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Revision and an empirical evaluation of the Chinese Patient Health Literacy Scale
CHEN Ying, DONG Jian, TIAN Xiang-yang,
, Available online  , doi: 10.11847/zgggws1136236
Abstract(226) HTML (51) PDF 613KB(112)
  Objective   To modify the Chinese Patient Health Literacy Scale (CPHLS) for improving the reliability and validity of the scale.   Methods   From January to May 2021, t he CPHLS was preliminarily revised by expert consultation and the revised electronic Scale was employed to measure the health literacy of 2 808 outpatients randomly selected at 14 hospitals in eastern, central and western China. SPSS23.0 was utilized for Cronbach′s α calculation and exploratory factor analysis (EFA) to further improve the revised scale; AMOS23.0 was applied to build a Structural Equation Model (SEM) to test the validity of the scale.   Results   The Cronbach′s α coefficient of the preliminarily revised CPHLS was 0.841 and the α coefficients of the scale′s five dimensions were 0.751 for concept of medical science, 0.787 for disease self-management skills, 0.568 for medical common sense, 0.725 for self-efficacy , and 0.412 for medical information cognition, respectively, with an overall cumulative proportion of variance of 62.538%. Three common factors of the revised scale (e.g. self-efficacy, disease self-management skills and medical common sense) were extracted according to the results of EFA. After deleting four original items, the α coefficient of the revised scale was raised to 0.845, the α coefficients of the three dimensions were 0.926, 0.831, and 0.753 and the cumulative proportion of variance was 67.228%. The SEM analysis on the revised scale demonstrated that the dimension-specific factor load capability ranged 0.53 – 0.90 and the constructed SEM is of good overall goodness of fit, with the root mean square residual (RMR) of 0.083, root mean square error of approximation (RMSEA) of 0.086, goodness-of-fit index (GFI) of 0.926, adjusted goodness-of-fit index (AGFI) of 0.891, normed fit index (NFI) of 0.928, relative fit index (RFI) of 0.909, incremental fit index (IFI) of 0.931, the Tacker-Lewis index/non-normed fit index (TLI/NNFI) of 0.913, comparative fit index (CFI) of 0.931, parsimony goodness-of-fit index (PGFI) of 0.631, parsimony-adjusted normed fit index (PNFI) of 0.737, parsimony-adjusted comparative fit index (PCFI) of 0.740, and the critical number (CN) of 171, respectively.   Conclusion   The revised Chinese Patient Health Literacy Scale is of good internal consistency reliability and construct validity, indicating a potential application in the evaluation on patients' health literacy.
Efficiency of dual test of SARS-CoV-2 antigen and nucleic acid among freight truck drivers and workers passing through expressway toll gates
HONG Hang, FANG Ting, DING Ke-qin,
, Available online  , doi: 10.11847/zgggws1139218
Abstract(203) HTML (35) PDF 524KB(41)
  Objective  To evaluate the efficiency of dual test of severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antigen and nucleic acid among freight truck drivers and workers passing through expressway toll gates.   Methods  Dual tests of SARS-CoV-2 antigen and nucleic acid were conducted among 48 734 freight truck drivers and workers passing through 8 expressway toll gates in Ningbo city from provinces other than Zhejiang province during the period of March 20 – April 17, 2022. The test results were statistically analyzed.   Results  Totally 9 infections of SARS-CoV-2 Omicron variant were detected; of which, 6 were diagnosed clinically as mild coronavirus disease 2019 (COVID-19) case and 3 as asymptomatic infection. No subsequent COVID-19 case was confirmed. For the SARS-CoV-2 antigen test, the sensitivity and specificity were 55.5% (5/9) and 99.9% (48 717/48 725); the positive and negative predictive value were 38.5% (5/13) and 99.9% (48 717/48 721), respectively. For multiplex fluorescence PCR test of SARS-CoV-2 nucleic acid among the participants with positive SARS-CoV-2 antigen result, the Ct values of ORF1ab and N gene M (25th percentile, 75th percentile) were 19.0 (17.1, 21.5) and 19.0 (16.6, 22.5); while, the Ct values of the participants with negative result was significantly higher than those of the participants with positive SARS-CoV-2 antigen result (P < 0.05).   Conclusion  In this study, the sensitivity of SARS-CoV-2 antigen test is low but the specificity of the test is high for the detection of SARS-CoV-2 infection. The results suggest that dual test of SARS-CoV-2 antigen and nucleic acid should be implemented to reduce the risk of imported case-induced local COVID-19 epidemic.
