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Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China.

ABSTRACT: BACKGROUND:Traditional "inverted triangle" healthcare resources allocation model in China has wasted a lot of health resources. The Chinese health reform began to strengthens the role of the primary health institutions in delivering primary health care especially in rural areas in the background of large development gap between urban-rural health and rapid growth in the incidence of chronic diseases in rural. We take hypertensive patients as an example, to verify the effect of policy implementation through distribution characteristics of rural primary health institutions preference of hypertensive patients and explore the influencing factor that promoting rationalized use of medical care for patients with chronic disease as well as rational allocation of health resources in rural areas. METHODS:A cross-sectional survey was conducted in Heilongjiang, a province in northeastern China by using a self-designed questionnaire. Stratified cluster sampling was used to choose 484 hypertensive patients from two villages in Heilongjiang province in 2010. RESULTS:About 88.4% of respondents reported preferred primary health institutions (83.5% preferred village clinics and 4.9% preferred township hospitals), 49.4% of respondents knew hypertension management administered by primary health institutions, 53.5% received hypertension education from primary care physicians, more than half of respondents reported that they didn't receive telephone interviews and family visits from primary care physicians over the past 6 months. Residence closer to the primary health institutions (OR?=?10.360), trust in village doctors (OR?=?7.323), elders (OR?=?3.001), and asked for return visits by primary health physicians (OR?=?2.073) promote preferences for primary health institutions. CONCLUSIONS:Accessibility to primary healthcare and doctor-patient trust stimulate patients to choose the primary health institutions. Primary health institutions should improve general approach to hypertension management and enhance the ability of providing basic public health services.

SUBMITTER: Liu J

PROVIDER: S-EPMC6868842 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China.

Liu Jingjing J Yin Hui H Zheng Tong T Ilia Bykov B Wang Xing X Chen Ruohui R Hao Yanhua Y Sun Hong H Jiao Mingli M Kang Zheng Z Gao Lijun L Wu Qunhong Q

BMC health services research 20191120 1

<h4>Background</h4>Traditional "inverted triangle" healthcare resources allocation model in China has wasted a lot of health resources. The Chinese health reform began to strengthens the role of the primary health institutions in delivering primary health care especially in rural areas in the background of large development gap between urban-rural health and rapid growth in the incidence of chronic diseases in rural. We take hypertensive patients as an example, to verify the effect of policy imp ...[more]

PMID: 31747908

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Project description:BackgroundHuman immunodeficiency virus type 1 (HIV-1) epidemic in China is featured by geographical diversity of epidemic patterns. Understanding the characteristics of regional HIV-1 epidemic allows carrying out targeted prevention and controlling measures. This seven-year cross-sectional study was conducted in Heilongjiang, one province of Northeast China, where newly diagnosed infection is fast increasing yearly, but temporal HIV-1 epidemic trend is largely unknown.MethodsInformation of 1,006 newly diagnosed HIV-1-infected participants were collected before antiretroviral therapy during 2010-2016 in Heilongjiang province. HIV-1 genotype was identified based on the viral gag and env gene sequences. Recent infection was determined by Limiting-Antigen Avidity assays. Comparison analyses on the median ages, CD4 counts, proportions of stratified age groups and CD4 count groups, and rates of recent HIV-1 infection among different population and sampling times were performed to understand temporal HIV-1 epidemic features.ResultsHomosexual contact among men who have sex with men (MSM) was the main transmission route and CRF01_AE was the most dominant HIV-1 genotype. During 2010-2016, the HIV-1 epidemic showed three new changes: the median age continued to decline, the cases with a CD4 count more than 500 cells/μl (CD4hi cases) disproportionally expanded, and the recent HIV-1 infection rate steadily increased. MSM cases determined the temporal trend of HIV-1 epidemic here. Increase of young MSM cases (aged <30 years) made the main contribution to the younger age trend of MSM cases. These young MSM exhibited a higher median CD4 count, a higher proportion of CD4hi cases, and a higher rate of recent HIV-1 infection than cases aged 30 years and more. MSM infected by CRF01_AE virus mostly affected HIV-1 epidemic patterns among MSM population.ConclusionYoung MSM have become a new hotspot and vulnerable group for HIV-1 transmission in Heilongjiang Province, Northeast China. The rapid increase in the number of young MSM cases, mainly those with CRF01_AE infection, changed temporal HIV-1 epidemic pattern here. Measures for prevention and control of HIV-1 infection among this population are urgently needed in the future.

Project description:Magnesium (Mg) plays a crucial role in rice yield. Heilongjiang Province is the main rice-producing region of China, playing an important role in guaranteeing China's and the world's grain security. However, rarely Mg fertilization is applied in this province. Soil Mg status of main rice-producing areas in Heilongjiang Province was investigated and Mg fertilizer experiments were conducted aiming to provide fertilizer recommendation in this region. A total of 358 soil samples from the 0-20 cm and 20-40 cm soil layer from the main rice-producing areas of Heilongjiang Province were collected to analyze soil exchangeable Mg (ex-Mg) and relative chemical properties. Meanwhile, field experiments of soil and foliar Mg application were performed in 2017-2019 to identify the effect of this nutrient on rice yield. The results showed that the ex-Mg concentration in the 0-20 cm and 20-40 cm soil layer was 282 mg kg-1 and 243 mg kg-1, respectively. Moreover, ex-Mg ranged on the abundant and exceptionally abundant level accounted for 75% in 0-20 cm and 55.3% in 20-40 cm. The ex-Mg concentration in the upper soil layer was higher than in the lower soil layer and varied depending on regions, which the west part of Heilongjiang Province showed the highest concentration in both soil layers. Correlation analysis showed that there had a significant (P < 0.05) linear relationship between ex-Mg and pH, CEC, ex-K, Ca, K/Mg, and Ca/Mg. Meanwhile, the results of path coefficients demonstrated that pH, CEC, and Ca/Mg had the most direct effect on ex-Mg concentration among these above factors. Soil Mg application had little effect on rice yield, which might be related to the soil Mg concentration and availability, and root uptake activity. Foliar Mg application increased rice yield by 8.45% (P < 0.05) compared to without Mg treatment, increased 1,000-grain weight by 2.62% (P < 0.05), and spikelet number per panicle by 4.19% (P < 0.05). In general, the paddy soil ex-Mg concentration in Heilongjiang Province was abundant. Soil-applied Mg played little role in rice yield in ex-Mg abundant regions, while foliar application increased rice yields significantly via increasing 1,000-grain weight and spikelet number per panicle.

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Dataset Information

Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China.

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Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China.

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