Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,p...Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].展开更多
Amid the global wave of digital economy,China's medical artificial intelligence applications are rapidly advancing through technological innovation and policy support,while facing multifaceted evaluation and regul...Amid the global wave of digital economy,China's medical artificial intelligence applications are rapidly advancing through technological innovation and policy support,while facing multifaceted evaluation and regulatory challenges.The dynamic algorithm evolution undermines the consistency of assessment criteria,multimodal systems lack unified evaluation metrics,and conflicts persist between data sharing and privacy protection.To address these issues,the China National Health Development Research Center has established a value assessment framework for artificial intelligence medical technologies,formulated the country's first technical guideline for clinical evaluation,and validated their practicality through scenario-based pilot studies.Furthermore,this paper proposes introducing a"regulatory sandbox"model to test technical compliance in controlled environments,thereby balancing innovation incentives with risk governance.展开更多
Objective To systematically review the published clinical and economic research on liposomal irinotecan in combination with 5-FU/LV for metastatic pancreatic ductal adenocarcinoma(mPDAC)at home and abroad.Methods PubM...Objective To systematically review the published clinical and economic research on liposomal irinotecan in combination with 5-FU/LV for metastatic pancreatic ductal adenocarcinoma(mPDAC)at home and abroad.Methods PubMed,Cochrane Library,Embase,CBM,CNKI,Wan Fang data,CRD database and health technology assessment official websites were searched to collect clinical and economic studies on liposomal irinotecan for mPDAC.Results and Conclusion Nine clinical studies and four economic studies were included.The result of clinical studies showed that liposomal irinotecan in combination with 5-FU/LV could extend survival with good drug compliance in patients with mPDAC who progressed on prior gemcitabine-based therapy.This agent represented a new treatment option for second-line chemotherapy in these patients.The results of the economic evaluations failed to reach a consistent conclusion due to different economic levels in various countries.展开更多
Objective This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline(BR)and the conventional treatment regimen(CR,not containing Bedaquiline)for the treatment of adu...Objective This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline(BR)and the conventional treatment regimen(CR,not containing Bedaquiline)for the treatment of adults with multidrug-resistant tuberculosis(MDR-TB)in China.Methods A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years.The model parameter data were synthesized from the literature,the national TB surveillance information system,and consultation with experts.The incremental cost-effectiveness ratio(ICER)of BR vs.CR was determined.Results BR(vs.CR)had a higher sputum culture conversion rate and cure rate and prevented many premature deaths(decreased by 12.8%),thereby obtaining more quality-adjusted life years(QALYs)(increased by 2.31 years).The per capita cost in BR was as high as 138,000 yuan,roughly double that of CR.The ICER for BR was 33,700 yuan/QALY,which was lower than China's 1×per capita Gross Domestic Product(GDP)in 2020(72,400 yuan).Conclusion BR is shown to be cost effective.When the unit price of Bedaquiline reaches or falls below57.21 yuan per unit,BR is expected to be the dominant strategy in China over CR.展开更多
BACKGROUND In recent decades,China has faced a double burden of infectious diseases and noncommunicable diseases(NCDs).The number of deaths due to NCDs accounts for 88.5%of total deaths in China in 2019.To address the...BACKGROUND In recent decades,China has faced a double burden of infectious diseases and noncommunicable diseases(NCDs).The number of deaths due to NCDs accounts for 88.5%of total deaths in China in 2019.To address these public health issues and improve the accessibility and affordability of primary health care,a National Basic Public Health Service Program(NBPHSP)was introduced as part of China’s healthcare reform initiated in 2009.Subsided by national and local government budgets,NBPHSP is mainly implemented by community and township health service centers,as well as health stations in urban areas and village clinics in rural areas(1).Health management of patients with hypertension and diabetes is an integral and pivotal part of the NBPHSP.展开更多
Medical artificial intelligence (AI) in China is now on the eve of a massive surge. Despite great promise from this emerging field, there remain formidable pitfalls and obstacles, especially the challenges to current ...Medical artificial intelligence (AI) in China is now on the eve of a massive surge. Despite great promise from this emerging field, there remain formidable pitfalls and obstacles, especially the challenges to current legal rules. We review the development of legal rules concerning medical AI in China, discuss risks of liability of commercial organizations and health care providers and whether current rules should be amended, and if so, what are the key issues to be addressed. Finally, we close by sketching possible ways forward for the legal and regulatory system.展开更多
