Current status of the application of radiodiagnosis and radiotherapy resources in Huai'an City in 2020

This study compared patient safety culture among health professionals in tertiary, secondary and primary hospitals. We conducted a cross-sectional survey among thirteen primary, secondary and tertiary hospitals in Ghana. A structured questionnaire was administered to 1,656 health professionals. Data were analysed using descriptive statistics and One-Way Analysis of Variance (ANOVA). This study was conducted in the Greater Accra, Bono and Upper East regions, representing the southern, middle and northern ecological zones, respectively. Health professionals. The primary outcome was patient safety culture. Five patient safety culture dimensions were rated moderate positive response, while five were rated high positive response. We found a statistically significant difference in patient safety culture across primary, secondary and tertiary hospitals (p < 0.05). For instance, the mean difference between tertiary and secondary hospitals was statistically significant (p < 0.05). Additionally, the mean difference between tertiary and primary hospitals was statistically significant (p < 0.05). There was also a significant difference in the means between secondary and primary hospitals (p < 0.05). This study has demonstrated a variation in patient safety culture across Ghana's tertiary, secondary and primary hospitals. Therefore, healthcare managers and professionals should prioritise patient safety. This work was supported by the University of Ghana [UGRF/13/MDG-001/2019-2020].

The status of glycemic control: A cross-sectional study of outpatients with type 2 diabetes mellitus across primary, secondary, and tertiary hospitals in the jiangsu province of China

This article analyzes the external occupational radiation exposure distribution and trends among radiation workers in Jiangsu Province. The results show that the total annual collective effective dose for radiation workers in Jiangsu Province from 2019 to 2022 was 24.82 person·Sv, with an average annual effective dose of 0.34mSv over the 4-y period. The average annual effective dose exhibited an initial increase followed by a subsequent decrease, with statistically significant differences (P<.001) between different years. In the medical uses, nuclear medicine and interventional radiology had higher average annual effective doses compared to other categories, at 0.42 and 0.38mSv, respectively (P<.05). In industrial applications, accelerator operation and industrial testing workers had higher average annual effective doses compared to others, at 0.32 and 0.31mSv, respectively (P<.001). Among different levels of medical institutions, secondary hospitals had the highest average annual effective dose (0.38mSv, P<.001). Overall, the average annual effective dose for radiation workers in Jiangsu Province remained relatively low from 2019 to 2022, meeting national standards. However, special attention should still be given to radiation workers in nuclear medicine, interventional radiology, industrial testing, and accelerator operation.

Objective: To analyze the personal dose of radiation exposure of radiation workers in some medical institutions in Tianjin, and to provide reference for radiation protection work. Methods: Using cluster sampling method, 8718 radiation workers from some medical institutions (including tertiary, secondary and first-level hospitals) in Tianjin from 2014 to 2018 were selected as the subjects of investigation. Monitoring data were collected, analyzed and evaluated. Results: From 2014 to 2018, a total of 8718 persons were monitored, with 14 persons (0.2%) whose annual effective dose was higher than 5 mSv; 8661 persons (99.3%) whose annual effective dose was lower than 2 mSv; 43 persons (0.5%) whose annual effective dose per capita was the highest in diagnostic radiology, which was 0.22 mSv; the annual effective dose per capita of radiation workers in primary and secondary hospitals was higher than that in tertiary hospitals; and the abnormal rate of individual dose monitoring was 73. Personnel, accounting for 0.8% of the total number of monitored personnel; the annual effective dose changes of the four types of radiation workers monitored from 2014 to 2018 showed a downward trend, and the annual effective dose of the four types of radiation workers in 2014 was the highest. Conclusion: Personal dosage of radiation workers in some medical institutions in Tianjin is at a low level, and attention should be paid to diagnostic radiology workers.

ObjectiveThis study aims to explore the relationship between slack resources and cost consumption index in tertiary and secondary hospitals and to provide targeted healthcare resource utilisation recommendations for tertiary and...

