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附属医院教学满意度问卷的制作和信效度分析
期刊论文 | 2021 , 29 (5) , 738-742 | 医学教育研究与实践
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目的 研制医学生对附属医院的教学满意度调查问卷,通过实际调查对其信度和效度进行评价和问卷的修正,为医学教育满意度测量提供可靠的工具.方法 检索2014-2020年间相关文献,选择可用于客观反映/评价教学质量或满意度的指标,组织问卷小组进行讨论,形成初稿.以在附属医院在读理论课的学生为调查对象,使用自制问卷对随机抽取的58名学生进行预调查.问卷的同质性采用内部一致性信度和重测信度、因素负荷量、相关分析法和主成分因子分析法进行分析.结果 经文献检索、讨论,初步确定包括针对课程体系、教学过程、教学管理服务、硬件设施、总体印象五个维度在内的50个条目的 量表.量表的内部一致性信度Cronbach''s α系数为0.957,KMO=0.864,P<0.05,根据信度分析、相关分析和主成分分析法,逐步删减问题后形成5个因子38个条目的 问卷,共解释变异度72.85%.4周后进行重测,α系数为0.944.结论 医学生对附属医院教学满意度调查问卷具有良好的信度和效度,能够较好地反映医学生对附属医院教学的满意度,适用于附属医院教学评价.

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GB/T 7714 刘瑛 , 沈迟 , 潘龙飞 et al. 附属医院教学满意度问卷的制作和信效度分析 [J]. | 医学教育研究与实践 , 2021 , 29 (5) : 738-742 .
MLA 刘瑛 et al. "附属医院教学满意度问卷的制作和信效度分析" . | 医学教育研究与实践 29 . 5 (2021) : 738-742 .
APA 刘瑛 , 沈迟 , 潘龙飞 , 程悦 , 周忠良 . 附属医院教学满意度问卷的制作和信效度分析 . | 医学教育研究与实践 , 2021 , 29 (5) , 738-742 .
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Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS) SCIE SSCI PubMed
期刊论文 | 2021 , 18 (8) | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
WoS CC Cited Count: 2
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Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban-rural dual structure, depressive symptoms of the elderly in urban and rural areas are significantly different. In order to compare depressive symptoms and its influencing factors among the elderly in urban and rural areas, we used the data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7690 participants at age 60 or older were included in this study. The results showed that there was a significant difference in the prevalence estimate of depression between urban and rural elderly (chi(2) = 10.9.76, p < 0.001). The prevalence of depression among rural elderly was significantly higher than that of urban elderly (OR-unadjusted = 1.88, 95% CI: 1.67 to 2.12). After adjusting for gender, age, marital status, education level, minorities, religious belief, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities and having income or not, the prevalence of depression in rural elderly is 1.52 times (OR = 1.52, 95% CI: 1.32 to 1.76) than that of urban elderly. Gender, education level, self-reported health, duration of sleep, chronic diseases were associated with depression in both urban and rural areas. In addition, social activities were connected with depression in urban areas, while minorities, marital status and having income or not were influencing factors of depression among the rural elderly. The interaction analysis showed that the interaction between marital status, social activities and urban and rural sources was statistically significant (divorced: coefficient was 1.567, p < 0.05; social activities: coefficient was 0.340, p < 0.05), while gender, education level, minorities, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities having income or not and urban and rural sources have no interaction (p > 0.05). Thus, it is necessary to propose targeted and precise intervention strategies to prevent depression after accurately identifying the factors' effects.

Keyword :

