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Huang R, Li W, Shi B, Su H, Hao J, Zhao C, Chai J. Evaluating China's primary healthcare services' efficiency and spatial correlation: a three-stage DEA-Malmquist model. Front Public Health 2024; 12:1366327. [PMID: 38962768 PMCID: PMC11220123 DOI: 10.3389/fpubh.2024.1366327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/23/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Enhancing the efficiency of primary healthcare services is essential for a populous and developing nation like China. This study offers a systematic analysis of the efficiency and spatial distribution of primary healthcare services in China. It elucidates the fundamental landscape and regional variances in efficiency, thereby furnishing a scientific foundation for enhancing service efficiency and fostering coordinated regional development. Methods Employs a three-stage DEA-Malmquist model to assess the efficiency of primary healthcare services across 31 provincial units in mainland China from 2012 to 2020. Additionally, it examines the spatial correlation of efficiency distribution using the Moran Index. Results The efficiency of primary healthcare services in China is generally suboptimal with a noticeable declining trend, highlighting significant potential for improvement in both pure technical efficiency and scale efficiency. There is a pronounced efficiency gap among provinces, yet a positive spatial correlation is evident. Regionally, efficiency ranks in the order of East > Central > West. Factors such as GDP per capita and population density positively influence efficiency enhancements, while urbanization levels and government health expenditures appear to have a detrimental impact. Discussion The application of the three-stage DEA-Malmquist model and the Moran Index not only expands the methodological framework for researching primary healthcare service efficiency but also provides scientifically valuable insights for enhancing the efficiency of primary healthcare services in China and other developing nations.
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Affiliation(s)
- Rui Huang
- Department of Management, School of Management, Minzu University of China, Beijing, China
| | - Wan Li
- Department of Management, School of Management, Minzu University of China, Beijing, China
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Hao Su
- Department of Management, School of Management, Minzu University of China, Beijing, China
| | - Jing Hao
- Department of Management, School of Management, Minzu University of China, Beijing, China
| | - Chuanjun Zhao
- Department of National Security, School of National Security, Minzu University of China, Beijing, China
| | - Juhong Chai
- Department of Management, School of Management, Minzu University of China, Beijing, China
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Lau LCM, Chau WW, Ng R, Ng JP, Chui ECS, Ong MTY, Griffith JF, Yung PSH. Reconsidering "Critical" Bone Loss in Shoulder Instability: 17-Year Follow-Up Study following Arthroscopic Bankart Repair. Adv Orthop 2024; 2024:5598107. [PMID: 38328468 PMCID: PMC10849799 DOI: 10.1155/2024/5598107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/30/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
Background Glenoid bone loss is a risk factor leading to the failure of arthroscopic Bankart repair. While 20-25% glenoid bone loss has long been considered the level to necessitate bony augmentation, recent studies indicate that 13.5% has a "subcritical" glenoid bone loss level, which is associated with decreased short- and medium-term functional scores. Few researchers worked on the long-term effect of "subcritical" or even less severe degrees of glenoid bone loss on redislocation rates and functional outcomes after arthroscopic Bankart repair. This study aimed to evaluate the effect of subcritical or less severe glenoid bone loss on redislocation rates and function after arthroscopic Bankart repair. Methods A patient cohort who had undergone computed tomography (CT) of glenoid bone loss and arthroscopic Bankart repair over 15 years ago was reviewed. Western Ontario Shoulder Instability (WOSI) score, Single Assessment Numeric Evaluation (SANE) score, redislocation after operation, mechanism of recurrence, and revision details were reviewed. Results Seventy-five patients were reassessed 17.6 ± 1.9 years following initial surgery. The age at enrolment was 26.8 ± 8.3 years. Twenty-two (29%) patients of the 75 patients had a redislocation on long-term follow-up, though this was not related to glenoid bone loss severity. The impaired functional score was found in patients with initial glenoid bone loss of 7% or more on long-term follow-up: WOSI (physical symptoms): 0.98 ± 2.00 vs 2.25 ± 4.01, p=0.04 and WOSI (total): 0.79 ± 1.43 vs 1.88 ± 3.56, p=0.04. Conclusions At a mean of 17.5 years following arthroscopic Bankart repair, redislocation occurs in over a quarter of 75 patients, and they are not related to initial glenoid bone loss severity. Impaired functional outcome is apparent in patients with initial glenoid bone loss of >7%, though this impairment does not seem sufficiently severe to warrant an alternative treatment approach.
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Affiliation(s)
- Lawrence Chun-Man Lau
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wai-Wang Chau
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Randy Ng
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jonathan Patrick Ng
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Elvis Chun-Sing Chui
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Michael Tim-Yun Ong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - James Francis Griffith
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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