scholarly journals Evolution of the Output–Workforce Relationship in Primary Care Facilities in China from 2009 to 2017

2020 ◽  
Vol 17 (9) ◽  
pp. 3043 ◽  
Author(s):  
Shan Lu ◽  
Liang Zhang ◽  
Niek Klazinga ◽  
Dionne Kringos
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Latent Class ◽  
Clinical Care ◽  
Public Health Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Facilities ◽  
Facility Level ◽  
Latent Class Growth

This study evaluates trends in workforce supply compared with those in the volume of service delivery (output) for basic clinical care (CC) and public health (PH) services from 2009 to 2017 in China. A cross-sectional survey (2018) was combined with retrospective data (2009–2017) from 785 primary care (PC) facilities in six provinces. Measures for the output of clinical care and of public health services were aggregated into a single (weighted) index for both service profiles. The output–workforce relationship was measured by its ratio. Latent class growth analysis and logistic regression analysis were applied to classify trajectories and determine associations with facility-level, geographic, and economic characteristics. From 2009 to 2017, the proportion of PC to overall healthcare workforce decreased from 24.25% to 18.57%; the proportion of PH to PC providers at PC facilities increased from 23.6% to 29.5%, while the proportion of PH output increased from 44.3% to 65.9%. Four trajectories of the output–workforce relationship were identified for CC, and five trajectories for PH services of which 85.3% of the facilities showed initially increasing and then slightly decreasing trends. Geographic characteristics impacted different trajectories. The PC workforce falls behind hospital workforce. The expansion in workload of PH services is unbalanced with that of workforce.

scholarly journals Person-centred care in complementary medicine for individuals with chronic conditions in Australia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Foley ◽  
A Steel ◽  
J Adams
Keyword(s):  
Public Health ◽  
Complementary Medicine ◽  
Health Systems ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Medical Doctors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Public Health Systems

Abstract Background Increasing chronic condition diagnoses burden public health systems, individuals and communities. The duration and complexity of chronic conditions require ongoing, multifaceted care - such as person-centred care (PCC) - to address the individual needs and quality of life for patients. Many patients with chronic conditions seek additional care outside mainstream medicine, often consulting complementary medicine (CM) practitioners. This study examines the extent of PCC being experienced by patients with chronic conditions who consult CM practitioners. Methods Cross-sectional survey (n = 191), conducted nationally, November 2018 to March 2019, in clinics of the five CM professions most commonly consulted by individuals with chronic conditions in Australia (massage, chiropractic, osteopathy, acupuncture, naturopathy). Participants with chronic conditions (n = 153) were surveyed about experiences of PCC during CM consultation, and regarding consultation with medical doctors, using four validated measures. Results During consultation with CM practitioners, patient perceptions of PCC were consistently high. Ratings of PCC were consistently higher for consultations with any CM practitioners (summary mean 3.33) than consultations with medical doctors (summary mean 2.95). The highest mean scores for PCC were reported by patients of naturopaths (summary mean 4.04). Variations in perceived PCC for different items between professions indicate nuance in the experience of consultation across different CM professions. Conclusions This study indicates PCC is characteristic of CM consultation, which may reflect CM philosophies such as holism. CM practitioners may present an existing resource of PCC. Further attention should be given to CM professions regarding the potential to address unmet needs of individuals with chronic conditions, and subsequently to better manage the public health burden associated with chronic conditions. Key messages Person-centred care appears to be a consistent characteristic of complementary medicine clinical care for individuals with chronic conditions. Due to rising rates of chronic conditions and the associated burden on public health systems, complementary medicine professions should be considered as a resource to optimise chronic illness care.

scholarly journals Rural Resident Experience on National Basic Public Health Services: A Cross-Sectional Survey in 10 Western Provinces of China

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 160
Author(s):  
Jinlin Liu ◽  
Ying Mao
Keyword(s):  
Public Health ◽  
Health Services ◽  
Large Scale ◽  
Health Management ◽  
Rural Resident ◽  
Public Health Services ◽  
Cross Sectional Survey ◽  
Rural Residents ◽  
Cross Sectional ◽  
Health Related

