Institutions In Beijing Research Articles

Based on sustainable development of skating sports training new ecological and environmental protection measures

In recent years, under the background of exam-oriented physical education reform, the government has issued a lot of physical education documents and policies. As a result, many schools have made fundamental changes in physical education activities. These policies are mainly aimed at getting young people to be more active and autonomous in school sports. This requires physical education training teachers must adhere to the people-oriented, student-oriented, so as to highlight the subject status of students. Based on this, students should establish a good sports values and ethics and form a good habit of lifelong sports, so as to further promote the sustainable development of youth sports activities. Based on the ecological theory of sustainable development as the background, this study constructs a unified theory of Unified Theory of Acceptance and Use of Technology (UTAUT) model for the sustainable training and development of youth skating sports training institutions. This study selects the youth skating sports training institutions in Beijing, China as the investigation object, covering small, medium and large institutions of different sizes, and analyzes based on the statistical data in 2023 and the results of field research. The results show that the application of this model not only increases the willingness of youth skating training institutions to continue to participate by 3.66%, but also promotes the diversified development of youth skating training. In addition, this study also discusses the environmental protection measures implemented in the process of skating training to ensure that the training activities are sustainable while reducing the impact on the environment, so as to build a sustainable development of the new ecology of skating sports training.

Barriers and facilitators to implementing imaging-based diagnostic artificial intelligence-assisted decision-making software in hospitals in China: a qualitative study using the updated Consolidated Framework for Implementation Research

ObjectivesTo identify the barriers and facilitators to the successful implementation of imaging-based diagnostic artificial intelligence (AI)-assisted decision-making software in China, using the updated Consolidated Framework for Implementation Research (CFIR) as...

Evaluating tuberculosis knowledge and awareness of effective control practices among health care workers in primary- and secondary-level medical institutions in Beijing, China

ObjectiveInadequate tuberculosis (TB) knowledge and awareness of proper TB control practices among health care workers (HCWs) may increase the risk of nosocomial TB transmission. This study aimed to assess HCWs’ TB-related knowledge and control practices to guide the development of more effective targeted TB health education and training programs.MethodsIn January 2023 a cross-sectional survey was administered to 323 HCWs employed by five primary health care centers and three secondary comprehensive medical institutions in Beijing, China. Survey data were collected using a standard questionnaire.ResultsAnalysis of survey responses revealed TB knowledge and practices awareness rates of 60.4% and 90.6%, respectively. The overall average awareness rate across all 19 TB knowledge- and practice-related questions was 70.0%. Intermediate- and senior-level HCW’s average TB knowledge score was respectively 2.225 and 8.175 times higher than that of primary-level HCWs, while the average TB knowledge score of HCWs in secondary comprehensive medical institutions was 3.052 times higher than that of HCWs in primary health care centers. Higher average TB knowledge score correlated with higher-level professional titles and higher level work units, but higher average TB control practices score correlated with employment at primary health care center rather than secondary comprehensive medical institution. Notably, 13.6% of HCWs had not received TB training during the past three years, while 86.1% expressed willingness to undergo online TB training.ConclusionThese findings highlight inadequate TB knowledge and awareness of proper TB control practices among HCWs in primary health care centers and secondary comprehensive medical institutions in Beijing, underscoring the urgent need for targeted educational and training initiatives to improve TB awareness and control efforts.

Transnational juku: Japanese shadow education institutions in Hong Kong, Beijing, and Shanghai

Japan has a longstanding history of shadow education, which has evolved, transformed, and extended beyond its borders. Japanese shadow education institutions, known as juku, have expanded worldwide, including in Asia, the US, and Europe, offering offline and online tutoring services mainly for Japanese expatriates. This study examines the role and features of juku, specifically in Beijing, Hong Kong, and Shanghai. It identifies 20 different juku, analyzes their types, and explains a different type of juku, the “Japanese cultural supplementary school,” that caters to expatriate parents aiming to nurture Japanese culture and traditions in their children. Although the Japanese juku phenomenon has previously attracted the attention of scholars, there is a gap in the literature when it comes to transnational juku and its operation outside Japan. This paper contributes to informing scholars, policymakers, and the public on the transnational movement of shadow education as a global phenomenon.

