Chinese General Practice

Traditional Chinese Medicine Policies and Development Status in China

WAN Xiaowen, HUANG Rong, MA Lirong, SHI Muran, SHENG Wenbin, ZENG Cheng, WU Ning

2025, 28(10): 1161-1169. DOI: 10.12114/j.issn.1007-9572.2024.0267

Asbtract ( )

HTML ( )

PDF (1415KB) ( )

Figures and Tables | References | Related Articles | Metrics

The research on traditional Chinese medicine policies in China's academic circles became increasingly active and the connotations became richer. However, most of the existing research focused on a certain specific field of traditional Chinese medicine policies, lacking all-round comprehensive research. By systematically retrieving China's traditional Chinese medicine-related policies and journal literature from 2011 to 2023 and obtaining the comprehensive statistical system data of traditional Chinese medicine, this article analyzed Chinese medicine policies from the 12th Five-Year Plan to the 14th Five-Year Plan from the perspectives of Chinese medicine, health care, scientific research, education, industry and culture, reviews relevant Chinese medicine policies and measures, sorts out the development status. It found that China had problems such as insufficient basic Chinese medicine service ability, imperfect Chinese medicine health care network, imperfect education model, and weak scientific research strength. It also proposed to strengthen the traditional Chinese medicine medical system, strengthen health care for treating non-sick patients, strengthen the construction of scientific research forces, integrate and innovate the education model, strengthen the supervision of the traditional Chinese medicine industry, and promote the dissemination of traditional Chinese medicine culture and health education.

Study on Resource Allocation for Order-directed General Practitioners Working at the Grassroots Level in China

LI Mingyue, LIU Xiaoyun

2025, 28(10): 1170-1172. DOI: 10.12114/j.issn.1007-9572.2024.A0020

Asbtract ( )

HTML ( )

PDF (1259KB) ( )

Figures and Tables | References | Related Articles | Metrics

Interpretation of the Consensus Statement of the British and Irish Hypertension Societies on Adult Hypertension Referral Pathway and Therapeutic Management

ZHOU Yiheng, LYU Yao, YANG Ziyu, YANG Rong, LIU Lidi, ZHANG Peng, DAI Hua, ZENG Rui, WAN Zhi, JIA Yu, LIU Changming, LEI Yi, LIAO Xiaoyang

2025, 28(10): 1173-1178. DOI: 10.12114/j.issn.1007-9572.2024.0097

Asbtract ( )

HTML ( )

PDF (1366KB) ( )

Figures and Tables | References | Related Articles | Metrics

The British and Irish Hypertension Society (BIHS) summarized guidelines from the National Institute for Health and Care Excellence (NICE), the European Society of Cardiology and the European Society of Hypertension (ESH), and published Adult Hypertension Referral Pathway and Therapeutic Management in the Journal of Human Hypertension on January 9, 2023. Based on the existing evidence and expert opinions, this article focuses on the referral criteria of hypertensive patients and the treatment of patients during the referral waiting period, so as to optimize the management of hypertensive patients by primary doctors. The purpose of this article is to interpret the core points of the consensus statement to provide recommendations for primary care physicians in China on the referral criteria and treatment of hypertensive patients during referral waiting period. In view of the complexity and regionalism of China's primary medical problems, it is still necessary for primary doctors to conduct comprehensive evaluation and practice the clinical practice plan that is most beneficial to patients.

Advances in Quantitative Assessment Indexes of Continuity of Care and Their Application

MA Jingxin, YANG Rong, LIU Lidi, ZHANG Yalin, SONG Haiqi, LUO Jianzhao, ZHU Linlin, LIAO Xiaoyang

2025, 28(10): 1179-1184. DOI: 10.12114/j.issn.1007-9572.2023.0304

Asbtract ( )

HTML ( )

PDF (1331KB) ( )

References | Related Articles | Metrics

Continuity of care is the basic principle and core feature of general practice. A high level of continuity of care is beneficial to improve patient satisfaction and reduce mortality. Accurate assessment of continuity of care is the prerequisite for improving the level of it. Quantitative assessment indexes of continuity of care can not only guide medical staff to improve continuity of care, but also assist healthcare administrators in improving governance measures, so as to provide the best service for patients by reflecting the level of continuity of care. Therefore, quantitative assessment of continuity of care is necessary and crucial. However, at present, there are few researches on the concept and application of quantitative assessment indexes of continuity of care in China. Therefore, by summarizing domestic and foreign literature, this paper classifies the common quantitative assessment indexes of continuity of care, summarizes the diseases and populations to which the indicators are applied, and analyzes the limitations of existing indexes and possible improvement directions in the future, in order to provide a theoretical basis for domestic researchers to select indexes for application.

Associated Factors and Characteristics of PRISm: a Study Based on Community Residents

SONG Rongwei, WU Chunxiang, YU Jie, LU Yuqing, ZHANG Fengying

2025, 28(10): 1185-1192. DOI: 10.12114/j.issn.1007-9572.2024.0281

Asbtract ( )

HTML ( )

PDF (1565KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

20%-30% of individuals with Preserved Ratio Impaired Spirometry (PRISm) will develop chronic obstructive pulmonary disease (COPD). However studies on characteristics of PRISm in China remain limited.