Objective To re-evaluate the systematic review of the safety and effectiveness of epidural analgesia(EA)for labor analgesia.Methods The Cochrane database,PubMed,EMBASE,EBSCO,Web of Science,ScienceDirect,China Biomedic...Objective To re-evaluate the systematic review of the safety and effectiveness of epidural analgesia(EA)for labor analgesia.Methods The Cochrane database,PubMed,EMBASE,EBSCO,Web of Science,ScienceDirect,China Biomedical Literature database,CNKI,Wanfang and VIP databases were searched,and the search time was limited to August 2020.Two researchers screened the literature and extracted data according to the inclusion criteria.AMSTAR was used to evaluate the methodological quality of the included studies.Pain intensity and pain relief satisfaction were used as the main indicators for re-evaluation of the effectiveness.Midwifery rate,cesarean section rate,back pain,fever,nausea and vomiting,umbilical artery pH value,and newborn Apgar score were used as the main indicators to re-evaluate the safety.Results and Conclusion A total of 9 meta-analyses were included.The safety and effectiveness of EA and opioid intravenous analgesia,acupuncture stimulation,inhalation analgesia,no analgesia,and continuous delivery were evaluated separately.The included systematic reviews showed that EA could increase the rate of device-assisted delivery,causing maternal fever,and prolonging the first and second stages of labor.But the incidence of back pain,nausea,and vomiting was lower.Therefore,analgesia had a good effect with better satisfactory degree.Current evidence shows that EA is safe and effective for labor analgesia,but the quality of the reports of current studies is not high.展开更多
This paper explores the expansion from fintech-based regulatory sandboxes to those that include medical artificial intelligence(AI)by examining their potential to foster innovation and accelerate market access while e...This paper explores the expansion from fintech-based regulatory sandboxes to those that include medical artificial intelligence(AI)by examining their potential to foster innovation and accelerate market access while ensuring safety and compliance,especially considering how they provide a flexible framework for medical AI companies to develop and test new technologies.This work also highlights the key risks involved,including data privacy,ethical concerns,real-world validation,and regulatory consistency,and proposes strategies for mitigation.Using case studies from the United States,the United Kingdom,the European Union,Indonesia,Japan,and China,this paper illustrates how regulatory sandboxes can support AI-driven healthcare innovation.Overall,although regulatory sandboxes present several risks,they are valuable for advancing medical AI,granted that they balance innovation with robust oversight to ensure patient safety and long-term benefits.展开更多
Objectives:To analyze the satisfaction of patients with community health service(CHS)and the changes of the CHS delivered before and after the new health reform in different regions of China,and to put forward relevan...Objectives:To analyze the satisfaction of patients with community health service(CHS)and the changes of the CHS delivered before and after the new health reform in different regions of China,and to put forward relevant policy recommendations for CHS development.Methods:Twelve community health centers were selected by random sampling in each of the eight typical cities in the east,middle and west regions of China.Questionnaire survey was conducted among patients visiting these institutions during daily work hours.Results:The proportions of the participants who stated that the medical environment,service attitude and medical skills of the doctors were improved were higher in the west region than those of the east and middle regions;but the percentage of patients who held that the drug price had lowered was higher in the east region than those of the middle and west region,the differences were of statistical significance(P<0.0125).The patients’satisfaction rates with medical environment,service attitude,and technical skills of the medical staff in the west region were 88.9%,91.5%and 81.6%respectively,which were higher than those in the east and middle regions.In the east region,the satisfaction rate with the reimbursement for this visit was 58.5%,which was highest among the three regions;in the west region,patients’satisfaction rates with drug types and preventive care were 51.5%and 65.9%,respectively,which was significantly higher than those in the east and middle regions(P<0.0125).As recommended by the participants,the top three aspects of health services that need to be improved were drug type and quality(25.3%),drug prices(21.8%)and technical skills(18.2%)in the east region;infrastructure(28.2%),drug prices(21.8%)and drug types and quality(21.2%)in the middle region;infrastructure(30.8%),drug types and quality(28.1%)and reimbursement(27.9%)in the west region.Conclusions:The comprehensive CHS reform should take the opinions of patients into account;essential drug system should be consolidated continually;and the reform of the payment system should be promoted by actively cooperating with the health insurance organizations.展开更多
