Objective To analyse the content and structure of the health management policy text for chronic obstructive pulmonary disease (COPD) in China, and to provide a reference for the optimization and improvement of subsequent relevant policies. Methods We searched for relevant policy documents on COPD health management at the national level from January 2017 to December 2023, constructed a two-dimensional analysis framework for policy tools and chronic disease health management processes, coded and classified policy texts, and used content analysis method to analyze policy texts. Results Twenty-four policy texts were included. There were 183 codes for policy tool dimension, with supply based, environmental based, and demand based tools accounting for 43.72%, 47.54%, and 8.74%, respectively. There were 124 codes for the dimension of health management processes, with health information collection and management accounting for 12.10%, risk prediction accounting for 14.52%, intervention and treatment accounting for 66.13%, and follow-up and effectiveness evaluation accounting for 7.26%. Conclusions At present, the proportion of policy tools related to the management of COPD in China needs to be dynamically adjusted. Environmental tools should be appropriately reduced, the internal structure of supply tools should be optimized, the driving effect of demand tools should be comprehensively enhanced, the coupling of COPD health management processes should be strengthened, and the relevant policy system and overall quality should be continuously improved.
Colorectal cancer is the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide. In recent years, with the development and change of society and economy, the epidemiological characteristics of colorectal cancer related to geographic economy and health resources have caused its incidence to show a trend of regional differentiation. At present, the diagnosis, treatment, prevention and control of colorectal cancer in China are still facing great challenges, therefore, summarizing the risk factors related to the incidence of colorectal cancer in China from the global epidemiological characteristics of colorectal cancer can further guide the prevention, control and clinical diagnosis and treatment of colorectal cancer in China, and is of great significance to improve the heavy burden of colorectal cancer. Therefore, this paper discusses the epidemiological characteristics of colorectal cancer in recent years and the screening policies in different regions based on the report of the International Agency for Research on Cancer and related studies, so as to provide the relevant basis for the prevention and control of colorectal cancer in the new situation in the future.
Objectives To analyze the development and implementation of the national drug policy in order to provide decision-making for the establishment of the Chinese national drug policy. Methods Nineteen electronic databases, the WHO, the World Bank, and governmental websites were included in this study. A pre-designed data extraction form was used to collect information. The data were analyzed and described by a pre-designed analytic framework. Result A total of 182 studies were included in this review. The main points of common concern in the national drug policy were: drug regulation and quality assurance, rational use of drugs, drug supply, the selection of essential drugs, human resource development and training, traditional medicine, drug financing and affordability, drug research, monitoring and assessment of the nation drug policy, technical cooperation, and the national pharmaceutical industry. The selection of essential drugs, quality assurance, supply, pricing, and supply of traditional medicine were gradually carried out in China. Pharmaceutical research, monitoring and evaluation, as well as the development of pharmaceutical industry and technical cooperation within it should be further strengthened. Conclusion China should establish related organizations and working procedures; speed up the implementation of the legislation of national drug policy; integrate the mechanism of essential drugs selection and supply system; regulate the order of medicine production and regulation; establish scientific and reasonable pricing mechanisms for drugs and assessment systems; strengthen the monitoring and evaluation of national drug policy and update and improve the national drug policy.
Objective To systematically analyze the research landscape of China’s rehabilitation industry, identify core contradictions and evolutionary pathways, and provide evidence for policy optimization and academic innovation. Methods Literature published up to December 31, 2024 was retrieved from China National Knowledge Infrastructure, Wanfang, and Chongqing VIP databases using rehabilitation industry as the subject term. Bibliometric methods such as keyword clustering, strategic coordinate analysis, temporal evolution (CiteSpace and R language) were employed to dissect research patterns, hotspot evolution, and innovation bottlenecks of the rehabilitation industry. Results Finally, 183 articles were included for analysis. China’s rehabilitation research exhibits a policy-driven, fragmented pattern (policy-focused journals accounted for 25.68% of publications; the Ministry of Civil Affairs had the highest publication volume, accounting for 2.19%. There was a structural disconnect between demand and research: on the one hand, the outbreak of elderly rehabilitation demand was marginalized in research (located in the lower left quadrant of the strategic coordinates, but keyword clustering dissolved in the “# 0 rehabilitation industry”); on the other hand, although exercise rehabilitation was a hot topic (ranked first in frequency, centrality>0.1), its maturity was insufficient (located in the lower right quadrant of the strategic coordinates). The research hotspots continued to shift towards “integration of industry and education” and “high-quality development” (temporal evolution), with the emergence of the term “rehabilitation” (strength=4.09) marking a historical focus, while technology transformation and collaboration in the public welfare market (isolation of the language rehabilitation industry) had become key breakthrough directions. Conclusion The rehabilitation industry in China urgently needs to break the dilemma of “high yield and low cooperation”, promote research and practice collaboration through three-dimensional innovation of technology education system, and support the rehabilitation needs of an aging society.