CHARLS (wave 4) depressive symptoms difference of urban and rural area elderly

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GB/T 7714 Liu, Haixia , Fan, Xiaojing , Luo, Huanyuan et al. Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS) [J]. | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH , 2021 , 18 (8) .
MLA Liu, Haixia et al. "Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)" . | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 18 . 8 (2021) .
APA Liu, Haixia , Fan, Xiaojing , Luo, Huanyuan , Zhou, Zhongliang , Shen, Chi , Hu, Naibao et al. Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS) . | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH , 2021 , 18 (8) .
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The effects of family physician-contracted service on health-related quality of life and equity in health in China SSCI PubMed
期刊论文 | 2021 , 20 (1) | INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
WoS CC Cited Count: 2
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BackgroundFamily physician-contracted service (FPCs) has been recently implemented in Chinese primary care settings. This study was aimed at measuring the effects of FPCs on residents' health-related quality of life (HRQoL) and equity in health among the Chinese population.MethodsThe study data was drawn from the 2018 household health survey (Shaanxi Province, China) using multistage, stratified cluster random sampling. We measured HRQoL using EQ-5D-3L based on the Chinese-specific time trade-off values set. Coarsened exact matching (CEM) technique was used to control for confounding factors between residents with and without a contracted family physician. The concentration index (C) was calculated to measure equity in health.ResultsIndividuals with a contracted family physician had significantly higher HRQoL than those without, after data matching (0.9355 vs. 0.8995; P< 0.001). Additionally, the inequity in HRQoL among respondents with a contracted family physician was significantly lower than those without a contracted family physician (Cs of EQ-5D utility score: 0.0084 vs. 0.0263; p< 0.001).ConclusionsThis study highlights the positive effects of FPCs on HRQoL and socioeconomic-related equity in HRQoL. Future efforts should prioritize the economically and educationally disadvantaged groups, the expansion of service coverage, and the competency of family physician teams to further enhance health outcome and equity in health.

Keyword :

China Equity in health Family physician Health-related quality of life

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GB/T 7714 Lai, Sha , Lu, Li , Zhou, Zhongliang et al. The effects of family physician-contracted service on health-related quality of life and equity in health in China [J]. | INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH , 2021 , 20 (1) .
MLA Lai, Sha et al. "The effects of family physician-contracted service on health-related quality of life and equity in health in China" . | INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH 20 . 1 (2021) .
APA Lai, Sha , Lu, Li , Zhou, Zhongliang , Shen, Chi , Yang, Xiaowei , Zhao, Yaxin et al. The effects of family physician-contracted service on health-related quality of life and equity in health in China . | INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH , 2021 , 20 (1) .
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Comparison of inequity in health-related quality of life among unemployed and employed individuals in China SCIE SSCI PubMed
期刊论文 | 2021 , 21 (1) | BMC PUBLIC HEALTH
WoS CC Cited Count: 4
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BackgroundIn China, achieving health equity has been regarded as a key issue for health reform and development in the current context. It is well known that unemployment has a negative effect on health. However, few studies have addressed the association between unemployment and inequity in health-related quality of life (HRQOL). This study aims to compare the inequality and inequity in HRQOL between the unemployed and employed in China.MethodsThe material regarding this study was derived from the Chinese National Health Services Survey of Shaanxi Province for 2013. We controlled for confounding factors by utilizing the coarsened exact matching method. Finally, 7524 employed individuals and 283 unemployed individuals who were 15 to 64years old in urban areas were included in this study. We used HRQOL as the outcome variable, which was evaluated by using the Chinese version of EQ-5D-3L. The health concentration index, decomposition analysis based on the Tobit model, and the horizontal inequity index were employed to compute the socioeconomic-related equity between the unemployed and employed and the contribution of various factors.ResultsAfter matching, unemployed people tended to have poorer EQ-5D utility scores than employed people. There were statistically pro-rich inequalities in HRQOL among both employed and unemployed people, and the pro-rich health inequity of unemployed people was substantially higher than that of employed people. Economic status, age, education, smoking and health insurance were the factors influencing inequality in HRQOL between employed and unemployed individuals. Education status and basic health insurance have reduced the pro-rich inequity in HRQOL for unemployed people.ConclusionIt is suggested that unemployment intensifies inequality and inequity in HRQOL. According to policymakers, basic health insurance is still a critical health policy for improving health equity for the unemployed. Intervention initiatives aiming to tackle long-term unemployment through active labour market programmes, narrow economic gaps, improve educational equity and promote the health status of the unemployed should be considered by the government to achieve health equity.