Objective:This research aims to develop a more scientific and reasonable performance evaluation indicator system for the implementation of an essential drug system in community health service institutions.Methods:The ...Objective:This research aims to develop a more scientific and reasonable performance evaluation indicator system for the implementation of an essential drug system in community health service institutions.Methods:The Delphi method was used to establish an indicator system based on three rounds of expert consultations,and the fuzzy comprehensive evaluation method was used to determine the weights of the indicators.Results:The participation in the three rounds of consultations were 100%(10/10),90%(18/20),and 85%(17/20),which showed that the experts had real enthusiasm for participating in this research.The authority coefficients of the first-,second-,and third-level indicators were 0.75,0.76,and 0.76,respectively,which showed that the consultation results were dependable.The concordance coefficients of the second and third rounds were 0.489 and 0.487,respectively(P<0.001),indicating that the expert opinions were highly consistent.The performance evaluation indicator system consisted of three first-level indicators(supporting,implementation,and effect indicators),nine second-level indicators,and 21 third-level indicators.Conclusion:In this new performance evaluation indicator system,the selected experts were representative,the consultation results were dependable,the constructed evaluation indicator system was reasonable,and the setting of weights was scientific.展开更多
What is already known about this topic?The global burden of chronic kidney disease(CKD)is on the rise.What is added by this report?In 2019,5.58 million individuals in China were affected by CKD related to hypertension...What is already known about this topic?The global burden of chronic kidney disease(CKD)is on the rise.What is added by this report?In 2019,5.58 million individuals in China were affected by CKD related to hypertension,leading to 70,260 fatalities and 1.69 million disability-adjusted life years(DALYs).The most affected groups were men,older individuals,and residents of western China.Over the period from 2010–2019,the age-standardized prevalence rate(ASPR)remained constant,and the agestandardized mortality rate(ASMR)and agestandardized DALY rate(ASDR)showed a decreasing trend.However,there was an increase in the number of cases,deaths,and DALYs associated with this condition.What are the implications for public health practice?Hypertension significantly contributes to the burden of CKD;therefore,raising awareness and implementing early screening measures are essential.展开更多
Diagnosis-related Groups(DRG)is an internationally recognized advanced hospital management method.It was pioneered by Yale University in the late 1960s and has been used as the inpatient prospective payment system by ...Diagnosis-related Groups(DRG)is an internationally recognized advanced hospital management method.It was pioneered by Yale University in the late 1960s and has been used as the inpatient prospective payment system by the U.S.Medicare program since 1983(1,2).It has since been introduced in Australia,Germany,France,the UK,Japan,South Korea,and Scandinavia.It is widely used in the fields of pricing and payment,budget allocation,performance evaluation,and comparison(2).As a refined hospital management tool,DRG combined with the corresponding payment mechanism can effectively meet the requirements of health expenditure control,hospital management,and health insurance management(3).DRG is also crucial for promoting the shift of payment methods from retrospective payment to prospective payment and for improving the performance management of the healthcare system.展开更多
Currently, China has a growing need for rehabilitative care;however, rehabilitative care has been underdeveloped for decades. Since the end of 2010, pilot programs in 46 cities (districts) of 14 provinces have been in...Currently, China has a growing need for rehabilitative care;however, rehabilitative care has been underdeveloped for decades. Since the end of 2010, pilot programs in 46 cities (districts) of 14 provinces have been initiated by the Ministry of Health in China to establish formal arrangements for facilitating the delivery of continuous medical rehabilitative care for local communities. After 2 years of pilot work, an evaluation was conducted by researchers. This paper reviews the current status of rehabilitative care in China and discusses the findings of the nationwide pilot program on the integrated rehabilitative service. Some key mechanisms and main issues were identified after analyzing the preliminary outcomes of some of the pilot programs.展开更多