Objective

To analyze factors associated with PRISm, and to explore the difference in the distribution of risk factors between individuals with PRISm and COPD.

Methods

This study was conducted as part of health management in Shanghai communities. Elderly individuals over 60 years old from 11 communities in Putuo District, Shanghai, who participated COPD screening from July 2022 to June 2023, were surveyed and underwent lung function tests. A total of 876 participants were initially included, but 141 were excluded due to incomplete questionnaire information or poor lung function test quality, resulting in 735 valid subjects. According to the "Guidelines for Graded Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease" and GOLD 2024, participants were classified into three subgroups based on post-bronchodilator lung function: COPD group (FEV₁/FVC < 70%), PRISm group (FEV₁%Pred< 80% and FEV₁/FVC≥ 70%), and normal lung function group. Multivariate Logistic regression analyses were conducted to identify factors associated with COPD and PRISm, using normal lung function as the control.

Results

A total of 735 individuals aged 60~81 were included. COPD and PRISm were observed in 157 (21.36%) and 113 (15.37%) participants, respectively. COPD-SQ scores were highest in the COPD group (20.46±4.53), followed by the PRISm group (19.04±4.41) and lowest in the normal lung function group (18.03±4.26) with statistically significant differences (P<0.001). Univariate analysis showed that the PRISm group had higher proportions of males, smokers, individuals with frequent wheezing, chronic bronchitis and hypertension compared to the normal lung function group (P<0.05). Compared to COPD patients, the PRISm group had lower proportions of males, smokers, individuals with symptoms of wheezing or coughing after exercise, and those with a history of emphysema, but a higher prevalence of hypertension (P<0.05). Multivariable Logistic regression analyses revealed that increasing age, male gender, higher smoking levels, insufficient physical activity, frequent wheezing, wheezing or coughing after exercise, family history of COPD or bronchial asthma, and history of bronchial asthma or emphysema were associated with COPD (P<0.05). In contrast, higher smoking levels, insufficient physical activity, frequent wheezing, chronic bronchitis, and hypertension were associated with PRISm (P<0.05) .

Conclusion

PRISm is a high-risk state between COPD and normal lung function, sharing similar associated factors with COPD such as age, smoking states, physical activity, symptoms and comorbidities. However, the COPD-SQ score and the predictive performance of multivariable logistic regression model for lung function status were significantly lower for PRISm compared to COPD. Hypertension was an independent associated factor for PRISm, but not for COPD, suggesting a potential risk of cardiovascular disease independent of COPD. Further research is warranted to verify the role of PRISm characteristics in disease progression.

The Current Status and Influencing Factors of Multiple Chronic Conditions among the Elderly Aged 60 and above in Gansu Province

ZHU Xianshang, ZENG Hongyu, LYU Fengli, WANG Jiancheng

2025, 28(10): 1193-1199. DOI: 10.12114/j.issn.1007-9572.2024.0369

Asbtract ( )

HTML ( )

PDF (1626KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

With the acceleration of population aging in my country, the multiple chronic conditions in the elderly has become increasingly common. This not only seriously affects the quality of life of the elderly, but also places a heavy burden on families and society. Gansu is a province with a relatively high aging population in the northwest region, and it is urgent to pay attention to the multiple chronic conditions among the elderly.

Objective

In order to understand the current status and influencing factors of multiple chronic conditions among the elderly in Gansu Province, and provide a reference basis for the prevention, treatment and management of multiple chronic conditions in Gansu Province.

Methods

From 2023-07-15 to 2023-08-10, a multi-stage stratified random cluster sampling method was used to select 20 000 elderly people aged ≥60 years old in Gansu Province for a questionnaire survey. The questionnaire was designed by the research team itself and mainly investigated the prevalence of 15 common chronic diseases among the elderly, as well as their demographic characteristics and family circumstances. In the end, 19 038 valid questionnaires were collected, and the effective questionnaire recovery rate was 95.19%.

Results

The prevalence rate of chronic diseases among the elderly in Gansu Province was 74.78% (14 236/19 038), and the incidence rate of multiple chronic conditions was 38.97% (7 419/19 038). The top six chronic diseases with the highest prevalence were hypertension[9 693 (50.91%) ], arthritis or rheumatism[3 648 (19.16%) ], and heart disease[3 418 (17.95%) ], diabetes or elevated blood sugar[3 033 (15.93%) ], chronic lung disease[1 645 (8.64%) ], stroke[1 548 (8.13%) ]. Common comorbidity combination patterns are all related to hypertension. The top-ranked binary comorbidity pattern is hypertension + diabetes or elevated blood sugar[2 112 (11.09%) ], and the top-ranked ternary comorbidity pattern is hypertension + diabetes or elevated blood sugar + heart disease[532 (2.79%) ]. The results of multi-factor Logistic regression analysis showed that gender, age, ethnicity, pre-retirement occupation, spouse, number of children, relationship with children, self-rated health status, self-rated life satisfaction, and loneliness are influencing factors for the occurrence of multiple chronic conditions in the elderly (P<0.05) .

