Abstract Objective: Household is a fundamental unit in many fields. This study was to analyse consistency degree and people’s health service needs from the perspective of household. Methods: A multi-stage random sampling was conducted. A total of 7293 individuals in 2715 households were interviewed, and 1606 individuals in 803 empty-nest households were enrolled in this study. A questionnaire was used to ask each individual about their health service needs in empty nest households. The consistency degree was calculated based on their consistent answers to the questionnaire, and a correlation analyse was used to study the relationship of individuals’ health service needs in the same empty nest households. A family collective model was used to analyse household-based health service needs. Results: Individual’s needs consistency rates in empty nest households, such as diagnosis and treatment service(H1), follow-up service for chronic disease(H2), telemedicine care(H3), physical examination service(H4), health education service(H5), mental healthcare(H6), and Chinese traditional medicine service(H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Service needs of H1, H3, H4, H5, H7 for individuals in the same empty nest households had significant correlations with each other (r=0.404, 0.177, 0.286, 0.265, 0.220, P<0.001). Health service needs from a perspective of household in rural China mainly included H1 (12.4%), H4 (44.2%), H5 (26.9%) and H7(18.9%). Conclusions: Individuals in the same household are highly consistent with each other in health service needs. Individuals could affect other members’ health service needs in their households, when one of them get illness, their spouse would likely to have same health service needs to avoid getting disease or to keep health. In this study, health service needs in empty nest households are mainly concerned with health promotion and maintenance services, which could be an indicator for primary care to improve the effectiveness of service delivery, such as family doctor and family-based health insurance system. Also, more focus should be paid on households that need great help on different health services.
Background: Integrated care has gained popularity in recent decades. This study aims to explore its global progress, current foci, and future trends.Methods: We conducted a scientometric analysis. Data (including subject categories, countries/territories, institutions, journals, citations, and author keywords) were exported from the Web of Science database. Publication number and citations, co-authorship between countries and institutions, co-occurrence of author keywords and cluster analysis were calculated with Histcite12.03.07 and VOSviewer1.6.4.Results: A total of 6127 articles were retrieved from 1997 to 2016. Results indicate the following: (1) The USA, UK, and Canada led research with the most publications, citations, and productive institutions. (2) The top 10 cited papers and journals (such as BMC Health Services Research) are crucial for the knowledge distribution. (3) The 50 author keywords were clustered into five groups, including digital medicine and e-health, community health and chronic disease management, primary health care and mental health, health care system for infectious diseases, health care reform and qualitative research, social care and health policy services.Conclusions: This paper confirmed that integrated care is undergoing rapid development with more categories involved and additional collaboration networks established. Various research foci are forming like economic incentives mechanism for integration, e-health data mining, systematically quantitative study. Moreover, an urgent need exists for the development of the performance measurement for policies and models.
<span lang="EN-US">The integration of quality management in physical education has changed the traditional approach to teaching. The information overload and an enormous amount of irrelevant data available to qualified specialists may lead to professional stress. Quality management offers educators tips on how to avoid information overload while still staying updated with the necessary information, knowledge and skills. The research aimed to examine the main characteristics of quality management in teaching. The sample consisted of 296 students: 73% - male subjects, 27% - females subjects. The average age is 19.37±0.31. The research analyzed the factors affecting the quality of education using the quality competency and student satisfaction questionnaire. The findings revealed that Chinese students were satisfied with the physical and environmental conditions (8.1±0.23 points) and it was 22% higher than the results of Ukrainian students. The education programs, technological opportunities and student scientific work have the greatest influence on the quality of education in China (8.38±0.32). The least influence has the adequacy of management and staff (7.21±0.27). Career support, tours and practices related to physical education have the greatest influence on the education quality in Ukraine (8.43±0.32). The parameters identified by the research can be integrated into the system of higher physical education to improve the quality and academic achievements.</span>
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021.