Exploring music students' resistance to innovation as a moderator in the relationship between e‐learning adoption and academic performance

AbstractA teaching strategy known as an “e‐learning system” involves the use of electronic technology to encourage and assist learning in a classroom setting. According to the increasing rise in the number of pupils using modern communication technologies, alterations to the e‐learning system are now feasible. The study aims to explore the relationship between e‐learning adoption, attitude, and academic performance in the regulations of students' resistance to innovation from the perspective of Chinese students. Recognizing the mediating impact of e‐learning adoption (ELAD) as well as the regulating function of resistance to innovation (RTI) is crucial for completely comprehending how e‐learning attitude (ELAT) influences music student performance (SP). The objective of this study is to find an association between ELAT and students' performance and to find out the association between ELAD and students' performance. A random sampling technique was utilized quantitatively. Data were collected from 293 music education students in China using a questionnaire method. The study obtained data were analyzed through descriptive statistics using SPSS statistical software. The research was conducted in Chinese music educational institutions in Beijing. PLS‐SEM stands for Partial Least Squares Structural Equation Modeling. It's a statistical method used for analyzing relationships between variables. Partial Least Squares (PLS) software is chosen for its versatility in handling complex relationships with small sample sizes. PLS is known for its ability to handle multicollinearity, making it a robust choice for research requiring accurate and stable predictions with limited data. The study analyzes the connection between music student performance and e‐learning attitude. The findings of the study indicate the regulating role of objections to innovation and the mediation effect of e‐learning adoption. The study suggests that a positive attitude toward e‐learning adoption enhances students' work performance. The findings underline the significance of ELAT and ELAD and offer useful policies for improving students' performance.

Analysis of Influencing Factors of Organizational Health Literacy in Healthcare Institutions in Beijing, China: A Cross-Sectional Study.

This study aimed to evaluate the organizational health literacy of healthcare institutions in Beijing and to analyse its influencing factors to provide suggestions for the construction of health-promoting medical institutions. This study used multi-stage cluster sampling and conducted an online survey of medical staff in the sampled healthcare institutions in Beijing from May to July 2023. The Chinese version of the Health Literate Health Care Organization 10-item Questionnaire (HLHO-10-C) was used to assess the organizational health literacy of healthcare institutions. Univariate analysis and generalized linear models (GLM) were used to analyze the influencing factors. Finally, 2527 participants were included. The majority of participants were female (87.6%). More than half of the participants indicated that they had engaged in outpatient or inpatient health education work. The respondents' score for HLHO-10-C was 6.170±1.056. The score of the respondents from tertiary hospitals (6.003±1.167) was slightly lower than those from secondary hospitals (6.328±0.747) and primary healthcare centers (6.418±0.864). All healthcare institutions scored relatively high on institutional environmental construction support (6.284±1.034). The results of the GLM showed that educational level, healthcare institution level, and engagement in health education work were factors influencing HLHO-10-C (P<0.05). Overall, the organizational health literacy of healthcare institutions in Beijing was relatively good. However, there is room for improvement in tertiary hospitals. In the future, to promote the construction of health-literate hospitals, targeted measures should be taken to encourage healthcare workers to engage in health education.

Emerging infectious disease surveillance using a hierarchical diagnosis model and the Knox algorithm

Emerging infectious diseases are a critical public health challenge in the twenty-first century. The recent proliferation of such diseases has raised major social and economic concerns. Therefore, early detection of emerging infectious diseases is essential. Subjects from five medical institutions in Beijing, China, which met the spatial-specific requirements, were analyzed. A quality control process was used to select 37,422 medical records of infectious diseases and 56,133 cases of non-infectious diseases. An emerging infectious disease detection model (EIDDM), a two-layer model that divides the problem into two sub-problems, i.e., whether a case is an infectious disease, and if so, whether it is a known infectious disease, was proposed. The first layer model adopts the binary classification model TextCNN-Attention. The second layer is a multi-classification model of LightGBM based on the one-vs-rest strategy. Based on the experimental results, a threshold of 0.5 is selected. The model results were compared with those of other models such as XGBoost and Random Forest using the following evaluation indicators: accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. The prediction performance of the first-layer TextCNN is better than that of other comparison models. Its average specificity for non-infectious diseases is 97.57%, with an average negative predictive value of 82.63%, indicating a low risk of misdiagnosing non-infectious diseases as infectious (i.e., a low false positive rate). Its average positive predictive value for eight selected infectious diseases is 95.07%, demonstrating the model's ability to avoid misdiagnoses. The overall average accuracy of the model is 86.11%. The average prediction accuracy of the second-layer LightGBM model for emerging infectious diseases reaches 90.44%. Furthermore, the response time of a single online reasoning using the LightGBM model is approximately 27 ms, which makes it suitable for analyzing clinical records in real time. Using the Knox method, we found that all the infectious diseases were within 2000 m in our case, and a clustering feature of spatiotemporal interactions (P < 0.05) was observed as well. Performance testing and model comparison results indicated that the EIDDM is fast and accurate and can be used to monitor the onset/outbreak of emerging infectious diseases in real-world hospitals.

Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel.

To decelerate antibiotic resistance driven by inappropriate antibiotic prescribing, a prescription review and feedback (PRF) policy is implemented in primary healthcare institutions (PHIs) in Beijing, China. However, evaluation of PRF implementation in PHIs is scarce. This study aims to systematically identify the barriers and facilitators of PRF policy implementation to provide evidence for antimicrobial stewardship. We conducted key informant interviews with 40 stakeholders engaged in the implementation of PRF in Beijing, including physicians, pharmacists and administrators. Interviews were audio recorded and transcribed verbatim. We coded the interview transcripts and mapped informant views to domains of the Theoretical Domains Framework. We then used a behaviour change wheel to suggest possible behavioural interventions. Procedural knowledge (Knowledge) and skills (Skill) of PRF were possessed by stakeholders. They felt responsible to promote the appropriate use of antibiotics (Social/professional role and identity) and believed that PRF could help to change inappropriate provider behaviours (Behavioural regulation) in prescribing antibiotics (Beliefs about consequences) under increased intention on antibiotic use (Stages of change). Moreover, informants called for a more unified review standard to enhance PRF implementation (Goals). Frequently identified barriers to PRF included inadequate capacity (Skill), using punishment mechanism (Behaviour regulation), reaching consistently lower antibiotic prescription rates (Goals), lack of resources (Environmental context and resources) and perceived pressure coming from patients (Social influences). Stakeholders believed that PRF implementation promoted the rational use of antibiotics at PHIs in Beijing. Still, PRF was hampered by inconsistencies in review process and resources needed for PRF implementation.

Progressive Relationship Between Sustainable Development of Elderly Care Institutions and Spatial Environmental Factors: A Study Based on the Influence of Supermarkets, Medical Accessibility, and Parks in Urban Areas.

To study the relationship between three variables, namely, the number of supermarkets around, the average distance to medical institutions designated to be covered by basic medical insurance, and the presence of parks around, and the sustainable development of elderly care institutions. This paper is based on the census database of elderly care institutions in Beijing. We ran a self-developed Python program to mine the database after adding three variables, namely, the number of supermarkets around, the average distance to medical institutions designated to be covered by basic medical insurance (hereinafter referred to as "designated medical institutions"), and the presence of parks around, and then used the least squares method in regression analysis. The number of years of depreciation for fixed assets had some degree of influence on the occupancy rate of an elderly care institution under sustained operation. The occupancy rate of above 80% was efficient for an elderly care institution. There was a progressive relationship between the external spatial factors and the internal resources of an elderly care institution in terms of influencing the occupancy rate of the institution. Optimizing the spatial distribution of elderly care institutions should first optimize the choice of location. The occupancy rate of an elderly care institution was closely related to the convenience of living conditions and that site selection was crucial for such a facility. We arrived at two recommendations for the future development of elderly care institutions, 1. Reducing the number of the institutions in areas with unfavorable geographic positions and serving senior care needs within an appropriate close distance, so as to better optimize the spatial distribution of senior care facilities, improve the efficiency of resource allocation. 2. Strike a balance between the economic benefits of operating entities and the social benefits associated with older people.

Agent-Based Modeling and Simulation (ABMS)on the influence of adjusting medical service fees on patients' choice of medical treatment

BackgroundWe explored the impact of medical service fee adjustments on the choice of medical treatment for hypertensive patients in Beijing. We hope to provide decision-making reference to promote the realization of hierarchical diagnosis and treatment in Beijing.MethodsAccording to the framework of modeling simulation research and based on the data of residents and medical institutions in Beijing, we designed three models of residents model, disease model and hospital model respectively. We then constructed a state map of patients’ selection of medical treatment and adjusted the medical service fee to observe outpatient selection behaviors of hypertensive patients at different levels of hospitals and to find the optimal decision-making plan.ResultsThe simulation results show that the adjustment of medical service fees can affect the proportion of patients seeking medical treatment in primary and tertiary hospitals to a certain extent, but has little effect on the proportion of patients receiving medical treatment in secondary hospitals.ConclusionsBeijing can make adjustments of the current medical service fees by reducing fees in primary hospitals and slightly increasing fees in tertiary hospitals, and in this way could increase the number of patients with hypertension in the primary hospitals.