Conclusion

The incidence of multiple chronic conditions among the elderly in Gansu Province is lower than the national average. Multiple chronic conditions occurs among the elderly who are female, elderly, Tibetan, have a job before retirement, have a normal relationship with their children, have average/poor self-rated health, and have average self-rated life satisfaction. The risk of chronic disease is higher, and the risk of multiple chronic conditions is lower for the elderly who have a spouse, fewer children, and do not feel lonely. Relevant departments should focus on the prevention, treatment and management of common multiple chronic conditions in the elderly, promptly intervene in variable risk factors, strengthen the elderly's awareness of self-health management, and improve the multiple chronic conditions management system in primary medical and health institutions.

Analysis and Prediction of Disease Burden due to High BMI in China from 1990 to 2019

YAN Danhong, GAN Tongzhou, YUAN Kongjun, ZHOU Guangqing

2025, 28(10): 1200-1206. DOI: 10.12114/j.issn.1007-9572.2023.0903

Asbtract ( )

HTML ( )

PDF (1675KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

Obesity is a common metabolic disease that has become a serious public health problem worldwide. In recent decades, with the rapid development of China's economy and the acceleration of globalization and urbanization, the rate of overweight and obesity in China has shown a rapid rise, and it is urgent to carry out the prevention and control of obesity in the whole population.

Objective

To analyze the status quo and changing trend of disease burden due to high BMI in China from 1990 to 2019, and to predict the Disability-Adjusted Life Years (DALY) normalization rate of high BMI in China in the next decade, providing reference for formulating obesity prevention and control strategies in China.

Methods

The data of DALY number and DALY normalization rate attributed to high BMI in China from 1990 to 2019 were extracted from the global Burden of Disease database, and the burden of disease due to high BMI in China was analyzed from the aspects of gender, age and the burden of disease attributable to high BMI. Using the estimated annual percentage change (EAPC) to represent the change trend, a grey prediction model GM (1, 1) was established to predict the DALY normalization rate attributed to high BMI in China from 2020 to 2030.

Results

From 1990 to 2019, the number of deaths and DALY attributable to high BMI in China increased by 225% and 215%, respectively. The standardized mortality rate (EAPC=1.21%, P<0.001) and the standardized DALY rate showed an increasing trend (EAPC=1.41%, P<0.001). The burden of DALY attributed to high BMI and its growth rate was significantly higher in men than in women over the same period. The burden of DALY caused by high BMI increased with the increase of age, and the burden of <5-19 years old increased rapidly, and the increase trend of males at all ages was increasing, and the increase trend of females at 20-54 years old was unstable, and the increase rate was accelerated at 55 years old and above. In 1990 and 2019, the top four diseases with the greatest burden of DALY attributed to high BMI were stroke, ischemic heart disease, diabetes and hypertensive heart disease, and the diseases with rapid increase of DALY normalization rate were mainly tumor and musculoskeletal diseases. The number of DALY caused by high BMI in 2019 accounted for 6.50% of the total number of DALY in 2019, ranking fifth among 69 risk factors. GM (1, 1) forecast shows that the DALY normalization rate of high BMI in China will continue to rise from 2020 to 2030. In 2030, the DALY normalization rate of high BMI in China will be 1 452.52/ 100 000, among which 1 845.81/ 100 000 for males and 1 106.74/ 100 000 for females.

Conclusion

The burden of diseases caused by high BMI increased significantly in China from 1990 to 2019, and targeted intervention measures should be taken for people of different genders and different age groups, focusing on the prevention of diseases and cancers caused by high BMI. The disease burden of high BMI will increase further in the next decade, and a nationwide community obesity prevention and control effort is urgently needed.

The Relationship between Health Literacy and Online Health Information Search among Caregivers of Pediatric Oncology Children

SU Jun, WANG Jiamin, SUN Xiaojie

2025, 28(10): 1207-1212. DOI: 10.12114/j.issn.1007-9572.2023.0814

Asbtract ( )

HTML ( )

PDF (1513KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

Cancer is the second leading cause of death among children. The level of health literacy of caregivers of pediatric oncology patients not only affects their ability to search for health information on the Internet, but also has an impact on the health outcomes of patients. There is a lack of study exploring the relationship between health literacy and online health information search among caregivers of pediatric oncology patients.

Objective

To explore the relationship between health literacy and online health information search among caregivers of pediatric oncology patients and to analyze the factors that influence caregivers' online health information search.

Methods

A total of 424 caregivers of pediatric oncology patients were included in the study using purposive sampling in three hospitals in Shandong Province from May to August 2021, as well as whole cluster sampling and snowball sampling in Guangdong Province through Shenzhen HengHui Public Welfare Foundation from June to August 2022 as subjects. The survey was conducted using the basic characteristics questionnaire and the health literacy questionnaire, and subjective answers from caregivers were used to confirm whether online health information searches were done. Point two-column correlation analysis was used to test the correlation between health literacy and online health information search among caregivers of pediatric oncology patients; binary Logistic regression (forward stepwise regression based on maximum likelihood estimation) was used to analyze the influencing factors of online health information search among caregivers of pediatric oncology patients.