Effectiveness of centralized quarantine for close contacts′ close contacts: an evaluation on a Delta variant-induced local COVID-19 outbreak
PAN Jin-ren, CHEN En-fu
, Available online  , doi: 10.11847/zgggws1139183
Abstract(267) HTML (55) PDF 489KB(89)
  Objective  To evaluate the effectiveness of centralized quarantine for close contacts′ close contacts (sub-contacts) in coronavirus disease 2019 (COVID-19) epidemic.   Methods  The definition of sub-contacts for this study is based on the State Council′s Joint Prevention and Control Protocol for Prevention and Control of COVID-19 (Edition 8). The information on 8 192 sub-contacts were extracted from the dataset of a COVID-19 epidemic caused by a Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a district of Shaoxing city, Zhejiang province in December 2021. All the sub-contacts were followed retrospectively; the epidemiologic survey reports of all sub-contacts with subsequent SARS-CoV-2 infection and the infected sub-contacts′ related cases/close contacts were reviewed and analyzed. The effect of the centralized quarantine for the sub-contacts was assessed as effective, ineffective, adverse effect, and uncertain, respectively based on outcomes (SARS-CoV-2 infection incidence) of follow ups on both the close contacts and the sub-contacts.   Results  Totally 387 confirmed SARS-CoV-2 infections were reported in the epidemic and averagely 21 sub-contacts were associated with one confirmed infection in the epidemic. Of all the sub-contacts, 99.8% were negative for SARS-CoV-2 nucleic acid in multiple successive PCR tests, suggesting a unnecessity of the centralized quarantine. By the end of the retrospective follow-up period, 18 (0.2%) of the sub-contacts were with positive result of SARS-CoV-2 nucleic acid test and all the positive sub-contacts were associated close contacts′ familial cohabitants. Among the 18 SARS-CoV-2 nucleic acid positive sub-contacts, 9 were identified being with the associated close contacts never being positive for SARS-CoV-2 nucleic acid test throughout the retrospective follow-up period, indicating that the sub-contacts might be infected during the transfer or centralized quarantine period. The analysis results suggest that among the 18 SARS-CoV-2 nucleic acid positive sub-contacts, the centralized quarantine is not necessary for all the sub-contacts, ineffective for 3 (16.7%) sub-contacts, with an adverse effect for 9 (50.0%) sub-contacts, and with uncertain effect for 6 (33.3%) sub-contacts, respectively.   Conclusion  The analysis showed no evidence of positive control effect of centralized quarantine for sub-contacts in a Delta variant induced COVID-19 epidemic but that a few sub-contacts could be infected in the process of transfer and centralized quarantine. The analysis results suggest that centralized quarantine for close contacts′ close contacts could be suspended and more studies are needed for effective management on sub-contacts in containment of COVID-19 epidemic.
Safety of inactivated COVID-19 vaccine in 3 – 17 years old healthy children
LI Min-jie, WANG Lei, WU Zhi-wei,
, Available online  , doi: 10.11847/zgggws1138965
Abstract(169) HTML (39) PDF 568KB(48)
  Objective  To evaluate the safety of an inactivated coronavirus disease 2019 (COVID-19) vaccine in healthy children and adolescents aged 3 – 17 years.   Methods  Totally 500 healthy children and adolescents aged 3 – 17 years were recruited in Zanhuang county of Hebei province and randomly assigned into a vaccination group (n = 375) and a placebo group (n = 125) during May 2021. Two doses of inactivated COVID-19 vaccine (Sinovac Life Sciences Co., Ltd, Beijing) or placebo (day 0 and day 28) were administered to the participants. The participants were observed for adverse reactions within 30 minutes after each vaccination. The participants′ information on local and systemic solicited adverse events from day 0 to day 7, and unsolicited adverse events from day 0 to day 28 were collected after the vaccination. Serious adverse events were recorded from the beginning of vaccination to 6 months after the second dose vaccination to evaluate the safety of the vaccine.  Results  The incidence of adverse reactions was 19.2% (72/375) in the vaccination group and 15.2% (19/125) in the placebo group, without significant difference between the incidence of the two groups (P > 0.05). The most common adverse reactions were injection site pain and fever. There was no significant statistical difference in the incidence of other adverse reactions between the two groups except for pain at the injection site. Most observed adverse reactions were grade 1 and 2 in severity, only 3 participants reported grade 3 adverse reactions. The vaccination group′s incidences of adverse reactions of grade 1 (14.93% vs. 12.8%), grade 2 (7.73% vs. 4%), and grade 3 (0.53% vs. 0.8%) were not significantly different from those of the placebo group. No serious vaccination-related adverse event was reported in either group. The incidence of adverse reactions (28%) was higher in the 3 – 5 years old participants than those in the participants aged 6 – 11 and 12 – 17 years (16% and 15.5%) and the age-group- specific adverse reaction incidences were not significantly different between vaccination group and placebo group. The incidence of adverse reactions for the first dose vaccination was significantly higher than that for the second dose (14.6% vs. 5.69%, P < 0.05) and there was no significant difference in the dose order-specific adverse reaction incidence between the vaccination group and the placebo group.  Conclusion  The inactivated COVID-19 vaccine is of good safety when administered in 3 to 17 years old healthy children.
