Health Administrative Departments Research Articles

Analysis of sterilizer allocation and related factors in dental health-care settings in Yunnan Province, China: a cross-sectional study

ObjectiveTo investigate the status and related factors of sterilizers in dental health-care settings in Yunnan Province, with the aim of providing a theoretical basis for the health administrative department to formulate regional quality control programs and systems, proposing reasonable suggestions for optimizing the allocation of sterilizer resources in Yunnan’s dental health-care settings, thereby improving resource utilization efficiency.MethodsThis cross-sectional survey was conducted in 2600 dental health-care settings in Yunnan Province in March 2020. Uni-variable linear regression, multi-variable linear regression, curve fitting and threshold effect analysis were used to understand the relationship between dental units and sterilizers.ResultsA total of 2600 dental health-care settings were included. The disinfection and sterilization work were mainly completed by the dental department in 1510(58.1%) institutions. 44(1.7%) institutions were not allocated sterilization equipment, and 1632 (62.8%) had only one sterilizer. The median allocation of sterilizers was 1.0. Uni-variable linear regression showed significant differences in covariates such as dental unit, dental handpiece, disinfection equipment, dentist, and dental assistant, which were more sensitive (p < 0.001) and statistically significant. The adjusted model was more stable in the multi-variable linear regression, and the differences in covariates between different settings were statistically significant. Curve fitting revealed an S-shaped curvilinear relationship between the number of dental units and sterilizers in oral healthcare settings.ConclusionThe disinfection and sterilization work was mainly completed by the dental department in dental health-care settings in Yunnan Province. Sterilizer allocation increases with the number of dental units, but some institutions have insufficient allocation of sterilizer and manpower resources, resulting in certain risks of infection control. Thus, it is necessary to strengthen supervision, inspection and regional quality control work in infection control of dentistry.

Leading Causes of In-Hospital Death of Older Patients of Different Age Groups in Shanghai.

Despite great achievements in clinical medicine, the in-hospital mortality of older patients remains high. How to reduce the in-hospital mortality of older inpatients is of great clinical value in clinical practice. This study is to analyze the leading causes of in-hospital death of older inpatients of different ages in Shanghai. An observational study was conducted in Shanghai. A total of 3894 older inpatients (≥60 years old) were investigated. According to the age stratification standard of World Health Organization, they were divided into young older patients group (aged 60 to 74), old older patients group (aged 75 to 89) and very old patients group (aged ≥90). Diseases of in-hospital death of older inpatients in different age groups were classified according to the 10th edition of the International Classification of Diseases. Constituent ratio of causes of in-hospital death in each group was analyzed. The constituent ratio of pulmonary infection had the highest rate of in-hospital death in older patients. The constituent ratio of lung malignant tumors had the highest rate of in-hospital death in young older patients. The constituent ratio of pulmonary infection had the highest rate of in-hospital death in old older patients. The constituent ratio of pulmonary infection had the highest rate of in-hospital death in very old patients. The leading cause of in-hospital death of young older patients group was lung malignant tumor. The leading cause of in-hospital death of old older patients group and very older patients group was pulmonary infection. Great importance should be attached to the prevention of lung tumor and lung infection in the elderly. Results of this study will provide a basis for health administrative departments to formulate corresponding health-care policies for older patients.

Incongruence between confirmed and suspected clinical cases of Japanese encephalitis virus infection.

