The impact of family doctor system on patients' utilisation of general practitioner in primary care facilities-Evidence from Hangzhou, China.

OBJECTIVE: This study aims to examine whether participating in the contracted family doctor system increases patients' utilisation of primary care general practitioner for multiple disease outcomes in China. METHODS: Binary logistic regression models were estimated using data collected from 372 community residents in nine selected districts of Hangzhou, China. RESULTS: Findings revealed that (1) for patients with influenza, diabetes, upper respiratory infection, and gingivitis, those who participated in the contracted family doctor system were approximately 4.3 times, 98.4%, 92.5%, and 52.8% more likely to choose primary care general practitioners (GP) for their initial diagnosis, respectively, as compared with their counterparts who did not have contracted family doctors; (2) For patients with stroke or cerebrovascular disease and cholecystitis or cholelithiasis, those who had contracted family doctors were 1.111 times and 80.6% more likely to choose primary care GP for their subsequent disease maintenance, respectively, as compared to their counterparts without contracted family doctors. CONCLUSION: Our findings indicate that the contracted family doctor system not only increases the utilisation of primary care GP for patients with many chronic conditions but also promotes the overall completion of China's hierarchical medical system in the long run. Policy implications were provided to help policymakers actively construct and develop the contracted family doctor system to promote the hierarchical medical system in China.

Application of metabolomics profiling in the analysis of metabolites and taste quality in different subtypes of white tea.

Three subtypes of white tea, Silver Needle (SN), White Peony (WP), and Shou Mei (SM), differ in their taste, aroma, bioactivity, and commercial value. Here, a metabolomics investigation on the chemical compositions combining taste equivalent-quantification and dose-over-threshold (DoT) determination on the taste qualities were applied to comprehensively characterize the white tea subtypes for the first time. Significant differences in the contents of catechins, dimeric catechins, amino acids, phenolic acids, flavonol/flavone glycosides, and aroma precursors were observed among these 3 white teas. Metabolite content comparison and partial least-squares (PLS) analysis suggest that theanine, aspartic acid, asparagine, and AMP were positively correlated with the umami taste in white tea, and flavan-3-ols, theasinensins, procyanidin B3, and theobromine had positive correlations with higher bitterness and astringency tastes. In addition, puckering astringent (-)-epigallocatechin gallate (EGCG), (-)-epicatechin gallate (ECG) and theogallin, bitter-tasting caffeine, and the mouth-drying/velvety-like astringent γ-aminobutyric acid (GABA) were identified as key taste compounds of white tea infusion by absolute quantification and DoT factor calculations. This work provided systematic and comprehensive knowledge on the chemical components, taste qualities, and sensory active metabolites for the subtypes of white tea.