Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-12-01 Cooperative journals: 《中国全科医学》
Abstract：
Background China's national basic public health service provides free health examination services for the older adults aged 65 and above once a year, and health examination is the first step of "early detection, early diagnosis and early treatment" of common diseases in the older adults. The contribution of the older adults health examination service of basic public health services to the detection of health abnormalities in the older adults and the information of the older adults have been reported in less relevant studies. This paper mainly focuses on the abnormal detection rate of health examination of the older adults in basic public health services, and understands the effect of health examination for the older adults in the national basic public health service project from the perspective of the demand side. Objective Understand the abnormal detection rate in the health examination services provided by the basic public health service for the older adults over 65 years of age. Methods Multi-stage stratified sampling was used to take the older adults aged >=65 years old from 20 primary medical institutions in 3 provinces and 5 cities in the eastern, central and western regions of China as the survey subjects, and according to the basic public health management, they were divided into three categories: general older adults (not suffering from hypertension or diabetes), hypertension older adults and diabetic older adults people, and one-to-one questionnaire survey was conducted for all survey subjects. Results (1) The abnormal detection rate of health examination for the older adults was 67.4%, and the rural older adults were higher than those in urban areas (70.6%> 64.1%, P<0.001); (2) Abnormal blood pressure: the highest detection rate of abnormal physical examination in the older adults is abnormal blood pressure, 38.9% of the respondents self-reported abnormal blood pressure in the latest annual physical examination results, which is higher in rural areas than in urban areas (41.2%> 36.6%, P=0.010); 49.1% of the older adults who have been diagnosed with hypertension have abnormal blood pressure values in the annual physical examination, 36.1% of the older adults with diabetes have abnormal blood pressure values, and 18.3% of the general older adults have found abnormal blood pressure values in the latest physical examination. (3) Abnormal blood sugar: 24.8% of the respondents reported that they found abnormal blood glucose in the latest physical examination; The proportion of abnormal blood glucose in the older adults who have been diagnosed with diabetes is 60.5%, the abnormal blood glucose rate of the hypertensive older adults is 9.7%, and the screening rate of abnormal blood glucose in the general older adults is 8.4%. (4) The overall detection rate of anemia was 2.0%, and the older adults in rural areas were higher than those in urban areas (2.6% > 1.4%, P=0.021); The overall detection rate of fatty liver was 14.7%, and the urban older adults were higher than those in rural areas (17.2% > 12.3%, P<0.001). (5) Compared with the general older adults, the detection rate of abnormal blood pressure in the older adults with high blood sugar is 2.66 times, the detection rate of abnormal blood lipids in the older adults with hypertension and hyperglycemia is 1.64 and 1.41 times, the detection rate of overweight and obesity in the older adults with hypertension and hyperglycemia is 2.81 and 2.57 times, the detection rate of fatty liver in the older adults with hypertension and hyperglycemia is 2.10 and 1.52 times, respectively, and the detection rate of anemia in the older adults with hypertension and hyperglycemia is 0.26 and 0.50 times that of the general older adults; Compared with urban areas, the abnormal blood pressure, abnormal blood sugar and anemia of the rural older adults were 1.29, 1.36 and 1.76 times higher, respectively, while the detection rate of fatty liver among the rural older adults was 0.30 times. Conclusion The detection rate of abnormal blood pressure in the health examination is high, the blood pressure and blood sugar control of the older adults with hypertension and diabetes has improved, and the health prevention and treatment of the older adults in rural areas is not as good as that in cities.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-07-09 Cooperative journals: 《中国全科医学》
