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Xiao F, Mei L, Jiang Q. Urban-rural differences in China's crude death rate changes. BMC Public Health 2022; 22:399. [PMID: 35216580 PMCID: PMC8881871 DOI: 10.1186/s12889-022-12717-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND From 1982 to 2010, the country's crude death rate (CDR) dropped sharply, fluctuated, and finally slightly declined. There is a big difference in CDR between urban and rural areas. From 1982 to 1990, the CDR in the country and the countryside declined, and the CDR in cities and towns rose. After 1990, the CDR in cities gradually decreased, the CDR in towns first fell and then rose, and the CDR in the countryside steadily increased. The CDR is affected by changes in the age-specific death rate (ASDR) and age structure. METHODS This paper decomposes CDR changes into the influence of declines in ASDR and the impact of age structure changes based on 1982, 1990, 2000, and 2010 census data. RESULTS The decline in ASDR reduces the CDR, and the aging population increases the CDR (including cities, towns, and the countryside). At the same time, decomposing the difference between the countryside and cities (or the countryside and towns) CDRs found that after 1990, the influence of ASDR differences and age structure differences increased with time. Our results revealed a more significant effect of ASDR differences. The combined effect of two factors (ASDR and age structure) makes the 0, 1-14, 15-64 age groups reduce the CDR, and the 65+ age group increases the CDR. In addition, the 0-year-old group has a not negligible impact on the changes in CDR, although it accounts for a small proportion of the total population. CONCLUSIONS The influence of ASDR and age structure differs over time (1982 to 1990, 1990 to 2000, and 2000 to 2010) and across regions (cities, towns, the countryside). Considering the slow decline in ASDR and the accelerated aging population, we can infer that the CDR in 2020 will stabilize or even rise slightly instead of dropping significantly (compared with the CDR in 2010). This study provides a basis for the formulation of relevant public health policies.
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Affiliation(s)
- Fan Xiao
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, No.28 Xianning West Road, Xi'an, Shaanxi, China
| | - Li Mei
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, No.28 Xianning West Road, Xi'an, Shaanxi, China
| | - Quanbao Jiang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, No.28 Xianning West Road, Xi'an, Shaanxi, China.
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Santosa A, Zhang Y, Weinehall L, Zhao G, Wang N, Zhao Q, Wang W, Ng N. Gender differences and determinants of prevalence, awareness, treatment and control of hypertension among adults in China and Sweden. BMC Public Health 2020; 20:1763. [PMID: 33228600 PMCID: PMC7685617 DOI: 10.1186/s12889-020-09862-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background Failure to promote early detection and better management of hypertension will contribute to the increasing burden of cardiovascular diseases. This study aims to assess the gender differences in the prevalence, awareness, treatment and control of hypertension, together with its associated factors, in China and Sweden. Methods We used data from two cross-sectional studies: the Västerbotten Intervention Program in northern Sweden (n = 25,511) and the Shanghai survey in eastern China (n = 25,356). We employed multivariable logistic regression to examine the socio-demographics, lifestyle behaviours, and biological factors associated with the prevalence, awareness, treatment and control of hypertension. Results Men had a higher prevalence of hypertension (43% in Sweden, 39% in China) than their female counterparts (29 and 36%, respectively). In Sweden, men were less aware of, less treated for, and had less control over their hypertension than women. Chinese men were more aware of, had similar levels of treatment for, and had less control over their hypertension compared to women. Awareness and control of hypertension was lower in China compared to Sweden. Only 33 and 38% of hypertensive Chinese men and women who were treated reached the treatment goals, compared with a respective 48 and 59% in Sweden. Old age, impaired glucose tolerance or diabetes, a family history of hypertension or cardiovascular diseases, low physical activity and overweight or obesity were found to increase the odds of hypertension and its diagnosis. Conclusions This study shows the age and gender differences in the prevalence, awareness, treatment and control of hypertension among adults in China and Sweden. Multisectoral intervention should be developed to address the increasing burden of sedentary lifestyle, overweight and obesity and diabetes, all of which are linked to the prevention and control of hypertension. Development and implementation of the gender- and context-specific intervention for the prevention and control of hypertension facilitates understanding with regard to the implementation barriers and facilitators. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09862-4.
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Affiliation(s)
- Ailiana Santosa
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, 90187, Umeå, Sweden.,Global Public Health, School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
| | - Yue Zhang
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Lars Weinehall
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, 90187, Umeå, Sweden
| | - Genming Zhao
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Na Wang
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Qi Zhao
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Weibing Wang
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China.
| | - Nawi Ng
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, 90187, Umeå, Sweden. .,Global Public Health, School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden.