Abstract Background: Shenzhen has the largest number of migrant children of all cities in China. Unequal access to basic health services among migrant and local children greatly affects health equity and has a profound impact on the quality of human capital. This study aimed to investigate differences in child health management service utilization between local and migrant children in the Futian District of Shenzhen and to identify factors influencing these differences.Methods: This study extracted the data on child health management in the Futian District of Shenzhen from the 2018 Survey of Health Service Needs of Chinese Residents in the New Era. The chi-square test was used to analyze differences between local and migrant children, and specific factors affecting child health management service utilization were analyzed with binary logistic regression.Results: In this study, 1512 families in 12 communities in Futian District, Shenzhen were investigated. Among this families, 936 participants were aged 0-14 years, and the final effective sample size was 508. The greatest difference between migrant and local children was in the utilization of development guidance services (59% vs. 77.5%, P < 0.001). The main factors influencing physical examination, development guidance, disease prevention guidance, injury prevention guidance, oral health guidance and mental health guidance service utilization were mother’s educational level, household registration, father’s educational level, father’s occupation and annual family income, household registration, the child’s sex and father’s occupation, respectively. The odds of having used disease prevention guidance were 2.257 times higher among children whose fathers had an undergraduate education or above compared with children whose fathers had a junior high school education or below (95% CI: 1.417–3.595). The odds of having used injury prevention guidance were 46.3% lower for children whose fathers were mixed white-/blue-collar workers compared with children whose fathers were white-collar workers (OR = 0.537, 95% CI: 0.361–0.799). The odds of having used mental health guidance were 52.2% lower among children whose fathers were mixed white-/blue-collar workers compared with those whose fathers were white-collar workers (OR = 0.478, 95% CI: 0.293–0.777).Conclusions: In the Futian District of Shenzhen, health management service utilization is significantly lower among migrant children than among local children. Father’s educational level and occupation limit the utilization of child health management services for migrant children. Fathers have a stronger influence on children’s health service utilization than do mothers. The potential influence of fathers in promoting children’s health maintenance should be carefully considered, and fathers’ attention to children’s health should be increased.
Global budget (GB) is considered one of the most important payment methods available. Since a new round of healthcare system reforms in 2009, the Chinese government has been paying attention to this prospective payment. However, it is unclear whether GB has influenced cost control and how it works in rural China.YC county was chosen as the intervention group, with 33,175 inpatients before and 36,883 inpatients after the reform (2012 and 2014, respectively). ZJ county acted as the control group, with 23,668 and 29,555 inpatients, respectively. The inpatients' information was collected from a local insurance agency. The difference-in-difference method (controlling for age, gender, living status, severity of the disease, whether the patient had surgery, the level of medical institutions, and the secular trends of the two groups) was applied to estimate the effects on total spending (TS), reimbursement expense (RE), out-of-pocket payment (OOP), readmission rate, and seven kinds of medical service items.At per practice level, the GB was associated with a ¥263.35 (p < .001) and ¥447.46 (p < .001) decrease in growth of TS and RE, respectively, while OOP increased by ¥188.06 (p < .001). At per capital level, the decrease in growth of TS and RE was ¥64.39 (p = .301) and ¥467.45 (p < .001), respectively, whereas the increase of OOP was more significant at ¥408.19 (p < .001). Savings were concentrated in unclassified items (¥197.68, p < .001), drug prescription (¥69.03, p < .001), surgery (¥40.18, p < .001), cure (¥4.95, p = .565), and diagnosis (¥3.61, p = .064). Meanwhile, the readmission rate increased by 11.4% (p < .001).The GB has a prominent impact on curbing the growth of insurance fund expenditures, as well as drug and medical consumable costs. However, the patients' out-of-pocket payment has risen. Doctors decomposed hospitalization to deal with supervision, which was harmful to patients. Any medical insurance payment reform should be undertaken prudently, and its likely outcomes should be weighed comprehensively.