Comparative Study on Chronic Obstructive Pulmonary Disease Screening Tools in Primary Healthcare Institutions in Beijing, China.

Chronic obstructive pulmonary disease (COPD) has a high incidence rate in China, but the diagnosis rate remains insufficient. This study aimed to explore and compare COPD screening tools for primary healthcare institutions in China. Exploring COPD Screening Tools and Their Combined Use for Primary Healthcare Institutions in China. From September 2022 to March 2023, a screening for COPD was conducted among residents aged 35 years and above in primary healthcare institutions in Beijing, China. The screening involved the use of the CAPTURE scale, COPD-SQ scale, and peak expiratory flow rate test. Any positive results from these screening tests were followed by further pulmonary function testing to confirm the diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic (ROC) curves were calculated for each screening tool alone and in combination. A total of 986 individuals completed the screening tests. The positive rates for the CAPTURE scale, COPD-SQ scale, and peak flow meter screening were 41.78%, 29.11%, and 52.03%, respectively. Of the participants, 166 (24.09%) underwent pulmonary function tests, with an average age of 61.69±13.68 years. The peak flow meter screening showed the highest sensitivity (83.78%) when used alone, while the COPD-SQ scale exhibited the best specificity (59.69%), positive predictive value (31.58%), and negative predictive value (58.56%). Significant differences (P<0.05) were observed between any two of the three screening tools. Among the combinations, the peak flow meter screening + COPD-SQ scale showed the highest accuracy, with a Youden index of 0.277 and an AUC of 0.638. There is variation in the accuracy of existing screening tools for COPD when used alone. For primary healthcare institutions, the optimal COPD screening tool is the combination of peak flow meter screening and the COPD-SQ questionnaire. If limited by screening equipment conditions, the COPD-SQ questionnaire can be used alone for screening.

Who consumes curative care expenditure of medical institutions in Beijing: a case study based on System of Health Accounts 2011

BackgroundChina’s health system is challenged by complex health problems experienced by different population groups and caused by multiple diseases. This study examined the distribution of curative care expenditure (CCE) of medical institutions in Beijing using beneficiary characteristics such as residency, gender, age, and disease. Suggestions are presented for the development of health policies.MethodsA total of 81 medical institutions with approximately 80 million patients in Beijing, China, were selected via a multistage stratified cluster random sampling approach. Based on this sample, the System of Health Accounts 2011 was used to estimate the CCE of medical institutions.ResultsThe CCE of medical institutions in Beijing was ¥246.93 billion in 2019. The consumption of patients from other provinces was ¥60.04 billion, accounting for 24.13% of the total CCE. The CCE of female consumption (52.01%/¥128.42 billion) exceeded that of male consumption (47.99%/¥118.51 billion). Almost half of the CCE (45.62%/¥112.64 billion) was consumed by patients aged 60 or above. Adolescent patients up to an age of 14 (including those aged 14) mainly chose secondary or tertiary hospitals for treatment. Chronic non-communicable diseases accounted for the largest share of CCE consumption, with circulatory diseases accounting for the highest proportion.ConclusionsThis study identified significant differences in CCE consumption in Beijing according to region, gender, age, and disease. Currently, the utilization of resources in medical institutions is not reasonable, and the hierarchical medical system is not sufficiently effective. Therefore, the government needs to optimize the allocation of resources according to the needs of different groups and rationalize the institutional process and functions.

What factors affect Beijing residents' contracts with family doctors? A comparative study of Beijing's urban and suburban areas.