National basic public health services (BPHSs) are important for promoting the health of rural populations. A better understanding of rural BPHSs from the viewpoint of residents utilizing the services can help health-related departments and primary health care (PHC) centers further improve rural BPHSs. By conducting a large-scale cross-sectional survey in 10 western provinces of China, the study depicts rural resident experiences with rural BPHSs. Of the 9019 participants, 59.33% and 66.48% did not receive services related to health examinations or health education in the six months prior to the survey, respectively. A total of 56.90% were satisfied with the rural BPHSs, and the mean overall satisfaction score was 3.61 ± 0.908 (out of a maximum of 5). The most satisfying domain for rural residents with BPHSs was the attitude of PHC workers, whereas rural residents with chronic diseases were the least satisfied with the health management. Satisfaction with the attitude of PHC workers was identified as the strongest determinant of rural residents’ overall satisfaction with BPHSs. This study could enlighten rural BPHSs management in China.

scholarly journals 542. Los Angeles County Acute Care Regional Antibiogram Suggests Changing Landscape of MDRO Threats Between 2015 and 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S258-S259
Author(s):  
James McKinnell ◽  
Chelsea Foo ◽  
Kelsey OYong ◽  
Janet Hindler ◽  
Sandra Ceja ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Acute Care ◽  
Los Angeles County ◽  
Multivariable Analysis ◽  
Multidrug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Level Data ◽  
Facility Level

Abstract Background National surveillance for multidrug-resistant organisms (MDRO) are limited by narrow geographic sampling, few hospitals, and failure to account for local epidemiology. A Los Angeles County (LAC) regional antibiogram was created to inform public health interventions and provide a baseline for susceptibility patterns countywide. We present data to compare the 2015 and 2017 LAC regional antibiogram. Methods We conducted a cross-sectional survey of cumulative facility-level antibiograms from all hospitals in LAC; 83 hospitals (AH) and 9 Long-term Acute Care (LTAC). For 2015, submission was voluntary, 2017 data were collected by public health order. Non-respondents were contacted by phone and in person. Isolates from sterile sources were pooled. Countywide susceptibility was calculated by weighting each facility’s isolate count by its reported susceptibility rate with minimum–maximim observed (2015) and Interquartile range (IQR) for 2017. Change from 2015 mean susceptibility is reported. Results Seventy-five (75) facilities submitted antibiograms for 2015 and 86 facilities for 2017. Among non-respondents in 2017, two facilities could not provide an adequate antibiogram and 4 were specialty hospitals with too few cultures to create an antibiogram. Regional summmary tables are presented in Tables 1–4. Klebsiella pneumoniae (n = 50 hospitals/19,382 isolates) % S to meropenem was 97% (IQR 94–100%), no change from 2015. Pseudomonas aeruginosa (PA) (n = 52 hospitals/17,770 isolates)% S to meropenem was 84% (IQR 74–93%), no change from 2015. Susceptibility to Acinetobacter baumannii (AB) was reported by 48 hospitals, including 1,4361 isolates,% S to meropenem was 39% (IQR 25–75%), 14% lower than 2015. Streptococcus agalactiae (n = 13 hospitals/647 isolates)% S to clindamycin was 43% (IQR 13–59%), a 22% increase from 2015. Conclusion LAC regional antibiograms identified stable patterns of antimicrobial resistance for most pathogens, but concerning results with AB and PA. Analysis of highly drug-resistant pathogens such as AB and PA would be improved with patient-level data to generate a combination antibiogram. We favor presenting IQR %S as done for 2017. Ongoing analysis will include multivariable analysis of observed changed S controlling for hospital characteristics. Disclosures All authors: No reported disclosures.

scholarly journals Can India’s primary care facilities deliver? A cross-sectional assessment of the Indian public health system’s capacity for basic delivery and newborn services

BMJ Open ◽  
2018 ◽  
Vol 8 (6) ◽  
pp. e020532 ◽  
Author(s):  
Jigyasa Sharma ◽  
Hannah H Leslie ◽  
Mathilda Regan ◽  
Devaki Nambiar ◽  
Margaret E Kruk
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Cross Sectional ◽  
Care Facilities

scholarly journals Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031513 ◽  
Author(s):  
Sheng Zhi Yang ◽  
Dan Wu ◽  
Nan Wang ◽  
Therese Hesketh ◽  
Kai Sing Sun ◽  
...  
Keyword(s):  
Primary Care ◽  
Workplace Violence ◽  
Rural Areas ◽  
Health Workers ◽  
Physical Violence ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Facilities