Keyword :

China Coarsened exact matching EQ-5D Health equity Health-related quality of life Unemployment

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GB/T 7714 Zhao, Yaxin , Zhou, Zhongliang , Fan, Xiaojing et al. Comparison of inequity in health-related quality of life among unemployed and employed individuals in China [J]. | BMC PUBLIC HEALTH , 2021 , 21 (1) .
MLA Zhao, Yaxin et al. "Comparison of inequity in health-related quality of life among unemployed and employed individuals in China" . | BMC PUBLIC HEALTH 21 . 1 (2021) .
APA Zhao, Yaxin , Zhou, Zhongliang , Fan, Xiaojing , Nawaz, Rashed , Zhao, Dantong , Xu, Tiange et al. Comparison of inequity in health-related quality of life among unemployed and employed individuals in China . | BMC PUBLIC HEALTH , 2021 , 21 (1) .
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Ethnic group differences in obesity in Asian Americans in California, 2013-2014 SCIE SSCI PubMed
期刊论文 | 2021 , 21 (1) | BMC PUBLIC HEALTH
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Background Obesity has been generally understudied in Asian Americans. It is important to identify subgroups of Asian Americans at high risk of obesity to help develop targeted interventions for those subgroups. This study aimed to examine the disparities in obesity among Asians (i.e., Chinese, Filipino, Japanese, Korean, and Vietnamese) living in California. Methods A sample of Adult Americans in California (n = 47,970) including Asian American adults (n = 3810) aged 18 years or older were obtained from the 2013-2014 California Health Interview Survey (the U.S. nation's largest state cross-sectional health survey). Body mass index was calculated using self-reported height and weight. Weight status was determined using the WHO Asian BMI cut points in 4 categories: < 18.5 kg/m(2) (underweight), 18.5-22.9 kg/m(2) (normal weight), 23-27.5 kg/m(2) (overweight), and >= 27.5 kg/m(2) (obese). Multiple logistic regression analyses were used to estimate odds ratio (OR) and 95% confidence interval (CI) after adjustment for covariates. Results Overall, the prevalence of Asians was 23.3% for obesity and 40.0% for overweight. The obesity prevalence was higher in Asians who were males, aged 45-64 years old, had higher family income, were current smokers, never got married, had lower education level, had an insufficient level of physical activity, and had more frequent consumption of fast foods. After adjusting for other factors, compared to Whites, being Hispanics and Blacks were associated with higher odds of obesity (OR = 1.47, 95%CI = 1.31-1.65; OR = 2.04, 95%CI = 1.65-2.53, respectively); being Chinese, Korean, and Vietnamese were associated with lower odds of obesity (OR = 0.28, 95%CI = 0.18-0.45; OR = 0.14, 95%CI = 0.04-0.46; OR = 0.28, 95%CI = 0.14-0.58, respectively). Compared to Chinese, being Japanese and Filipino were associated with higher odds of obesity (OR = 2.75, 95%CI = 1.52-4.95; OR = 2.90, 95%CI = 1.87-4.49, respectively). Conclusions The prevalence of adult obesity was high among Asian Americans in California. Ethnic/racial disparities in obesity among Asian Americans in California were observed in 2013-2014. Compared to Whites, being Chinese, Korean, Vietnamese were associated with lower odds of obesity. Among Asians, compared to Chinese, being Japanese and being Filipino were associated with higher odds of obesity. These findings can help design better interventions to reduce racial and ethnic disparities in obesity, especially for Asian Americans.

Keyword :

