Dataset Information

The development of bronchoscopy in China: a national cross-sectional study.

ABSTRACT: Objective: To investigate the development of bronchoscopy in China and compare it with its application in the early 21st century. Methods: The data collection was based on questionnaires. Three hundred and nineteen hospitals, which distributed across 30 provinces and 130 cities, were included in the study. Data about the application of bronchoscopy in Shanghai and Hunan province in the early 21st century are also involved for comparison. Results: The median period of performing diagnostic and therapeutic bronchoscopy was 19.7±11.0 and 7.4±7.0 years, respectively. On average, about 155.2 cases and 28.4 cases received diagnostic and therapeutic bronchoscopy in each hospital per month. The average area and number of the examination room was 122.7m2 and 2.2m2, respectively. More examination items were performed in specialty hospitals than those in general hospitals (P<0.05) and specialty hospitals owned more rooms exclusively for bronchoscopy (P<0.05), while no difference of the number of allocated doctors was found (P>0.05). On the other side, the whole amount of diagnosis and therapeutic items in teaching hospitals was slightly higher than that in non-teaching hospitals (P<0.01). Comparison of diagnosis and therapeutic endoscopy in Shanghai and Hunan province shows that the number of flexible bronchoscopy increased by 5.8 times in Shanghai from 2002 to 2017, while that increased by 3.4 times in Hunan province from 2005 to 2017. Furthermore, the average number of allocated doctors increased by 0.85 times in Shanghai, which was more rapidly compared with that of Hunan province (0.66 times) (P<0.05). Besides, the development rate of the diagnosis and therapeutic projects in Shanghai was significantly higher than that in Hunan province (P<0.05). Conclusion: All different classes of hospitals in China are capable of carrying out conventional bronchoscopy diagnosis and therapeutic projects, and newly developed bronchoscopy technology has gradually spread in high-level hospitals since 21st century. The higher class the hospital was, the earlier bronchoscopy was performed. Respiratory endoscopy in China has developed rapidly since the early 21st century and the construction of respiratory endoscopy center and the personnel training are on the right track, but it is also faced with inadequate equipment, unbalanced regional development and insufficient personnel allocation.

SUBMITTER: Shi D

PROVIDER: S-EPMC7477436 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The development of bronchoscopy in China: a national cross-sectional study.

Shi Dongchen D Li Fuqi F Wang Kaicheng K Kong Chen C Huang Haidong H Li Qiang Q Jin Faguang F Hu Chengping C Wang Changhui C Shi Hui H Hu Zhenli Z Dong Yuchao Y Ning Yunye Y Tsakiridis Kosmas K Sapalidis Konstantinos K Kosmidis Christoforos C Vagionas Anastasios A Hohenforst-Schmidt Wolfgang W Freitag Lutz L Turner J Francis JF Drevelegas Konstantinos K Perdikouri Eleni-Isidora EI Kovacevic Tomi T Sarcev Tatjana T Zaric Bojan B Petanidis Savas S Baka Sofia S Boukovinas Ioannis I Kakolyris Stylianos S Zarogoulidis Paul P Bai Chong C

Journal of Cancer 20200720 19

Objective: To investigate the development of bronchoscopy in China and compare it with its application in the early 21st century. Methods: The data collection was based on questionnaires. Three hundred and nineteen hospitals, which distributed across 30 provinces and 130 cities, were included in the study. Data about the application of bronchoscopy in Shanghai and Hunan province in the early 21st century are also involved for comparison. Results: The median period of perform ...[more]

PMID: 32913450

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Project description:BackgroundAtrial fibrillation (AF) is the most common persistent cardiac arrhythmia. This study aimed to estimate its prevalence and explore associated factors in adults aged 18 years or older in China.MethodsStudy data were derived from a national sample from July 2020 to September 2021. Participants were recruited using a multistage stratified sampling method from twenty-two provinces, autonomous regions, and municipalities in China. AF was determined based on a history of diagnosed AF or electrocardiogram results.FindingsA total of 114,039 respondents were included in the final analysis with a mean age of 55 years (standard deviation 17), 52·1% of whom were women. The crude prevalence of AF was 2·3% (95% confidence interval [CI] 1·7-2·8) and increased with age. The age-standardized AF prevalence was 1·6% (95% CI 1·6-1·7%) overall, and 1·7% (1·6-1·8%), 1·4% (1·3-1·5%), 1·6% (95% CI 1·5-1·7%), and 1·7% (1·6-1·9%) in men, women, urban areas, and rural areas, respectively. The prevalence was higher in the central regions (2·5%, 2·3-2·7%) than in the western regions (1·5%, 1·0-2·0%) and eastern regions (1·1%, 1·0-1·2%) in the overall population, either in the gender or residency subgroups. The associated factors for AF included age (per 10 years; odds ratio 1·41 [95% CI 1·38-1·46]; p < 0·001), men (1·34 [1·24-1·45]; p < 0·001), hypertension (1·22 [1·12-1·33]; p < 0·001), coronary heart disease (1·44 [1·28-1·62]; p < 0·001), chronic heart failure (3·70 [3·22-4·26]; p < 0·001), valvular heart disease (2·13 [1·72-2·63]; p < 0·001), and transient ischaemic attack/stroke (1·22 [1·04-1·43]; p = 0·013).InterpretationThe prevalence of AF was 1.6% in the Chinese adult population and increased with age, with significant geographic variation. Older age, male sex, and cardiovascular disease were potent factors associated with AF. It is crucial to increase the awareness of AF and disseminate standardized treatment in clinical settings to reduce the disease burden.FundingThis research was supported the Nature Science Foundation of Hubei province (No: 2017CFB204).