Objective To analyze the current status of neonatal resuscitation in medical institutions in China.Methods With the number of obstetric beds as the inclusion criteria,the survey was conducted in 163 medical institutions randomly selected in 11 provinces (including 51 tertiary hospitals,88 secondary hospitals and 24 primary hospitals) from October 1 to December 31 in 2011.The mail-questionnaire was sent to collect information about system establishment,personnel training,neonatal resuscitation equipment etc.Statistical data was analyzed by t-test,variance analysis and Chi-square test.Results The incidence of neonatal asphyxia among live birth babies was 2.15％ (3328/154 853) in tertiary hospitals,1.41％ (2829/200 731) in secondary hospitals and 1.50％ (701/46 695) in primary hospitals (x2=298.559,P＜0.01).The mortality rate during delivery was 0.41‰ (63/154 853),0.24‰ (48/200 731) and 0.60‰ (28/46 695) at the three different level hospitals,respectively (x2=16.993,P＜0.01).The mortality rate within 24 hours after delivery was 0.42‰ (65/154 853) in tertiary hospitals,0.24‰ (49/200 731) in secondary hospitals and 0.62‰ (29/46 695) in primary hospitals (x2 18.075,P＜0.01).About 86.5％ (141/163) of the included hospitals maintained routine neonatal resuscitation trainings,but only 73.0％ (119/163) applied resuscitation training equipments during the trainings.The outfit rate of basic neonatal resuscitation equipments (such as neonatal laryngoscope,radiant heater) was high in most hospitals,but the outfit rate of equipments recommended by the new guideline (such as umbilical venous catheter,T piece and oxygen saturation meter) was low.For example,the outfit rate of umbilical venous catheter was 23.5％ (12/51),10.2％ (9/88) and 4.2％ (1/24) in tertiary,secondary and primary hospitals respectively (x2 =6.992,P ＜ 0.05).47.9％ (78/163) of the hospitals had set up neonatal intensive care unit,with the proportion in tertiary,secondary and primary hospitals being 80.4％ (41/51),34.1％ (30/88) and 27.2％ (7/24),respectively (x2=31.677,P＜0.01).Most of the hospitals (80.4％,131/163) could ensure the pediatricians being presented in the delivery room for high risk women,and the proportion was 94.1％ (48/51),79.5％ (70/88) and 54.2％ (13/24) in tertiary,secondary and primary hospitals,respectively (x2 =16.591,P＜0.01).There were 88.3％ (144/163) of the hospitals had routine neonatal resuscitation case audit,with the proportion in the three different level hospitals being 94.1％ (48/51),92.0％ (81/88) and 62.5％ (15/24),respectively (x2 =18.388,P＜0.01).Conclusions Strengthen the training,equipment and system establishment in primary medical institutions is conducive to promote neonatal resuscitation. Key words: Asphyxia, neonatorum; Resuscitation; Intensive care units, neonatal; Inservice training

Background: Healthcare waste management is a critical component of public health, particularly in developing countries like Pakistan, where inadequate waste handling poses significant risks to healthcare workers, the environment, and the community. Primary and secondary hospitals often face different challenges due to infrastructure, resources, and waste volume variations. This study evaluates healthcare waste management practices and identifies associated problems in primary and secondary hospitals in Mianwali. Objective: To evaluate the healthcare waste management practices in primary and secondary hospitals in Mianwali. Methodology: A cross-sectional study was conducted in public hospitals of Mianwali. About 112 participants, including staff from primary (59) and secondary (53) hospitals, were selected through simple random sampling. Data were collected using structured questionnaires and quantitative observations. Key areas assessed included waste segregation, storage, transportation, treatment methods, staff training, and compliance with regulations. Results: Primary hospitals demonstrated higher compliance with segregation practices (80% using color-coded bins) compared to secondary hospitals (70%). However, secondary hospitals had more frequent training sessions (93% of staff trained) and generated higher volumes of hazardous waste (20% compared to 15% in primary hospitals). Challenges reported included a lack of resources (70-75%), inadequate infrastructure (11.7-5%), and insufficient enforcement of regulations. Significant gaps were observed in the disposal of pathological, cytotoxic, and liquid waste, with secondary hospitals more likely to use outdated incineration methods (85% vs. 60%). Conclusion: The study highlights disparities in healthcare waste management practices between primary and secondary hospitals. While primary hospitals excel in segregation compliance, secondary hospitals face challenges in resource allocation and infrastructure. Addressing these issues requires targeted training programs, stricter enforcement of regulations, and investment in modern waste treatment technologies.