Asian Americans Ethnicity Health disparity Obesity

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GB/T 7714 Gong, Shaoqing , Wang, Kesheng , Li, Ying et al. Ethnic group differences in obesity in Asian Americans in California, 2013-2014 [J]. | BMC PUBLIC HEALTH , 2021 , 21 (1) .
MLA Gong, Shaoqing et al. "Ethnic group differences in obesity in Asian Americans in California, 2013-2014" . | BMC PUBLIC HEALTH 21 . 1 (2021) .
APA Gong, Shaoqing , Wang, Kesheng , Li, Ying , Zhou, Zhongliang , Alamian, Arsham . Ethnic group differences in obesity in Asian Americans in California, 2013-2014 . | BMC PUBLIC HEALTH , 2021 , 21 (1) .
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Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China. PubMed SCIE SSCI
期刊论文 | 2021 , 268 | Social science & medicine
WoS CC Cited Count: 26
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The unbalanced allocation of healthcare resources and the underutilization of primary care facilities are the core problems that restrict the current healthcare reforms in China. In order to encourage residents to go to primary care facilities, China implemented the Hierarchical Medical System (HMS) in 2015. This study aims to evaluate the effect of HMS on health seeking behavior in China using panel data. Statistics for the study were derived from China Family Panel Studies (CFPS) 2012, 2014, 2016 and 2018, and China health and family planning statistical yearbook 2012, 2014, 2016 and 2018. We employed the difference-in-differences (DID) model with multiple periods. In total, 61,932 residents were incorporated for a final sample covered 25 provinces. The results indicated that the implementation of HMS had a significantly positive effect on the probability of urban residents going to primary care facilities for contact. However, the effect of HMS was not significant for rural residents. Basic health insurance was a significant factor for directing residents to primary care facilities. Self-assessed health, chronic disease, economic level and educational status were also found to be focal factors of health seeking behavior. In conclusion, the introduction of HMS has led to improved health seeking behavior and is worth putting more effort into. For policy makers, basic medical insurance is still an important health policy that enables systematic health seeking behavior. Initiatives to continue to expand the adjustment range of economic incentives should be adopted to promote the implementation of HMS. However, the effect of HMS in chronic disease is poor and efforts to formulate chronic disease as a breakthrough to HMS should be carried out. Moreover, the government should increase the publicity of HMS.

Keyword :

China Difference in differences Health seeking behavior Hierarchical medical system Primary care facilities

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GB/T 7714 Zhou Zhongliang , Zhao Yaxin , Shen Chi et al. Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China. [J]. | Social science & medicine , 2021 , 268 .
MLA Zhou Zhongliang et al. "Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China." . | Social science & medicine 268 (2021) .
APA Zhou Zhongliang , Zhao Yaxin , Shen Chi , Lai Sha , Nawaz Rashed , Gao Jianmin . Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China. . | Social science & medicine , 2021 , 268 .
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Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents SCIE PubMed SSCI
期刊论文 | 2021 , 21 (1) | BMC HEALTH SERVICES RESEARCH
WoS CC Cited Count: 2
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BackgroundPatient experience is a key measure widely used to evaluate quality of healthcare, yet there is little discussion about it in China using national survey data. This study aimed to explore rural and urban differences in patient experience in China.MethodsData regarding this study were drawn from Chinese General Social Survey (CGSS) 2015, with a sample size of 9604. Patient experience was measured by the evaluation on healthcare services. Coarsened exact matching (CEM) method was used to balance covariates between the rural and urban respondents. Three thousand three hundred seventy-two participants finally comprised the matched cohort, including 1592 rural residents and 1780 urban residents. Rural and urban differences in patient experience were tested by ordinary least-squares regression and ordered logistic regression.ResultsThe mean (SD) score of patient experience for rural and urban residents was 72.35(17.32) and 69.45(17.00), respectively. Urban residents reported worse patient experience than rural counterparts (Crude analysis: Coef.=-2.897, 95%CI: -4.434, -1.361; OR=0.706, 95%CI: 0.595, 0.838; Multivariate analysis: Coef.=-3.040, 95%CI: -4.473, -1.607; OR=0.675, 95%CI: 0.569, 0.801). Older (Coef.=2.029, 95%CI: 0.338, 3.719) and healthier (Coef.=2.287, 95%CI: 0.729, 3.845; OR=1.217, 95%CI: 1.008, 1.469) rural residents living in western area (Coef.=2.098, 95%CI: 0.464, 3.732; OR=1.276, 95%CI: 1.044, 1.560) with higher social status (Coef.=1.158, 95%CI: 0.756, 1.561; OR=1.145, 95%CI: 1.090, 1.204), evaluation on adequacy (Coef.=7.018, 95%CI: 5.045, 8.992; OR=2.163, 95%CI: 1.719, 2.721), distribution (Coef.=4.464, 95%CI: 2.471, 6.456; OR=1.658, 95%CI: 1.312, 2.096) and accessibility (Coef.=2.995, 95%CI: 0.963, 5.026; OR=1.525, 95%CI: 1.217, 1.911) of healthcare resources had better patient experience. In addition, urban peers with lower education (OR=0.763, 95%CI: 0.625, 0.931) and higher family economic status (Coef.=2.990, 95%CI: 0.959, 5.021; OR=1.371, 95%CI: 1.090,1.723) reported better patient experience.ConclusionsDifferences in patient experience for rural and urban residents were observed in this study. It is necessary to not only encourage residents to form a habit of seeking healthcare services in local primary healthcare institutions first and then go to large hospitals in urban areas when necessary, but also endeavor to reduce the disparity of healthcare resources between rural and urban areas by improving quality and capacity of rural healthcare institutions and primary healthcare system of China.