Results

The health literacy scores of caregivers of pediatric oncology patients were (2.60±0.30) (2.76±0.30) (2.76±0.30), and (2.76±0.30) for the four dimensions of "Perceived understanding and support from healthcare professionals""Evaluation of health information""Ability to interact with healthcare professionals", and "Know enough about health information to know what to do", respectively; the proportion of high health literacy was 56.13%, 63.21%, and 63.21%, 35.61%, respectively; negative correlation (r=-0.161), positive correlation (r=0.006), positive correlation (r=0.073), positive correlation (r=0.102), with online health information search, respectively. The education level of junior high school, high school/vocational school, or college/junior college and above, one-child family, "evaluation of health information" and "ability to interact with healthcare professionals" were facilitating factors for caregivers to conduct online health information search; and "perceived understanding and support from healthcare professionals" was a hindering factor for caregivers to conduct online health information search.

Conclusion

Most caregivers of pediatric oncology patients search for health information on the Internet, and a higher level of education, being a one-child family, having a better ability to assess health information, maintaining positive interactions with healthcare professionals, and rarely feeling the understanding and support of healthcare professionals can promote the occurrence of online health information searching behaviors among caregivers of pediatric oncology patients. The government and related departments should actively carry out health education initiatives for caregivers of pediatric oncology patients to improve their health literacy and ability to use the Internet to search for health information.

The Assessment Tools and Influencing Factors of Insomnia in Chinese Adolescents: a Scoping Review

YU Yuemin, MO Feifei, LI Lesi, PAN Jiyang

2025, 28(10): 1213-1219. DOI: 10.12114/j.issn.1007-9572.2023.0781

Asbtract ( )

HTML ( )

PDF (1700KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

Previous research has indicated that adolescence is associated with physiological changes in sleep patterns. And there are significant variations in sleep duration among adolescents from different regions. Chinese adolescents face short sleep durations and intense academic pressures, which can lead to insomnia and affect their physical and mental health development.

Objective

To systematically review the assessment tools and influencing factors of insomnia in Chinese adolescents, and provide guidance for future research in this field.

Methods

Initiated in October 2022, this study conducted a systematic search in 5 databases: Web of Science Core Collection, PubMed, China National Knowledge Infrastructure, Wanfang Data, and VIP Database. Two researchers screened articles related to insomnia in Chinese adolescents aged 12 to 18. And then they extracted the following information independently: authors, publication year, region, type of research design, size of study sample, assessment tools, prevalence, and influencing factors.

Results

A total of 1 440 articles were retrieved from the databases, with 39 articles ultimately included in the study-34 in English and 5 in Chinese-covering 23 studies. The sample sizes ranged from 62 to 33 692. Cross-sectional studies were the most common method (15 studies) among the included research. Analysis revealed that the 23 studies utilized 8 kinds of insomnia assessment tools. Only 1 study provided objectively measured sleep features. Three studies involved localized assessment or development of 5 self-report tools, and provided reliability and validity data. The internal consistency of the 5 tools ranged from 0.50 to 0.83, test-retest reliability after two weeks ranged from 0.40 to 0.82, and area under the curve ranged from 0.79 to 0.85. The influencing factors of insomnia in Chinese adolescents were diverse and complicated, which included demographic factors (age, gender, etc.), physiological factors (genetics, health status, etc.), psychological factors (anxiety, depression, etc.), and behavioral factors (exercise, smoking, etc.) .

Conclusion

The assessment tools and influencing factors of insomnia in Chinese adolescents are diverse. However, there is insufficient validation of the reliability and validity of the assessment tools. Few studies have provided objectively measured sleep features of insomnia in Chinese adolescents. And the causal relationship between insomnia and its influencing factors remains unclear. Further research is still required in the future.

The Job Satisfaction of General Practitioners in China and Its Influencing Factors: a Systematic Review

HUANG Jing, MIAO Yiting, HE Xuemei, JIANG Dongyang, LIANG Ying

2025, 28(10): 1220-1227. DOI: 10.12114/j.issn.1007-9572.2023.0610

Asbtract ( )

HTML ( )

PDF (1752KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

General practitioners are the "gatekeepers" of residents' health, and their job satisfaction largely affects the quality and efficiency of primary healthcare service, which shows that it is of great significance to establish a job satisfaction evaluation system of general practitioners suitable for Chinese national conditions, and to improve the job satisfaction of general practitioners in order to promote the reform of the primary healthcare service system.

Objective

To conduct a systematic review of the job satisfaction of general practitioners and its influencing factors in China, to analyze the commonalities and differences in evaluation indexes and research results of the job satisfaction of general practitioners and their influencing factors in different studies, in order to provide reference for the establishment of a general practitioners' job satisfaction evaluation system suitable for Chinese national conditions.

Methods

PubMed, Web of Science, Embase, National Knowledge Infrastructure, WanFang Data and CQVIP were searched to obtain cross-sectional studies on job satisfaction and influencing factors of general practitioners from inception to June 12, 2023. Two researchers independently screened the literature and extracted the authors of the included literature, the time of the survey, the area of the survey, the sample size, the dimensions and indicators of the evaluation of job satisfaction, and the influencing factors of job satisfaction, and other information. The descriptive analysis method was adopted to summarize, analyze and compare.

