Factors affecting psychological health and suicidal behavior: based on a survey of 10 340 medical students from three universities / 南方医科大学学报

OBJECTIVE@#To explore the factors influencing mental health and suicidal behaviors of medical students and provide a scientific basis for improving their mental health and reducing their suicidal behaviors.@*METHODS@#We conducted a questionnaire-based survey among 11 270 medical students in the first and second years at 3 universities in the southern, northern and central regions of a province in China, and 10 340 valid responses were retrieved. Multiple logistic regression was used to analyze the factors affecting anxiety, depression and suicidal behaviors, particularly the impact of family environment on the mental health status of the medical students.@*RESULTS@#Medical students of the female gender, in their second year in college, with dissatisfaction with their major, coming from poor families, families experiencing domestic violence or dysfunctional family were more likely to develop depression and anxiety; medical students who experienced violence by their parents or guardians and had childhood experience of separation from parents were more likely to develop anxiety (@*CONCLUSIONS@#The mental health and suicidal behavior of medical students are affected by various factors involving family conditions, childhood experience, to which parents and relevant agencies should give due attention.

Analysis of integrated healthcare model for Chronic Obstructive Pulmonary Disease patients / 中国卫生政策研究

Objective: The aim of this paper is to identify the basic organizational structure and the key elements of integrated healthcare model of patients with Chronic Obstructive Pulmonary Disease (COPD) and propose an appropriate development strategy.Methods: Based on the literature review of research articles about integrated care on patients with COPD, an analysis was conducted with the help of the Chronic Care Model (CCM) which is a chronic disease management model.Results: From of a total 16 articles about 13 case studies were found.An integrated healthcare of COPD was carried out in 10 hospital-based or community-based care programs.Most of the patients were the elderly and health status were moderately severe or more severe.The components of healthcare programs varied from 4 to 12 included at least two CCM dimension.A coordinator or a case manager was appointed in all healthcare programs and a follow-up plan was made as well.Decision making was supported by clinic guideline and specialist resource in 9 integrated healthcare programs which community facilities involved.All programs included self-management with health education and individualized behavioral support was in 10 programs.The action plan was applied in 8 studies.8 studies using a clinical information system connected health care provider and patients.Conclusions: COPD integrated care program can be constructed according to the management model of chronic disease, and it is suggested that we can organize the COPD integrated care program based on CCM and the program comprises 4 organizational components of at least two CCM dimensions.The key elements of COPD integrated healthcare are to appoint a coordinator, to make a follow-up plan, and the necessity of community participation to support decision making, support self-management by education and individualized behavioral management with an action plan.

Insights on multi-site physician practice in the cooperative medical background / 中华医院管理杂志

The paper introduced the multi-site physician practice operational in the modes of hospital departmental support,hospital trusteeship,and public-private hospital management,and summarized the merits of such a practice adopted in the background of cooperative hospital operations as follows.A cooperation of common interests enjoys supports of all stakeholders and minimum resistance;better policies and conditions mobilize physicians'incentives; better continuity of medical practice; better public benefits of the hospital.The paper also probed into such issues as setbacks of the practice in such a background,complicity of medical disputes definition and resolution,possible talent drain of public hospitals,and possible impacts on branding and core competence of public hospitals.

Strengthen the Revisit Management of Patients to Promote the Development of Hospital Marketing / 中国医学伦理学

The article discusses a number of important marketing ideas which should be clarified and fully understood in strengthening the follow-up management of patients,including understanding of the meaning of customers,the formation of the concept of market and the evolution of marketing.The adoption of patient follow-up management could delivered value to customers and promote their satisfaction.In the end,the article proposes that a long-term marketing mechanism of patient follow-up services should be established in order to achieve the a better development of hospitals.