Keyword :

China Coarsened exact matching Patient experience Rural and urban differences

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GB/T 7714 Zhao, Dantong , Zhou, Zhongliang , Shen, Chi et al. Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents [J]. | BMC HEALTH SERVICES RESEARCH , 2021 , 21 (1) .
MLA Zhao, Dantong et al. "Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents" . | BMC HEALTH SERVICES RESEARCH 21 . 1 (2021) .
APA Zhao, Dantong , Zhou, Zhongliang , Shen, Chi , Nawaz, Rashed , Li, Dan , Ren, Yangling et al. Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents . | BMC HEALTH SERVICES RESEARCH , 2021 , 21 (1) .
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Whether high government subsidies reduce the healthcare provision of township healthcare centers in rural China SCIE PubMed
期刊论文 | 2021 , 21 (1) | BMC HEALTH SERVICES RESEARCH
WoS CC Cited Count: 2
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Background China's government launched a large-scale healthcare reform from 2009. One of the main targets of this round reform was to improve the primary health care system. Major reforms for primary healthcare institutions include increasing government investment. However, there are insufficient empirical studies based on large sample to catch long-term effect of increased government subsidy and lack of sufficient incentives on township healthcare centers (THCs), therefore, this study aims to provide additional empirical evidence on the concern by conducting an empirical analysis of THCs in Shaanxi province in China. Methods We collected nine years (2009 to 2017) data of THCs from the Health Finance Annual Report System (HFARS) that was acquired from the Health Commission of Shaanxi Province. We applied two-way fixed effect model and continue difference-in-difference (DID) model to estimate the effect of percentage of government subsidy on medical provision. Results A clear jump of the average percentage of government subsidy to total revenue of THCs can be found in Shaanxi province in 2011, and the average percentage has been more than 60% after 2011. Continue DID models indicate every 1% percentage of government subsidy to total revenue increase after 2011 resulted in a decrease of 1.1 to 3.5% in THCs healthcare provision (1.9% in medical revenue, 1.2% in outpatient visit, 3.5% in total occupy beds of inpatient, 1.1% in surgery revenue, 2.1% in sickbed utilization rate). The results show that the THCs with high government subsidy reduce the number of medical services after 2011. Conclusions We think that it is no doubt that the government should take more responsibility for the financing of primary healthcare institutions, the problem is when government plays a central role in the financing and delivery of primary health care services, more effective incentives should be developed.

Keyword :