Results

We included 19 Chinese studies, including 15 354 general practitioners. The evaluation of the job satisfaction of general practitioners mainly involved four dimensions: material satisfaction, relationship satisfaction, growth satisfaction, and overall satisfaction, of which 19 articles mentioned income and interpersonal relationship, 14 articles mentioned working environment, job promotion, and personal value, and 8 articles mentioned training. The influencing factors of job satisfaction of general practitioners included income level, gender, age, title, education, work pressure, workload, promotion opportunities, employment methods, work environment, length of service, interpersonal relationship, welfare benefits, type of unit, social recognition and so on.

Conclusion

The overall level of job satisfaction of general practitioners in China was not high, and was affected by income level, gender, age, title, educational, workload, work pressure, promotion opportunities, employment methods and other factors.

Research on Pediatric Construction and Service Provision in Primary Health Institutions

ZHANG Xiaojuan, LIU Yang, PENG Bo, CAO Xiaolin, YE Yuan, ZHU Kun

2025, 28(10): 1228-1235. DOI: 10.12114/j.issn.1007-9572.2023.0301

Asbtract ( )

HTML ( )

PDF (1881KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

For a long time, pediatric resources in China have been mainly concentrated in large hospitals, and the pediatrics of primary health institutions are weak. Studies about the current situation of pediatric construction and service provision in primary health institutions are mainly concentrated in a few developed areas, and studies about the latest progress in the whole country are not found.

Objective

To analyze the construction and service provision of pediatrics in primary health institutions in China.

Methods

From January to February 2022, 6 406 primary health institutions were surveyed using stratified sampling and the self-made questionnaire was used to collect relevant data on pediatric construction, pediatric human resource allocation, pediatric essential drugs, major equipment allocation, pediatric service provision in all sampled primary health institutions in 2021. Descriptive analysis and multiple linear regression analysis were used to analyze the influencing factors of the number of pediatric consultations and the rate of child health management in primary health institutions by Stata 15.0.

Results

31.41% (1 488/4 737) and 39.07% (652/1 669) of township health centers and community health centers independently set up pediatrics, respectively. On average, the number of general practitioners providing services for children and pediatric practitioners in township health centers was (1.33±2.52) and (0.94±1.71), respectively, and the number of community health centers was (1.95±3.80) and (1.26±2.06), respectively. The proportion of institutions equipped with 1-3 kinds of pediatric essential drugs in township health centers and community health centers was relatively high, which were 38.91% (1 843/4 737) and 40.85% (694/1 669), respectively. Except CT, the equipped rates of automatic biochemical instrument, DR and B-ultrasound are more than 80%. The results of multiple linear regression analysis showed that the types of institutions, the total number of employees, the actual number of beds, independent pediatricians, the number of pediatric practitioners, the number of general practitioners providing pediatric services, the contract rate of children and the number of drugs were the influencing factors of pediatric clinical service provision (P<0.05). Region, the total number of employees, and the children contract rate were the influencing factors of the children health management rate in primary health institutions (P<0.05) .

Conclusion

The pediatric department of primary health institutions is insufficient and there is a certain shortage of manpower, medicine, and equipment resulting in insufficient clinical services for children and differences between urban and rural areas, and the integration of clinical service and prevention still needs to be implemented.

Development and Usability Evaluation of GIS-based Family Doctor Contracting Service Platform

WANG Jinzhen, LI Jun, LU Dongchun, LI Jiashun, JIANG Yan, NIE Lianlian, YANG Danhong

2025, 28(10): 1236-1242. DOI: 10.12114/j.issn.1007-9572.2023.0888

Asbtract ( )

HTML ( )

PDF (1734KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

The role of family doctors has become more and more important as people's demand for healthcare increases. However, there are still some problems in the implementation of family doctor contracting service, such as the difficulty of finding suitable family doctors and the difficulty of data sharing.

Objective

Develop a GIS-based Family Doctor Contract Service WeChat Mini Program (hereinafter referred to as the WeChat Mini Program), and complete the usability evaluation to provide residents with a faster and more efficient family doctor contracting service, and for the promotion of the application of mHealth technology in family doctor contracting service.

Methods

From January to June in 2022 through literature review to understand the residents' demand for family doctor contracting service and the development of WeChat applet; on-site survey of 200 community residents using random sampling method to analyze the residents' demand for WeChat applet; focusing on the design ideas and function orientation of WeChat applet, four focus group interviews were conducted with the residents, family doctors, administrators, and technicians; based on the demand analysis and the development elements, the development elements of WeChat applet were constructed. Four focus group interviews were conducted; based on the demand analysis and design ideas, the development elements of the WeChat applet were constructed. From June to August in 2022, a field survey was conducted on 96 users of the WeChat Mini Program using the System Usability Scale (SUS). Additionally, usability evaluation of the WeChat Mini Program was performed through key informant interviews and expert consultations.