ObjectivesTo determine the prevalence of physical violence and threats against health workers and the aftermath in tertiary, secondary and primary care facilities in China.DesignA cross-sectional questionnaire study.Setting5 tertiary hospitals, 8 secondary hospitals and 32 primary care facilities located in both urban and rural areas of Zhejiang Province, China, were chosen as the study sites.ParticipantsA total of 4862 health workers who have contact with patients completed a survey from July 2016 to July 2017.Outcome measuresThe prevalence of physical violence, threats and Yi Nao, specific forms of physical violence and their aftermath were measured by a self-designed and verified questionnaire. Multivariable logistic regression models were used to examine the association between perceived organisational encouragement of reporting workplace violence (WPV) and physical violence, threats and Yi Nao after controlling for age, sex, level of facility, professional ranking and type of health worker.ResultsAmong all respondents, 224 (4.6%) were physically attacked and 848 (17.4%) experienced threats in the past year. Respondents in secondary hospitals were more likely to experience physical violence (AOR=3.29, 95% CI 2.21 to 4.89), threats (AOR=1.61, 95% CI 1.32 to 1.98) and Yi Nao (AOR=2.47, 95% CI 2.10 to 2.91), compared with primary care providers. Lack of organisational policies to report WPV was associated with higher likelihood of physical violence (AOR=3.64, 95% CI 2.57 to 5.18) and threats (AOR=2.21, 95% CI 1.76 to 2.78). Among physical violence cases, only 29.1% reported the attack to police mainly because most felt it useless to do so (58.8%). Only 25.7% were investigated and 72.4% of attackers received no punishment. Of all those attacked or threatened, 59.4% wanted to quit current post and 76.0% were fearful of dealing with urgent or severe cases.ConclusionsProper management of the aftermath of violence against health workers is inadequate. Formal guidelines for reporting and managing WPV are urgently needed.

scholarly journals Physical accessibility of primary care facilities for people with disabilities: a cross-sectional survey in 31 countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peter P. Groenewegen ◽  
Madelon Kroneman ◽  
Peter Spreeuwenberg
Keyword(s):  
Primary Care ◽  
Point Of Care ◽  
People With Disabilities ◽  
European Countries ◽  
Large Share ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Facilities ◽  
General Practices ◽  
Physical Accessibility

Abstract Background Primary care is the first point of care, also for people with disabilities. The accessibility of primary care facilities is therefore very important. In this study we analysed comparative data on physical accessibility of general practices (GP practices) in 31 (mainly) European countries. Methods We used data from the QUALICOPC study, conducted in 2011 among GPs in 34 (mainly European) countries and constructed a physical accessibility scale. We applied multilevel analysis to assess the differences between and within countries and to test hypotheses, related to characteristics of the practices and of the countries. Results We found large differences between countries and a strong clustering of physical accessibility within countries. Physical accessibility was negatively related to the age of the GPs, and was less in single-handed and in inner city practices. Of the country variables only the length of the period of social democratic government participation during the previous decades was positively related to physical accessibility. Conclusion A large share of the variation in physical accessibility of GP practices was on the level of countries. This means that national policies can be used to increase physical accessibility of GP practices.

Gender Inequalities in the Management of Angina Pectoris: Cross-Sectional Survey in Primary Care

2005 ◽  
Vol 50 (4) ◽  
pp. 154-158 ◽  
Author(s):  
M A Crilly ◽  
P E Bundred
Keyword(s):  
Primary Care ◽  
Gender Differences ◽  
Angina Pectoris ◽  
Clinical Care ◽  
Gender Inequalities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exercise Ecg ◽  
Gp Care ◽  
To Receive

Background and Aims: To determine the extent of gender differences in the routine clinical care of patients with angina pectoris in primary care. Methods: A cross-sectional survey of general practitioner (GP) medical records undertaken by trained data managers in 6 GP practices. 925 adults (489 men) with a clinical diagnosis of angina (prevalence= 2.4%, 95%CI 2.3–2.6). Data extracted included: level of care; risk factor recording; prescribed medication; exercise ECG and coronary revascularisation. Adjusted male-to-female odds ratios (AOR) adjusted for age, angina duration, and previous myocardial infarction, (MI). Results: Women with angina were older than men (71 v 65 years) with a lower prevalence of MI (30% v 43%), but a longer duration of angina (5 v 4 years). Men were more likely to receive once daily aspirin (AOR = 2.07, 95% CI 1.56–2.74) and be prescribed triple anti-anginal therapy (1.58, 95% CI 1.03–2.42). Men were also significantly more likely to undergo exercise ECG (1.56, 95% CI 1.14–2.15) and surgical revascularisation (1.71, 95% CI 1.03–2.85). Women tended to receive GP care alone (AOR = 0.64, 95% CI 0.46–0.89), whilst men received specialist cardiac care (1.47, 95% CI 1.09–2.00). Beta-blocker use following MI was similar (0.99, 95% CI 0.59–1.69). Conclusion: Differences in the management of men and women are unaccounted for by differences in age, previous MI or duration of angina. Gender differences in management of CHD reported from secondary care may also exist in primary care.