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Lu L, Zeng J. Inequalities in the geographic distribution of hospital beds and doctors in traditional Chinese medicine from 2004 to 2014. Int J Equity Health 2018; 17:165. [PMID: 30419919 PMCID: PMC6233493 DOI: 10.1186/s12939-018-0882-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/28/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives This study identifies inequities in the provincial-level geographical distribution of traditional Chinese Medicine (TCM) hospital beds and doctors in China from 2004 to 2014. This provides policy implications of the optimal allocation of TCM health care resources. Methods Our study used province level data on TCM hospital beds and doctors from 2004 to 2014. These data were obtained from the China TCM Yearbook 2004–2014 and the China Statistical Yearbook 2004–2014.Global and local spatial autocorrelation was performed by using Moran’s index and the local Moran’s index to describe the spatial distribution of TCM hospital beds (doctors) as well as their density. A Gini coefficient was used to estimate inequalities in the geographic distribution of TCM hospital beds (doctors) based on their density. Correlations of the Gini coefficients between TCM hospital beds and doctors were calculated by Pearson correlation analysis. Results All indicators of TCM hospital beds and doctor density have increased over the past 11 years. The number of TCM hospital beds per 10,000 populations increased the fastest. Geographical clustering was not obvious in the density distribution of TCM hospital beds or doctors, as no significant spatial autocorrelation was found. Gini coefficients showed that from 2004 to 2014 the distribution of TCM hospital beds per 10,000 population and doctors per 10,000 populations were equitable between different regions. A large gap existed in the distribution inequality of TCM hospital beds (doctors) per square kilometer among different regions. Conclusion Targeted health policy with equitable distribution of TCM hospital beds (doctors) per square kilometer and the balance and coordination of related resources should be a priority in shaping China’s healthcare system reform.
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Affiliation(s)
- Liming Lu
- Clinical Research Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
| | - Jingchun Zeng
- Department of Acupuncture, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
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Ling DL, Lyu CM, Liu H, Xiao X, Yu HJ. The necessity and possibility of implementation of nurse prescribing in China: An international perspective. Int J Nurs Sci 2018; 5:72-80. [PMID: 31406805 PMCID: PMC6626201 DOI: 10.1016/j.ijnss.2017.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/07/2017] [Accepted: 12/28/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The number of countries where nurses are legally permitted to prescribe has grown rapidly due to a variety of external and internal forces. Despite its international popularity, nurse prescribing has not yet been implemented in China widely. OBJECTIVE The intent of this paper is to review the current international literature regarding nurse prescribing so as to explore the necessity and possibility of implementation of nurse prescribing in China and classify the research gap. METHODS Eight electronic databases including Embase, SpringerLink, EBSCO, CINAHL, Medline, Wiley, Science Direct, CochraneLibrary were electronically searched to identify related peer-review articles published in the English language only from 2007 to 2017. Relative references found from the identified studies were traced back to ensure that potentially eligible articles were included. RESULTS Thirty-three publications which met the inclusion criteria were included in this literature review. The literature shows that not only could nurse prescribing provide quicker service, improvements in quality, but also could make better utilization of the nurses' professional skills and increase nurses' autonomy. Moreover, the barriers of nurse prescribing are explored to identify the factors that may facilitate the success of its implementation. CONCLUSION The review advises that nurses' views towards nurse prescribing have played a significant role in the success of nurse prescribing. While no literature regarding Chinese nurses' attitudes towards nurse prescribing could be identified, it is imperative to examine their attitudes on it. This would help Chinese healthcare policymakers ascertain the necessity of the introduction of nurse prescribing and provide them with valuable information for service planning.