Japanese encephalitis (JE) is a notifiable infectious disease in China. Information on every case of JE is reported to the superior health administration department. However, reported cases include both laboratory-confirmed and clinically diagnosed cases. This study aimed to differentiate between clinical and laboratory-confirmed cases of Japanese encephalitis virus (JEV) infection, and improve the accuracy of reported JE cases by analyzing the acute-phase serum and cerebrospinal fluid of all reported JE cases in the Sichuan province from 2012 to 2022. All acute-phase serum and/or cerebrospinal fluid samples of the reported JE cases were screened for IgM(ImmunoglobulinM)to JEV using the enzyme-linked immunosorbent assay (ELISA), and the detection of the viral genes of JEV and 9 other pathogens including enterovirus (EV), using reverse transcription PCR was attempted. Epidemiological analyses of JE and non-JE cases based on sex, age, onset time, and geographical distribution were also performed. From 2012 to 2022, 1558 JE cases were reported in the Sichuan province. The results of serological (JEV-specific IgM) and genetic testing for JEV showed that 81% (1262/1558) of the reported cases were confirmed as JEV infection cases (laboratory-confirmed cases). Among the 296 cases of non-JEV infection, 6 viruses were detected in the cerebrospinal fluid in 62 cases, including EV and the Epstein-Barr virus (EBV), constituting 21% (62/296) of all non-JE cases. Among the 62 non-JEV infection cases with confirmed pathogens, infections with EV and EBV included 17 cases each, herpes simplex virus (HSV-1/2) included 14 cases, varicella- zoster virus included 6 cases, mumps virus included 2 cases, and human herpes viruses-6 included 1 case. Additionally, there were five cases involving mixed infections (two cases of EV/EBV, one case of HSV-1/HSV-2, one case of EBV/HSV-1, and one case of EV/herpes viruses-6). The remaining 234 cases were classified as unknown viral encephalitis cases. Our analysis indicated that those aged 0-15 y were the majority of the patients among the 1558 reported JE cases. However, the incidence of laboratory-confirmed JE cases in the >40 y age group has increased in recent years. The temporal distribution of laboratory-confirmed cases of JE revealed that the majority of cases occurred from May to September each year, with the highest incidence in August. The results of this study indicate that there is a certain discrepancy between clinically diagnosed and laboratory-confirmed cases of JE. Each reported case should be based on laboratory detection results, which is of great importance in improving the accuracy of case diagnosis and reducing misreporting. Our results are not only important for addressing JE endemic to the Sichuan province, but also provide a valuable reference for the laboratory detection of various notifiable infectious diseases in China and other regions outside China.

A network system for the prevention and treatment of mushroom poisoning in Chuxiong Autonomous Prefecture, Yunnan Province, China: implementation and assessment

BackgroundMushroom poisoning is a major public health issue in China. The integration of medical resources from different institutes of different levels is crucial in reducing the harm of mushroom poisoning. However, few studies have provided comprehensive implementation procedures and postimplementation effectiveness evaluations. To reduce the harm caused by mushroom poisoning, a network system for the prevention and treatment of mushroom poisoning (NSPTMP) was established in Chuxiong, Yunnan Province, a high-risk area for mushroom poisoning.MethodsThe NSPTMP consists of three types of institutions, namely, centers for disease prevention, hospitals, and health administration departments, with each kind of institution comprising prefecture, county/city, town, and village levels. After three years of implementation, the network was evaluated by comparing the indices before and after network implementation using data from the “Foodborne Disease Outbreak Surveillance System” and 17 hospitals in Chuxiong. The indices included the fatalities caused by mushroom poisoning, the composition ratios of different types of mushrooms for both outpatients and inpatients and the hospitalization rates.ResultsCompared to the average fatality rate of mushroom poisoning from 2015 to 2017, the average fatality rate from 2018 to 2020 significantly decreased from 0.57 to 0.06% (P < 0.001). Regarding the poisonous genus containing lethal mushrooms, the outpatient and inpatient composition ratios significantly decreased for Amanita (9.36–2.91% and 57.23–17.68%, respectively) and Russula (15.27–8.41%) (P < 0.05). Regarding poisonous mushrooms that caused mild symptoms, the outpatient and inpatient composition ratios significantly increased for Scleroderma (5.13–13.90% and 2.89–18.90%, respectively) and Boletaceae (19.08–31.71%) (P < 0.05), and the hospitalization rates significantly increased for Scleroderma (6.33–18.02%) and Boletaceae (5.65–12.71%) (P < 0.05).ConclusionsThese findings suggest that the NSPTMP effectively reduced the harm caused by mushroom poisoning. In addition to the integration of medical resources, the development of poisonous mushroom identification, hierarchical treatment systems in hospitals, public education, and professional training also played important roles in improving the system’s effectiveness. The establishment and evaluation of the NSPTMP in Chuxiong Prefecture can provide valuable insights and serve as a model for other regions facing similar challenges in managing mushroom poisoning.