This paper seeks to explore the relevance between the Western 'expert patient' rhetoric and the reality of non-communicable diseases (NCDs) control and management in low and middle income settings from the hea...This paper seeks to explore the relevance between the Western 'expert patient' rhetoric and the reality of non-communicable diseases (NCDs) control and management in low and middle income settings from the health sociological perspective.It firstly sets up a conceptual framework of the 'expert patient' or the patient self-management approach, showing the rhetoric of the initiative in the developed countries.Then by examining the situation of NCDs control and management in low income settings, the paper tries to evaluate the possibilities of implementing the 'expert patient' approach in these countries.Kober and Van Damme's study on the relevance of the 'expert patient' for an HIV/AIDS program in low income settings is critically studied to show the relevance of the developed countries' rhetoric of the 'expert patient' approach for the reality of developing countries.In addition, the MoPoTsyo diabetes peer educator program is analyzed to show the challenges faced by the low income countries in implementing patient selfmanagement programs.Finally, applications of the expert patient approach in China are discussed as well, to remind us of the possible difficulties in introducing it into rural settings.Copyright 2015, Chinese Medical Association Production.Production and hosting by Elsevier B.V.on behalf of KeAi Communications Co., Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).展开更多
Non-communicable diseases (NCDs) are a leading cause of deaths and of disease burden in China.This paper analyzes the rationale and implications of a community-based approach to a better coordinated NCDs care and mana...Non-communicable diseases (NCDs) are a leading cause of deaths and of disease burden in China.This paper analyzes the rationale and implications of a community-based approach to a better coordinated NCDs care and management system in China.As argued by the author, the buildup of an integrated NCDs care delivery system is feasible now and large health expenditures will be saved if more stable outpatients with NCDs could be shifted to community health facilities to receive their medications.However,the key issues remain in building a general practitioner led (GP-led) primary care delivery system in China.Some prominent issues include the shortage of quality generalists, lack of proper incentives and management mechanisms, and the absence of patients and provider, and restrictive arrangements in basic health insurance policies.Even with these hard-to-solve issues, some recent reform initiatives for integrated NCDs care delivery in some localities have demonstrated originality and creativeness in developing better coordination between primary and secondary NCDs care.However, without large-scale public sector reform, innate issues with human resource development, income distribution and financing of public healthcare providers cannot be solved.It may take a long time to see deep integration of primary and secondary NCDs care in China.Copyright 2015, Chinese Medical Association Production.Production and hosting by Elsevier B.V.on behalf of KeAi Communications Co., Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).展开更多
To the Editor:The coronavirus disease2019(COVID-19)outbreak developedinto a pandemic.Patientsundergoing hemodialysis(HD)are more susceptible to COVID-19,and isolating patients undergoing HD after exposure are extremel...To the Editor:The coronavirus disease2019(COVID-19)outbreak developedinto a pandemic.Patientsundergoing hemodialysis(HD)are more susceptible to COVID-19,and isolating patients undergoing HD after exposure are extremely challenging since they frequently travel between their homes and dialysis centers,during which they share a hall for dialysis sessions that may last for hours.We successfully quarantined one infected HD patient and other potentially exposed patients.This experience might serve as an important reference for dialysis centers or for people in similar situations across the country to reduce the spread of COVID-19.展开更多
基金supported by the Ministry of Science and Technology of the People’s Republic of China under the“New Generation Artificial Intelligence”Major Project of Science and Technology Innovation 2030(2020AAA0105002).
文摘Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].
文摘Amid the global wave of digital economy,China's medical artificial intelligence applications are rapidly advancing through technological innovation and policy support,while facing multifaceted evaluation and regulatory challenges.The dynamic algorithm evolution undermines the consistency of assessment criteria,multimodal systems lack unified evaluation metrics,and conflicts persist between data sharing and privacy protection.To address these issues,the China National Health Development Research Center has established a value assessment framework for artificial intelligence medical technologies,formulated the country's first technical guideline for clinical evaluation,and validated their practicality through scenario-based pilot studies.Furthermore,this paper proposes introducing a"regulatory sandbox"model to test technical compliance in controlled environments,thereby balancing innovation incentives with risk governance.
