Thinking on the informatization development of China's healthcare system in the post-COVID-19 era

Using a participatory design to develop an implementation framework for integrating falls prevention for older people within the Chinese primary health care system

BACKGROUND

Chinese National Essential Public Health Service Package (NEPHSP) has mandated primary health care providers to provide falls prevention for community-dwelling older people. But no implementation framework is available to guide better integration of falls prevention for older people within the primary health care system.

METHODS

This is a two-stage online participatory design study consisting of eight workshops with stakeholders from three purposively selected cities. First, two workshops were organised at each study site to jointly develop the framework prototype. Second, to refine, optimise and finalise the prototype via two workshops with all study participants. Data analysis and synthesis occurred concurrently with data collection, supported by Tencent Cloud Meeting software.

RESULTS

All participants confirmed that the integration of falls prevention for older people within the NEPHSP was weak and reached a consensus on five opportunities to better integrate falls prevention, including workforce training, community health promotion, health check-ups, health education and scheduled follow-up, during the delivery of NEPHSP. Three regional-tailored prototypes were then jointly developed and further synthesised into a generic implementation framework by researchers and end-users. Guided by this framework, 11 implementation strategies were co-developed under five themes.

CONCLUSIONS

The current integration of falls prevention in the NEPHSP is weak. Five opportunities for integrating falls prevention in the NEPHSP and a five-themed implementation framework with strategies are co-identified and developed, using a participatory design approach. These findings may also provide other regions or countries, facing similar challenges, with insights for promoting falls prevention for older people.

Effectiveness of tele-rehabilitation after total hip replacement: a systematic review and meta-analysis of randomized controlled trials

PURPOSE

To identify articles that evaluated the efficacy of tele-rehabilitation after total hip replacement and to provide a reference for clinical decision-making and continuous improvement of rehabilitation exercise intervention strategies for clinical medical staff.

METHODS

Embase, PubMed, Web of Science, Medline, China National Knowledge Network and Google Scholar databases were searched for randomized controlled trials of tele-rehabilitation after total hip replacement from inception to March 4, 2023. The two researchers used the PEDro scale to assess the methodological quality of the included studies. Two researchers used the PEDro scale to assess the methodological quality of the included studies.

RESULTS

Ten studies with 632 participants were analysed.Compared to face-to-face rehabilitation, Internet-based telerehabilitation showed better outcomes in Get-up and go test (SMD -0.54, 95% CI -0.79 to -0.29). telerehabilitation showed no significant difference in outcomes of other functional tests and functional questionnaires.

CONCLUSION

In this systematic review and meta-analysis, internet-based tele-rehabilitation and face-to-face rehabilitation had the same effect on patients after total hip replacement, and compliance was higher in the tele-rehabilitation group, but attention should be devoted to standardizing this form of rehabilitation to avoid adverse events. In addition, the number and quality of included studies in this study are limited, and the outcome indicators and intervention means have not been unified. More high-quality studies are needed to verify these conclusions to better evaluate the effectiveness and advantages of telerehabilitation.Implications for rehabilitationWith the development of science and technology, remote rehabilitation technology will be applied to various fields of rehabilitation, providing personalized and extensive rehabilitation services.The application of tele-rehabilitation technology to postoperative rehabilitation after total hip arthroplasty is feasible and can reduce the workload of healthcare professionals to a certain extent.This review evaluated the randomized controlled trials of telerehabilitation after total hip arthroplasty, and the results showed that the clinical efficacy of telerehabilitation after total hip arthroplasty was not inferior to that of traditional rehabilitation.

Insights from COVID-19: Reflecting on the Promotion of Long-Term Health Policies in China

China announced the Healthy China Initiative (2019-2030) in 2019, an action program aimed to support the country's current long-term health policy, Healthy China 2030, which focuses on public health promotion and health awareness. Following the implementation of the policy, China had the COVID-19 pandemic, which had an influence on both the public's degree of health awareness and the adoption of the HCI. This research examines whether the COVID-19 epidemic has increased public understanding and acceptance of China's long-term health policy. In addition, it analyzes whether the Chinese public's awareness of health policy has been impacted by China's usage of smart healthcare in its response to the pandemic. To correspond to these study aims, we used a questionnaire based on the research questions and recent relevant research. The results of the study, based on an examination of 2488 data, demonstrate that the Healthy China Initiative is still poorly understood. More than 70% of respondents were unfamiliar with it. However, the results imply that respondents are becoming more aware of smart healthcare and that public acceptance of official health policies can be aided by the sharing of knowledge about this. As a result, we examine the situation and draw the conclusion that the spread of cutting-edge health-related technology can enhance the communication of health policy and provide participants and policymakers with fresh insights. Finally, this study also can provide lessons for other countries in the early stages of policy dissemination, particularly health policy advocacy and promotion during epidemics.

Evaluation of the integration of industrialization and information-based entropy AHP–cross-efficiency DEA model

Purpose

The purpose of this paper is to provide scientific guidance for the integration of industrialization and information (TIOII). In recent years, TIOII has promoted the development of intelligent manufacturing in China. However, many enterprises blindly invest in TIOII, which affects their normal production and operation.

Design/methodology/approach

This study establishes an efficiency evaluation model for TIOII. In this paper, entropy analytic hierarchy process (AHP) constraint cone and cross-efficiency are added based on traditional data envelopment analysis (DEA) model, and entropy AHP–cross-efficiency DEA model is proposed. Then, statistical analysis is carried out on the integration efficiency of enterprises in Guangzhou using cross-sectional data, and the traditional DEA model and entropy AHP–cross-efficiency DEA model are used to analyze the integration efficiency of enterprises.

Findings

The data show that the efficiency of enterprise integration is at a medium level in Guangzhou. The efficiency of enterprise integration has no significant relationship with enterprise size and production type but has a low negative correlation with the development level of enterprise integration. In addition, the improved DEA model can better reflect the real integration efficiency of enterprises and obtain complete ranking results.

Originality/value

By adding the entropy AHP constraint cone and cross-efficiency, the traditional DEA model is improved. The improved DEA model can better reflect the real efficiency of TIOII and obtain complete ranking results.

Collaboration of issuing agencies and topic evolution of health informatisation policies in China

Digital transformation in the Chinese healthcare industry has led national government agencies to issue a series of policies to guide the construction of health informatisation. However, little is known about the issuing agencies and the topics of health informatisation policies. This study aimed to explore the collaboration of policies issuing and the evolution of policy topics. In this study, a total of 156 policy documents were identified. Author–Topic model and pre-discretised method based on Latent Dirichlet Allocation model were employed to mine the correlation between the issuing agencies and policy topics, and the evolution of policy contents. Findings suggest that the development of health informatisation policies can be divided into three stages. The number of policies has been increasing constantly, among which the policy of opinion and notification accounts for the vast majority. Many government agencies are involved in formulating policies collaboratively. On the whole, the topics changed constantly over time. From 2003 to 2008, policy topics focused on standards and specifications, with the phenomenon of splitting and development. From 2009 to 2014, policies were predominantly related to the construction of regional health informatisation, with some emerging topics generating. Internet + medical and new information technology gained attention from 2015 to 2020; most topics in this period were inherited, split or merged from the previous period. This study is helpful to research and formulation of the health informatisation-related policies.