Investigation and analysis of oral health resources allocation status in Yunnan Province

Objective: To investigate and analyze the allocation status of oral health resources in Yunnan Province at the end of the 13th Five-Year Plan, providing a scientific basis for the rational resource allocation and formulation regional oral health plan for government health administrative departments. Methods: With the method of general survey, a cross-sectional study was conducted to investigate the allocation of material and human resources of all kinds of stomatological medical institutions registered in the health administrative departments in Yunnan before January 1, 2020. The general situation of oral health resources was analyzed by descriptive statistical analysis. Results: There were 2 712 stomatological medical institutions in Yunnan, 634 public and 2 078 non-public included. The largest number was in Kunming (1 167) and the least in Diqing (19). There were 9 018 dental chairs in total, among which 2 584 in public and 6 434 in non-public. Kunming had the largest number of chairs (3 612) and Nujiang had the least (57). There were 702 oral and maxillofacial surgical beds, all of which were distributed in public. There were 15 148 stomatological personnel, including 3 667 in public and 11 481 in non-public. The average ratio of stomatologist to population was 1∶6 615. Dehong (1∶6 620) was close to this average level, while Kunming (1∶2 283) and Yuxi (1∶4 936) were lower than the average and the other 13 states (cities) were higher. The population ratio of licensed stomatologist was only 1∶9 110. The average ratio of stomatologist to nurses was 1∶0.94. Honghe (1∶1.05), Kunming (1∶1.00), Yuxi (1∶1.18) and Qujing (1∶0.94) was better than or reached the average level, while the other 13 states (cities) were lower than this average. And this ratio in public comprehensive medical institutions was only 1∶0.38. Conclusions: The distribution of oral health resources in Yunnan was unbalanced between public and non-public institutions and among states (cities), mainly distributed in economically developed states (cities) and non-public institutions. For the oral health in Yunnan Province, the workforce was insufficient and the structure was unreasonable, and the proportion of nurses was seriously insufficient in public comprehensive medical institutions.

Associations of socioeconomic status and obesity with hypertension in tibetan adults in a Chinese plateau area

BackgroundPrevious studies have identified that socioeconomic status (SES) and obesity are associated with hypertension. However, their interaction on hypertension risk has not yet been assessed.MethodsThe study used data from 6,069 Tibetan residents in Chengguan District in Lhasa, the Chinese Tibetan autonomous region’s capital, based on a cohort study conducted from May 2018 to September 2019 in five provinces in southwest China. We used logistic regression models to assess the complex relations of SES and obesity with hypertension.ResultsCompared with individuals of high SES, low and moderate SES were positively associated with high risk of hypertension. SES and obesity have significant additive interaction on hypertension (general obesity by BMI: RERI = 1.33, P < 0.001; abdominal obesity by WC: RERI = 0.76, P < 0.001; abdominal obesity by WHtR: RERI = 0.96, P < 0.001). In people from the low and moderate SES segments, obesity was linked to an increased risk of hypertension, but the correlations were stronger in people from the moderate SES category. Compared with people of high SES and non obese, those with moderate SES and obesity had a higher risk of hypertension, and ORs were 4.38 (2.80, 6.84) for general obesity by BMI, 3.38 (2.05, 5.57) for abdominal obesity by WC, and 3.18 (1.57, 6.42) for abdominal obesity by WHtR.ConclusionThere is an independent and additive interaction effect of obesity and SES on the risk of hypertension. People with obesity, especially those of moderate and low SES, should reduce weight and waist circumference, and pay more attention to blood pressure. Moreover, the government, health administration departments, and society should prioritize improving the socioeconomic status of the Tibetan population and addressing risk factors like obesity.

