Ranking the Healthcare Resource Factors for Public Satisfaction with Health System in China-Based on the Grey Relational Analysis Models

Smoking Bans and Circulatory System Disease Mortality Reduction in Macao (China): Using GRA Models

This study evaluates the association between smoking rates and mortality from circulatory system diseases (CSD) after implementing a series of smoking bans in Macao (China). (1) Background: Macao phased in strict total smoking bans since 2012. During the past decade, smoking rates among Macao women have dropped by half. CSD mortalities in Macao also show a declining trend. (2) Method: Grey relational analysis (GRA) models were adopted to rank the importance of some key factors, such as income per capita, physician density, and smoking rates. Additionally, regressions were performed with the bootstrapping method. (3) Results: Overall, smoking rate was ranked as the most important factor affecting CSD mortality among the Macao population. It consistently remains the primary factor among Macao's female population. Each year, on average 5 CSD-caused deaths were avoided among every 100,000 women, equivalent to about 11.45% of the mean annual CSD mortality. (4) Conclusions: After the implementation of smoking bans in Macao, the decrease in smoking rate among women plays a primary role in the reduction in CSD mortality. To avoid excess CSD mortality due to smoking, Macao needs to continue to promote smoking cessation among the male population.

Identification and Prioritization of Critical Factors Affecting the Performance of Iranian Public Hospitals Using the Best-Worst Method: A Prospective Study

BACKGROUND

In the ever-changing healthcare environment, policymakers and managers need a comprehensive evaluation system to accurately identify and prioritize factors affecting hospital performance. The present study aimed to identify and rank critical factors affecting hospital performance using the best-worst method (BWM).

METHODS

A cross-sectional study was conducted during 2016-2019 to identify and prioritize factors affecting the performance of Iranian public hospitals using the BWM. Initially, the content validity ratio (CVR) was used to screen the identified factors. Then, using a linear programming formula, a pairwise comparison between the best/worst criterion with all other identified criteria was performed.

RESULTS

The most important internal factor was efficiency, and its associated indicators were mainly related to financial factors. Among all external factors, the most prominent were economic, legal, and political factors, which were negatively affected by budgeting policies and the payment system. A megatrend was also identified in the form of a national health insurance system as well as a shift from employer-based to government-subsidized insurance coverage.

CONCLUSION

External factors (economic and political) had a greater impact on the performance of public hospitals than internal factors (efficiency and effectiveness). A preprint of this study was published at https://www.researchsquare.com/article/rs-453223/v1 with doi: 10.21203/rs.3.rs-453223/v1.

Conflict or Coordination? Spatiotemporal Coupling of Urban Population-Land Spatial Patterns and Ecological Efficiency

The coordinated relationship between urban population–land spatial patterns (UPLSPs) and ecological efficiency (EE) is conducive not only to the rational utilization of resources and environment and the sustainable development of society, but also to the provision of a living environment that benefits public health. Identifying the coupling relationship of urban development and EE can provide critical information for urban planning. Previous studies have mainly focused on the coupling relationship between urban population and land, urbanization, and ecological development, while ignoring that between UPLSPs and EE. This study integrates several models to construct a novel framework for coupling UPLSPs and EE. Taking Hubei Province as the research area, we calculate the UPLSPs, EE, and their coupling coordination degree for 12 cities from 2000 to 2019. The paper offers several conclusions. (1) the urban population–land spatial matching degree increased, but the overall matching level was not high; the average value of EE showed an “N”-shaped change trajectory, and its overall level was low, with small changes and obvious regional differences. (2) The average value of the coupling coordination degree between UPLSPs and EE was a slow upward trend, with a radial distribution high in the middle and low in the periphery. There was conflict between the spatial patterns and EE, and the former restricted the development of the latter. (3) There were strong correlations between coordination degree and various indicators of UPLSPs and EE. While we should revitalize the stock of construction land and optimize the upgrading of the industrial structure, we also must coordinate human and land resources and the ecological environment, and narrow regional development differences. This study provides a new framework for urban environmental assessment and urban planning decision-making.

Evaluation of the quality of COVID-19 prevention and control by a novel comprehensive evaluation model in a tertiary general hospital: a prospective observational study

BACKGROUND

Prevention and control (P&C) of Corona Virus Disease 2019 (COVID-19) is still a critical task in most countries and regions. However, there are many single evaluation indexes to assess the quality of COVID-19 P&C. It is necessary to synthesize the single evaluation indexes reasonably to obtain the overall evaluation results.

METHODS

This study was divided into three steps. Step 1: In February 2020, the improved Delphi method was used to establish the quality evaluation indexes system for COVID-19 P&C. Step 2: in March 2020, the CRITIC method was used to adjust the Order Relation Analysis (G1) method to obtain the subjective and objective (S&O) combination weights. The comprehensive evaluation value was obtained using the weighted Efficacy Coefficient (EC) method, weighted TOPSIS method, weighted rank-sum ratio (RSR) method, and weighted Grey Relationship Analysis (GRA) method. Finally, the linear normalization method was used to synthesize the evaluation values of different evaluation methods. Step 3: From April 2020 to May 2021, this evaluation method was used to monitor and assess COVID-19 P&C quality in critical departments prospectively. The results were reported to the departments monthly.

RESULT

A quality evaluation indexes system for COVID-19 P&C was established. Kendall's consistency test shows that the four evaluation method had good consistency (χ² = 43.429, P<0.001, Kendall's consistency coefficient = 0.835). The Spearman correlation test showed that the correlation between the combined evaluation results and the original method was statistically significant(P < 0.001). According to the Mann-Kendall test, from March 2020 to May 2021, the mean value of COVID-19 P&C quality in all critical departments showed an upward trend (P < 0.01).

CONCLUSIONS

The combined comprehensive evaluation method based on the S&O combined weight was more scientific and comprehensive than the single weighting and evaluation methods. In addition, monitoring and feedback of COVID-19 P&C quality were helpful for the improvement of P&C quality.

Prediction and Analysis of Tourist Management Strategy Based on the SEIR Model during the COVID-19 Period

Tourism destinations are now facing a dilemma choice of controlling the epidemic or developing the economy. This paper takes Macao, a typical international tourist city, as an example to study the strategy of tourist source control during the COVID-19 period. According to the published epidemic data of Macao, this study has established an improved SEIR (Susceptible-Exposed-Infected-Recovered) model, formulated six control strategies against the current epidemic, and used the model above to simulate the time required for all confirmed cases to recover and discharge under different strategies. By taking into consideration the gross revenue of Macao's gambling industry from 2017 to 2019, the impact of different strategies on the economy is predicted and three control strategies are found to be feasible. This study shows that an effective way to break through the above dilemma is to design the tourist management strategy by screening the source of passengers and controlling the upper limit of capacity of destination. These findings provide a scientific basis for tourism destinations in formulating public policies. The improved SEIR model is more consistent with the actual conversion rule of patients in the current COVID-19 epidemic, and it can be applied to further public health related research.