Vaccination-related contamination-induced false positive SARS-CoV-2 specimen from a suspected COVID-19 case in Chengdu city: a gene tracing-based analysis
XIE Wen-jun, CHEN Heng, FENG Jing,
, Available online  , doi: 10.11847/zgggws1137810
Abstract(157) HTML (45) PDF 642KB(42)
  Objective  To conduct a gene tracing-based analysis on a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive oropharyngeal swab specimen from a suspected coronavirus disease 2019 (COVID-19) case without epidemiologically-confirmed exposure history and with negative results in confirmation tests in Chengdu city, Sichuan province for providing evidence to the operation of clinic vaccination with suspected vaccination clinic-related infection.  Methods  An epidemiological investigation was conducted on a suspected COVID-19 case reported by a medical institution providing both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services in a district of Chengdu city, Sichuan province on February 24, 2021. The information on case′s onset and treatment, travel and close contacts within 14 days before the onset were collected and analyzed. Specimen collection and laboratory nucleic acid testing were conducted for the case, the case′s close contacts and living environment, and the environment and work clothes of medical staff of the reporting medical institution. Second generation gene sequencing and gene tracing analysis were performed for the case′s positive specimen collected for the screening test.   Results  The suspected case was a 57-year old man seeking medication for cough, throat discomfort, and runny nose at a medical institution provided both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services and having a oropharyngeal swab test for screening SARS-CoV-2 infection at the medical institution on February 23, 2021. The case reported no history of travelling abroad himself and his close contacts, contacting with confirmed/suspected COVID-19 patients, potential exposure to SARS-CoV-2, and COVID-19 vaccination. No positive results of SARS-CoV-2 nucleic acid were detected for case′s oropharyngeal/nasal and anal swab specimens, close contacts′ oropharyngeal swab specimens, swab specimens of living/working/relevant public place environment, swab specimens of environment and working clothes of the staff of the medical institution for retests performed one day after the case′s screening test. The results of gene sequencing for the case′s positive specimen at the screening test showed a 99.99% sequence homology with the sample of COVID-19 vaccine for inoculation service at the medical institution. The Pangolin type was B for both the case′s specimen and the vaccine sample.   Conclusion  The clinical manifestation and laboratory test of the suspected case were not consistent with the diagnosis criterion for COVID-19 patient and asymptomatic SARS-CoV-2 infection. The case′s false SARS-CoV-2 positivity of the suspected specimen at the screening test probably result from vaccination related contamination of the case′s oropharyngeal swab specimen at the medical institution proving both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services. The result needs to be concerned when conducting SARS-CoV-2 nucleic acid screening.
A discussion on rapid response decision-making mechanism for public health emergency in port cities in China
HUANG Li-qun, FANG Peng-qian, CHEN Dan,
, Available online  , doi: 10.11847/zgggws1137412
Abstract(124) HTML (37) PDF 672KB(23)
Severe circumstance of global public health has posed higher requirements for rapid response to public health emergencies in port cities, especially at border ports, and it is urgent to construct a rapid decision-making mechanism for the response to public health emergency in port city in China. In this paper, the basic elements of public health emergency management decision-making, the structure of decision-making system, as well as the experience of port cities in responding to public health emergencies, are summarized. Specific problems in decision-making mechanism for the response to public health emergency in port city were also discussed in the paper, including the risk identification and screening of infectious diseases, novel model for comprehensive risk management of public health event, the application of artificial intelligence technology to construct rapid response infrastructure, and the structure and operation mode of the early-warning decision-making system.