A survey of performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China

Objective: To understand the performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China, and provide suggestions for the improvement of public health risk assessment. Methods: A self-administered survey was conducted in professionals involved in public health risk assessment in emergencies from national institution, provincial institutions and some prefectural institutions for disease control and prevention (1-2 prefectural institutions were selected using convenience sampling in each province) between March and April in 2021. Results: A total of 79 institutions for disease control and prevention were investigated, including 1 national institution, 32 provincial institutions and 46 prefectural institutions. By April 2021, all the 79 institutions surveyed had conducted risk assessment of public health emergencies, in which 61 (77.2%) had established departments responsible for the public health risk assessment, i.e. emergency management office or communicable disease prevention and control office (section), and regular risk assessment mechanisms. The main sources of information for public health risk assessment were public health surveillance systems, including the National Notifiable Diseases Reporting System (100.0%) and Public Health Emergencies Management Information System (97.5%). Compared with the provincial institutions, the prefectural institutions were more likely to use specific disease surveillance systems (84.8% vs. 62.5%; χ2=5.09, P=0.024). The risk management recommendations made by 43 institutions for disease control and prevention (54.4%) after the risk assessment were accepted by the superior health administrative departments and used in epidemic prevention and control. Conclusions: Public health risk assessment in emergencies has been widely carried out by national, provincial and prefectural institutions for disease control and prevention in China. Specialized departments and mechanisms have been established, but the information sources are still confined to public health surveillance systems and the application of the risk assessment results still needs to be further improved.

Individual- and institution-level predictors of the turnover intention of medical staff among rural primary medical institutions in Xinjiang Production and Construction Corps, China: a cross-sectional multi-level analysis.

Primary medical staff (PMS) are the guardians of population health. However, their loss further worsens the shortage and uneven distribution of human health resources, which should be addressed immediately. This study aimed to investigate the current status of turnover intention of rural PMS in Xinjiang Production and Construction Corps (XPCC) in China and its influencing factors atthe individual and institutional levels to provide reliable baseline data for intervention strategies to protect valuable rural PMS. Participants were recruited from rural public health institutions of the XPCC using a cross-sectional multistage sampling process. Data on participants' turnover intention and individual- and institution-level indicators were obtained through standardized electronic questionnaires and statistical reports of regional health administrative departments. The key factors influencing PMS turnover intention were identified us ingunivariateandmulti-level logistic regression analysis. Overall, 20.5% (447/2182) of participants reported turnover intention. Univariate analysis showed that the occurrence of turnover intention was significantly influenced by marriage, education, age, year of working, monthly income, human resource management practices (HRMP), job satisfaction, per capita served population (PCSP) and number of beds (p < 0.05). Multi-level logistic regression analysis showed that bachelor's degree or above and intermediate professional title were closely related to the occurrence of turnover intention (p < 0.05), age 41-50 years old and above, high human resource management practice, and high job satisfaction effectively reduced the odds (p < 0.05). The odds of turnover intention increased by 37% (p < 0.10) for PMS in institutions with PCSP more than 250 people. In contrast, the odds of turnover intention decreased to 68% (p < 0.05) for PMS in institutions with more than 50 beds. Government-run primary medical institutions face the risk of PMS turnover intention. From a personal perspective, the high-risk population fortheturnover intention was mainly the PMS with bachelor's degrees or above and intermediate professional titles. The low-risk population was the PMS with aged over 40 years, a higher evaluation of human resource management practice, and job satisfaction. From the perspective of primary medical institutions, larger institutions can reduce the turnover intention of individuals, whereas the size of the service population has the opposite effect.

Analysis on 1481 case of medical complaints in a Tertiary Hospital in Fujian Province: A 5-year retrospective study.

