Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-02-19 Cooperative journals: 《中国全科医学》
Abstract： Background As China's Traditional medicine is included in the ICD-11 code，the rational allocation of basic TCM medical resources is the guarantee to promote the integration of traditional Chinese medicine and western medicine and the universal coverage of high-quality medical resources. The uneven layout and service capabilities of grassroots medical institutions have led to a widespread imbalance in the supply and demand of medical resources in urban and rural areas. Objective Understand the development status of traditional Chinese medicine services in rural areas of China，scientifically evaluate the coverage and accessibility of grassroots traditional Chinese medicine diagnosis and treatment，provide new ideas for optimizing the spatial resource allocation of grassroots traditional Chinese medicine services，and propose optimization strategies accordingly.Methods Based on the seventh national population census data and path planning data，the concept of medical service radius is introduced to calculate the diagnosis and treatment scope of different levels of traditional Chinese medicine medical institutions under walking mode. Using methods such as spatial kernel density index and spatial standard deviation ellipse to reveal the spatial fairness of the supply and demand capacity of traditional Chinese medicine medical services. Based on the above results，propose types and measures for optimizing the layout of traditional Chinese medicine medical resources. Results As of 2022，there are a total of 699 medical institutions in Zengcheng District，including 18 traditional Chinese medicine medical institutions with beds. There are significant differences in the distribution of beds in traditional Chinese medicine medical institutions in different townships and streets. Meanwhile，the number of beds per thousand population in Zhongtan Town is 14.31，ranking first among all streets. The number of beds per thousand people in Yongning Street ranks last，with only 0.89 beds. Traditional Chinese medicine medical institutions in Zengcheng District have shown a clear dual center pattern，with weak accessibility to traditional Chinese medicine services for residents in the central part of Zhongxin Town，the northern part of Paitan Town，and the southwestern part of Shitan Town. The supply capacity of traditional Chinese medicine services varies greatly among different townships. There is still a certain degree of inconsistency between the spatial distribution of traditional Chinese medicine medical institutions and the overall spatial clustering of urban residents. There are differences in the radius of traditional Chinese medicine services between different townships. Conclusion Since the implementation of the development strategy of traditional Chinese medicine，China's Traditional medicine has been protected and developed. We should adopt a more scientific strategy to closely integrate traditional Chinese medicine services with the development of the city and the needs of residents. We should actively adopt a differentiated strategy of increasing facility points，combining resource transfer and sinking，and integrating traditional Chinese medicine information technology for diagnosis and treatment across regions，gradually achieving a true strategy of full coverage and equal emphasis on traditional Chinese and Western medicine.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-01-11 Cooperative journals: 《中国全科医学》
Abstract： Background With the change of disease spectrum and the development of modern medical model，traditional Chinese medicine（TCM） is playing an important role in disease prevention， health care and rehabilitation. It is necessary to further promote the development of prevention of disease in TCM and vigorously promote the unique role of TCM in maintaining and promoting people's health. However，popularization and education of the concept of prevention of disease in TCM among community residents remains unclear. Objective To understand the overall awareness，trust，and adoption behavior of prevention of disease in TCM of community residents in Guangzhou，and explore the influencing factors of community residents' trust in prevention of disease in TCM services. Methods From April to August 2022，a stratified cluster sampling method was used to interview 652 community residents from 12 streets in 4 administrative regions of Guangzhou city based on geographic location （central city，urban-rural areas，and suburbs） and economic factors by questionnaires The survey included residents' basic information，awareness and access to knowledge of prevention of disease in TCM，as well as their demand，utilization and trust in it. The influencing factors of community residents' trust in prevention of disease in TCM services were explored. Results Among the 652 community residents，67.79% （442/652） were aware of prevention of disease in TCM，77.91% （508/652）trusted prevention of disease in TCM services，69.63% （454/652） had received traditional TCM physiotherapy，and only 6.59%（43/652） had received prevention of disease in TCM services more than 4 times in the past year. Univariate correlation analysis showed that age（χ2 =9.218），household type（χ2 =19.356），marriage status（χ2 =2.490），occupation（χ2 =17.889），and medical insurance payment type（χ2 =13.516） were influencing factors of residents ＇ prevention of disease in TCM services. Binary Logistic regression analysis showed that household type（non-agricultural，agricultural to resident，and nonagricultural to resident） was an influential factor for community residents' trust in prevention of disease in TCM services（OR=2.646，5.593，10.502）. Conclusion The overall awareness（67.79%） and trust （77.91%） of prevention of disease in TCM among community residents in Guangzhou are relatively high，but the actual number of services received is insufficient，with a phenomenon of knowledge，attitude and practice separation”. Community residents with non-agricultural household type and professional technical occupation have a higher level of trust，while those with agricultural household type，irregular/commercial and service/ other occupations have a higher level of trust. During popularization and services of prevention of disease in TCM，it is necessary to fully utilize the residents' preferred forms， as well as to target specific groups，so as to cultivate the health habits of prevention of disease in community residents.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-09-01 Cooperative journals: 《中国全科医学》
Abstract： Background The 72nd World Health Assembly reviewed and adopted the International Classification of Diseases Eleventh Revision （ICD-11），which for the first time included traditional medicine originating from traditional Chinese medicine（TCM） in its chapter coding， of which the code for wasting thirst disorder is SD71 （TM1）. At present，wasting thirst disorder is a high clinical prevalence disease，with middle-aged and older adults being the high incidence population， and TCM constitutions bias are risk factors for wasting thirst disorder. There was no research on the burden of TCM diseases and risk factors. Objective Based on the ICD-11 chapter on traditional medicine and the national standards of TCM，the burden of wasting thirst disorder among middle-aged and elderly in Guangzhou was calculated and attributed to the TCM constitutions. The role of TCM constitutions monitoring in health management was evaluated，providing reference for the prevention and treatment of wasting thirst disorder by TCM and the application of constitutions theory. Methods A cross#2;sectional survey was conducted to investigate the prevalence of wasting thirst disorder and the distribution of TCM constitutions among middle-aged and elderly in Guangzhou. The comprehensive theory of Global Burden of Disease（GBD），calculate the years of life lost （YLL），years lived with disability（YLD），and disability adjusted life year （DALY） of wasting thirst disorder in the middle-aged and elderly population in Guangzhou were used to evaluate the disease burden of wasting thirst disorder. Relative risk （RR） was used to assess the risk of different TCM constitutions for wasting thirst disorder in middle-aged and elderly people. Results A total of 1 576 middle aged and older adults in central Guangzhou were surveyed， 55 were lost，1 521 valid questionnaires were recovered， and the effective response rate was 96.51%. Among them， 782 were male， aged 62 （56， 69） years; 739 were female， aged 62 （55， 70） years. The prevalence of wasting thirst disorder among middle-aged and elderly people in Guangzhou was 13.08%，with a standardized prevalence of 12.64%. The most distributed constitution among middle-aged and elderly people in Guangzhou were phlegm-dampness constitution， qi-deficiency constitution， and damp#2;heat constitution; among them， the most distributed constitutions in patients with wasting thirst disorder were phlegm-dampness constitution， yin-deficiency constitution， and qi-deficiency constitution. The DALY rate of wasting thirst disorder burden was 86.64‰，with a YLL rate of 4.86‰ and a YLD rate of 81.60‰ . The proportion of single constitution and composite constitution was 48.98% and 51.02%，respectively. Yin-deficiency constitution was the risk constitution of wasting thirst disorder（RR=1.73，P<0.01）， which led to a disease burden of 33，092 DALYs， with a DALY rate of 10.98， accouting for 12.70% of the disease burden in the middle-aged and elderly population with wasting thirst disorder. In terms of different age groups， phlegm#2;dampness constitution（RR=1.62，P<0.05）and yin-deficiency constitution（RR=1.80，P<0.05） were risk constitutions in the age group of 60-69 years， in which phlegm-dampness constitution resulted in a wasting thirst disorder burden of 18 530 DALYs， with a DALY rate of 18.75‰， accounting for 21.63% burden of wasting thirst disorder in this age group; yin-deficiency constitution led to wasting thirst disorder burden of 10 520 DALYs， with a DALY rate of 10.65‰， accounting for 12.28% of burden of wasting thirst disorder in this age group; the disease burden caused by the combination of phlegm-dampness constitution and yin-deficiency constitution was 2 6780 DALYs，with a DALY rate of 27.10 ‰， accounting for 31.26% of the burden of wasting thirst disorder in this age group. For different genders，male phlegm-dampness constitution（RR=2.29，P<0.01） and female yin-deficiency constitution（RR=2.27，P<0.01） were risk constitutions for wasting thirst disorder. The disease burden caused by phlegm-dampness constitution in middle-aged and elderly males was 45017 DALYs，resulting in a DALY rate of 30.96 ‰， accounting for 36.82% of the burden of wasting thirst disorder in middle-aged and elderly males. The burden of wasting thirst disorder caused by female yin-deficiency constitution was 2 8753 DALYs，resulting in a DALY rate of 18.43 ‰， accounting for 20.79% of the burden of wasting thirst disorder among middle-aged and elderly females. Conclusion The prevalence of wasting thirst disorder among middle-aged and older adults aged ≥ 50 in Guangzhou is relatively high，with heavy disease burden. Yin#2;deficiency and phlegm-dampness constitutions are risk constitutions for wasting thirst disorder in middle-aged and elderly people. TCM constitutions monitoring and management can effectively reduce the burden of wasting thirst disorder.