Project description:BackgroundThe phenomenon of medical migration is common in China. Due to the limited capacity and substantial geographical variation in medical practice, patients with chronic kidney disease (CKD) travel more frequently to seek medical care. We aimed to assess the cost-effectiveness of medical migration for CKD patients in China and provide real-world evidence for the allocation of CKD resources.MethodsRecords of patients with CKD between January 2014 and December 2018 were extracted from a large national database. A patient is defined as a medical migrant if she travelled across the provincial border to a non-residential province to be admitted for inpatient care. The propensity score matching method is used to estimate the effect of medical migration on medical expenditure, length of hospital stay, and in-hospital mortality. The cost-effectiveness is evaluated by comparing the estimated cost per life saved with contemporaneous estimates of the value of a statistical life.ResultsAmong 4,392,650 hospitalizations with CKD, medical migrants accounted for 4.9% in 2018. Migrant patients were estimated to incur a 26.35% increase in total medical expenditure, experience a 0.24-percentage-points reduction in in-hospital mortality rates, and a 0.49-days reduction in length of hospital stay compared to non-migrant patients. Overall, medical migration among CKD patients incurred an average of 1 million yuan per life saved, which accounted for 20-40% of contemporaneous estimates of the value of a statistical life. Compared with migrant patients with self-payment and commercial insurance, migrant patients with public health insurance (urban basic medical insurance and new rural co-operative medical care) incurred lower cost per life saved. Cost per life saved for CKD patients was similar between female and male, lower among older population, and varied substantially across regions.ConclusionsThe medical care seeking behaviors of CKD patients was prominent and medical resources of kidney care were unevenly allocated across regions. Medical migration led to a reduction in mortality, but was associated with higher medical expenditure. It is imperative to reduce the regional disparity of medical resources and improve the clinical capacity. Our study shows that it is imperative to prioritize resource allocation toward improving kidney health and regional health care planning.

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Project description:ObjectiveThe reasons that physicians leave the institutions have not been extensively studied. We aimed to evaluate these reasons, which include the desire to work at another hospital or the intention to make a career change, among physicians in tertiary hospitals in China and explore the associations between the individual-level and organizational-level factors related to these two reasons for leaving.MethodsWe conducted a national survey of 136 tertiary hospitals across all 31 provinces in China between December 2017 and January 2018. A total of 20 785 physicians were selected to self-report on the two evaluated reasons related to physicians' intent to leave. A univariate analysis and multilevel regression model were applied to evaluate the factors associated with intention to leave.ResultIn all, 10.4% of the participating physicians had thought about working at another hospital, and 20.5% intended to leave to make a career change. At the hospital level, the government subsidy per bed (OR=0.88, 95% CI: 0.86 to 0.98 and OR=0.91, 95% CI: 0.90 to 0.99), personnel funding per capita (OR=0.86, 95% CI: 0.76 to 0.96 and OR=0.80, 95% CI: 0.73 to 0.88) and the number of physicians per bed (OR=0.83, 95% CI: 0.81 to 0.86 and OR=0.89, 95% CI: 0.81 to 0.92) were negatively associated, while the number of hospital-level medical disputes (OR=1.04, 95% CI: 1.03 to 1.05 and OR=1.06, 95% CI: 1.01 to 1.11) was positively associated with both reasons for leaving. At the individual level, income (OR=0.74, 95% CI: 0.71 to 0.79 and OR=0.88, 95% CI:0.83 to 0.92) and job satisfaction (OR=0.18, 95% CI: 0.17 to 0.20 and OR=0.16, 95% CI: 0.15 to 0.18) acted as preventive factors against both reasons for leaving, while work hours per week (OR=1.11, 95% CI: 1.06 to 1.17 and OR=1.23, 95% CI: 1.19 to 1.28) and medical dispute (OR=1.49, 95% CI:1.35 to 1.65 and OR=1.77, 95% CI: 1.64 to 1.91) acted as promotive factors.ConclusionsAlthough the intention to leave is not prevalent among physicians in tertiary hospitals in China, providing more organisational support and a better occupational environment may promote retention among physicians.

Dataset Information

The development of bronchoscopy in China: a national cross-sectional study.

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The development of bronchoscopy in China: a national cross-sectional study.

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