Abstract： Objective: to systematically sort out and summarize the progress and achievements of basic public health projects in the past decade (2009-2019). Methods: The monitoring data (2009-2016) of basic public health projects in 31 provinces (autonomous regions and municipalities directly under the central government) were collected by correspondence, the monitoring data of the national basic public health service management platform (2017-2019) and the relevant indicators of China's Health Statistical Yearbook (2010-2020) were analyzed, and the coverage of basic public health services in the country in the past ten years was analyzed from the perspective of suppliers; From November to December 2019, a national ten-year assessment survey of basic public health services was conducted in Shanxi Province, Zhejiang Province and Chongqing City, with a total of 10213 people surveyed. From the perspective of the demander, the awareness rate, utilization rate and satisfaction of residents with basic public health projects were investigated. Results: Over the past decade, the coverage of various service items of basic public health in China has increased significantly: (1) the filing rate of health files, the filing rate of electronic health files and the utilization rate of health files have increased from 48.78%, 35.07% and 22.14% in 2009 to 88.25%, 86.82% and 55.34% in 2019, with an average annual growth rate of 6.41%, 10.92% and 15.62% respectively; (2) A total of 6.311 billion printed materials on health education were distributed nationwide, about 337 million audio-visual materials on health education were broadcast, and a total of 1.144 billion people attended health education lectures; (3) By 2019, there will be about 109million registered hypertensive patients and about 31357100 patients with diabetes in China. The standardized management rate of hypertensive / diabetes patients has increased by 30.35% and 27.25% respectively in the past decade. The blood pressure/blood glucose control rate of hypertension/diabetes management group increased by 16.84% and 24.69%, respectively, with an average annual growth rate of 3.28% and 5.56%, respectively. The gap between the above indicators in the eastern, central and western regions is gradually narrowing; (4) The ten-year growth rates of neonatal visit rate and health management rate of children aged 0-6 years were 14.09% and 17.82% respectively, with an average annual growth rate of 1.74% and 2.30%; The rate of early pregnancy registration and postpartum visit increased by 6.06% and 7.79%; In 2019, the national elderly health management rate was 67.41%, an increase of 26.23% over 2009, with an average annual growth rate of 5.96%; The average annual growth rate of traditional Chinese medicine health management services for the elderly and children is 13.20% and 10.10%; (5) The vaccination certificate establishment rate and various vaccination rates of residents were stable at more than 90%; The standardized management rate of patients with severe mental disorders reached 89.17% in 2019, the management rate of patients with pulmonary tuberculosis and the regular medication rate of patients with pulmonary tuberculosis have been stable at more than 90% in the past 10 years, and the reporting rate of infectious diseases has been stable at more than 98%; (6) In 2019, the awareness rate of residents participating in the survey on the "national basic public health service project" was 85.4%, and the service satisfaction of key groups was more than 90%; (7) The service capacity of grass-roots medical and health service institutions has been improved, and the number of institutions has shown a continuous upward trend. The number of personnel in grass-roots medical and health institutions, the proportion of doctors and nurses and the proportion of Bachelor degree or above have increased year by year. Conclusion: Over the past decade, the population coverage of basic public health services has increased significantly, the goal of wide service coverage has been basically achieved, the health management level of key populations has been significantly improved, the effect of health management has been presented, the residents' sense of access to basic public health services has been gradually improved, and the service capacity of basic medical and health institutions has been continuously improved. The comprehensive implementation of basic public health services in China is an important step towards the goal of "universal health coverage".
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-07-09 Cooperative journals: 《中国全科医学》
Abstract： In 2009, the National Essential Public Health Services Program (NEPHSP) was launched as an important measure to deepen the reform of the medical and health system. Funded by the central and local governments, the program provides a package of free public health services in primary health care institutions, with a focus on children, maternal, the elderly, and patients with chronic diseases, and is dedicated to solving and improving the major health problems of the population. Commissioned by the Department of Primary Health of the National Health and Wellness Commission, we conducted an evaluation of the effects, experiences, and problems of the ten years of implementation of the NEPHSP. This paper aims to briefly introduce the main framework of the evaluation study, and then will analyze the challenges and problems faced by the NEPHSP since its implementation for ten years, and make targeted recommendations to provide a reference for the sustainable and high-quality development of the NEPHSP.
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