文摘Objective To systematically review the published clinical and economic research on liposomal irinotecan in combination with 5-FU/LV for metastatic pancreatic ductal adenocarcinoma(mPDAC)at home and abroad.Methods PubMed,Cochrane Library,Embase,CBM,CNKI,Wan Fang data,CRD database and health technology assessment official websites were searched to collect clinical and economic studies on liposomal irinotecan for mPDAC.Results and Conclusion Nine clinical studies and four economic studies were included.The result of clinical studies showed that liposomal irinotecan in combination with 5-FU/LV could extend survival with good drug compliance in patients with mPDAC who progressed on prior gemcitabine-based therapy.This agent represented a new treatment option for second-line chemotherapy in these patients.The results of the economic evaluations failed to reach a consistent conclusion due to different economic levels in various countries.
基金supported by The National 13th Five-year Mega-Scientific Projects of Infectious Diseases in China[Grant Number:2017ZX10201302001004]。
文摘Objective This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline(BR)and the conventional treatment regimen(CR,not containing Bedaquiline)for the treatment of adults with multidrug-resistant tuberculosis(MDR-TB)in China.Methods A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years.The model parameter data were synthesized from the literature,the national TB surveillance information system,and consultation with experts.The incremental cost-effectiveness ratio(ICER)of BR vs.CR was determined.Results BR(vs.CR)had a higher sputum culture conversion rate and cure rate and prevented many premature deaths(decreased by 12.8%),thereby obtaining more quality-adjusted life years(QALYs)(increased by 2.31 years).The per capita cost in BR was as high as 138,000 yuan,roughly double that of CR.The ICER for BR was 33,700 yuan/QALY,which was lower than China's 1×per capita Gross Domestic Product(GDP)in 2020(72,400 yuan).Conclusion BR is shown to be cost effective.When the unit price of Bedaquiline reaches or falls below57.21 yuan per unit,BR is expected to be the dominant strategy in China over CR.
基金Supported by the World Health Organization(WHO)“National Action Strategies for Promoting Population-Based Prevention and Control of Behavior Risk Factors for NCDs”(CPMA-831).
文摘BACKGROUND In recent decades,China has faced a double burden of infectious diseases and noncommunicable diseases(NCDs).The number of deaths due to NCDs accounts for 88.5%of total deaths in China in 2019.To address these public health issues and improve the accessibility and affordability of primary health care,a National Basic Public Health Service Program(NBPHSP)was introduced as part of China’s healthcare reform initiated in 2009.Subsided by national and local government budgets,NBPHSP is mainly implemented by community and township health service centers,as well as health stations in urban areas and village clinics in rural areas(1).Health management of patients with hypertension and diabetes is an integral and pivotal part of the NBPHSP.
文摘Medical artificial intelligence (AI) in China is now on the eve of a massive surge. Despite great promise from this emerging field, there remain formidable pitfalls and obstacles, especially the challenges to current legal rules. We review the development of legal rules concerning medical AI in China, discuss risks of liability of commercial organizations and health care providers and whether current rules should be amended, and if so, what are the key issues to be addressed. Finally, we close by sketching possible ways forward for the legal and regulatory system.
文摘Objective To re-evaluate the systematic review of the safety and effectiveness of epidural analgesia(EA)for labor analgesia.Methods The Cochrane database,PubMed,EMBASE,EBSCO,Web of Science,ScienceDirect,China Biomedical Literature database,CNKI,Wanfang and VIP databases were searched,and the search time was limited to August 2020.Two researchers screened the literature and extracted data according to the inclusion criteria.AMSTAR was used to evaluate the methodological quality of the included studies.Pain intensity and pain relief satisfaction were used as the main indicators for re-evaluation of the effectiveness.Midwifery rate,cesarean section rate,back pain,fever,nausea and vomiting,umbilical artery pH value,and newborn Apgar score were used as the main indicators to re-evaluate the safety.Results and Conclusion A total of 9 meta-analyses were included.The safety and effectiveness of EA and opioid intravenous analgesia,acupuncture stimulation,inhalation analgesia,no analgesia,and continuous delivery were evaluated separately.The included systematic reviews showed that EA could increase the rate of device-assisted delivery,causing maternal fever,and prolonging the first and second stages of labor.But the incidence of back pain,nausea,and vomiting was lower.Therefore,analgesia had a good effect with better satisfactory degree.Current evidence shows that EA is safe and effective for labor analgesia,but the quality of the reports of current studies is not high.
基金National Science and Technology Major Project(2020AAA0105000)Beijing Science and Technology Plan(Z241100007724003).
