BackgroundAlthough China’s modern education for public health was developing over the past 60 years, there is a lack of authoritative statistics and analyses on the nation’s development of education for public health at higher education institutions (HEIs). Few quantitative studies on this topic have been published in domestic and international peer-reviewed journals. To address this knowledge gap, we aimed to use national data to quantitatively analyse the scale, structure, and changes of public health education in China’s HEIs, and to compare the changes of public health education with those of other health science disciplines.MethodsThis study uses previously unreleased national data provided by the Ministry of Education of China that includes the number of health professional students by school and major. The data, which spans from 1998 to 2012, are descriptively analyzed.ResultsThe number of HEIs for public health education per 100 million population increased from 7.2 in 1998 to 11.3 in 2012. The total enrolment, number of students, and number of graduates increased at rates of 7.3, 7.4, and 5.8% per year, respectively. The percentage of junior college students dropped drastically from 24.0 to 8.4% from 1998 to 2012. During that same period, the number of undergraduates, master and doctorate students increased. Undergraduates accounted for the majority of public health graduates (63.1%) in 2012, and master and doctorate students increased by 10.0 and 5.1 times, respectively, from 1998 to 2012. The relative percentage of public health enrollment, students, and graduates to all health education disciplines dropped from about 6.0% percent in 1998 to around 2% in 2012.ConclusionsThe overall scale of public health education has clearly expanded, though at a slower pace than many other health science disciplines in China. The increase of public health graduates helped to address the previous shortage of public health professionals. Gradually adopting a modern model of education, public health education in China has undergone notable changes that may be informative to other developing countries though it still faces a complex situation in terms of graduates’ adherence to public health, student recruitment, teaching and training, program planning and reform.

Background This study describes the implementation of an electronic medical record (EMR)‐based initiative aimed at identifying and reducing the number of patients with diabetic retinopathy (DR) lost to follow‐up (LTF). Method Providers were enlisted to review the EMRs and re‐engage patients with DR seen 1 year prior and who had not returned for care within the past 6 months. Binary logistic regression analysis was used to identify demographic, clinical and sociomedical factors associated with being LTF, as well as those predictive of re‐engagement. Results Out of 673 patients with DR, 78 (12%) were identified as LTF. Patients LTF were more likely to be younger (p = 0.001) and have poorly controlled haemoglobin A1c (HbA1c ≥ 8%, p = 0.04) and cholesterol (LDL ≥ 100 mg/dL, p < 0.001) levels. These patients were also more likely to have completed fewer ophthalmology appointments (p < 0.001), and less likely to have had retinal imaging within the last year (p < 0.001). Charts reviewed 1 month after the EMR‐based initiative revealed that 22 patients (28%) had been successfully re‐engaged by providers, while 56 patients (72%) remained LTF. History of prior treatment for DR was associated with re‐engagement by providers (p = 0.04). One month following the provider‐based intervention, the LTF rate dropped to 8.3%, and by 1 year only 3.6% of the patients remained LTF. Conclusions Electronic medical record‐based tools can successfully identify DR patients as being LTF, offering an opportunity for providers to re‐engage patients in a timely manner. Future studies are needed to determine the long‐term impact of patient re‐engagement on DR outcomes and efficiency of clinical practice.

Having the two largest nursing workforces across the globe, both China and the United States have implemented licensure examinations to standardize the qualifications of registered nurse. China established the National Nursing Licensure Examination (NNLE) in 1995. Like the National Council Licensure Examination for Registered Nurses (NCLEX-RN) in the United States, the NNLE has become an important link in the nurse registration process and contributed a lot in quality assurance and development of nursing profession. It may be necessary for the NNLE to learn from NCLEX-RN in several aspects, including increasing the frequency of exam, providing examinees with individualized services, and continuing reforming exam content and format. By better aligning the content and format of the examination with the current nursing paradigm and clinical requirements, nurses may enter the healthcare field better prepared to care for patients. Considering the magnitude of their nursing workforce, both China and the United States have great potential to serve as a role model for other developing countries as they look towards establishing national nursing education programs. As new policies around standardized nurse education in China take form, we urge that the NNLE be included alongside curricular reforms. As these reforms are implemented, continued research will be needed to evaluate the effectiveness of curriculum and licensure exam regulations upon nurse preparedness and quality of nursing care in China.

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