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-27 Cooperative journals: 《中国全科医学》
Abstract： Burden of disease measurement based on the International Statistical Classification of Diseases and Related Health Problems （ICD） codes have been widely used worldwide. However，most of the current studies are based on Western medical codes of ICD. As the internationalization of Traditional Chinese Medicine（TCM），the inclusion of TCM codes in ICD-11 will facilitate the improvement of TCM disease diagnosis，the calculation of prevalence，survival，medication use，and treatment levels of TCM disease，which can further evaluate the disease burden of TCM diseases，promote medical decision making and rational allocation of health resources，thus further promoting the internationalization of TCM. However，the imperfection of TCM codes in ICD-11 and inadequate mapping between it and Western medicine codes，our national standards for TCM has also brought new challenges to the measurement of TCM disease burden. Based on the coding system of disease burden，this paper reviewed the deficiencies in the current research on the calculation of disease burden of TCM，and the impact of ICD-11 inclusion of TCM codes on the calculation of disease burden of TCM，made a preliminary comparison among the TCM codes and Western medical codes in ICD-11 and new national standard codes in China，to provide reference for the improvement of the calculation and coding of TCM disease burden. It is proposed that in the future，big data technologies can be used to facilitate the mapping between standardized TCM terms and ICD-11 TCM codes，ICD-11 TCM codes and Western medical codes，thus facilitating research on the burden of disease in TCM.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-07-24 Cooperative journals: 《中国全科医学》
Abstract： Background The disease burden of esophageal cancer is high in China，more and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer. Objective To understand trends inesophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019，and provide data to inform the development of public health policies and interventions. Methods Global burden of disease 2019 （GBD 2019） data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019. Mortality，disability adjusted life years（DALYs），years of life lost（YLLs），and disability adjusted life years （YLDs） were used to assess the disease burden of esophageal cancer attributable to tobacco in China. Joinpoint regression software and age#2;period-cohort modeling methods were applied to analyze the trends of disease burden and mortality with age，period and cohort. the Bayesian-period-cohort analysis （BAPC） was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030. Results From 1990 to 2019，the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76，400 to 123，900，with an increase of 62.17%，and the standardized mortality rate declined from 9.30/100 000 to 6.20/100 000，with a decrease of 33.33%；the DALYs rose from 1，972，500 person-years to 2，822，600 person-years，with an increase of 43.10%，and the DALYs rate decreased from 220.50/100 000 to 134.47/100 000，with a decrease of 39.02%. In terms of gender，the disease burden of esophageal cancer attributable to tobacco was mainly caused by males，with 117，700 deaths and a standardized mortality rate of 12.82/100 000 in 2019 due to tobacco-attributable esophageal cancer in males，compared to 0.62 million deaths number and a standardized mortality rate of 0.63/100 000 in females. In 2019，the number of esophageal cancer deaths attributable to tobacco among Chinese residents peaked in the age group of >69-74 years，while DALYs peaked in the age group of >64-69 years，at 23，000 and 510，300 cases，respectively. The mortality rate continued to increase with age，especially after 50 years of age. The results of Joinpoint regression analysis showed that the AAPC value of esophageal cancer mortality attributable to tobacco was -1.4〔95%CI（-1.6，-1.2）〕 in China from 1990 to 2019，with -3.3〔95%CI（-3.6，-2.9）〕 for females，and -1.3〔95%CI（-1.4，-1.1）〕 for males；the AAPCfor DALYs rate was -1.7〔95%CI（-1.9，-1.5）〕，with -3.7〔95%CI（-4.0，-3.4）〕 for females and -1.5〔95%CI（-1.7，-1.3）〕 for males. Analysis of the age-period-cohort model of mortality from esophageal cancer attributable to tobacco showed a negative net offset of -1.690%〔95%CI（-2.024%，-1.354%）〕. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer among Chinese residents will be relatively stable with a small decrease from 2020 to 2030，with mortality rates declining from 12.64/100 000 in 2020 to 12.63/100 000 in 2030 for males，and from 0.6/100 000 in 2020 to 0.46/100 000 for females. Conclusion Mortality rates and DALYs due to tobacco-attributable esophageal cancer among Chinese residents increased and then declined from 1990 to 2019. The burden of disease due to tobacco-attributable esophageal cancer is mainly caused by males in term of gender，by middle-aged and elderly people by age，which should be given sufficient attention. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer will be stable and slightly decreasing from 2020 to 2030.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-03-28 Cooperative journals: 《中国全科医学》