文摘This paper explores the expansion from fintech-based regulatory sandboxes to those that include medical artificial intelligence(AI)by examining their potential to foster innovation and accelerate market access while ensuring safety and compliance,especially considering how they provide a flexible framework for medical AI companies to develop and test new technologies.This work also highlights the key risks involved,including data privacy,ethical concerns,real-world validation,and regulatory consistency,and proposes strategies for mitigation.Using case studies from the United States,the United Kingdom,the European Union,Indonesia,Japan,and China,this paper illustrates how regulatory sandboxes can support AI-driven healthcare innovation.Overall,although regulatory sandboxes present several risks,they are valuable for advancing medical AI,granted that they balance innovation with robust oversight to ensure patient safety and long-term benefits.
基金Supported by the CAHHF project(AuSAID):FA55 HSS409。
文摘Objectives:To analyze the satisfaction of patients with community health service(CHS)and the changes of the CHS delivered before and after the new health reform in different regions of China,and to put forward relevant policy recommendations for CHS development.Methods:Twelve community health centers were selected by random sampling in each of the eight typical cities in the east,middle and west regions of China.Questionnaire survey was conducted among patients visiting these institutions during daily work hours.Results:The proportions of the participants who stated that the medical environment,service attitude and medical skills of the doctors were improved were higher in the west region than those of the east and middle regions;but the percentage of patients who held that the drug price had lowered was higher in the east region than those of the middle and west region,the differences were of statistical significance(P<0.0125).The patients’satisfaction rates with medical environment,service attitude,and technical skills of the medical staff in the west region were 88.9%,91.5%and 81.6%respectively,which were higher than those in the east and middle regions.In the east region,the satisfaction rate with the reimbursement for this visit was 58.5%,which was highest among the three regions;in the west region,patients’satisfaction rates with drug types and preventive care were 51.5%and 65.9%,respectively,which was significantly higher than those in the east and middle regions(P<0.0125).As recommended by the participants,the top three aspects of health services that need to be improved were drug type and quality(25.3%),drug prices(21.8%)and technical skills(18.2%)in the east region;infrastructure(28.2%),drug prices(21.8%)and drug types and quality(21.2%)in the middle region;infrastructure(30.8%),drug types and quality(28.1%)and reimbursement(27.9%)in the west region.Conclusions:The comprehensive CHS reform should take the opinions of patients into account;essential drug system should be consolidated continually;and the reform of the payment system should be promoted by actively cooperating with the health insurance organizations.
基金the“Research on Performance Evaluation of Chinese Community Health Service Institutions’Implementation of Essential Medicine System”supported by National Natural Science Foundation[71103130]。
文摘Objective:This research aims to develop a more scientific and reasonable performance evaluation indicator system for the implementation of an essential drug system in community health service institutions.Methods:The Delphi method was used to establish an indicator system based on three rounds of expert consultations,and the fuzzy comprehensive evaluation method was used to determine the weights of the indicators.Results:The participation in the three rounds of consultations were 100%(10/10),90%(18/20),and 85%(17/20),which showed that the experts had real enthusiasm for participating in this research.The authority coefficients of the first-,second-,and third-level indicators were 0.75,0.76,and 0.76,respectively,which showed that the consultation results were dependable.The concordance coefficients of the second and third rounds were 0.489 and 0.487,respectively(P<0.001),indicating that the expert opinions were highly consistent.The performance evaluation indicator system consisted of three first-level indicators(supporting,implementation,and effect indicators),nine second-level indicators,and 21 third-level indicators.Conclusion:In this new performance evaluation indicator system,the selected experts were representative,the consultation results were dependable,the constructed evaluation indicator system was reasonable,and the setting of weights was scientific.
文摘What is already known about this topic?The global burden of chronic kidney disease(CKD)is on the rise.What is added by this report?In 2019,5.58 million individuals in China were affected by CKD related to hypertension,leading to 70,260 fatalities and 1.69 million disability-adjusted life years(DALYs).The most affected groups were men,older individuals,and residents of western China.Over the period from 2010–2019,the age-standardized prevalence rate(ASPR)remained constant,and the agestandardized mortality rate(ASMR)and agestandardized DALY rate(ASDR)showed a decreasing trend.However,there was an increase in the number of cases,deaths,and DALYs associated with this condition.What are the implications for public health practice?Hypertension significantly contributes to the burden of CKD;therefore,raising awareness and implementing early screening measures are essential.