Results

The main needs of residents for WeChat applets included health consultation (78.00%), quick location of nearby family doctors (75.00%), and health science popularization (71.50%). The design scheme of the WeChat applet covered the core functions of path planning and navigation, information query and display, residents' health management, online contracting and renewal, and online consultation; after the trial operation of the WeChat applet, the usability analysis was conducted, and the average score of SUS was (78.62±9.23), suggesting that the WeChat applet was practically operable and easy to learn.

Conclusion

The connotation of family doctor contracting service based on the GIS platform and the use of multifaceted thinking can ensure the scientificity and usability of WeChat applet development.

Application of GIS-based Information Service Platform for Family Doctors

YANG Danhong, LI Jun, LI Feng, LI Junlei, HE Fang, LU Yehua, WANG Jinzhen, JIANG Yan

2025, 28(10): 1243-1248. DOI: 10.12114/j.issn.1007-9572.2023.0901

Asbtract ( )

HTML ( )

PDF (1681KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

With the development of society and the aging of the population, the demand for community medical services is increasing. As an important part of community medical service, the informationization level and information service ability of family doctors are of great significance to improve the quality and efficiency of community medical service.

Objective

To investigate the effect of the WeChat applet "Intelligent geographic information system (GIS) Family Doctor Information Platform" based on GIS in the application of family doctor contracting service.

Methods

from March to April 2023, among 27 family doctor teams in Zhujing Town, Jinshan District, Shanghai, 185 residents served by two neighbourhood family doctor teams and two rural family doctor teams were selected as the control group using stratified random sampling method, and 186 residents served by the same two neighbourhood family doctor teams and two rural family doctor teams were selected as the intervention group; the control group adopted the existing family doctor contracting management mode, and the intervention group adopted the existing family doctor contracting management mode. The control group adopts the existing family doctor contracting management model, while the intervention group develops a contracting service management model based on the "Intelligent GIS Family Doctor Information Platform" WeChat app on the basis of the existing management model. A retrospective data collection method was used to compare the family doctor contracting service before and after the use of the "Smart GIS Family Doctor Information Platform" WeChat app in the intervention group, as well as the knowledge, belief and behaviour of the residents in the control group and the intervention group, in order to analyse the "Smart GIS Family Doctor Information Platform" WeChat app to analyse the application effect of "Intelligent GIS Family Doctor Information Platform".

Results

The municipal contracting service assessment score of the intervention group was higher after using the "Smart GIS Family Doctor Information Platform" WeChat app (87.76±4.60) than before (63.65±4.53) (P<0.05) ; the score of the control group was higher than that of the intervention group after using the "Smart GIS Family Doctor Information Platform" WeChat app (63.65±4.53) (P<0.05) ; the score of the intervention group was higher than that of the control group after using the "Smart GIS Family Doctor Information Platform" WeChat app. The signing rate, community visit rate, family doctor visit rate, and the physical examination rate for signed individuals aged 65 and above for the control group are 41.70%, 26.67%, 3.30% and 71.43%, respectively. The contracting rate, community consultation rate, family doctor consultation rate, and contracted medical examination rate of people over 65 years old in the intervention group were 44.48%, 28.89%, 6.15%, and 74.02% respectively, and all the indicators of the intervention group were higher than those of the intervention group before the use of the WeChat applet of the "Intelligent GIS Family Physician Information Platform" (P<0.05). In the control group, the scores of knowledge, attitude and behaviour of family doctor contracting service were (8.14±1.46) (22.47±2.78) and (4.57±1.35), while in the intervention group, the scores of knowledge, attitude and behaviour of family doctor contracting service were (8.77±1.28) (23.54±1.98) and (4.97±1.17), respectively. The intervention group's scores on knowledge, attitude and behaviour of family doctor contracting service were higher than those of the control group (P<0.05) .

Conclusion

The application of "Intelligent GIS Family Doctor Information Platform" can improve the quality of the work of family doctor contracting service and enhance the residents'adherence to family doctor contracting service.

Construction Model and Optimization Strategy of Outpatient Clinics of Combination of General Practice and Specialty in the Community

SHI Jianjun, JIN Hua, LU Yuan, YU Dehua

2025, 28(10): 1249-1255. DOI: 10.12114/j.issn.1007-9572.2023.0424

Asbtract ( )

HTML ( )

PDF (1760KB) ( )

References | Related Articles | Metrics

The professional capacity and infrastructure of general practitioners in grass-roots medical and health institutions in China are relatively weak, and the energy of specialists in general hospitals is limited and resources are abundant. Strengthening the cooperation between general practitioners and specialists can effectively improve the quality of community medical care and promote the health of patients. This paper systematically sorts out the typical practices and experiences of the construction of outpatient clinics of integration of general practice and specialty, and takes the source, connotation, construction path and construction path of the concept of full-specialty combination of outpatient clinics development effectiveness, existing problems and strategic recommendations are elaborated. Point out the challenges that may be faced in the construction of outpatient clinics of integration of general practice and specialty management model. In addition, this paper summarizes the possible challenges of the construction of integrated outpatient clinics, and puts forward five suggestions for the different practice methods of integrated outpatient clinics in different regions: improve the rules and regulations for the construction of outpatient clinics of integration of general practice and specialty, coordinate and unify the outpatient path of outpatient clinics of integration of general practice and specialty, pay attention to the protection of outpatient clinics of integration of general practice and specialty teams, clarify the population of outpatient clinics of integration of general practice and specialty services, and improve the health evaluation system for the outcomes of outpatient clinics of integration of general practice and specialty. In order to provide reference for the country to carry out the construction of outpatient clinics of integration of general practice and specialty in depth. Further expanding the community service function and deepening the cooperation with specialist physicians is an important direction for the future exploration of the construction of outpatient clinics of integration of general practice and specialized health care service. The joint participation and promotion of the government, medical institutions and general and specialist physicians can better promote the construction and development of community general and specialized outpatient clinics.