To improve the health of residents and promote hierarchical diagnosis and treatment to achieve an orderly pattern of medical treatment, Beijing implemented family doctor contract services (FDCSs) in 2011. The aims of this study were to analyze the current status of Beijing residents' contracts with family doctors (FDs), compare the differences in contracting between urban and suburban residents, and explore the factors that affect residents' contract behavior. From August 2020 to October 2020, a stratified sampling method was adopted to select residents from community health centers (CHCs) in districts D (urban area) and S (suburb) of Beijing to conduct a questionnaire survey. Chi-square tests, rank sum tests and logistic regression analyzes were used to analyze the current status and influencing factors of residents' contracting with FDs. A total of 4,113 valid questionnaires were included in the final analysis. District D was rich in medical resources, and the FD contract rate of residents there (93.09%) was significantly higher than that of residents in district S (78.06%; p < 0.05). Residents' district (OR = 1.55, 95% CI = 1.18-2.05), understanding of FDCS policies (OR = 4.13, 95% CI = 3.63-4.69), preferred medical institutions (OR = 0.58, 95% CI = 0.42-0.79 for tertiary hospitals in the district; OR = 0.36, 95% CI = 0.22-0.59 for urban medical institutions in Beijing), age, education level, average annual medical expenses and medical insurance type were factors that influenced residents' contracts with FDs (p < 0.05). This study shows that residents who are located in districts with rich medical resources, prefer CHCs as their first choice, have a better understanding of FDCS policies, and are more inclined to contract with FDs than other residents. It is recommended that the number and quality of FDs in suburban areas be increased and that medical staff strengthen publicity about FDCSs and actively encourage residents to contract with FDs.

Physical examination performed by general practitioners in 5 community health service institutions in Beijing: an observational study

BackgroundPhysical examination is a core component of consultation. Little is known about the status quo of physical examinations performed by general practitioners in community health service institutions in China. The aim of this study was to investigate general practitioners’ performance of physical examinations in consultations.MethodsAn observational study was conducted in 5 community health service institutions in Beijing between November 2019 and January 2020. Eleven general practitioners were observed for one workday. Information of consecutive consultations was recorded including patient characteristics, reasons for encounter, physical examinations performed by general practitioners, length of consultation time and time spent on specific activities in consultations.ResultsA total of 682 consultations of 11 general practitioners were recorded. Physical examinations were performed in 126 consultations (15.8%). Physical examination was more likely to be performed in patients visiting with symptoms (P < 0.001). Majority of the 126 physical examinations were distributed in “Head, face, and neck examination” (n = 54, 42.9%) and “Cardiovascular examination” (n = 55, 43.7%). No physical examination was performed on skin, male genitalia, female breasts and genitalia, and neurological systems. Total 2823 min of activities were observed and recorded. General practitioners only spent 3.1% of the recorded time on physical examination, which was less than the time spent on taking history (18.2%), test (4.9%), diagnosis (22.7%), therapy (38.4%), and health education (8.6%). The average time spent on physical examinations was 0.8±0.4 min per consultation.ConclusionPhysical examination was insufficiently performed by general practitioners in community health service institutions in Beijing. More time and commitment should be advocated for improving the quality of physical examinations in primary care.

Pulmonary tuberculosis diagnosing and reporting in different type of medical and health institutions in Beijing, 2019

Objective To evaluate pulmonary tuberculosis (TB) distribution and reporting in different types of medical and health institutions in Beijing, and provide evidence for standardizing TB diagnosis and reporting in medical institutions. Methods The information of pulmonary TB cases in Beijing in 2019 was collected via national Tuberculosis Information Management System (TBIMS) and analyzed by descriptive epidemiology method. Results In 2019, a total of 25 566 pulmonary TB cases were reported by 336 medical and health institutions in Beijing, of which 11 301 were confirmed pulmonary TB cases, accounting for 44.20%. A total of 12 151 pulmonary TB cases were reported by 21 designated medical institutions, accounting for 47.53%, and 13 415 pulmonary TB cases were reported by 315 non-designated medical institutions, accounting for 52.47%. Among the designated medical institutions, Beijing Chest Hospital reported the most pulmonary TB report cases (9 228 cases, 36.09%). Among the non-designated medical institutions, the Eighth Medical Center of PLA General Hospital reported the most pulmonary TB cases (1 402 cases, 5.48%). A total of 15 721 pulmonary TB cases were local residents in Beijing (61.49%) and 9 845 cases were not local residents in Beijing (38.51%). The pulmonary TB cases in local residents were mainly reported by general hospitals (7 737 cases, 49.21%), and the pulmonary TB cases in non-local residents were mainly reported by special hospitals (5 163 cases, 52.44%). The pulmonary TB cases in non-local residents were mainly from the surrounding provinces of Beijing, such as Hebei (3 703 cases, 37.61%). The proportions of confirmed pulmonary TB cases in designated and non-designated medical institutions were 58.76% and 31.02% respectively. The difference was significant (χ2=1 989.69, P Conclusion More pulmonary TB patients visited non-designated medical institutions, but the proportion of confirmed pulmonary TB cases reported by them was lower than that reported by designated medical institutions. The reported pulmonary TB cases were mainly local residents in Beijing, and the pulmonary TB cases in non-local residents were mainly from Hebei. The registration management rate was higher in pulmonary TB cases in local residents than in pulmonary TB cases in non-local residents, and there were also differences in the registration management rate in pulmonary TB cases in local residents among different districts (counties) in Beijing.