China Healthcare reform Incentives Township healthcare centers

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GB/T 7714 Shen, Chi , Zhou, Zhongliang , Lai, Sha et al. Whether high government subsidies reduce the healthcare provision of township healthcare centers in rural China [J]. | BMC HEALTH SERVICES RESEARCH , 2021 , 21 (1) .
MLA Shen, Chi et al. "Whether high government subsidies reduce the healthcare provision of township healthcare centers in rural China" . | BMC HEALTH SERVICES RESEARCH 21 . 1 (2021) .
APA Shen, Chi , Zhou, Zhongliang , Lai, Sha , Dong, Wanyue , Zhao, Yaxin , Cao, Dan et al. Whether high government subsidies reduce the healthcare provision of township healthcare centers in rural China . | BMC HEALTH SERVICES RESEARCH , 2021 , 21 (1) .
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Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study SCIE SSCI PubMed
期刊论文 | 2021 , 18 (10) | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
WoS CC Cited Count: 1
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Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions between physicians and standardized patients across 63 CHCs in Xi'an, China. We measured the quality of primary care on seven criteria: (1) adherence to checklists, (2) correct diagnosis, (3) correct treatment, (4) number of unnecessary exams and drugs, (5) diagnosis time, (6) expense of visit, (7) patient-centered communication. Significant quality differences were observed between public CHCs and private CHCs. Private CHC physicians performed 4.73 percentage points lower of recommended questions and exams in the checklist. Compared with private CHCs, public CHC providers were more likely to give a higher proportion of correct diagnosis and correct treatment. Private CHCs provided 1.42 fewer items of unnecessary exams and provided 0.32 more items of unnecessary drugs. Private CHC physicians received a 9.31 lower score in patient-centered communication. There is significant quality inequality in different primary care models. Public CHC physicians might provide a higher quality of service. Creating a comprehensive, flexible, and integrated health care system should be considered an effective approach towards optimizing the management of CHC models.

Keyword :

China primary care private CHCs public CHCs quality standardized patient

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GB/T 7714 Su, Min , Zhou, Zhongliang , Si, Yafei et al. Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study [J]. | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH , 2021 , 18 (10) .
MLA Su, Min et al. "Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study" . | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 18 . 10 (2021) .
APA Su, Min , Zhou, Zhongliang , Si, Yafei , Sylvia, Sean , Chen, Gang , Su, Yanfang et al. Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study . | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH , 2021 , 18 (10) .
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Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren SCIE SSCI PubMed
期刊论文 | 2021 , 21 (1) | BMC PUBLIC HEALTH
WoS CC Cited Count: 1
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Background Caring for grandchildren is regarded as one of the principle roles of middle- and old-aged adults, especially among rural Chinese grandparents. This study aims to examine the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren, based on the gender differences in grandparental role engagement and the theories of role strain and role enhancement. Methods A total of 4833 rural citizens with one or more grandchildren were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Grandchild care was measured by continuous variable (duration) and categorical variable (no care, low intensity, moderate intensity, high intensity). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). We used coarsened exact matching (CEM) to balance the covariates of caregivers and non-caregivers. Following CEM, 1975 non-caregivers and 2212 caregivers were identified (N = 4187). Multilevel linear regression was employed to examine the gender differences in depressive symptoms. We also tested for the moderating role of gender on the association between grandchild care and depressive symptoms. Results Grandmothers were more likely to provide grandchild care (54.42% vs 51.43%) at high intensity (61.46% vs 51.01%), with longer duration (39.24 h vs 33.15 h) than that given by grandfathers. Grandmothers suffered more from depressive symptoms than grandfathers, and such gap increased when grandparents were involved in high-intensity care. Grandmothers providing grandchild care, particularly at moderate intensity, were associated with fewer depressive symptoms (Coef. = - 0.087, 95%CI: - 0.163, - 0.010; Coef. = - 0.291, 95%CI: - 0.435, - 0.147), compared with non-caregivers. Grandmothers giving moderate intensity of grandchild care were also associated with fewer depressive symptoms (Coef. = - 0.171, 95% CI: - 0.313, - 0.029), compared with those with low-intensity care. However, such associations were not significant among grandfathers. Conclusions Our findings highlight the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. Grandparents should be encouraged to engage in grandchild care, but at moderate intensity. The health status of middle- and old-aged adults, particularly females, should be monitored closely. Humanistic care, preventive care and curative treatment strategies focusing on such populations should be developed and refined.

Keyword :

Depressive symptoms Gender differences Grandchild care Intensity Rural China

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GB/T 7714 Zhao, Dantong , Zhou, Zhongliang , Shen, Chi et al. Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren [J]. | BMC PUBLIC HEALTH , 2021 , 21 (1) .
MLA Zhao, Dantong et al. "Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren" . | BMC PUBLIC HEALTH 21 . 1 (2021) .
APA Zhao, Dantong , Zhou, Zhongliang , Shen, Chi , Ibrahim, Sahardid , Zhao, Yaxin , Cao, Dan et al. Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren . | BMC PUBLIC HEALTH , 2021 , 21 (1) .
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