Advances in researches on Transmission route of SARS-CoV-2 and personal health intervention: a review on research advances
TU Hong-wei, GAN Ping, ZHONG Ruo-xi,
, Available online  , doi: 10.11847/zgggws1138953
Abstract(240) HTML (82) PDF 636KB(109)
The conronavirus disease 2019 (COVID-19) pandemic exerts a major impact on the world. Understanding the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can help public health personnel to define the prevention and control priorities in practical work. This study summarized the existing literature (update to May 2, 2022) and analyzed and classified the main transmission routes of SARS-CoV-2 based on typical cases and laboratory studies, and proposed relevant prevention and personal protection strategies to provide a basis for more accurate and effective control of SARS-CoV-2 transmission.
Clinical symptoms and severity of elderly COVID-19 patients infected with different SARS-CoV-2 variants
WANG Hai-feng, LI Ya-fei, PAN Jing-jing, You Aiguo, Wang RuoLin, Fan Wei, Wang Wenhua, Wang Yingying, Ye Ying, Huang Xueyong, Guo Wanshen
, Available online  , doi: 10.11847/zgggws1138940
Abstract(257) HTML (85) PDF 541KB(99)
  Objective   To analyze differences in clinical symptoms and severity of elderly coronvirus disease 2019 (COVID-19) patients infected with Delta, Omicron BA.1 and Omicron BA.2 variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).   Methods  From China′s Infectious Disease Information System and provincial center for disease control and prevention and local designated hospitals, we collected socio-demographic and clinical information on 60 years and older COVID-19 patients reported in the four large-scale COVID-19 epidemics in Henan province during 2022 and the SARS-CoV-2 variants for the patients′ infections were identified based on gene sequencing in combination with epidemiological investigation. Chi-square and Fisher′s precision probability test were used to compare the differences in the incidence of patients infected with different variants and multivariate logistic regression was adopted analyze the influencing factors of disease severity.   Results  The total number of elderly cases for the four local COVID-19 epidemics was 234, including 118, 36, and 80 cases infected with SARS-CoV-2 Delta, Omicron BA.1, and Omicron BA.2 variant. Of all the cases, 56.8% were female; 47.6% suffered from underlying diseases; and 88.0% had COVID-19 vaccination. The main clinical manifestations for all the cases were fever, fatigue and upper respiratory symptoms such as cough, sore and dry throat. The symptomatic proportion in the cases with Delta variant infection was significantly higher than that in the cases with Omicron variant infection (34.7% vs. 19.0%, P = 0.007). The proportion of severe or critical conditions was significantly higher in the cases with Delta variant infection than that in the cases with Omicron variant infection (12.7% vs. 1.7%, P = 0.002). The results of multivariate logistic regression analysis revealed following risk factors for the occurrence of severe or critical conditions among the elderly cases: infected with Delta variant (odds ratio [OR] = 5.7, 95% confidence interval [95% CI]: 1.1 – 31.2), aged ≥ 80 years (OR = 8.4, 95% CI = 2.0 – 34.4), suffering from dyskinesia (OR = 5.3, 95% CI: 1.5 – 18.3), and suffering from diabetes (OR = 5.7, 95% CI: 1.1 – 31.3).   Conclusion  In COVID-19 patients aged 60 years and above, clinical symptoms and the occurrence of server or critical conditions differ by different SARS-CoV-2 variants and the patients with Delta variant infection, at older age, and with underlying diseases are at a higher risk of having severe or critical conditions.
Social attributes and social prevention and control of disease: a comment
WANG Chao, LU Zu-xun
, Available online  , doi: 10.11847/zgggws1138138
Abstract(243) HTML (76) PDF 569KB(68)
The social attributes of people determine that illness is not only a medical problem, but also a social disease. The illness has a wide range of social attributes from its occurrence and development, diagnosis and treatment to its social impacts. The prevention and control of disease require a full participation of the whole society, including the government, medical institutions, social organizations, and individuals. However, a healthy social environment urgently requires further innovations in disease prevention and control concepts and strategies to strengthen social foundations against to various diseases.
