Primary health care has been emphasized as a pillar of China’s current round of health reforms throughout the previous decade. The purpose of this study is to analyze the accessibility of primary health care services in Beijing and to identify locations with a relative scarcity of health personnel. Seven ecological conservation districts, which are relatively underdeveloped, were selected in the study. The Gini coefficient and Lorenz curve, as well as the shortest trip time and modified two-step floating catchment area (M2SFCA) approach, are used to quantify inequalities in primary health care resources and spatial accessibility. The Gini coefficient of primary medical services was calculated as high as 0.705, showing a significant disparity in primary care services. A total of 81.22% of communities reached the nearest primary care institution within 15 min. The average accessibility of primary healthcare services, as measured by the number of health professionals per 1000 population, was 2.34 in the 1715 communities of seven ecological conservation districts. Three hundred and ninety-one communities (22.80%) were identified with relatively low accessibility. More primary health professionals should be allocated to Miyun, Mentougou, and Changping Districts. Overall, the primary healthcare resources were distributed unevenly in most districts. According to our study, expanding primary healthcare institutions, increasing the number of competent health professionals, and enhancing road networks will all be effective ways to increase spatial accessibility and reduce primary healthcare service disparity in Beijing.
The Chinese government has launched six rounds of national drug price negotiation since 2016 to lower the price and expand access to innovative drugs, many of which are anticancer drugs. This study aims to examine the effect of the second round of negotiation at the provincial level on the expenditure, volume, and availability of anti-cancer drugs. Procurement data at the provincial level from January 2017 to September 2018 were extracted from the China Drug Supply Information Platform (CDSIP). The volume, expenditure, and availability of three targeted anti-cancer drugs, rituximab, trastuzumab, and recombinant human endostatin (RHE), in 11 provinces that implemented the policy in September 2017 were analyzed through a controlled interrupted time series (ITS) analysis. A significant 6.0% increase (p < 0.1) in monthly average expenditure, an increase in the volume of 99.51 DDDs (defined daily doses) (p < 0.1), and a 0.24% (p < 0.1) increase in availability were observed for rituximab following the implementation of the policy. The volume and availability of rituximab increased by 949.6 DDDs (p < 0.05) and 1.56%, respectively, immediately after implementation. The availability of trastuzumab increased by 5.14% (p < 0.01) immediately after the implementation while no instant changes in expenditure and volume were observed. A 15% (p < 0.01) increase in monthly expenditure, 3673.17 DDDs increase in volume, and 0.66% increase in availability were observed after the inclusion of Trastuzumab. However, for RHE, only a 0.32% (p < 0.01) increase was observed after its inclusion. Eastern and middle provinces benefited more than western provinces. National negotiation related to the drug price significantly increased the volume and expenditure of anti-cancer drugs and improved their availability. The effect of the policy might be different across different regions and across different anticancer drugs.
Timely access to essential health services is a concern as COVID-19 continues. This study aimed to investigate health services utilization during the first wave of the pandemic in China. A cross-sectional online survey was conducted using a self-administrated questionnaire in March 2020. Descriptive statistics and logistic regression were used for data analysis. A total of 4744 respondents were included, with 52.00% reporting affected services utilization. Clinical testing (68.14%) and drug purchase (49.61%) were the most affected types. Higher education level, being married, chronic disease, frequently visiting a provincial medical institution, spending more time on pandemic-related information, perception of high-risk of infection, perception of large health impact of the pandemic, and anxiety/depression were significant predictors for reporting affected services utilization. For the 431 chronic disease respondents, 62.18% reported interruption, especially for drug purchase (58.58%). Affected health services utilization was reported during the first wave of the pandemic in China, especially for those with higher education level, chronic diseases, and COVID-19 related concerns. Enhancing primary healthcare, use of telehealth, extended prescription, and public communication were countermeasures undertaken by China during the rapid rise period. As COVID-19 progresses, the changing disease characteristics, adapted health system, along with enhanced public awareness/knowledge should be considered for the evolution of health services utilization, and further investigation is needed.
Thermal characters behavior of five crude oils samples covered a wide range of fluid composition and properties were studied by differential scanning calorimeter (DSC). By comparing with standard alumina method, it is proved that checking the paraffin recovery ratio in kerosene solution containing different concentration wax by thermal method is feasible.
In recent years, Augmented reality (AR) technology has gained great attention. One critical component of AR devices is the see-through optical combiner. Several approaches have been proposed, such as using either refractive, reflective, diffractive, holographic optics, or a combination of them. Meta-surfaces can realize the design of more required optical element due to its superb abilities of controlling the amplitude, phase, polarization or other parameters of wave-front at subwavelength scale. Thus, we proposed a waveguide coupler based on a polarization independent doublet meta-surface, which can realize field of view (FOV) to 50° at the wavelength of 638 nm. Compare to the diffractive grating based optical combiner architecture, our doublet meta-surfaces improve the problem of FOV limited by the refractive index of the waveguide and uneven brightness in AR display devices. The polarization independent doublet meta-surfaces presented in this paper can provide a large phase mutation rate to achieve a large deflection angle. The meta-surfaces consist of a group of Silicon nanofins with different side length, but same height arranged on a rectangle glass substrate lattice with the reflection index of 1.764. Each unit structure has different electromagnetic responses to plane electromagnetic waves with different incident angles. By designing the shape and size of each silicon nanorods and other parameters, the phase and amplitude modulation we need can be achieved. Here we only consider one-dimensional eye-box expansion at a single wavelength. The design approach can be generalized to two-dimensional eye-box expansion. Besides, full-color display can be achieved by coordination of the coupling-in and coupling-out device in waveguides.
About Me
postgraduate from School of public health, Pkeing University,
postgraduate from School of public health, Pkeing University,