Objective To investigate the satisfaction of patients who signed up for chronic disease continuous health management services, so as to provide a theoretical basis for improving service quality. Methods We conducted an online anonymous survey by issuing an electronic questionnaire to all patients who met the inclusion criteria through the short message platform of the hospital from October 8th to 19th, 2021, and used χ2 test and logistic regression to compare the differences in satisfaction among different patients and explore the factors affecting satisfaction. Results A total of 3311 short messages were send out, and 816 valid copies of questionnaire were recalled. The total satisfaction was 77.3%, and the satisfaction before, during and after service were 86.0%, 75.2% and 73.7%, respectively. The items with low satisfaction included service pricing (58.9%), online follow-up (57.5%) and overall cost reduction (43.9%). There were significant differences in satisfaction among patients of different permanent addresses and health status (P<0.05). The multiple binary logistic regression analysis showed that the respondents in Chengdu city had lower satisfaction than those outside Sichuan province [odds ratio (OR)=0.377, 95% confidence interval (CI) (0.156, 0.908), P=0.030], and the respondents with poor, general, and good self-reported health status had lower satisfaction than those with very good self-reported health status [OR=0.196, 95%CI (0.067, 0.577), P=0.003; OR=0.165, 95%CI (0.058, 0.468), P=0.001; OR=0.317, 95%CI (0.108, 0.927), P=0.036]. Conclusions The patients’ satisfaction with chronic disease continuous health management services is at a high level. The next step should focus on service pricing and online follow-up, and strive to improve the service experience of people with low satisfaction.
Exercise intervention is an important non-pharmacological intervention for various diseases, and establishing precise exercise load assessment techniques can improve the quality of exercise intervention and the efficiency of disease prevention and control. Based on data collection from wearable devices, this study conducts nonlinear optimization and empirical verification of the original "Fitness-Fatigue Model". By constructing a time-varying attenuation function and specific coefficients, this study develops an optimized mathematical model that reflects the nonlinear characteristics of training responses. Thirteen participants underwent 12 weeks of moderate-intensity continuous cycling, three times per week. For each training session, external load (actual work done) and internal load (heart rate variability index) data were collected for each individual to conduct a performance comparison between the optimized model and the original model. The results show that the optimized model demonstrates a significantly improved overall goodness of fit and superior predictive ability. In summary, the findings of this study can support dynamic adjustments to participants' training programs and aid in the prevention and control of chronic diseases.
With the promoting of “the Belt and Road Initiative”, medical assistance to Xinjiang is one ofthe important tasks of public hospitals in China. West China Hospital of Sichuan University actively explores the“Huaxi-Karamay” model of multi-disciplinary group assistance and scientific and technological assistance to Xinjiang, and leverages the technical leadership and leading role of medical experts to improve the medical and health service capabilities of Karamay, especially in chronic diseases management. This article takes the People’s Hospital ofKaramay City in Xinjiang province as an example to discuss the exploration and practice of the new chronic diseasemanagement model of the endocrinology and metabolism center with medical assistance from West China Hospital ofSichuan University, aiming to provide a certain reference for the in-depth development of medical aid to Xinjiang in thefuture.
The 14th Five-Year Plan for National Health explicitly proposes elevating the comprehensive prevention and control strategy for chronic diseases to the national strategy, aiming to address the growing demand for long-term management and individualized treatment of chronic diseases. In this context, the adaptive treatment strategy (ATS), as an innovative treatment model, offers new ideas and methods for the management and treatment of chronic diseases through its flexible, personalized, and scientific characteristics. To construct ATS, the sequential multiple assignment randomized trial (SMART) has emerged as a research method for multi-stage randomized controlled trials. The SMART design has been widely used in international clinical research, but there is a lack of systematic reports and studies in China. This paper first introduces the basic principles of ATS and SMART design, and then focuses on two key elements of the SMART design: re-randomization and intermediate outcomes. Based on these two elements, four major types of SMART designs are summarized, including: (1) SMART designs in which the intermediate outcome corresponds to a single re-randomization scheme (the classical type), (2) SMART designs in which no intermediate outcome is embedded, (3) SMART designs in which the intermediate outcome corresponds to a different re-randomization scheme, and (4) SMART designs in which the intermediate outcome and the previous interventions jointly determine the re-randomization. These different types of SMART designs are appropriate for solving different types of scientific problems. Using specific examples, this paper also analyzes the conditions under which SMART designs are applicable in clinical trials and predicts that the mainstream analysis methods for SMART designs in the future will combine frequentist statistics and Bayesian statistics. It is expected that the introduction and analysis in this paper will provide valuable references for researchers and promote the widespread application and innovative development of SMART design in the field of chronic disease prevention, control, and treatment strategies in China.
This paper introduces the background and research design (including site of investigation, study population, baseline survey and follow-up monitoring), which belongs to the Precision Medicine Project of the National Key Research and Development Program of China.