BACKGROUND Current research highlights the importance of addressing multiple risk factors concurrently to tackle the complex etiology of dementia. However, limited evidence exists on the efficacy of technology-driven, multidomain community-based interventions for preventing cognitive decline. OBJECTIVE To evaluate the efficacy of ADL+, an artificial intelligence (AI)-enabled digital toolkit integrating cognitive assessments and multidomain interventions, on outcomes of cognitive function, activity levels, and quality of life in older adults at risk of cognitive decline. Adherence and usability were also evaluated. METHODS We conducted a quasi-experimental study including community-dwelling older adults aged 60 years and above without dementia, but with subjective memory complaints (AD8 score≥2). Participants received a 6-month intervention (app-based cognitive training, personalized nutritional, physical, and social activities recommendations) or a control group treatment (cognitive health educational package). The primary outcome was change in neuropsychological test battery (NTB) Z-scores (NTB composite and its individual domains–attention, processing speed, memory, and executive function). Secondary outcomes were activity levels (Frenchay Activities Index, FAI), and quality-of-life (EQ-5D). Outcomes were assessed at the end of the intervention and three months post-intervention using linear mixed effects models. RESULTS One-hundred and fifty-two individuals were assigned to the intervention group (N=75) or control group (N=77). 72 (96%) participants in the intervention group and 67 (87%) in the control group completed the study. At six months, the intervention group showed a significant NTB composite score improvement (mean change: 0.086 (95% CI 0.020-0.15)), resulting in a between-group difference of 0.17 (95% CI 0.071-0.27). Significant differences in attention, processing speed, and memory domains were observed, with benefits sustained in processing speed domain at nine months. The control group's FAI scores declined at six months (mean change: -1.04 (95% CI -1.83- -0.26)), while the intervention group's scores remained stable. The intervention group's EQ-5D Visual Analogue Scale (VAS) scores improved at both six and nine months with between-group differences of 4.06 (95% CI 0.23-7.90) at six months and 5.12 (95% CI 0.81-9.43) at nine months. Adherence was high, while average usability scores were obtained. CONCLUSIONS The ADL+ toolkit shows potential beneficial effects on cognitive function, activity levels, and quality-of-life for older adults at risk of cognitive decline. Findings will guide future randomized controlled trials and implementation efforts. CLINICALTRIAL
Inappropriate admissions have contributed to the rapid increase in hospitalisations in rural China. This study characterised the degree and determinants of inappropriate admissions in county hospitals. We used expert consultation to develop an appropriateness evaluation protocol that included nine requirements for services and 21 indicators of disease severity. A total of 2230 medical records from 2014 were collected from five county hospitals by stratified cluster sampling and evaluated for appropriateness using the protocol in 2016. The determinants of inappropriate admissions were analysed by two-level logistic regression. The overall inappropriate admission rate was 15.2%. Patients aged <20 years (19.3%), patients in the paediatrics department (22.9%), patients with lower disease severity (22.3%), and patients without complications (17.0%) were more likely to have been inappropriately admitted than other groups. Age, treating department, disease severity, causes of hospitalisation, complications, and length of stay were determinants of inappropriate admission. Policymakers must act to reduce the high prevalence of inappropriate admissions in county hospitals in rural China, by guiding patients to seek primary care and changing the motivating mechanism of these hospitals.
Self-rated health among old adults (SHOA) indicates individuals' subjective assessments and evaluations of their overall health based on objective physical circumstances. The purpose of this study was to analyze the current state and influencing factors of the subjective perception-based self-rated health (SH) by qualifying selected older adults with similar objective physical conditions, as well as to explore the equality and changing trends of SHOA based on influencing factors.This study designed a cross-sectional study, conducted in three provinces in east, central and west China, and included 1,153 older adults (> = 60 years) with intact physical condition (IPC). The current state of SHOA and its influencing factors were analyzed using mean comparisons and Logistic regression (LR) models. The equality level and trend of SHOA's effect on health literacy, health habits, and access to health care were determined using the Lorenz curve, Gini coefficient, and Vector Autoregression (VAR) model.The mean SHOA with IPC was 74.37 ± 13.22. Findings from LR modeling indicated that SHOA with IPC was mainly influenced by age and communication methods (P < 0.05). It was also observed that the total Gini coefficient of the allocation of SHOA with IPC based on communication methods was equal to 0.0188, and the VAR results showed that the total effect of change in SHOA on health literacy among older adults was negative and its duration of the effect exceeded 50.The SHOA with IPC was shown to be better and was primarily influenced by age and communication methods. The observed effect of SHOA on health literacy was negative and lasting. To improve SHOA with IPC even further, policymakers could consider promoting the use of modern and convenient communication methods (such as smartphones) through training and purchasing subsidies, as well as focusing on increasing sustained attention and promoting health literacy and behavior among older adults with improved SH.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)