As the implementation of the high-quality development policy of public hospitals is faced with the problems of diversified environment and the coordination of execution of complex actors, the network structure has changed from the closed resistance type to the open competition type. At present, China’s high-quality development policy of public hospitals needs to improve the policy system and refine the top-level design; strengthen the executive power of network entities and innovate the joint governance mechanism; optimize the structure of policy tools to improve the resilience and flexibility of the network; implement the performance evaluation mechanism and strengthen supervision. This article is based on policy network theory and provides an in-depth analysis of the current high-quality development policy texts for public hospitals in China, with the aim of providing suggestions for policy development
Evidence-based medicine (EBM) emphasizes the combination of the physician's experience, the best research evidence and patient's values to ensure the best prevention and treatment effect. Evidence is the core of the EBM, and quantitative systematic review can synthesize interventional studies; however, it can't provide synthetic evidence for patients' demands, opinions and attitudes and so on. Qualitative systematic review can offset these limitations. With the development of methodology of qualitative research and systematic review of qualitative studies, the number of qualitative studies increased year by year and they provided more and more evidence for decision making in public health, social work, management and education. The international research institutions including the Cochrane Collaboration, the Campbell Collaboration and the 3ie have mature methods for qualitative systematic review; however, few studies introduced how to write it in China. Therefore, this paper briefly introduces how to write the qualitative systematic review.
ObjectivesTo evaluate the intention of having a second child among females of childbearing age after the implementation of China’s universal two-child policy so as to provide evidence for further studies.MethodsCNKI, VIP, WanFang Data, CSSCI, PubMed, EMbase and ScienceDirect databases were electronically searched to collect cross-sectional studies on the intention of females of childbearing age to have a second child from January 1st, 2016 to August 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using R software.ResultsA total of 15 studies involving 18 820 cases were included. The results of meta-analysis showed that the fertility rate for the second child of females of childbearing age was 0.42 (95%CI 0.37 to 0.47), and the result was stable. Subgroup analysis showed that the fertility rate of second child in eastern region was higher than that in western region (0.44 vs. 0.40), in rural areas was higher than that in non-rural areas (0.46 vs. 0.35), females aged 18 to 34 was higher than those aged above 35 (0.49 vs. 0.29), and non-working females was higher than that among working females (0.48 vs. 0.40). The fertility rate of the sex of the first child being female was higher than the sex of the first child was male (0.48 vs. 0.39). The fertility rate of the couple who were both the non-only child was higher than the couple who were both the only child and who was only child while the other was non-only child (0.46 vs. 0.41 vs. 0.40).ConclusionsSince the implementation of the “universal two-child policy” in China, the fertility rate of females of childbearing age with the intention of having a second child is lower, especially those females who are from the western regions and non-rural areas, aged above 35 and the sex of the first child is male and non-dual-non-couples. Due to the quantity and quality of the included studies, more high quality studies are required to verify the above conclusions in future.
Objective To discuss the epidemiological characteristics of young and middle-aged people infected with COVID-19 in Gansu province under the new epidemic policy. Methods A total of 1800 people were collected from two tertiary hospitals in Gansu province from November 8, 2022 to January 28, 2023. The vaccination status, nucleic acid antigen detection, the specific time of infection, main symptoms and severity of the disease were investigated. Results Among 1800 participants, 1685 (93.6%) were vaccinated and 1565 (86.9%) were infected with COVID-19. Among the 1565 infected persons, 523 (33.4%) completed both nucleic acid and antigen testing, 382 (24.4%) completed nucleic acid testing, 490 (31.3%) completed antigen testing, 170 (10.9%) received IgG testing. 1490 (95.2%) were slight ill, 75 (4.8%) were critical ill, and 96 (6.1%) were hospitalized, and no one died. In 2022, 92 cases (5.9%) were infected in the first half of November, 141 cases (9.1%) in the second half of November, 630 cases (40.3%) in the first half of December, and 553 cases (35.4%) in the second half of December. 109 cases (7.0%) were infected in the first half of January, 38 cases (2.2%) in the second half of January, and 2 cases (0.1%) in the first half of February of 2023. and no cases in the second half of February. Among the 1565 infected persons, 825 (52.7%) had respiratory symptoms, 293 (18.7%) had gastrointestinal symptoms, 257 (16.4%) had autonomic disorders, 140 (8.9%) had other symptoms such as decreased smell and taste, and 48 (3.3%) had no symptoms after infection. Conclusions The vaccination rate of young and middle-aged people in Lanzhou city of Gansu Province is high. Since the new policy, the infection rate of the novel coronavirus among young and middle-aged people is high, the number of antigen tests is more than nucleic acid tests, most of the infected patients are slight, with fewer critical patients, and the hospitalization rate is low. The peak of infection occurred in early December 2022, and the infection rate was basically zero by February 2023. The main symptoms of COVID-19 infection are mainly respiratory tract, followed by digestive tract and autonomic nervous system disorders, and few patients are completely asymptomatic.
