Association Between Service Agreements and Frequency of Primary Care Visits in a Chinese Community Health Service Center

Abstract Background: Hypertensive patients can freely choose the informal medical facilities such as pharmacies, community health service centers, and cardiology clinics in secondary or tertiary hospitals, as the routine places for medical treatment in China at present. It is not clear the proportion, influencing factors and the effects on blood pressure (BP) of different health-seeking behaviors among hypertensive patients in urban communities. The aim of the study is to investigate the health-seeking behaviors and the effect on BP of different health-seeking behaviors among hypertensive patients in urban communities in China.Methods: A cross-sectional survey of hypertension was conducted in urban communities in Chengdu. 437 hypertensive patients seeking medical help regularly were sequentially enrolled to fill out the questionnaire on health-seeking behaviors.Results: The average age was 67.1±7.5 years. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 144.2±17.9 mmHg and 75.4±10.4 mmHg, respectively, and the control rate of BP was 41.0%. Among the hypertensive patients investigated, 5.2% of which chose the informal medical facilities, 62.8% chose the community health service center, 21.5% chose the cardiology clinics in secondary or tertiary hospitals, and 10.5% chose both community health service center and cardiology clinics as the usual places for medical treatment. There were statistical differences in education levels, proportions of home BP monitoring, establishing chronic disease archives in community, medication compliance and side effects of drugs among the four groups. The SBP was 150.9 ±19.8, 145.1±18.0, 143.8±17.5 and 136.3±15.1 mmHg (P=0.007) in the four groups respectively and it was significantly lower in the combined management group than in the other three groups. The control rate of BP was 23.8%, 39.4%, 43.0% and 54.8% (P=0.100), respectively. Compared with patients choosing the informal medical facilities, patients in the combined management group had significant higher BP control rate (OR = 3.679, P = 0.035).Conclusions: Combined management with both community health service center and higher-level hospitals can decrease BP.

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Risk factors for the frequent attendance of older patients at community health service centers in China: a cross-sectional study based on stratified sampling

BMC Family Practice ◽

10.1186/s12875-021-01575-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Nana Li ◽

Juan Shou

Keyword(s):

Risk Factors ◽

Health Service ◽

Community Health ◽

Chronic Diseases ◽

Cross Sectional Study ◽

Community Health Service ◽

Service Center ◽

Sectional Study ◽

Cross Sectional ◽

Frequent Attendance

Abstract Background This study aimed to investigate the characteristics of frequent attenders (FAs) among older patients in Shanghai, China, and explore the associated factors. Methods This cross-sectional study was conducted in six community health service centers in Shanghai, China, from August to December 2018 based on stratified sampling. On the basis of our preliminary study, FAs were defined as those attending at least four consultations in a month. A self-administered questionnaire was used to collect the clinicodemographic data of the participants. Social support, pain severity, depression, and anxiety were evaluated using the Social Support Revalued Scale, six-point Behavioral Rating Scale, Patient Health Questionnaire–9, and Generalized Anxiety Disorder Scale, respectively. Results This study included 619 patients aged > 60 years. Among these patients, 155 (25%) were FAs to a community health service center, 366 (59.1%) had 1 or 2 chronic diseases, 179 (28.9%) had ≥3 chronic diseases, 313 (50.4%) opted for a family doctor service, and 537 (86.8%) chose a community health service center for the first consultation. The following were identified as independent risk factors for frequent attendance: widowed status, unmarried status, the presence of > 3 chronic diseases, first consultation at a community health service center, high medical expenses, frequent attendance of the spouses, long-term medication, the use of both traditional Chinese and Western medicine services, and depression. Conclusions This study summarizes the characteristics of older FAs to community health service centers in China and identifies 10 risk factors significantly associated with frequent attendance.

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Impact of intelligent family physician optimized coordination model On Primary Hypertension Patients in a Beijing Community (Preprint)

10.2196/preprints.14437 ◽

2019 ◽

Author(s):

Dan Li ◽

Xuejuan Wei ◽

Hao Wu ◽

Xing-Ying Liu ◽

Wen-Juan Gao

Keyword(s):

