Objective To investigate the knowledge level about pulmonary rehabilitation in respiratory physicians in Shanghai. Methods A self-designed questionnaire about pulmonary rehabilitation was sent to respiratory physicians in 18 tertiary-care referral hospitals of Shanghai from June to September 2011. Results A total of 237 valid questionnaires were collected. Accuracy rate of single-answer questions was(62.1±18.3)% , while correct rate of multiple-answer questions ( more than one answer) was ( 35.5±15.6) % . Neither working years nor doctor rank had correlation with accuracy of questionnaires. Conclusion The knowledge about pulmonary rehabilitation in respiratory physicians of Shanghai was poor. We need to strengthen the relevant training and continuing education.
Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
Objective To investigate the diabetic knowledge of primary hospital doctors and diabetes patients, and to explore the way to improve the capability of primary hospitals in preventing and treating diabetes. Methods Between January 2013 and June 2014, we set questionnaires to learn the profiles of diabetes knowledge of 328 internal and general medicine doctors including 43 chronic disease management workers from fifteen township hospitals and two community health centers, 152 doctors from village clinics, and 575 diabetes patients in Xindu District of Chengdu City. We made questionnaires for doctors and patients respectively to investigate their knowledge on diabetes and blood sugar control in the patients. Finally, we made plans to train doctors in primary hospitals according to the results of the investigation. Results For township hospitals, 328 questionnaires were given out with 319 retrieved, and the valid retrieval rate was 97.3%; 152 questionnaires were given out to village doctors and 149 were retrieved, with a valid retrieval rate of 98.0%; and we gave out 575 questionnaires to the diabetes patients and retrieved 539, with a valid retrieval rate of 93.7%. Primary hospitals were insufficient in their drug varieties. Among doctors in township hospitals, 7.8% had bachelor’s degree, 53.6% had received post-secondary education, and 38.6% had received secondary vocational education. Most of the village doctors had not received any professional medical education, among whom, 89.9% had a certificate of village doctors and 10.1% had a certificate of assistant doctors. The diabetes questionnaire score of primary hospital doctors was low, while the score of chronic disease management workers was relatively higher (P<0.05). For diabetes patients, medical investment was inadequate, treatment rate was low, common sense of diabetes was insufficient, and glycosylated hemoglobin control rate was only 13.5%. Conclusions Diabetes patients in primary hospitals have a poor disease control, which is probably associated with the insufficient publicity and education from doctors. It is necessary to train primary hospital doctors at all levels. In order to get the best therapeutic effect, we advocate that diabetes should be managed by doctors of chronic disease management, although they should receive systematic training for a long time.
ObjectiveTo understand the cognition and mediation tendencies of health care workers in terms of third-party mediation for medical disputes, analyze the factors influencing the trust of both doctors and patients on third-party mediation, and propose suggestions on building third-party mediation mechanisms for medical disputes. MethodsBetween August and December 2012, we made the cognition questionnaire on third-party mediation for medical disputes based on the past medical literature, and the knowledge of doctor-patient relationship as well as third-party mediation agency's organizational structure (including locations and management authorities), staffing, mediation basis, validity sources and fund ensuring. We performed the random cluster sampling survey on all health care workers in five hospitals of different levels. The original data were put into the computer for statistical analysis by SPSS 18.0. ResultsThe knowledge of health care workers on third-party mediation was high. They believed that the best place for solving medical disputes should be the court or judicial administrative department, and the management authorities should be health administrative departments. In case of mediation failure, the majority of health care staff chose to continue to solve the dispute through legal channels. For the effectiveness of mediation conclusion, most health care workers tended to believe in the form of arbitration. They thought that mediators should have professional background of medicine and law; the majority of those surveyed doctors tended to accept forensic conclusions as a basis for mediation. For determining the compensation, doctors were in favor of Applicable Regulations for Medical Malpractice. Over 40% of medical staff believed that third-party mediation should be financed by government financial allocation, and more than half of the medical staff believed that it should be paid by the insurance company. ConclusionThird-party mediation should be set in and managed by the court or judicial and administrative departments. Mediator group should be formed by professionals of law and medical sciences. In the mediation process, it is recommended that the focus of controversy should be identified by forensic identification in order to form a clear division of responsibilities and high mediation efficiency. We recommend that the government introduce in financial allocations at all levels on the basis of medical liability insurance system, and force medical institutions to purchase medical liability insurance through the regulations of law, in order to provide funding support for the operation of third-party mediation organizations. Meanwhile, medical liability insurance companies should be operated under strict supervision to avoid their interference on the mediation work.