Birt–Hogg–Dubé syndrome in Chinese patients: a literature review of 120 families

ObjectiveTo clarify the epidemiological and clinical features of Birt–Hogg–Dubé syndrome (BHDS) in Chinese patients.MethodsWe identified reports on Chinese patients with BHDS by searching the China Academic Journals Database, Wanfang Chinese Database, and PubMed databases, either in Chinese or English languages published from January 1, 2008 to December 31, 2020. Studies without sufficient clinical data were excluded and cases under 18 years old were excluded.ResultsTwenty papers were included and comprised 120 families with 221 cases. Most families with BHDS were reported from institutions in Beijing (66.7%) and Jiangsu Province (15.8%); 80.8% of cases were reported within the past five years. The average duration from clinical presentation to diagnosis was 9.6 years. The average age was 47.0 ± 13.9 years (range, 18–84 years) and the ratio of male to female was 1:1.6. The most common manifestations of BHDS were multiple pulmonary cysts (92.4%), spontaneous pneumothorax (71.0%), skin lesions (18.1%) and renal tumors (3.6%). Pulmonary cysts were predominantly distributed in the lower lobe on chest CT imaging. Family history of spontaneous pneumothorax was identified in 84.7% of the families and average number of pneumothoraxes was 1.8 (range, 1–6). The FLCN gene mutation c.1285dupC/delC in exon 11 was the most frequent mutation observed (17.4% of patients). The recurrence rate of pneumothorax after conservative treatment (including tube thoracostomy) was 29/41 (71%) while the pneumothorax recurred after surgical treatment (pulmonary bullectomy or pleurodesis) in only 4/37 (11%).ConclusionsAlthough BHDS has been increasingly reported in the recent years, only minority of families were reported from institutions outside of Beijing and Jiangsu Province. The dominant clinical manifestations were pulmonary cysts associated with recurrent pneumothorax, while skin lesions and renal tumors were less commonly reported. Delayed diagnosis along with suboptimal management appear to represent critical challenges for Chinese patients with BHDS.

Using Trend Extrapolation Model to Predict the Needs of Elderly Care Talents in Beijing Institutions

2020-2050 is a period of rapid development of China's population aging, and it is also a critical period for the country to actively respond to population aging. Under the background of the combination of medical care and nursing, institutional elderly care services, as an important branch of the multi-level elderly care service system, have become the main battlefield of the integrated medical and elderly care policy. Therefore, institutional care talents for the aged have also become a key link in improving the quality of life of the elderly population. This paper using trend extrapolation model to predict the needs of elderly care talents in institutions in Beijing, including nursing staff who provide basic living care and professional medical staff who provide services such as rehabilitation, medical treatment, nutrition, and psychological consultation. The results show that, in 2050, the demand for institutional elderly nursing staff in Beijing will exceed 150,000, and the demand for institutional elderly medical staff will reach about 20,000.

Infectious Disease Prevention and Control Capacity of Community Health Institutions in Beijing: Current Status and Recommendations for Problems