This study aims to review the 1481 cases of medical complaints from Fujian Provincial Jinshan Hospital in the past 5 years for providing a reference for new hospitals to deal with medical complaints, optimize medical procedures, improve medical quality, and enhance patient experience. The medical complaint information received by the hospital's medical department and service center accepted and transferred by the health administrative department in the past 5 years was systematically reviewed and statistically analyzed by using hierarchical clustering method. The transfer of the health administration department (61.5%) and the acceptance of the service center (28.9%) were the main sources of medical complaints in hospital. The incidence of medical complaints per 10,000 patients in the hospital was between 3 and 6. The maximum number of complaints was 2017 (5.28 cases/10,000 population), and the least was in 2019 (3.2 cases/10,000 population). The median of complaints was 25, and May to Sep was the period of high incidence of medical complaints each year. In 5 years, the month with the largest number of complaints was May 2020 (41 cases), followed by August 2017(40 cases), and the month with the least number was November 2020 (11 cases). In the past 5 years, the hospital's medical complaints were mainly in 4 aspects: medical process (n = 329, 22.2%), medical environment (n = 282, 19%), humanistic care (n = 277, 18.7%), and medical management (n = 209, 14.1%). The most frequent complaints were in clinical departments, among which the emergency, outpatient, and pediatric departments accounted for more than 50%. The top 3 complaints were doctors (n = 778, 53%), logistics (n = 284, 19%), and nurses (n = 239, 16%). The main way to resolve complaints was letter and telephone feedback (n = 1372, 92.6%). Our research recommends that new hospitals change their concepts, pay more attention to the services and quality of medical resources and logistical support, follow the best practices of patient-centered, perfect various medical complaint channels, and establish multiple methods. They should also properly accept and dispose medical complaints, improve the timeliness and feedback efficiency of responding to medical complaints, strengthen communication, exchange, and dialogue, and improve patients' medical experience and sense of gain.

Analysis of dental clinic and dental chair distribution in Sichuan.

To thoroughly understand the current dental chair equipment status of dental clinics in Sichuan Province and provide a reference for administrative departments. Data were collected from a health administrative department and a regional social development yearbook. The number of existing dental clinics and dental chairs in Sichuan Province was investigated. In Sichuan Province, 7 103 dental clinics were determined to be equipped with 21 760 dental chairs. The Gini coefficients of per capita dental clinics in the province were 0.50, 0.22, and 0.06, and the Gini coefficients of per capita dental chairs were 0.68, 0.31, and 0.15; these coefficients had the same distribution as that reflected by the Lorenz curve. In consideration of geographic distribution, the Theil index for the distribution of dental clinics and dental chairs among cities and states were 0.690 7 and 0.822 3, respectively. The overall Theil index va-lues for the distribution of dental clinics and dental chairs in the province were 0.902 4 and 1.079 4, respectively. The difference in the distribution of dental clinics and dental chairs among cities and states in the province contributed 0.765 4 and 0.761 8 to the total difference, respectively. The allocation of oral health resources in Sichuan Pro-vince is relatively equitable in terms of population and economic distribution but uneven in geographical distribution.

Retrospective analysis of cataract surgery outcomes in China from 2009 to 2018: from a national registry system data

ObjectiveTo evaluate patients’ benefits after cataract surgery and to form recommendations for Chinese national health policy decision makers and administration departments based on the quality of cataract treatments.MethodAn observational study...

Impact of work-family support on job burnout among primary health workers and the mediating role of career identity: A cross-sectional study.

