Background: Protecting and improving the personal health of healthcare workers is critical to improving the efficiency and quality of care. To effectively meet the needs of the emergency service system, emergency physicians need to be in a good state of health. However, due to the special characteristics of work in the emergency department, emergency physicians have to face various psychosocial pressures, which may bring them physical and mental distress. Therefore, this study aims to explore the emergency physicians' self-rated health status and its related factors, to provide an empirical study for the improvement of emergency physicians' self-rated health status.Method: A cross-sectional survey of emergency physicians was conducted in China between July and August 2018. The questionnaires contained items on demographic characteristics, behavioral lifestyle and job-related factors, as well as self-rated health. The generalized ordinal logistic model was used to identify related factors of emergency physicians' self-rated health status.Results: Only 14.4% of Chinese emergency physicians considered themselves in good health status. Results showed that emergency physicians who never exercised (β = 0.76, p < 0.001) and exercised <2 times per week (β = 0.34, p < 0.001) were more likely to report poor health status. In addition, emergency physicians with good sleep quality (β = −3.84, p < 0.001), fewer night work shifts (β = −0.47, p < 0.001), less frequency of visiting patients (β = −0.33, p < 0.001), never suffered the workplace violence (β = −0.47, p < 0.001) and never perceived effort-reward imbalance (β = −0.68, p < 0.001) were more likely to report good self-rated health.Conclusion: Chinese emergency physicians' self-rated health status was not optimistic. Self-rated health is associated with multiple domains of work-related factors and personal lifestyle. Feasible measures should be taken to improve the working environment of emergency physicians, develop acceptable shift schedules for employees, monitor and maintain the health status of emergency department physicians.

Background: Cirrhosis and other chronic liver diseases are the 12th leading cause of death globally and impose a substantial economic burden. Estimating the macroeconomic burden and distribution can provide a policy rationale for the prevention and treatment of these issues. We aimed to estimate and project the macroeconomic burden of cirrhosis and other chronic liver diseases in 190 countries and territories, as well as their distribution across world regions. Methods: We calculated the macroeconomic burden of cirrhosis and other chronic liver diseases in 190 countries using a health-augmented macroeconomic model that accounts for the impact of morbidity and mortality on labor supply, age differences in education and experience among those affected by cirrhosis and other chronic liver diseases, and reduced investment due to the shifting of costs of these disease-related treatments from savings. Results: Our findings suggest that cirrhosis and other chronic liver diseases will cost the world economy INT$ 2.649 trillion (2.502–2.827) in 2021–2050. The United States has the largest economic burden of cirrhosis and other chronic liver diseases, followed by China and India. Although low- and middle-income countries have the highest health burdens (91.4% of the global disability-adjusted life years), their share of the economic burden of cirrhosis is only 57.1% of the global loss. Conclusions: The macroeconomic burden of cirrhosis and other chronic liver diseases is sizeable and distributed unequally across countries and world regions. Our study emphasizes the need for greater investment globally in controlling cirrhosis and other chronic liver diseases and their associated health and economic burdens.

Objectives: To understand the current status of smoking behavior among emergency physicians in China and to explore its determinants.Background: The emergency department is considered a more appropriate setting for tobacco interventions. However, the smoking behavior of emergency physicians can reduce the effectiveness of interventions for patient smoking behavior.Methods: From July to August 2018, we conducted a structured online questionnaire among Chinese emergency medicine physicians. We used descriptive analysis with binary logistic regression to analyze the current smoking status of Chinese emergency physicians and its determinants.Results: A total of 10,457 emergency physicians were included in this study. The prevalence of smoking among physicians was 25.35% (with 34.15 and 1.59% among male and female physicians, respectively). Results of logistic regression showed that postgraduate education (OR = 0.52, 95% CI: 0.41–0.66), chief-level title (OR = 0.79, 95% CI: 0.65–0.97), and regular exercise habits (OR = 0.83, 95% CI: 0.76–0.92) were associated with a lower risk of smoking behavior. However, being over 50 years old (OR = 1.71, 95% CI: 1.29–2.27), being fixed-term (OR = 1.25, 95% CI: 1.10–1.42), and having depressive symptoms (OR = 1.43, 95% CI: 1.28–1.61) were associated with a higher risk of smoking.Conclusion: The prevalence of smoking behavior among emergency physicians in China is high. Hospital management could reduce the incidence of smoking behavior among emergency physicians by strengthening smoking cessation training, paying attention to physicians' psychological health, reducing pressure on physicians in fixed-term positions, and encouraging physicians to develop regular exercise habits.