BackgroundDoctor turnover is a significant challenge faced by hospitals worldwide, particularly in public hospitals in China. By understanding how job attributes influence job preferences among doctors, effective and targeted policies can be designed to attract doctors to key positions or organizations, providing insights for evidence-based workforce interventions.ObjectivesThe aim of our study is to examine the difference of job preferences of doctors in different hospitals levels using DCE.MethodsA discrete choice experiment was applied in the public hospital in China. A total of 920 eligible doctors from primary, secondary, and tertiary public hospital in China participated in this study. A mixed logit model was applied to assess job preferences among doctors in public hospital in China.ResultsDoctors in primary hospitals preferred job offers with 30% salary increase over the unchanged (OR = 8.906, p < 0.001). Similar trends were observed in secondary and tertiary hospitals (OR = 4.785, p < 0.001; OR = 5.56, p < 0.001). Doctors from all hospital levels (primary, secondary, and tertiary) preferred sufficient opportunities of professional development (OR = 1.43, p = 0.032; OR = 1.47, p = 0.008; OR = 1.44, p < 0.001). A 20% increase in workload was generally less favored in all hospital levels (OR = 0.63, p = 0.015; OR = 0.45, p < 0.001; OR = 0.42, p < 0.001). Environmental support was only preferred in tertiary hospitals (OR = 1.46, p < 0.001). Monthly salary was the top priority for doctors across all hospital levels, followed by work atmosphere. Employee care came third in primary and secondary hospitals, while opportunities of professional development ranked the third in tertiary hospitals. Environmental support from hospital was the least prioritized factor in both secondary hospitals, while workload was the least important in primary and tertiary hospitals.ConclusionDoctors preferred job offers with salary increases across all hospital levels. Professional development opportunities were prioritized universally, while 20% increase in workload was generally least favored. Environmental support was most important in tertiary hospitals. Monthly salary and work atmosphere were top priorities across all hospital levels, with employee care ranking third in primary and secondary hospitals. Workload and environmental support were the least prioritized, varying by hospital level.

ObjectivesWe assess whether China’s diabetes pilot hierarchical diagnosis and treatment reforms shifted patient healthcare-seeking behaviour towards primary health institutions (PHIs) and away from secondary and tertiary hospitals. From the patients’...

Investigation on the current situation of the development of intensive care units in Inner Mongolia Autonomous Region in 2022

Blood pressure control rate and associated risk factors in hospitals of different grades in Chongqing, China

Objective: To understand the current status of diagnosis and treatment of community-acquired pneumonia (CAP) among doctors in various hospitals across Shanghai, for the purpose of promoting the 2016 clinical practice guidelines for adult CAP of China. Methods: A questionnaire was designed to address the common questions in CAP management. The responses were collected via WeChat and the data were analyzed. Results: A total of 1 254 valid questionnaires were received, 46.1% from tertiary , 26.4% from secondary and 27.5% from primary care hospitals. Of these valid respondents, 31.4% were respiratory physicians and 68.6% from non-respiratory physicians. When diagnosing CAP, 78.1% of the doctors would use chest CT in more than 50% of the patients. Regarding the tools for evaluating the severity of CAP, 60.3% of the respondents would prefer CURB-65. "Respiratory failure requiring mechanical ventilation and septic shock" were the most common criteria for admission to ICU. Blood culture was not widely used in severe CAP regardless of the level of hospitals (P>0.05). The results of this survey showed that the top 5 pathogenic microorganisms of CAP were Streptococcus pneumoniae, Mycoplasma pneumoniae, Klebsiella pneumoniae, Haemophilus influenza and Chlamydia pneumoniae. For non-severe CAP patients, all the doctors tended to select monotherapy. The most frequently used antimicrobial regimen for severe CAP was third- or fourth-generation cephalosporin monotherapy. As for combination therapy, the most frequently used regimen in tertiary hospitals was "carbapenem plus vancomycin" , while in primary and secondary hospitals it was "β-lactams plus macrolides" . More doctors from primary hospitals and non-respiratory medicine would consider "complete resolution of pulmonary opacity" as the indication to discontinue antimicrobial therapy or to discharge patients, and "prolonged high fever" , "large area consolidation" , "multiple lobe-segment involvement " as the indication for corticosteroid therapy. A significantly lower proportion of doctors in secondary and tertiary hospitals would recommend patients to receive vaccination than in primary hospitals (P<0.05). Conclusions: This questionnaire study showed that there was a gap between the ideal and the real world practice in CAP management. Efforts should be made to popularize the 2016 CAP guideline in hospitals of any level of care, especially primary hospitals, for the purpose of further standardizing CAP management in China.