文摘Diagnosis-related Groups(DRG)is an internationally recognized advanced hospital management method.It was pioneered by Yale University in the late 1960s and has been used as the inpatient prospective payment system by the U.S.Medicare program since 1983(1,2).It has since been introduced in Australia,Germany,France,the UK,Japan,South Korea,and Scandinavia.It is widely used in the fields of pricing and payment,budget allocation,performance evaluation,and comparison(2).As a refined hospital management tool,DRG combined with the corresponding payment mechanism can effectively meet the requirements of health expenditure control,hospital management,and health insurance management(3).DRG is also crucial for promoting the shift of payment methods from retrospective payment to prospective payment and for improving the performance management of the healthcare system.
文摘Currently, China has a growing need for rehabilitative care;however, rehabilitative care has been underdeveloped for decades. Since the end of 2010, pilot programs in 46 cities (districts) of 14 provinces have been initiated by the Ministry of Health in China to establish formal arrangements for facilitating the delivery of continuous medical rehabilitative care for local communities. After 2 years of pilot work, an evaluation was conducted by researchers. This paper reviews the current status of rehabilitative care in China and discusses the findings of the nationwide pilot program on the integrated rehabilitative service. Some key mechanisms and main issues were identified after analyzing the preliminary outcomes of some of the pilot programs.
文摘This paper seeks to explore the relevance between the Western 'expert patient' rhetoric and the reality of non-communicable diseases (NCDs) control and management in low and middle income settings from the health sociological perspective.It firstly sets up a conceptual framework of the 'expert patient' or the patient self-management approach, showing the rhetoric of the initiative in the developed countries.Then by examining the situation of NCDs control and management in low income settings, the paper tries to evaluate the possibilities of implementing the 'expert patient' approach in these countries.Kober and Van Damme's study on the relevance of the 'expert patient' for an HIV/AIDS program in low income settings is critically studied to show the relevance of the developed countries' rhetoric of the 'expert patient' approach for the reality of developing countries.In addition, the MoPoTsyo diabetes peer educator program is analyzed to show the challenges faced by the low income countries in implementing patient selfmanagement programs.Finally, applications of the expert patient approach in China are discussed as well, to remind us of the possible difficulties in introducing it into rural settings.Copyright 2015, Chinese Medical Association Production.Production and hosting by Elsevier B.V.on behalf of KeAi Communications Co., Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).
文摘Non-communicable diseases (NCDs) are a leading cause of deaths and of disease burden in China.This paper analyzes the rationale and implications of a community-based approach to a better coordinated NCDs care and management system in China.As argued by the author, the buildup of an integrated NCDs care delivery system is feasible now and large health expenditures will be saved if more stable outpatients with NCDs could be shifted to community health facilities to receive their medications.However,the key issues remain in building a general practitioner led (GP-led) primary care delivery system in China.Some prominent issues include the shortage of quality generalists, lack of proper incentives and management mechanisms, and the absence of patients and provider, and restrictive arrangements in basic health insurance policies.Even with these hard-to-solve issues, some recent reform initiatives for integrated NCDs care delivery in some localities have demonstrated originality and creativeness in developing better coordination between primary and secondary NCDs care.However, without large-scale public sector reform, innate issues with human resource development, income distribution and financing of public healthcare providers cannot be solved.It may take a long time to see deep integration of primary and secondary NCDs care in China.Copyright 2015, Chinese Medical Association Production.Production and hosting by Elsevier B.V.on behalf of KeAi Communications Co., Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).
基金Peking University Special Fund for COVID-19 Prevention and Control(No.PKU2020PKYZX001)。
文摘To the Editor:The coronavirus disease2019(COVID-19)outbreak developedinto a pandemic.Patientsundergoing hemodialysis(HD)are more susceptible to COVID-19,and isolating patients undergoing HD after exposure are extremely challenging since they frequently travel between their homes and dialysis centers,during which they share a hall for dialysis sessions that may last for hours.We successfully quarantined one infected HD patient and other potentially exposed patients.This experience might serve as an important reference for dialysis centers or for people in similar situations across the country to reduce the spread of COVID-19.