Objective To provide basic data for further application of national essential medicine list (EML) in Chengdu, through a survey of key-workers or persons, who attended the lecture of EML, in charge of village town hospitals or community medical service centers, and to find out their awareness of and attitudes to the essential medicine and requirements and suggestions for EML training. Methods Based on principles and methods of modern cognitive psychology, we designed the questionnaire and carried out the survey face to face. Two people input the data independently and verified them. Proportions were used to analyze the data through the Excel software. Results (1) The proportions ofcorrect answers to the questions of essential medicine conception, use range of EML and the relationship between EML and essential insurance medicines list were 89%, 91% and 87%, respectively. (2) 46% of the persons investigated (117 persons) chose “always consider preferentially using the essential medicine when prescribing”, 31% (81 persons) “consider using the essential medicine in most cases”. (3) 41% of the persons investigated (103 persons) chose “comparatively welcome” for the EML. (4) Problems of implementing EML in village town hospitals or community medical service centers, in the order of importance decreasing, were: “income and compensation”, “awareness of the essential medicine and prescribing habit of the doctor”, “patient’s cognition of essential medicine and preference to drug use”, “safety and effectiveness of the essential medicine”, “the applicability of essential medicine ” and “the purchase and delivery of essential medicine”, respectively. (5) The ways of getting information of essential medicine were 19.6% (187 person-time) through documents, 18.6% (177 persontime) through conferences and 15.3% (146 person-time) through lectures. (6) 60% of the persons investigated (154 persons) attended training of the essential medicine once or twice. (7) 77% of the persons investigated (196 persons) were trained for less than one week for essential medicine. (8) Requirements and suggestions on the training of essential medicine: 42% (71 person-time) enlarging the targeted people, 22% (38 person-time) increasing the training time,16% (27 person-time) improving practicability and specificity of training contents, 11% (18 person-time) diversifying training ways, 9% (15 persontime) requiring “training according to needs ” which addresses specific problems after investigation. Conclusion Training of essential medicine should be strengthened for medical workers in the village town hospitals or community medical service centers, and researches should be carried out on evaluation of EML applicability, performance of EML implementation, financial aiding, income of medical worker, procurement and reimburse, etc.
Objective To investigate the cognition degree and clinical use of new COPD classification system of 2011 GOLD in respiratory specialists, and further analyze the reasons of failing to clinical use. Methods Respiratory specialists from 42 hospitals in Chongqing were investigated through questionnaire survey. The questionnaire contains two parts. The first part contains nine questions about the knowledge of 2011 GOLD new COPD classification system and its clinical use. The second part contains six questions about the reasons of failing to clinical use of the COPD classification system. Results A total of 204 valid questionnaires were recovered. More than 90% respiratory specialists had understood the new COPD classification system with different degree, and believed it is suitable for clinical use. More than twothirds respiratory specialists knew well the ways about CAT and mMRC, but only 24% specialists were using these ways. The main reasons of failing to clinical use were as follows: 60% specialists believed the pulmonary function test can evaluate the COPD classification, and 66. 7% specialists were limited by short visit time. The cognition degree and clinical use of the new COPD classification systemin the specialists from third grade A class hospitals was better than those from the other hospitals. But the difference was not significant among specialists with different professional title.Conclusion Respiratory specialists in Chongqing knew well about the new COPD classification systemin 2011 GOLD, but did not use it widely in clinical works due to the complicated operation of the new COPD classification system.