ObjectiveTo evaluate the effect of rural alone-two-child policy (RAC policy) on zero population growth, high sex ratio at birth (SRB), and aging population in China. MethodsRural areas of cities which implement the RAC policy were included. Data from the fifth and the sixth population censes were used to analyze the variation of the total fertility rate (TFR), SRB, and the number of teenagers of every household (NTH) in context of different social and economic levels. ResultsThe implementation of RAC policy in rural areas with middle and upper social economic levels showed a long-term effect of increasing the TFR and decreasing the SRB. The implementation of rural girl policy mixed with RAC policy in areas with middle social economic level showed a long-term effect of decreasing the TFR and increasing the SRB; but the long-term effect in areas with low social economic level was uncertain. The NTHs were decreased in all included areas. According to the urban and rural birth preference, we made inferences that the implementation of alone-two-child policy in cities could result in the increase of TFR and the decrease of SRB. ConclusionThe long-term effect of RAC policy implemented in rural areas with middle social economic level could solve the problems of zero population growth and the high SRB, but the long-term effect of mixed policy implemented in rural areas with middle social economic level may aggravate the two problems above. The RAC policy cannot solve the aging population problem in rural area.
Objective To compare the newest essential medicine lists (EMLs) of China and the World Health Organization (WHO) in 2009, so as to provide the evidence for the selection, adjustment and implementation of the newest national EML of China. Methods Differences in the procedures of selection, implementation and the categories as well as the number of medicines in 2009 EMLs of the WHO and China were compared by descriptive analysis. Result Principles and procedures of selecting and updating EML of China were based on those of the WHO EML. However, the transparency of procedures, methods of selection, and evidence of efficacy, safety, cost-effectiveness and suitability were not enough. Essential medicines of the WHO were categorized by the Anatomical-Therapeutic-Chemical (ATC) classification system, while those of China were classified by clinical pharmacology. Twenty-one identical categories of the first class were found in the two lists. There were 8 and 3 unique categories in the WHO EML and China EML, respectively. A total of 358 and 255 medicines (including medicines in its explanation) were included in the EMLs of the WHO and China, respectively, with 133 identical medicines as well as 206 and 108 unique medicines. There were 51 antiinfective medicines in China EML, accounting for half of the WHO EML. Forty medicines were the same in both lists, and 11 and 60 anti-infective medicines were unique in EMLs of China and the WHO, except for 40 identical medicines. Among them, 22 and 31 antibacterials were included in the lists of the WHO and China with 17 identical medicines. Antifungal, antituberculosis and antiviral medicines in China EML were fewer than those in the WHO EML. The numbers of the identical medicines acting on the respiratory, digestive, and nervous systems and hormones in the both lists were 1, 7, 9, and 17, respectively, while the unique ones in China EML were 6, 12, 7, and 14, respectively. However, most of them were selected without adequate evidence in efficacy and safety. The medicines acting on cardiovascular system were 19 and 29 in both lists with 14 identical medicines. Some antihypertensive and antiarrhythmic medicines were included in China EML with similar mechanism, whereas some of them were excluded by the EML. Conclusion The total numbers of both EMLs are close to each other with half of the identical medicines. The selection of China EML mostly meets the needs of disease burden in China. However, the transparency of selection and evidence are not enough. We suggest that health authorities should cooperate with other stakeholders to promote the transparency of selection, to enhance the capacity of producing high-quality evidence, to develop related technical documents and guidelines, and to disseminate and monitor the implementation of EML.