Epidemiological characteristics of a local COVID-19 outbreak caused by Omicron (BA.2.2) variant in Henan province
PAN Jing-jing, WANG Ying-ying, WANG Wen-hua,
, Available online  , doi: 10.11847/zgggws1138726
Abstract(576) HTML (148) PDF 1184KB(153)
  Objective  To analyze epidemiological characteristic and transmission process of a local coronavirus disease 2019 (COVID-19) outbreak induced by imported cases from other provinces in Henan province.   Methods  The data on all local COVID-19 cases in Xiuwu county, Henan province reported during March 18 – 28, 2022 were extracted from National Notifiable Disease Report System of China. The results of field investigations on the cases were also collected simultaneously. Descriptive statistics was performed on the data collected with SPSS 22.0.   Results  Totally 45 cases (16 males and 29 females, 14 minor or common patients and 31 asymptomatic infections) were reported during the 11-day outbreak period. The median age (25th percentile [P25], 75 percentile [P75]) of the cases was 23.02 (18.57, 28.64) years. The median (P25, P75) of cycle threshold (Ct) value for Orf1ab gene and N gene for positive cases in primary screening were 23.02 (18.57, 28.64) and 23.10 (18.63, 28.03), respectively. A case clustering involving 18 cases was identified in a local textile factory, with an incidence rate of 6.6%; seven family clusters were also identified, with a family secondary attack rate of 20.78% and a secondary attack rate of 3.79% among close contacts. Of all the cases, 12.5% could attributed the infection to the exposure to the asymptomatic infections being negative for nucleic acid test at that time. The results of genome second generation sequencing for the isolates from 29 infections indicated that the pathogen of the outbreak was severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant Omicron (BA.2.2) and the local transmission of the virus variant was traced back to the 2 first generation cases returning home from other epidemic area. The median (P25, P75) of incubation period was 3 (2, 4.25) days and that of generation interval was 3 (2, 3) days. Five generations of transmission were identified for the outbreak . The estimated basic reproductive number (R0) of this epidemic was 6.14, and the effective reproduction number (Rt) decreased 2 days after the control measures were taken and declined to less than 1 in 8 days after the implementa-tion of control measures.   Conclusion  The reported COVID-19 outbreak in Henan province was caused by imported cases from other epidemic area and spread mainly in factories, families and schools. The control measures on the outbreak were effective and subsequent transmission was prevented.
Construction of grounded theory-based vaccination decision-making process model for the public: a empirical study in college students
FAN Kai-sheng, HAO Yan-hua, GUAN Han-wen,
, Available online  , doi: 10.11847/zgggws1136354
Abstract(487) HTML (137) PDF 654KB(145)
  Objective  To construct a decision-making process model on vaccination of coronavirus disease 2019 (COVID-19) vaccine and to explore reasons of unwilling to have the vaccination from public perspective for providing theoretical evidences to COVID-19 vaccination promotion.   Methods  Using a self-designed open-ended questionnaire on COVID-19 vaccine hesitancy, we conducted a survey among 347 students in a medical university during March 27 – 29, 2021 – one week after the students′ applying voluntarily for COVID-19 vaccination. Word frequency and text node analysis on collected information were carried out and word cloud maps were generated with NVivo 12 software. A theoretical framework for vaccination decision-making process model was constructed based on grounded theory.   Results  Valid information were collected from all the participants. In the respondents′ responses in writing about reasons for having COVID-19 vaccination, the words with high frequency included COVID-19, prevention, vaccination, and free of charge; while, safety, vaccine, effectiveness and adverse reaction were among the high frequency words in the writings on COVID-19 vaccine hesitancy. In the respondents′ writing texts, 3 parent nodes and 9 child nodes were identified. According to theoretical models of bio-psycho-social medicine, protective behavior decision, and vaccine hesitation/vaccination willingness and considering the results of previous studies, the public motivation for COVID-19 vaccination could be summarized into three aspects with nine causal factors as following: objective biological determination (factors relevant to virology/pharmacology and physiology/pathology), subjective psychological determination (personal risk and benefit judgment, vaccine safety, vaccine efficacy, and perceived social responsibility), and social determination (service accessibility, information accessibility). The three determinant aspects with nine relevant factors ought to be concerned in the construction of theoretical framework of vaccination decision-making process model for the public.   Conclusion  A vaccination decision-making process model for the public was preliminarily constructed for the promotion of COVID-19 vaccination willingness and behavior in Chinese population.
Application of aptamer-based hybridization chain reaction in detections
SU Liu, DENG Sheng-liang, HE Wei-hua,
, Available online  , doi: 10.11847/zgggws1134506
Abstract(201) HTML (103) PDF 697KB(31)
Developing simple and sensitive detection methods is of great significance to researches on medical diagnosis, environmental analysis and food safety. As a new biological indicator molecule, aptamers are combined with hybridization chain reaction (HCR) to form a new detection model for sensitive detection of analytes. HCR is a typical amplification technology, which can be carried out without enzyme and self-assembled at room temperature. The aptamer-based HCR technology has be attracted great interest due to its high specificity and sensitivity, simple protocol and low cost. The study reviews basic features of HCR with an emphasis on the application of aptamer-based HCR in detection, such as proteins, enzyme activities, small molecules and tumor cells, etc. Major existing problems of the technology are also discussed. The review is aimed to provide a theoretical reference for establishing a highly efficient and sensitive HCR detection system.