Development Strategy of Community Specialized Diseases Diagnosis and Treatment Technology Combining General Practice and Specialist

YU Dehua

2025, 28(10): 1256-1258. DOI: 10.12114/j.issn.1007-9572.2023.0567

Asbtract ( )

HTML ( )

PDF (1503KB) ( )

References | Related Articles | Metrics

Primary healthcare institution undertakes a significant responsibility in medical and health provision. As the medical industry has undergone continuous development, which is evident in the obvious improvement of facilities and medical treatment environment of community health service institutions, and the effectively upgraded health information systems, the public's demand for specialized medical treatment in community health service institutions is becoming increasingly prominent. This article discusses the significance of developing specialized medical technology in community, the connotation of general-specialized combination, as well as the implementation strategies and methods. The article points out that the construction and development of specialized diagnosis and treatment technology in community health service centers can enhance the ability of community general practitioners to practice, improve the level of primary medical care technology, upgrade the level of community health services and meet the public's demand for specialized diagnosis and treatment. The goal of general-specialty integration can be achieved either by developing specialized diagnostic and treatment techniques on the basis of general practice, or by collaborating with higher-level hospitals to introduce a series of specialized techniques. In terms of specific implementation strategies, it is necessary to find appropriate specialized technologies according to the local needs, develop advanced technologies, carry out scientific research around specialized diseases, and build technical resources by opening specialized outpatient clinics, allocating medical conditions, etc., and cultivate community talents along with the four construction work, so as to implement the development strategy of the all-specialized combination of community diagnosis and treatment technologies in the four-plus-one way.

Empirical Exploration on the Collaboration of General Practice and Speciality in Chronic Disease Management: Taking the "Six Ones" Construction of Community Osteoarthritis Management as an Example

ZHANG Hanzhi, YU Dehua

2025, 28(10): 1259-1264. DOI: 10.12114/j.issn.1007-9572.2023.0350

Asbtract ( )

HTML ( )

PDF (1739KB) ( )

Figures and Tables | References | Related Articles | Metrics

At present, the collaboration of general practice and speciality has been applied to the diagnosis, treatment and management of various chronic diseases in the community based on the technical support of disease diagnosis and treatment and the implementation of hierarchical diagnosis and treatment. Based on the patient-centered, systematic and holistic thinking characteristics of general practice, the general practice team of Yangpu Hospital Affiliated to Tongji University explored and practiced a more comprehensive, in-depth and effective collaboration model of general practice and speciality around the multi-dimensional construction of 'six ones'. The construction of 'six ones' was based on the collaboration of general practice and speciality between general hospitals and community health service centers. Taking osteoarthritis (OA), a common chronic disease in the community, as an example, its contents and characteristics were as follows. (1) Establishment of a multidisciplinary team: the established team could rely on the basis of the three-dimensional integrated health care system of the general hospitals, to give play to the liaison and coordination role of general practice department in general hospitals, refine and coordinate the multidisciplinary division of labor; (2) Improvement of a set of diagnosis and treatment processes: improve a set of hierarchical diagnosis and treatment process for diseases based on scientific evidence, and evaluate the effectiveness of the diagnosis and treatment process, so that it could help to improve patients' symptoms and quality of life; (3) Development of an APP: the developed APP could cover multiple functions such as hierarchical diagnosis and management of OA patients, doctor-patient communication, popularization of science, appointment registration, and could record the complete diagnosis and treatment data in the exclusive information platform; (4) Designing a set of publicity and promotion programs: Publicize the program in multiple scenarios such as disease diagnosis and treatment, health examination and consultation in general hospitals and communities through a variety of forms of text, pictures and videos; (5) Establishment of a case database: establish a specific disease database for OA patients, continuously follow up patients and implement hierarchical management of the collected data, so as to provide more cases with general characteristics; (6) Construction of a set of curricula: the curriculum is built around OA specialties, including "bone pain as an undifferentiated disease in general practice" and "chronic disease management of OA", the course is conducted in the form of problem-oriented learning, outpatient consultation and teaching round demonstration, which was for multi-level training of undergraduate, graduate and continuing education. Taking the 'six ones' construction of OA management in the community as an example, the practice of the collaboration of general practice and speciality for the management of chronic disease based on the thinking of general practice suggests the potential of comprehensive, in-depth cooperation and mutual promotion between the two sides in multiple dimensions of medicine, teaching and research, as well as the effectiveness of optimizing and integrating the team, technology and information support related to hierarchical disease management for promoting the physical and mental health of patients.