With the increasing burden of chronic diseases, the issue of comorbidities has become increasingly important. In practice, patients with comorbidity of chronic diseases struggle to access continuous and integrated healthcare experiences. This article introduces the construction of the referral management system for comorbidity of chronic diseases based on “internet plus” in West China Hospital of Sichuan University. By formulating a standardized and convenient referral process and using artificial intelligence to optimize the referral platform, it creates a referral system for comorbidity of chronic diseases suitable for the hospital’s clinical workflows, makes reasonable use of the resources of the return pool, and improves the referral efficiency. After the implementation of the comorbidity referral system, patient satisfaction has increased, providing new ideas and reference experience for the management of comorbidity of chronic diseases for other medical institutions.
ObjectiveTo analyze the health examination results of hospital retirees, understand their health status and provide the evidence for health management. MethodsThe data were collected from our 1 089 hospital retirees (51-96 years old) who received health examination in West China Hospital of Sichuan University from January to December 2013, including 345 males and 744 females, with a mean age of 70 years. The data were analyzed by SPSS 16.0 software. ResultsHypertension, dyslipidemia and diabetes were the three chronic diseases with the highest detectable rate, and the rate was respectively 49.49%, 44.90% and 31.04%. The detectable rate of hypertension was not significantly different between male and female. The rate of dyslipidemia in females was higher than that in males. The rate of diabetes in males was higher than that in females. The detectable rate of hypertension and diabetes increased with the increase of age. The detectable rate of dyslipidemia had no significant relationship with age. ConclusionThe health condition of retirees cannot be neglected. We need to strengthen the health management for the retirees.
Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, and it is a key ocular fundus disease that needs to be paid attention to in the next five years according to the "14th Five-Year" Plan for Eye Health. Promoting the systematic management of DR and constructing the chronic disease management system are the key to the next step of national eye health work. It is necessary to further improve the management mode of the whole course of DR patients with chronic eye disease through the joint action of medical security system at all levels, including strengthening supporting policies of primary medical institutions, optimizing medical service mode and process, strengthening scientific education to improve patients' and doctors' disease cognition, and updating authoritative Chinese DR guidelines to standardize diagnosis and treatment. It is hoped that the low vision and blindness caused by DR in China can be greatly reduced after the implementation of the "14th Five-Year" Plan for Eye Health.
ObjectiveTo explore the prevalence and risk factors of hypertension and diabetes in floating population in Hubei province, so as to provide reference for the prevention of chronic disease of floating population. MethodA multi-stages sampling was performed among six counties in Hubei province in 2012, according to the different occupations. A questionnaire survey was conducted to collect the demography, sociology and health-related behavioral characteristics of subjects. Then a univariate analysis and a multivariate analysis were conducted by SPSS 20.0 software. ResultsA total of 1 800 individuals were surveyed, and the prevalence of hypertension and diabetes in floating population was 22.7% and 4.9%, respectively. Univariate analysis indicated that significant associations were found between hypertension and such factors as age, occupations, smoking and life satisfaction (all P values < 0.05); and significant associations were found between diabetes and such factors as occupations, educational level and BMI (all P values < 0.05). The results of further logistic regression analysis showed that age (OR=2.194, 95% CI 1.940 to 2.483, P=0.001) and life satisfaction (OR=0.291, 95% CI 0.248 to 0.341, P=0.002) were independent risk factors of hypertension, and educational level (OR=3.219, 95%CI 2.016 to 7.565, P=0.011) and gender (OR=0.568, 95% CI 0.323 to 0.999, P=0.049) were independent risk factors of diabetes. ConclusionsThe prevalence of hypertension and diabetes are relative high in floating population of Hubei Province. Increasing age and low life satisfaction are independent risk factors of hypertension in floating population, while male and low educational level are independent risks factors of diabetes.
The population of various fundus diseases in China is vast, and the number of patients is continuously increasing due to the aging population. In contrast, fundus disease awareness among the general public in China is low, and grassroots screening needs urgent improvement. At the same time, the diagnosis and treatment rate are quite low, and the treatment methods for late-stage diseases are limited, resulting in poor prognosis of visual function and high blindness rate. Chronic fundus diseases require long-term, standardized treatment and long-term follow-up, which can be burdensome for patients, leading to high missed visit rates and reduced therapeutic effects. The "14th Five-Year Plan for Eye Health (2021-2025)" clearly put forward the requirements of strengthening the construction of the fundus disease prevention and control system. We urgently need to develop a management model for chronic diseases of fundus diseases tailored to China's national conditions. This will require establishing corresponding management platforms, improving personnel allocation, and enhancing compliance in the treatment of fundus diseases, to improve treatment effectiveness and fundamentally reduce blindness rates. After China's authoritative experts in the field of fundus diseases through the organization of in-depth and comprehensive thematic discussion, and the use of the improved version of Delphi method for collective decision-making and opinion consultation, a series of consensus guidance and suggestions were finally formed. These valuable professional insights will strongly promote the establishment of an appropriate chronic fundus disease management system in China, ensure that patients with fundus disease get long-term, standardized medical services, and lay a solid foundation for improving the overall prevention and treatment of fundus diseases.