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Affiliation(s)
- Dong-Lan Ling
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chun-Mei Lyu
- The First People's Hospital of Foshan, Foshan, Guangdong Province, China
| | - Hui Liu
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Xiao Xiao
- Southern Medical University Affiliated Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Hong-Jing Yu
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Liu S, Li C, Shi Z, Wang X, Zhou Y, Liu S, Liu J, Yu T, Ji Y. Caregiver burden and prevalence of depression, anxiety and sleep disturbances in Alzheimer's disease caregivers in China. J Clin Nurs 2016; 26:1291-1300. [PMID: 27681477 DOI: 10.1111/jocn.13601] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 01/07/2023]
Affiliation(s)
- Shuai Liu
- Department of Neurology and Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases; Tianjin Dementia Institute; Tianjin Huanhu Hospital; Tianjin China
| | - Chonghui Li
- Yanbian Hospital of Traditional Chinese Medicine & Yanji Hospital of Traditional Chinese Medicine; Jilin China
| | - Zhihong Shi
- Department of Neurology and Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases; Tianjin Huanhu Hospital; Tianjin China
| | - Xiaodan Wang
- Department of Neurology and Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases; Tianjin Huanhu Hospital; Tianjin China
| | - Yuying Zhou
- Department of Neurology and Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases; Tianjin Huanhu Hospital; Tianjin China
| | - Shuling Liu
- Department of Neurology and Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases; Tianjin Huanhu Hospital; Tianjin China
| | - Jing Liu
- Tianjin University of Traditional Chinese Medicine; Tianjin China
| | - Tao Yu
- Rehabilitation Department; First Teaching Hospital of Tianjin University of Traditional Chinese Medicine; Tianjin China
| | - Yong Ji
- Department of Neurology and Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases; Tianjin Dementia Institute; Tianjin Huanhu Hospital; Tianjin China
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Sun J, Shen X, Li M, He L, Guo S, Skoog G, Grape M, Cars O, Dong S. Changes in patterns of antibiotic use in Chinese public hospitals (2005-2012) and a benchmark comparison with Sweden in 2012. J Glob Antimicrob Resist 2015; 3:95-102. [PMID: 27873677 DOI: 10.1016/j.jgar.2015.03.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 02/20/2015] [Accepted: 03/01/2015] [Indexed: 10/23/2022] Open
Abstract
Changes in patterns of antibiotic use in Chinese hospitals before and after intensive nationwide interventions are reported and compared with Chinese national targets and antibiotic use in Swedish hospitals. Chinese data were collected quarterly and yearly from selected patient prescriptions/medical records and medicines inventory control systems from 15 hospitals (2005-2012). Swedish data were extracted from a 2010-point prevalence survey and 2009-2012 sales data from seven university hospitals. An interrupted time series with segmented regression analysis was used to measure changes in patterns of antibiotic use in Chinese hospitals before and after the interventions. Following the 2011 interventions, significant reductions in antibiotic use in Chinese hospitals were seen: the proportion of prescriptions with antibiotics decreased 4.7% (P=0.03) and the proportion of medical records with antibiotic prescription decreased 7.3% (P=0.04). The proportions of prescriptions and medical records with antibiotics in Chinese hospitals in 2012 were 10% and 50%, respectively, and remained much higher than Swedish hospitals (1.1% in DDD for outpatients and 34% in number of patients for inpatients). Inpatient consumption in Chinese hospitals dropped significantly from 910 DDD/1000 inpatient days in 2008 to 473 in 2012 (588 in Swedish hospitals). Antibiotics are being used less frequently in Chinese hospitals, broad-spectrum antibiotics are still preferred, and overall usage is higher than Sweden. A significant reduction in overall inpatient antibiotic consumption was observed after the interventions. It is not possible to identify whether the changes have resulted in less inappropriate antibiotic use. Further studies are needed.
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Affiliation(s)
- Jing Sun
- Department of Health Science, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
| | - Xiao Shen
- School of Political Science and Public Administration, Wuhan University, Luojiashan, Wuchang District, Wuhan 430072 Hubei Province, People's Republic of China
| | - Meng Li
- National Institute of Hospital Administration, National Health and Family Commission of P.R. China, 38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Liu He
- School of Political Science and Public Administration, Wuhan University, Luojiashan, Wuchang District, Wuhan 430072 Hubei Province, People's Republic of China
| | - Shuyan Guo
- National Institute of Hospital Administration, National Health and Family Commission of P.R. China, 38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Gunilla Skoog
- Antibiotics and Infection Control, Public Health Agency of Sweden, 18 SE-171 82 Solna, Sweden
| | - Malin Grape
- Antibiotics and Infection Control, Public Health Agency of Sweden, 18 SE-171 82 Solna, Sweden
| | - Otto Cars
- Antibiotics and Infection Control, Public Health Agency of Sweden, 18 SE-171 82 Solna, Sweden; ReAct - Action on Antibiotic Resistance, Uppsala University, Box 256, SE-751 05 Uppsala, Sweden
| | - Siping Dong
- National Institute of Hospital Administration, National Health and Family Commission of P.R. China, 38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China.
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