In China, medical workers in the primary sector shoulder the task of providing people with the basic medical and public health services, and are the "gatekeepers" of the public health. This study aims to analyze the current situation of job burnout among primary health workers of China, and shed light on the effect of work-family support and career identity on job burnout among them and their relationships. This may provide a new perspective for primary health care institutions and health administrative departments so as to formulate policies to "attract, retain and stabilize" primary health workers. A multi-stage sampling method was adopted to select 8,135 primary health workers from 320 primary health care institutions in a province of central China. A descriptive statistical analysis, univariate analysis, Pearson correlation analysis, and mediation effect analysis were applied to analyze the effects of work-family support and career identity on job burnout among primary health workers as well as the mediating role of career identity. Among 8,135 primary health workers, 4,911 (60.4%) participants had mild to moderate levels of job burnout, 181 (2.2%) participants had severe job burnout, and the burnout detection rate is 62.6%. Work-family support was negatively correlated with job burnout (r = -0.46, p < 0.01) and positively correlated with career identity (r = 0.42, p < 0.01). Work-family support (β = -0.346, p < 0.01) and career identity (β = -0.574, p < 0.01) were negative predictors of job burnout respectively. In addition, career identity had a mediating effect between work-family support and job burnout, with the mediating effect contributing 33.7% to the overall effect. The findings of this study demonstrate that work-family support is a protective factor against job burnout in primary health workers and reveal that career identity is a critical mediating mechanism linking work-family support to burnout. We propose to reduce job burnout by strengthening work-family support (especially work support), enhancing career identity, increasing the number of primary health workers and reducing the workload of existing incumbents, which can provide important practical implications for the future prevention and intervention programs.

Analysis on the Allocation Status and Fairness of TCM Resources in Guizhou Province

<i>Background: </i>TCM plays an important role in ensuring people's health and developing TCM undertakings. However, some studies have shown that the current allocation of TCM and health resources in China is relatively poor, and there are few regional research literature. <i>Objective</i>: To analyze the status and fairness of TCM (Traditional Chinese medicine) resources in Guizhou Province and provide evidence-based basis for health administrative departments. <i>Methods</i>: The status of TCM resources in Guizhou and the fairness of Lorentz curve, gini coefficient and health density index. <i>Results</i>: From 2010 to 2019, The TCM and health resources in Guizhou province have increased year by year, The average annual growth rate of TCM doctors per 1,000 people and their ownership per 100 square kilometer was 13.88% and 14.43%, respectively; Regarding the Gini coefficient, By population distribution is mainly located at 0.2-0.4, By area, the distribution is mostly below 0.3, The Gini coefficient of the economic distribution showed an overall downward trend, In 2019, Chinese pharmacists had the lowest economic distribution (0.093), The highest distribution by population distribution of practicing (assistant) physicians in 2015 (0.523); In terms of density-based exponential growth, In 2019, The highest bed density in Guizhou Province (0.3506), The lowest density of mechanism number (0.0016). <i>Conclusion</i>: The resources grow overall, but the total amount is relatively small; the region is unbalanced; the fairness by economic allocation is better than allocation by population than allocation by area. Therefore, the health administrative departments perform their functions, optimize the resource structure, strengthen the layout of TCM industry, give full play to the local characteristics, and stimulate the potential of TCM and health services.

Review on Processing Methods of Toxic Chinese Materia Medica and the Related Mechanisms of Action.

Toxic Chinese materia medica (CMM) has both pharmacological activities and toxic effects. Based on thousands of years of experience in the application of CMMs, people have explored many practical processing methods of CMMs, also known as "Pao Zhi", to reduce/control toxicity and preserve/enhance efficacy. Toxic CMMs have been used throughout China's hospitals. Yet, the production and use of toxic CMM should be carried out in accordance with the Chinese pharmacopoeia (ChP) and the processing regulations formulated by the health administrative departments of provinces, autonomous regions, and municipalities directly under the Central Government. This paper summarizes the current understanding and awareness of toxicity and 45 toxic CMMs, the commonly used processing methods of toxic CMMs recorded in the 2020 edition of ChP, and the changes in the chemical component, toxicity, or efficacy profiles after processing. This review may provide useful information for the processing methods of toxic CMMs worldwide. We believe that with an in-depth study and understanding of toxic CMMs combined with a standardized application, the toxicity of CMMs will be predictable and controllable in the future.