Abstract： Background Diabetes is highly prevalent in China，the prevention and treatment of it and its related complications need a lot of medical resources. Local reports have revealed that although the mortality of diabetes is declining，the burden of diabetes is still increasing. Objective To understand the epidemiological characteristics and burden of diabetes in China from 1990—2019，forecast the incidence of diabetes in China from 2020 to 2030，to provide data for evaluating and formulating diabetes-related prevention and treatment policies and measures. Methods In August 2022，this study used data from the Global Burden of Disease Study 2019. Temporal trends of the incidence，mortality，disability-adjusted life years（DALY），years of life lost（YLL），and years lost due to a disability（YLD） of diabetes in China from 1990 to 2019 were described. The Bayesian-age-period-cohort analysis was used to predict the incidence of diabetes in China from 2020 to 2030. Results Compared with 1990，in 2019，the crude prevalence of diabetes increased to 265.45/100 000，with an increase of 63.12%，the standardized prevalence of diabetes increased to 204.31/100 000，with an increase of 15.93%，the crude mortality rate of diabetes increased to 12.16/100 000，with an increase of 105.41%，and the standardized mortality rate of diabetes increased to 9.44/100 000，with an increase of 2.61%. The YLL rate decreased from 204.71/100 000 in 1990 to 178.45/100 000 in 2019. The YLD rate increased from 260.74/100 000 in 1990 to 316.30/100 000 in 2019. The DALY rate increased from 465.46/100 000 in 1990 to 494.76/100 000 in 2019. Compared with 1990，the DALY rate of diabetes increased by 21.08% in males and decreased by 6.68% in females. The YLL rate，YLD rate and DALY rate increased with age in 2019. According to the prediction of the standardized incidence of diabetes in China from 2020 to 2030，the overall standardized incidence of diabetes would present a decreasing trend during the period，and the standardized incidence of diabetes in 2030 would decrease by 11.45% in men and 18.60% in women compared with 2020. Conclusion The burden of diabetes in China is still heavy，with a large number of illness cases and decreased cases，mainly manifested by a high burden caused by diabetes-related disability. Attention should be paid to early prevention of diabetes to reduce the occurrence of complications. The disease burden of males and middle-aged and elderly people is heavy，so sufficient attention should be paid to them. Although the predicted diabetes incidence will reduce between 2020 and 2030，the number of patients is still increasing，so the prevention and control of diabetes should not be slack.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-30 Cooperative journals: 《中国全科医学》
Abstract：
Background Diabetes is a chronic metabolic disease that has become one of the chronic diseases that threaten the health of our population. Objective To understand the epidemiological characteristics and disease burden of diabetes in China from 1990-2019, and to provide data for evaluating and formulating diabetes-related prevention and treatment policies and measures. Methods Using the results of the Global Burden of Disease Study 2019, we describe the changes and age distribution characteristics of incidence, mortality, disability adjusted life year (DALY), year of life lost (YLL), and year lived with disability (YLD) of diabetes in China from 1990 to 2019, and project the incidence of diabetes in China from 2020 to 2030 using Bayesian-period-cohort analysis (BAPC) method. Results In 2019, the crude prevalence of diabetes in China was 265.45/100,000 and the standardized prevalence was 204.31/100,000, an increase of 63.12% and 15.93%, respectively, relative to 1990; the crude mortality rate was 12.16/100,000 and the standardized mortality rate was 9.44/100,000, an increase of 105.41% and 2.61%, respectively. The YLL rate showed a decreasing trend, the YLD rate and DALY rate showed an increasing trend. The disease burden of diabetes in men is higher than that in women, and the growth rate is faster than that in women; the disease burden of diabetes increases with age; the incidence of diabetes in our population shows a decreasing trend during 2020-2030. Conclusion The disease burden of diabetes in China is still high, with a high number of morbidity and mortality. The disease burden is manifested by a high disease burden caused by disability, and attention should be paid to the early prevention of diabetes to reduce the occurrence of complications; the disease burden is higher in the male and middle-aged and elderly population, and sufficient attention should be paid to this population.
Hits
Hits
Downloads
Comment