To observe the early reperfusion therapy status for patients with ST elevation acute myocardial infarction (STEMI) hospitalized in tertiary and secondary hospitals in Henan province. Baseline data, early reperfusion treatment and in-hospital mortality of STEMI patients hospitalized in 17 hospitals in Henan province (8 tertiary hospitals, 9 secondary hospitals) from June 2011 to June 2012 were obtained using a uniformed questionnaire. One thousand six hundred and eighty six patients were enrolled, of which 886 patients were hospitalized in tertiary hospitals and 880 patients were early hospitalized in secondary hospitals. Six hundred and fifty four patients (38.8%, 654/1 686) underwent early reperfusion therapy (543 with thrombolysis and 111 with primary percutaneous coronary intervention (PCI)). There was no difference in the proportion of early reperfusion therapy between tertiary and secondary hospitals (40.1% (355/886) vs. 37.4% (299/800), P = 0.257). The median time from symptom onset to first medical contact, door-to-needle and door-to-balloon was 132 min, 18 min and 60 min, respectively. The median time from symptom onset to first medical contact (150 min vs. 120 min, P = 0.001), door-to-needle (30 min vs. 18 min, P = 0.003) and symptom onset-to-thrombolysis (3.5 h vs. 2.7 h, P = 0.001) were significantly longer in tertiary hospitals than in secondary hospitals. No difference was found in median time of door-to-balloon, symptom onset-to-primary PCI or symptom onset-to-elected PCI between tertiary and secondary hospitals (all P > 0.05). The proportion of door-to-needle ≤ 30 min was lower in tertiary hospitals than in secondary hospitals (46.4% (84/181) vs. 62.2% (153/246), P = 0.001). However, there was no difference in the proportion of door-to-balloon ≤ 90 min between tertiary and secondary hospitals (58.8% (60/102) vs. 57.1% (4/7), P = 1.000). In-hospital mortality was also similar between tertiary and secondary hospitals (5.8% (51/886) vs. 5.5% (44/800), P = 0.820). Early reperfusion rate is low, and thrombolysis is the main early reperfusion therapy in both tertiary and secondary hospitals in Henan province. Tertiary hospitals did not take advantage of their primary PCI capability. There is great room for improvement in early reperfusion therapy in tertiary and secondary hospitals.

Objective To explore the influence of long-term low-dose ionizing radiation on 8-hydroxy-2-deoxyguanosine(8-OHdG)level in the serum of radiation workers in hospitals. Methods 307 age-and sex-matched hospital radiation workers were recruited by stratified random sampling method. After deleting the subjects without dosage information, 230 individuals were divided into four groups according to their job title [including diagnostic radiology(n=75), radiotherapy(n=60), nuclear medicine(n=41)and interventional radiology(n=54)]. Serum 8-OHdG level was measured by ELISA assay. Results According to the statistical analysis, there was significant difference in the serum 8-OHdG level among four groups (F=9.071, P<0.05), and the content of serum 8-OHdG was significantly higher in the interventional radiology group than that in the groups of diagnostic radiology, radiotherapy and nuclear medicine (t=-4.473, -3.011, -2.189, P<0.05). There were significant differences in serum 8-OHdG level among different dose groups and working period groups(F=7.659, 3.058, P<0.05). The serum 8-OHdG levels significantly increased along with exposure dose and working period(r=0.300, 0.142, P<0.05). Conclusions Serum 8-OHdG may be a potential biomarker of oxidative DNA damage in radiation workers exposed to low-dose ionizing radiation. Key words: Ionizing radiation; Radiation workers; Interventional radiology; 8-hydroxy-2-deoxyguanosine

Different categories of hospitals in China have varying levels of patient education. Stroke recognition and emergency medical services (EMS) usage in patients appears to be closely associated with patient education in hospital. This study aimed to explore the effect of hospital classification in China on a patient's ability to recognise stroke symptoms and the likelihood of using the EMS. A cross-sectional, community-based study was conducted from January to May 2017, and 1,426 residents who had previously been hospitalised were analysed. The patients involved in the study were from 69 administrative areas in China. Multivariable logistic regression models were developed separately for primary, secondary, and tertiary hospitals to identify the associations between hospital grades and patient stroke recognition or the prospects of them using the EMS. Among the 1,426 patients studied, 725 had been admitted to tertiary hospitals, 448 to secondary hospitals, and 253 to primary hospitals. According to univariate analysis, tertiary hospital patients were more likely to use the EMS than patients in primary and secondary hospitals. The difference therein was still significant after full adjustment. Patients in tertiary hospitals were significantly more likely to use the EMS promptly compared to patients in primary or secondary hospitals. Therefore, patient education on timely EMS usage at stroke onset should be enhanced in primary and secondary hospitals in China.