Objective To investigate human resource allocation in primary health care and the essential medical service and publ ic health service status in urban and rural areas in Chengdu, so as to provide basel ine data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-Rural Development in Chengdu. Methods We carried out a stratified (three circles in Chengdu) sampl ing of 7 township hospitals (rural hospitals) and community health service centers; and then performed secondary research based on a comparative analysis of relevant pol icies of the World Health Organization (WHO) and Chinese governments at all levels. Results According to the WHO and national average standards, the number of staff per 1 000 rural hospitals / centers health personnel of the 7 rural hospitals / centers occupied only 1%-22% of the global average standard. There was a very large gap between the number of staff and the number of personnel required, based on the size of the population that should be served in the administrative areas in 2006 or the number of cl inic patients in 2006. The primary healthcare personnel structure was irrational. For example, the constituent ratio of health technical personnel was 4% to 33% higher than the global average level, and the constituent ratio of (assistant) physicians was also 17% to 45% higher than the global average level. However, the ratio of nurses, laboratory workers, other health professionals, administrative and supporting personnel was generally lower than the global average level. Women dominated among the primary healthcare personnel, and people aged 45 years or below counted for more than 75% (except Bailu and Wangjiang rural hospitals/centers). People with an educational background of two-year college education or secondary education or below took up 70% to 90%; while those with an intermediate title or assistant /primary title accounted for 50% to 100%. The structure rational ity of distribution density, educational background and academic titles of healthcare personnel showed a decreasing trend from the first circle to the third circle in Chengdu city. Conclusion The primary health workers in the second and third circle have been overloaded with low incomes for some time. They are facing enormous challenges in their professional skills, service awareness, as well as difficulties in continuing education and professional title promotion. It is very difficult to provide qual ified "six in one" primary health care and publ ic health services in a long-term and stable manner. It is suggested that we enroll and train more skilled people for primary health care service, and provide continuing education chances for current health care personnel. We should also adopt a mechanism to select qual ified personnel based on their performance, and take measures to solve some of the problems faced by the grass-root health personnel, such as heavy work burden, low income, poor skill and promotion. This will help us to construct a stable and qual ified primary healthcare team.
Objective To investigate the current situations of operation management and corporate culture in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of operation management and corporate culture, we designed the questionnaire to investigate the operation management and corporate culture among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results (1) Over 70% participants considered that the public pharmacies lacked in consciousness of service and quality and that they cooperated as their clear responsibilities. (2) Nearly 60% considered that the public pharmacies lacked in awareness of costs and efficiency. (3)Nearly 50% thought that they could not get information in time and communicate enough. (4) About 50% considered that the working processes needed improvement. (5) About 60% realized corporate culture promoted pharmacies.Conclusion Public hospital pharmacies need to improve operation management and foster unique corporate cultures to enhance comprehensive competitive strength.
ObjectiveTo survey on the health-related knowledge in cadres, in order to regulate corresponding health management strategies. MethodsQuestionnaires were used to collect data of 816 examinees who accepted physical examination in our hospital between June and July 2014. Factors affecting health examination service efficiency were identified to formulate a scale and a questionnaire for surveying examinees' preparatory status before examination and general information. The correlation between their preparatory status and demographic features was analyzed. The results were used to support management decision-making. ResultsOf the 816 examinees, 396 had a score over 6 points (48.5%, well prepared) and 420 had 6 points or below (51.5%, poorly prepared). The male preparation before examination was significantly poorer than the female (χ2=4.318, P=0.038). ConclusionWe should strengthen the knowledge education for cadres before physical examination.
Objective To assess the effect of a new educational model for evidence-based medicine (EBM), which is called "2+N" model with the main characteristic of classroom teaching plus volunteer practice. Methods Questionnaire survey was conducted to collect data. Results There were averagely 39 volunteers participated in this activity per year, with an increasing trend. Most of them were sophomore and junior undergraduates from different specialties in medical filed. All participates acquired a better understanding of EBM knowledge; more than 60% of them could handle data searching, collecting and assessing by themselves in the end of the activity. Conclusion Our five years’ experience of EBM education practice for medical students suggested that the new educational model has a promising future.