CRAFTING AN UNDERGRADUATE CONCENTRATION IN AGING ACROSS THE UNIVERSITY AND ASSESSING COMPETENCIES

Abstract In the last few years, our Health Administration Department has grown its undergraduate offerings in aging and now is promoting those courses as a concentration available for any major. A recent collaborative effort between our college and the honors college, our university has created a university-wide set of courses across all majors related to topics in aging. In our university, students can pursue a concentration with as few as three courses that are relevant to their majors. Usually, the courses in a concentration are taught by those in the major. However, the global issue of aging can be taught as a specialty area for many majors. To ensure students meet the learning objectives, the following assessment plan was developed for three key courses offered by the Health Administration Department—Healthy Aging, Aging and the Law and either Aging in a Global Context or Aging Services Management. First, a curricular map of the areas of competency within our program are outlined and then the content and areas of assessment are considered based on whether the competencies are “Introduced”, “Reinforced,” and “Mastered.” Next, the key assignments in each course within the concentration were aligned with the Program Objectives for the Health Administration bachelor’s program to assess student achievement of key competencies. In the process of offering the concentration in Aging across multiple majors, it is important for various departments to understand how courses in aging add valuable competencies regardless of their major.

Outbreak of occupational Brucella infection caused by live attenuated Brucella vaccine in a biological products company in Chongqing, China, 2020

ABSTRACT The northern areas of China are traditional endemic regions for brucellosis in both animals and humans, while occasional outbreaks of brucellosis have been observed in neglected southern provinces. On 16 December 2020, Chongqing Center for Disease Control and Prevention (CQCDC) received a report of 15 Brucella seropositive employees in a biological products company. The CQCDC and the local health administrative department launched an investigation that included identification of cases, laboratory testing of samples, and employees’ interview to identify the cause of this incident. A case-control study was implemented to compare high-risk factors between cases and serology-negative personals. Human and animal serum samples and environmental swabs were collected for testing. A total of 61 recessive infectors were found with an infection rate of 43.57% (61/140). Fisher’s exact test showed that there were significant differences in Brucella infection rates among different post classifications (p = 0.02), working places (p = 0.007), and buildings (p < 0.0001). Case-control study showed that working in vaccine production workshop was independently associated with an increased risk of infection (odds ratio (OR): 2.60; 95% confidence interval (CI): 1.31–5.19). The positive detection rate was 88.06% (59/67) for production environment and 16.67% (2/12) for external environment. The investigation indicated that close contact with biological products and aerosol were the potential transmission routes of this outbreak under the condition of insufficient personal protection and disinfection. Our study provides new epidemiological evidence for a more detailed understanding of occupational infections with live attenuated Brucella vaccine.

Exploring the influence of COVID-19 on the spread of hand, foot, and mouth disease with an automatic machine learning prediction model.

Hand, foot, and mouth disease (HFMD) is an important public health problem and has received concern worldwide. Moreover, the coronavirus disease 2019 (COVID-19) epidemic also increases the difficulty of understanding and predicting the prevalence of HFMD. The purpose is to prove the usability and applicability of the automatic machine learning (Auto-ML) algorithm in predicting the epidemic trend of HFMD and to explore the influence of COVID-19 on the spread of HFMD. The AutoML algorithm and the autoregressive integrated moving average (ARIMA) model were applied to construct and validate models, based on the monthly incidence numbers of HFMD and meteorological factors from May 2008 to December 2019 in Henan province, China. A total of four models were established, among which the Auto-ML model with meteorological factors had minimum RMSE and MAE in both the model constructing phase and forecasting phase (training set: RMSE = 1424.40 and MAE = 812.55; test set: RMSE = 2107.83, MAE = 1494.41), so this model has the best performance. The optimal model was used to further predict the incidence numbers of HFMD in 2020 and then compared with the reported cases. And, for analysis, 2020 was divided into two periods. The predicted incidence numbers followed the same trend as the reported cases of HFMD before the COVID-19 outbreak; while after the COVID-19 outbreak, the reported cases have been greatly reduced than expected, with an average of only about 103 cases per month, and the incidence peak has also been delayed, which has led to significant changes in the seasonality of HFMD. Overall, the AutoML algorithm is an applicable and ideal method to predict the epidemic trend of the HFMD. Furthermore, it was found that the countermeasures of COVID-19 have a certain influence on suppressing the spread of HFMD during the period of COVID-19. The findings are helpful to health administrative departments.