scholarly journals More public health service providers are experiencing job burnout than clinical care providers in primary care facilities in China

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Shan Lu ◽  
Liang Zhang ◽  
Niek Klazinga ◽  
Dionne Kringos
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Service ◽  
Public Health Service ◽  
Service Providers ◽  
Clinical Care ◽  
Job Burnout ◽  
Care Providers ◽  
Health Service Providers ◽  
Care Facilities

Abstract Background Health workers are at high risk of job burnout. Primary care in China has recently expanded its scope of services to a broader range of public health services in addition to clinical care. This study aims to measure the prevalence of burnout and identify its associated factors among clinical care and public health service providers at primary care facilities. Methods A cross-sectional survey (2018) was conducted among 17,816 clinical care and public health service providers at 701 primary care facilities from six provinces. Burnout was measured by the Chinese version of the Maslach Burnout Inventory-General Scale, and multilevel linear regression analysis was conducted to identify burnout’s association with demographics, as well as occupational and organisational factors. Results Overall, half of the providers (50.09%) suffered from burnout. Both the presence of burnout and the proportion of severe burnout among public health service providers (58.06% and 5.25%) were higher than among clinical care providers (47.55% and 2.26%, respectively). Similar factors were associated with burnout between clinical care and public health service providers. Younger, male, lower-educated providers and providers with intermediate professional title, permanent contract or higher working hours were related to a higher level of burnout. Organisational environment, such as the presence of a performance-based salary system, affected job burnout. Conclusions Job burnout is prevalent among different types of primary care providers in China, indicating the need for actions that encompass the entirety of primary care. We recommend strengthening the synergy between clinical care and public health services and transforming the performance-based salary system into a more quality-based system that includes teamwork incentives.

scholarly journals Predicting Pharmacist Intention to Contribute to COVID-19 Management at the Community Level: A Cross-Sectional Survey Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Junlei Li ◽  
Hao Hu ◽  
Wei Liu ◽  
Chi Ieong Lei ◽  
Carolina Oi Lam Ung
Keyword(s):  
Public Health ◽  
Community Setting ◽  
Survey Study ◽  
Perceived Behavioral Control ◽  
Public Health Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tpb Model ◽  
Key Variables ◽  
The Impact

Introduction: The role of pharmacists in public health management is expected to grow into a key player in the continuing measures of managing the COVID-19 pandemic, especially in the community setting. However, their intention to provide essential public health services for combating the pandemic and the impact of their attitude and beliefs are largely unknown. This study aimed to investigate the intention-to-practice COVID-19-related responsibilities of pharmacists based on the theory of planned behavior (TPB), identify the key factors predicting their intention, and explore the usefulness of the TPB model in predicting such an intention.Methods: A cross-sectional, self-administered questionnaire was completed by pharmacists in Macao between May and August 2020. Quantitative responses regarding intention-to-practice COVID-19-related duties, and the four TPB variables [attitude (A), subjective norms (SN), perceived behavioral control (PBC), and past behavior (PB)] were measured. Cronbach's alpha and composite reliability were used to determine the reliability and validity of the tool. In addition to descriptive statistics, Pearson's correlation was used to determine the strengths of the association, and multiple linear regression was used to predict the association between the intention and the four key variables.Results: More than half of the pharmacists practicing in Macao completed the questionnaire (296/520) giving a response rate of 56.9%. Among them, 75% were 26–40 years old and 56% were female. The majority of the participants (91.9%) demonstrated a positive intention to contribute to the COVID-19 infection management (mean = 4.19 ± 0.51). The mean scores for A, SN, PBC, and PB were 4.06 ± 0.52, 3.71 ± 0.58, 3.76 ± 0.65, and 4.03 ± 0.54, respectively. A (β = 0.671), SN (β = 0.608), PBC (β = 0.563), and PB (β = 0.829) were all positively correlated with intention (all P < 0.001). It was found that 72.5% of the variance in the intention-to-practice COVID-19-related duties could be explained by the TPB model using the four key variables with A and PB being two possible predictors.Conclusion: Pharmacists showed favorable A, SN, PBC, and intention in participating in COVID-19 management in the community setting. Specific training, enhanced stakeholder communication, and improved pharmacy management are essential to increase the willingness of pharmacists to take part in the COVID-19 pandemic and other public health emergencies alike in the future.

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