre-operation-education or local anesthesia method during the process of tooth filling.</p><p><b>METHODS</b>One hundred and fifty school children of age 7 to 12, participating in this study, suffered from occlusal caries on their mandibular first molars. They were divided into 3 groups, with 25 boys and 25 girls each. Group A (pre-operation-education) was showed video tape on caries to, familiarized with clinic environment, including dental chairs and instruments; Group B (local anesthesia) received injection of 1.8 ml of 2% lidocaine for local anesthesia about 15 minutes before treatment; Group C (blank) received no intervention for DF. Thereafter, all subjects received same filling treatment. During that process, each DF case was evaluated blindly based on Venham's clinical ratings of anxiety and cooperation. Cost-minimization analysis was then studied.</p><p><b>RESULTS</b>Significant difference was found between groups, but not between group A and B in DF rate (5/50, 9/50 and 21/50, chi(2) = 15.503 1, P = 0.000 4). The costs of each case in 3 groups were 83.99 Yuan, 87.09 Yuan and 87.76 Yuan respectively.</p><p><b>CONCLUSION</b>Between pre-operation-education and local anesthesia methods, the former was worth promoted for it's better clinical effect in DF prevention with lower cost.</p>
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Child , Female , Humans , Male , Dental Anxiety , Economics , Epidemiology , Dental Caries , Therapeutics , Dental Cavity Preparation , Economics , Methods , IncidenceABSTRACT
Objective To seek a rational method of estimating the demands for medical services so as to work out regional health planning in a scientific way. Methods A metropolis including 19 counties and districts was selected as a region and demands for medical services were forecasted via retrospective analysis and the econometric model. Results A model of the demands for outpatient and inpatient services was obtained based on the impact of many social and economic factors on medical health services, and illustrations were given to indicate the demands for medical health services in the 19 counties and districts in future when prices should rise by 15% and 20%. Conclusion The econometric model can be used as a tool for estimating the demands for medical health services, and yet improvements need to be made.
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With the support of international organizations like the United Nations Children's Fund, the Health Economy Network conducted a five－year experimental study of various forms of cooperative medical care in 10 counties involving 8 provinces of the country. The paper reports the results of a survey of 8 141 persons from 2 076 households. The rate of insurance coverage of individuals reached 73.7%. Among the peasant households that participated in cooperative medical care, 54.6% received compensations, 38.9% thought that their economic burdens had been lightened, 43.3% thought that it was more convenient now to seek medical service, and 41.5% thought that service quality had been improved as a result of cooperative medical care. Comparison with the control group indicates that adoption of cooperative medical care can provide community residents with medical and health security, lighten their economic burdens and enhance the utilization of health services.