Disease burden of depression among Chinese residents in 1990 and 2019: a comparative analysis
MA Xiao-mei, WANG Jin-jin, XU Xue-qin,
, Available online  , doi: 10.11847/zgggws1133771
Abstract(404) HTML (119) PDF 483KB(121)
  Objective  To compare the disease burden of depression among Chinese residents in 1990 and 2019 and to provide a reference for the prevention and control of depression.  Methods  The data on depression in Chinese population in 1990 and 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019). Incidence, disability-adjusted life years (DALY) and years lived with disability (YLD) of depression were used to analyze disease burden in 1990 and 2019 and its changing trend during the period.  Results  Among Chinese residents, the number of incidence and DALY of depression increased from 31 303 436 cases and 5 486 751 person-years in 1990 to 41 005 280 cases and 7 561 985 person-years in 2019, with an increase of 31.0% and 37.8%; while, the standardized incidence and the standardized DALY rate of depression decreased from 2 647.72/100 000 and 470.65/100 000 in 1990 to 231.41/100 000 and 416.95/100 000 in 2019. Compared with those in 1990, the number of incidence and DALY of depression increased by 37.0% and 41.9% among male residents and both the increases were higher than those (27.8%, 35.5%) among female residents; but the standardized incidence rate and DALY rate declined by 7.8% and 7.6% among male residents and both the decreases were lower than those (16.5% and 14.2%) among female residents. Declines in DALY rate of depression in 2019 were observed in both male and female residents aged 10 – 49 years but rises in the DALY rate were found in male and female residents age 50 years and above in comparison with those in 1990. Being the heaviest disease burden of depression among Chinese residents in 1990 and 2019, the DALY of major depression was 4 006 829 person-years and 5 087 997 person-years, accounting for 73.0% and 67.3% of the total disease burden of depression, respectively. Compared with those in 1990 in Chinese residents, the DALY rate of major depression and dysthymia increased by 5.7% and 39.1% in 2019, indicating a significantly increased disease burden of the disease.  Conclusion  In 1990 and 2019 in China, the main part of disease burden of depression was contributed to the disease incidents among females but the disease burden of depression also increased among male residents and the middle-aged and elderly residents.
Status quo of contracted family doctor services in China: a literature study
Mei-xuan LI, Xiu-xia LI, Xin XING,
, Available online  , doi: 10.11847/zgggws1122093
Abstract(4586) HTML (2451) PDF 483KB(337)
  Objective  To examine the status of and research progress in contracted family doctor services in China and to summarize general problems existing in the implementation the services for providing references for the development of applicative mode of contracted family doctor services in China.  Methods  Studies on contracted family doctor services in China published till April 2018 were systematically searched through China National Knowledge Infrastructure (CNKI), Chinese Biomedicine Database (CBM), Wanfang and Chinese Science-Technology Periodical Database (VIP) database. EndNote X7 and Excel 2010 were used to manage and analyze the retrieved studies.  Results  All the 24 finally included articles were cross-sectional studies, of which 20 and 4 were conducted among urban and rural residents. Higher rates (36% – 96%) of awareness about contracted family doctor services were reported by studies conducted among residents in Guangdong province, followed by among those (16% – 90%) in Beijing. Higher proportions (42% – 100%) of participating in contracted family doctor services were reported by the studies conducted among the residents in Beijing, followed by those (30% – 74%) in Shanghai. A higher rate (86.33%) of satisfaction to contracted family doctor services was reported by the studies conducted among the residents in Beijing, followed that (56% – 80%) in Guangdong province. Major hindering factors for the implementation of contracted family doctor services indicated by the studies were shortage of family doctors, lack of awareness on the services among the public, low salary of family doctors, imperfect management, incentive, insurance, and information support for the services.  Conclusion  The rate of awareness about, participating in, and satisfaction to contracted family doctor services are higher among residents in economically developed provinces/municipalities and in urban area than among those in less developed regions and in rural areas in China. More researches on the issue need to be performed for effective implementation of contracted family doctor services.