A historical review of performance appraisal of public hospitals in China from the perspective of historical institutionalism.

The government performance appraisal of public hospitals serves as an effective management tool to promote high-quality development. It is also an important means of realizing the “Healthy China” initiative. Since the founding of the People's Republic of China, changes in performance appraisal have been divided into the following four periods: the early stage of performance appraisal (1949–1977), the exploration period (1978–2008), the development period (2009–2018), and the integration period (2019–present). This clarifies the regional practice of public hospital performance and identifies the institutional factors of the evolution. It also demonstrates that administrative forces, market-driving forces, and mission-driving forces combine to bring about change in the public hospital performance appraisal system. However, problems such as insufficient application of performance appraisal and coordination between health administrative departments and medical insurance departments still loom large.

A Survey to Understand Necessity of Administrative Training of A Medical Teacher

Medical teacher has an indispensible role in teaching, patient care and research work. However, it is difficult to define the array of roles of a medical teacher. For the various roles, leadership, managerial and administrative skills of teachers are crucial. But usually medical teachers are not trained to enhance these skills. This survey aims to assess perception of medical teachers about their administrative and managerial skills beyond academic work, research and patient care. A questionnaire was designed, pilot-tested and administered to all faculty members (N=197). A self-administered questionnaire containing 20 items was developed on Google form. 146 responses were recorded on Google form (response rate of74 %) and analysed. The majority of the teachers' were of the opinion that there is a need to improve their individual administrative skill. However, in the absence of formal faculty administrative training programs in the college, most of the teachers indicated that their administrative skills are currently being improved through sporadic informal community of practice involving interested colleagues and modelling identified good teachers. A well-structured training to departmental administrative requirements shall have positive impact not only on academics, research and patient care but also on job satisfaction among medical teachers. This will also lead to better utilization of various resources in health sector. While setting up separate health administration department in each medical college will lead to better management of multidisciplinary challenges of healthcare. This will further decrease the administrative burden on Medical teachers.

What are the demands of telegeriatrics medical services for elderly patients during the COVID-19 pandemic.

PurposeElderly patients are associated with a higher risk of nosocomial cross infection during the COVID-19 pandemic. Providing medical services and primary care for elderly patients is a worldwide challenge. A new telegeriatrics system was established to provide medical services and primary care for elderly patients treated by family physicians. This study aimed to describe the operation mechanism of the new system and investigate the demands of telegeriatrics medical services for elderly patients treated by family physicians during the COVID-19 pandemic.MethodsA total of 1,353 elderly patients (aged≥60) treated by family physicians were enrolled. The proportion of the top 10 diseases of elderly patients applying the new system was analyzed. Differences in main diseases between elderly patients applying telegeriatrics medical services and outpatients in hospitals were compared. Differences between the new telegeriatrics system in our study and telemedicine systems of other studies in other countries were analyzed.ResultsConstituent ratios of chronic kidney disease, type 2 diabetes mellitus, and coronary heart disease have the highest rate in elderly patients applying the new telegeriatrics system. Digestive diseases, cardiovascular diseases, and neurology diseases were the top three diseases of elderly outpatients.ConclusionThis is the first time that a new telegeriatrics system has been applied to provide medical services for elderly patients treated by family physicians during the COVID-19 pandemic. Chronic kidney disease, Type 2 diabetes mellitus, and coronary heart disease were found to be the top three diseases of elderly patients applying telegeriatrics medical services during the COVID-19 pandemic, which were different from the outpatients in general hospitals. The new telegeriatrics system guarantees elderly patients get equal rights to medical services. Results will provide a basis for the government health administrative department to formulate new telegeriatrics policies for elderly patients.