A Network Meta-analysis of Primary Hypertension Management Patterns in China

GU Mingyu, QIN Tingting, QIAO Kun, BAI Xinyuan, WANG Yao, YANG Yutong, LI Xingming

2025, 28(10): 1265-1272. DOI: 10.12114/j.issn.1007-9572.2022.0872

Asbtract ( )

HTML ( )

PDF (2309KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

Hypertension as a risk factor can significantly increase the morbidity and mortality of cardiovascular and cerebrovascular diseases, and effective control of hypertension is the key to prevent and treat cardiovascular diseases.

Objective

Collect literature on the evaluation of the effectiveness of hypertension management models in China. Evaluate the management effects of different models and provide a reference for further optimization of hypertension management models.

Methods

Using StataSE-64, a network Meta-analysis of the 18 included hypertension management model papers was performed using blood pressure control rates as an evaluation metric. The models included five models: joint hospital-community management, community management, hospital treatment management, general management, and combined Internet management.

Results

Joint hospital-community management, community management, hospital management, and combined Internet management are all effective for hypertension control. The order is joint hospital-community management ≈ combined Internet management> hospital treatment management>community management>blank control. Among them, the joint hospital-community management model has significant effect on hypertension control; the joint hospital-community management model and combined Internet management has similar effect; and hospital management has better effect than community management.

Conclusion

In order to improve the hypertension management model, the construction of hospital-community-family management model in primary health care institutions should be promoted, and the combination of chronic disease management model and combined Internet model should be guided to strengthen the whole-life, whole-cycle management of chronic disease patients.

Cognition and Experience of Social Participation in Stroke Survivors: a Meta-synthesis Based on Qualitative Studies

ZHAO Zhixin, MEI Yongxia, WANG Xiaoxuan, JIANG Hu, WANG Wenna, ZHANG Zhenxiang

2025, 28(10): 1273-1280. DOI: 10.12114/j.issn.1007-9572.2023.0267

Asbtract ( )

HTML ( )

PDF (2044KB) ( )

Figures and Tables | References | Related Articles | Metrics

Background

As one of the important evaluation indicators of rehabilitation effect in stroke survivors, social participation has gradually attracted attention. Understanding the cognition and experience of social participation in stroke survivors is beneficial in helping stroke survivors recover quickly, return to families and reintegrate into society. However, the results of single qualitative studies may not be generalisable and representative.

Objective

To systematically review the qualitative studies on cognition and experience of social participation in stroke survivors by meta-synthesis methods, so as to provide a reference for further improving the rehabilitation effect of stroke survivors.

Methods

PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CINAHL, JBI evidence-based health care database, CNKI, Wanfang Data, VIP and CBM were searched by computers to screen qualitative studies on cognition and experience of social participation in stroke survivors from inception to November 2022. Pooled meta-integration method was used to perform the meta-synthesis of research themes, implications, classifications and so on.

Results

A total of 14 papers were included, involving 183 stroke survivors, and 26 findings were derived from meta-synthesis, which were summarized into 8 new categories, and 3 integrated findings were finally synthesized, including cognition and experience of social participation in stroke survivors, multiple social participation were limited in stroke survivors by multiple factors, multiple support for social participation was essential in stroke survivors.

Conclusion

Stroke survivors have new insights into social participation, and it is necessary to correct and eliminate the self-identification disorder and limiting factors of social participation, and focus on multi-party support of social participation in stroke survivors.

Research on the Multidimensional Frailty in Community-dwelling Older Adults

ZHAO Linlin, LUO Qi, HU Qinghua, CHEN Xiaolei, DU Juan, SHAO Shuang

2025, 28(10): 1281-1288. DOI: 10.12114/j.issn.1007-9572.2023.0719

Asbtract ( )

HTML ( )

PDF (2043KB) ( )

References | Related Articles | Metrics

The concept landscape of frailty has evolved from a single dimension which emphasising predominantly physical frailty into a multidimensional concept encompassing physical, psychological and social frailty. Conducting researches on multidimensional frailty armong community-dwelling older adults is an important way to address the current fragmentation of community-based elderly care services and enhance the comprehensive health of this population. In this paper, firstly, we review the evolution of the concept of multidimensional frailty; secondly, classify and describe the multidi. mensional frailty assessment tools that can be applied to community-dwelling older adults; thirdly, analysis the influencing factors of multidimensional frailty in community-dwelling older adults as well as the interactions between the dimensions of frailty, finally, assess the predictive value of multidimensional frailty in community-dwelling older adults in relation to health outcomes. Existing evidences suggest that the multidimensional frailty is found to be the result of a combination of physiological, psychological, and social factors, and that assessing multidimensional frailty in community-dwelling older adults can predict a variety of health outcomes such as disability, disease risk, and mortality, and that the different dimensions of frailty are correlated and interact with each others. However, there is no a standardized tool for evaluating multidimensional frailty in the community-dwelling older adults, and the underlying mechanisms of its occurrence and development have not been clarified. So, the follow-up studies could explore the developmental trajectory of multidimensional debility based on large prospective cohort studies, in order to provide a referable basis for the development of intervention strategies to reverse or delay the frail process in community-dwelling older adults.

Table of Content