Background & Objective: In recent years there have been many cases of violence against healthcare professionals (HCPs) in China leading to the death of some doctors as well as nurses by patient’s relatives. Our objective was to identify the causative factors for these violent acts and address these isssues which is vital to ensure patient safety.Methods:A multidisciplinary research task force was formed to do a root cause analysis of the violent acts against the healthcare professionals. A flowchart was developed to identify the steps in the process and discover the potential links.Results:There are complex reasons behind the violence against HCPs. However, the main reasons were found to be poor quality of medical services and increased awareness of patients’ rights and their willingness to knock at the doors of courts to seek justice. The feasible counter measures includes stimulating hospital directors to improve patient safety, aligning incentives with quality of service provided in healthcare facilities, monitoring educational quality of HCPs, making necessary changes in medical education programmes besides setting up a reasonable academic promotion mechanism for health professionals based on merit and competence.Conclusion: Poor quality of medical services, increased awareness among patients about their rights has resulted in increase in medical disputes and at times violence against healthcare professionals. A number of effective measures can be undertaken by the government, hospitals, and medical schools ensuring patient safety. However, it is essential to sensitize the hospital directors to elevate their quality of medical services.
Background Tuberculosis (TB) remains a significant global public health problem. China has the second highest TB burden in the world. With a growing TB population with diabetes mellitus (DM), the TB control system faces mounting challenges. To date, evidence remains inconclusive regarding the association between TB-DM co-morbidity and delayed diagnosis of TB patients. This study aims to assess the diagnostic delay of TB patients with known DM and identify the factors associated with this delay. Methods Data was collected from China’s Tuberculosis information management system in two counties of Zhejiang province, China. Patient delay, health system delay and total diagnostic delay are defined as follows: 1) the interval between the onset of TB symptoms and first visit to any health facility; 2) from the first visit to the health facility to the confirmed TB diagnosis in the designated hospital; 3) the sum of patient and health system’s respective delays. Comparison of these delays was made between TB patients with and without DM using Mann-Whitney U test and Chi-square test. Univariate and multivariate regression analysis was used to identify factors influencing delays among TB patients with DM. Results Of 969 TB patients, 67 (7%) TB patients had DM co-morbidity. Compared with TB patients without DM, TB patients with DM experienced significantly shorter health system delays (p < 0.05), and there was a significantly lower proportion of patients whose health system delayed> 14 days (7.0% vs. 18%, p < 0.05). However, no significant difference was observed between both patient categories regarding patient delay and total diagnostic delay. The multivariate regression analysis suggested that TB patients with DM who were aged < 60 years (AOR = 3.424, 95%CI: 1.008–11.627, p < 0.05) and non-severe cases (AOR = 9.725, 95%CI: 2.582–36.626, p < 0.05) were more likely to have a total diagnostic delay of> 14 days. Conclusions Our study suggests that DM does not contribute to further diagnostic delay as expected. Instead, we observed significantly improved health system delay among TB patients with DM. The findings indicate the importance of early screening and diagnosis for TB among diabetic patients and of strengthening the integrated control and management of TB and diabetic programs.
BackgroundHealth and education are two closely related factors that affect human development. A limited number of studies have been conducted in China, most of which have been based on small sample sizes and with inconsistent results. The study investigates the association between mortality rate and educational level in China based on the sixth national population census in 2010.MethodsThis is large-scale population study based on the nationally administrated data sets of population census in 2010, 2000 and 1990. The 2010 census covered a total population of 1 332 810,869 in China.ResultsIn general, standardized mortality rate decreased as educational level increased. The standardized mortality rate is higher among males than among females with equivalent educational levels. The standardized mortality rate in all the educational groups declined to varying degrees from 1990. 2000 to 2010. The standardised mortality rate declined with increasing educational levels from no education to university undergraduate groups in 1990, 2000 and 2010. The standardized mortality rate declined as the degree of education increased in cities, towns, and villages, but gradually increased at the same educational level from cities, towns, to villages in general. The difference in each region is considerable and the population quality of the developed area is generally high. The percentage of the uneducated population to the total population aged 15 years and over (%) was positively correlated with the standardized mortality rate. By contrast, the percentage of the population with a high school education to the total population aged 6 years and over (%) was negatively correlated with the standardized mortality rate.ConclusionsWe found that educational level was negatively correlated with the mortality rate. The crude and standardized death rate is lower among individuals with higher educational level. Together with previous research findings, this study indicates that improving total population education attainment remains an important challenge that requires imperative action, while reducing educational inequities remains crucial for the government.
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