Background: During the fight against the COVID-19 pandemic, Beijing's community health institutions showed some weaknesses in infectious disease prevention and control. To improve their capabilities in this aspect to fully play their role as a sentinel for monitoring infectious diseases, it is urgent to investigate and analyze their current status to find problems, then put forward recommendations. Objective: To investigate the infectious disease prevention and control level in Beijing's community health institutions, and identify and analyze the problems, with suggestions put forward. Methods: From May to July 2020, a questionnaire survey was conducted in all community health centers(CHCs) in Beijing. Information was collected, including the basic situation, departments, staff structure, infrastructure situation, the provision of public health services, and emergency response capacity for infectious diseases and public health emergencies of the CHC, and was analyzed using descriptive analysis. The above-mentioned data were checked and supplemented if necessary in accordance with the information in the China's National COVID-19 Surveillance Network and Beijing Community Health Statistics 2019. Results: Of the 342 CHCs in total in Beijing as of 2019, 90(26.32%) had a fever clinic, 102(29.82%) had a gastrointestinal clinic, and 54(15.79%) had both a fever clinic and a gastrointestinal clinic. Among the incumbent workers in the CHCs(n=28 809), 2 887(10.02%) held a position in public health, and 178(6.17%) had a senior professional title. HIV testing was carried out in 159 CHCs(46.49%). SARS-CoV-2 nucleic acid testing was accessible in 11 CHCs(3.22%). For 29 kinds of common infectious diseases, 140(40.94%) CHCs had no diagnosis and treatment capabilities, 135(39.47%) had capabilities managing 1-5 kinds, only 29(8.48%) were able to diagnose and treat >10 kinds. Conclusion: The CHCs in Beijing may have a series of problems in the infectious disease prevention and control system and mechanism, sentinel fever clinic, infectious disease diagnosis and treatment capacity, public health workforce development and other aspects. Therefore, the infectious disease prevention and control plan of the CHCs should be developed more appropriately from an overall point of view, to address the problems and improve the current status as soon as possible. Copyright © 2021 by the Chinese General Practice.

Establishment of reference intervals for pediatric complete capillary blood counts: A multicenter study in Beijing.

Clinical reference intervals represent the normal range of clinical parameters for distinguishing healthy and sick individuals, and they show some variation among different populations. Many reference intervals are still lacking for the pediatric population in China. Thus, the aim of this study was to establish and validate pediatric reference intervals for capillary blood cell counts. A total of 9942 children were enrolled from 10 medical institutions in Beijing, China, for capillary complete blood count (CCBC) values according to the EP28-A3c guideline issued by the Clinical and Laboratory Standards Institute. Pediatric reference intervals for 17 CCBC parameters were established for children aged 6months to 7years. The red blood cell count and red blood cell distribution width were generally higher in males than in females, and the mean corpuscular hemoglobin and mean corpuscular volume were higher in females than in males. The red blood cell, hemoglobin, hematocrit, and neutrophil percentages increased while the percentage of lymphocytes decreased with age. The overall trends for each reference interval were relatively similar in different ethnic groups and regions in the world, but with variation in the upper and lower limits, which confirms the existence of racial and geographical differences. Further validation with 508 healthy subjects showed that the verified proportions were within 90.9%-100% of the reference intervals. This study offers local reference intervals for CCBC values for the pediatric population in Beijing, China, and thus provides basic criteria for the diagnosis, treatment, and health assessment of childhood diseases in China.

Potentially inappropriate medications among elderly patients in community healthcare institutions in Beijing, China.

To evaluate potentially inappropriate medications (PIMs) prevalence and predictors in community healthcare institutions (CHIs) for the elderly. We conducted a retrospective observational study, deriving data of patients aged ≥60 from 66 CHIs in Beijing, 2014-2018. The system of Criteria of PIM for Older Adults in China was applied to identify PIMs. The primary outcome was the prevalence of visits with at least one PIM; secondary outcomes were the frequency and rate per thousand visits of specific PIMs. We used descriptive analysis and generalized linear models to analyzed PIMs and the predictors, and marginal effects methods were applied to estimate the mean adjusted PIMs prevalence. Overall, 4 528 884 elderly patient visits from 2014 to 2018 were eligible for inclusion. A total of 719 757 PIMs were detected, with 14.1% of the visits contained at least one PIM. PIM prevalence was significantly correlated with age, number of prescribed medications and number of diagnoses. Overall, 6.0 per thousand elderly patients in CHIs were exposed to at least one high-risk PIM, while 117.5 per thousand were exposed to at least one low-risk PIM. In 2018, 20% of GPs were responsible for more than half of overall PIM visits. Prescribing of PIMs for older adults is common in CHIs in China, especially for patients who are aged, having multiple medications and diagnostic diseases. Strategies should be developed to enhance prescribing quality for geriatric patients, with special targeting of doctors responsible for a high number of PIMs.