Health Service ◽

Community Health ◽

Chronic Diseases ◽

Family Physician ◽

Community Health Service ◽

Lifestyle Changes ◽

Categorical Variables ◽

Service Center ◽

Patient Centered ◽

Collaborative Model

BACKGROUND In order to address the challenges of chronic diseases, Beijing Municipal Government promoted intelligent family physician optimized collaborative model ( IFOC ) schema, which is poised to implement the patient-centered healthcare model, supported by intelligent chronic disease management system. The Fangzhuang community health service center is a National Demonstration Community Health Service Center in China, laid emphasis on the patient-centered model service, initiated, piloted and promoted IFOC schema optimize management of chronic diseases. OBJECTIVE To explore the effect of an intelligent family physician optimized collaborative model on selected hypertension patients of Fangzhuang Community in Beijing. METHODS This retrospective study used de-identified data of hypertension patients from the database of Fangzhuang community health service center. A comparative study pre- and post-implementation of IFOC for 2 years was performed to evaluate standardized management rate of blood pressure (BP), BP values, BP control rate, lifestyle changes and blood lipid levels. Continuous variables and categorical variables were analyzed using paired t-test and χ2 test, respectively. RESULTS A total of 6929 hypertension cases met inclusion/exclusion criteria. Compared with the pre-index period, standardized management rate increased from 34.4% to 67.4% in the post-index period (p < 0.001). SBP decreased from 144.10 mmHg to 141.38 mmHg (p < 0.001). BP control rate of the high-risk patients and overall BP control rate enhanced from 35.2% to 48.8%, from 44.7% to 49.9% , respectively (both p < 0.001). BMI decreased from 25.31 kg/m² to 24.65 kg/m².Exercise frequency increased from 2.83 times/week to 5.39 times/week; exercise duration increased from 20.03 min/d to 31.93 min/d; salt intake decreased from 9.56 g/d to 6.81 g/d; amount of cigarette smoking decreased from 11.31/d to 7.16 /d (all p < 0.005). TC decreased from 5.36 mmol/L to 4.65 mmol/L, LDL-C decreased from 3.35 mmol/L to 3.07 mmol/L (both p< 0.001), TG decreased from 1.79 mmol/L to 1.66 mmol/L (p= 0.021). CONCLUSIONS IFOC is an effective model in the management of hypertension and should be promoted and popularized by the Community Health Service Center in China as well as in other developing countries.

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Prediction and Decomposition of Efficiency Differences in Chinese Provincial Community Health Services

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102265 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2265 ◽

Cited By ~ 4

Author(s):

Qian Liu ◽

Bo Li ◽

Muhammad Mohiuddin

Keyword(s):

Health Service ◽

Health Services ◽

Community Health ◽

Care Service ◽

Health Care Service ◽

Community Health Services ◽

Community Health Service ◽

Theil Index ◽

Community Health Care ◽

Chinese Community

The objective of this paper is to analyze the provincial efficiency of the Chinese community health care service and its differences. This study allows us to predict the provincial differences in the efficiency of the Chinese community health care service from 2017 to 2026. This study analyzes the contributions of inter-regional and intra-regional differences in the total efficiency difference. We use the Super-SBM (Slacks-based Model) data envelopment analysis (DEA) model, Grey Model GM (1,1) for grey prediction, and the group-based Theil index decomposition method to study Chinese provincial panel data from 2008 to 2016. Results show that a fluctuating trend existed in the average provincial efficiency of community health services from 2008 to 2016. The community health services in a considerable number of provincial areas were inefficient. This study also reveals that there existed apparent inter-provincial differences in efficiency in Chinese community health services. The inter-provincial differences of the efficiency of Chinese community health services revealed by the Theil index declined at a relatively slow pace. With regard to the provincial efficiency difference of the Chinese community health service, the intra-regional efficiency difference is the most important structural reason for the overall efficiency difference, which explains the overall difference to a large extent. The inter-regional efficiency difference among the eastern, central, and western regions becomes the secondary structural reason, which should not be ignored. In conclusion, focus should be put on restructuring the investments into medical resources for community health service in each Chinese province. More attentions should be put into narrowing the inter-regional efficiency differences of the Chinese provincial community health service. The strategies targeted at reducing the inter-regional efficiency differences should not be ignored, so as to facilitate the improvement of overall efficiency of the Chinese community health service.

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Analysis of inpatient bed allocation equity and utilization in the city community health service center of China

Journal of Huazhong University of Science and Technology [Medical Sciences] ◽

10.1007/s11596-010-0201-6 ◽

2010 ◽

Vol 30 (2) ◽

pp. 141-144 ◽

Cited By ~ 9

Author(s):

Jing Xu ◽

Nina Wu ◽

Shengguo Jin ◽

Fang Wang ◽

Yunxia Wang ◽

...

Keyword(s):

Health Service ◽

Community Health ◽

Community Health Service ◽

Service Center ◽

City Community ◽

Bed Allocation ◽

The City

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Effect of Different Education Modes on Disease Recognition and Compliance in Patients with Type 2 Diabetes

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v3i6.882 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Lei Ma ◽

Shujin Wang ◽

Lihong Fan ◽

Xiaoyang Liu ◽

Tiao Bai ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Service ◽

Community Health ◽

Community Health Service ◽

Service Center ◽

Educational Models ◽

Education Group ◽

Group I ◽

Group Ii

Objective: To explore the impact of different educational models on disease recognition and compliance in patients with type 2 diabetes. Methods: For 100 patients with type 2 diabetes who were filed at the Changyanbao Community Health Service Center and the Electronic City Community Health Service Center from January 2017 to January 2018, the patients with diabetes were divided into 50 patients in the patient education group (group I) and 50 patients in the comprehensive education group (group II) according to the order of establishment. Observe the effects of different educational models on disease recognition and compliance in patients with type 2 diabetes. Results: After the relevant education, the effects of disease recognition and compliance were significantly higher in both groups (P<0.05), but the disease recognition and compliance of the patients in group II were significantly better than patients in group I (P<0.05). Conclusion: Through a variety of diabetes education models, and the network medical platform, patients can effectively improve disease awareness and compliance, thereby further control blood sugar, and improve patient quality of life.

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