• A Study of Space Allocation and Optimization of Traditional Chinese Medical Institutions Based on Medical Service Radius: a Case Study of Zengcheng District,Guangzhou City

    Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-02-19 Cooperative journals: 《中国全科医学》

    Abstract: Background  As China's Traditional medicine is included in the ICD-11 code,the rational allocation of basic TCM medical resources is the guarantee to promote the integration of traditional Chinese medicine and western medicine and the universal coverage of high-quality medical resources. The uneven layout and service capabilities of grassroots medical institutions have led to a widespread imbalance in the supply and demand of medical resources in urban and rural areas. Objective  Understand the development status of traditional Chinese medicine services in rural areas of China,scientifically evaluate the coverage and accessibility of grassroots traditional Chinese medicine diagnosis and treatment,provide new ideas for optimizing the spatial resource allocation of grassroots traditional Chinese medicine services,and propose optimization strategies accordingly.Methods  Based on the seventh national population census data and path planning data,the concept of medical service radius is introduced to calculate the diagnosis and treatment scope of different levels of traditional Chinese medicine medical institutions under walking mode. Using methods such as spatial kernel density index and spatial standard deviation ellipse to reveal the spatial fairness of the supply and demand capacity of traditional Chinese medicine medical services. Based on the above results,propose types and measures for optimizing the layout of traditional Chinese medicine medical resources. Results  As of 2022,there are a total of 699 medical institutions in Zengcheng District,including 18 traditional Chinese medicine medical institutions with beds. There are significant differences in the distribution of beds in traditional Chinese medicine medical institutions in different townships and streets. Meanwhile,the number of beds per thousand population in Zhongtan Town is 14.31,ranking first among all streets. The number of beds per thousand people in Yongning Street ranks last,with only 0.89 beds. Traditional Chinese medicine medical institutions in Zengcheng District have shown a clear dual center pattern,with weak accessibility to traditional Chinese medicine services for residents in the central part of Zhongxin Town,the northern part of Paitan Town,and the southwestern part of Shitan Town. The supply capacity of traditional Chinese medicine services varies greatly among different townships. There is still a certain degree of inconsistency between the spatial distribution of traditional Chinese medicine medical institutions and the overall spatial clustering of urban residents. There are differences in the radius of traditional Chinese medicine services between different townships. Conclusion  Since the implementation of the development strategy of traditional Chinese medicine,China's Traditional medicine has been protected and developed. We should adopt a more scientific strategy to closely integrate traditional Chinese medicine services with the development of the city and the needs of residents. We should actively adopt a differentiated strategy of increasing facility points,combining resource transfer and sinking,and integrating traditional Chinese medicine information technology for diagnosis and treatment across regions,gradually achieving a true strategy of full coverage and equal emphasis on traditional Chinese and Western medicine.

  • Analysis of Knowledge-attitude-practice Behavior and Influencing Factors for Prevention of Disease in TCM in Community Residents in Guangzhou

    Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-01-11 Cooperative journals: 《中国全科医学》

    Abstract: Background With the change of disease spectrum and the development of modern medical model,traditional Chinese medicine(TCM) is playing an important role in disease prevention, health care and rehabilitation. It is necessary to further promote the development of prevention of disease in TCM and vigorously promote the unique role of TCM in maintaining and promoting people's health. However,popularization and education of the concept of prevention of disease in TCM among community residents remains unclear. Objective To understand the overall awareness,trust,and adoption behavior of prevention of disease in TCM of community residents in Guangzhou,and explore the influencing factors of community residents' trust in prevention of disease in TCM services. Methods From April to August 2022,a stratified cluster sampling method was used to interview 652 community residents from 12 streets in 4 administrative regions of Guangzhou city based on geographic location (central city,urban-rural areas,and suburbs) and economic factors by questionnaires The survey included residents' basic information,awareness and access to knowledge of prevention of disease in TCM,as well as their demand,utilization and trust in it. The influencing factors of community residents' trust in prevention of disease in TCM services were explored. Results  Among the 652 community residents,67.79% (442/652) were aware of prevention of disease in TCM,77.91% (508/652)trusted prevention of disease in TCM services,69.63% (454/652) had received traditional TCM physiotherapy,and only 6.59%(43/652) had received prevention of disease in TCM services more than 4 times in the past year. Univariate correlation analysis showed that age(χ2 =9.218),household type(χ2 =19.356),marriage status(χ2 =2.490),occupation(χ2 =17.889),and medical insurance payment type(χ2 =13.516) were influencing factors of residents ' prevention of disease in TCM services. Binary Logistic regression analysis showed that household type(non-agricultural,agricultural to resident,and nonagricultural to resident) was an influential factor for community residents' trust in prevention of disease in TCM services(OR=2.646,5.593,10.502). Conclusion  The overall awareness(67.79%) and trust (77.91%) of prevention of disease in TCM among community residents in Guangzhou are relatively high,but the actual number of services received is insufficient,with a phenomenon of knowledge,attitude and practice separation”. Community residents with non-agricultural household type and professional technical occupation have a higher level of trust,while those with agricultural household type,irregular/commercial and service/ other occupations have a higher level of trust. During popularization and services of prevention of disease in TCM,it is necessary to fully utilize the residents' preferred forms, as well as to target specific groups,so as to cultivate the health habits of prevention of disease in community residents.

  • Impact of ICD-11 Inclusion of TCM Codes on the Global Burden of Disease

    Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-27 Cooperative journals: 《中国全科医学》

    Abstract: Burden of disease measurement based on the International Statistical Classification of Diseases and Related Health Problems (ICD) codes have been widely used worldwide. However,most of the current studies are based on Western medical codes of ICD. As the internationalization of Traditional Chinese Medicine(TCM),the inclusion of TCM codes in ICD-11 will facilitate the improvement of TCM disease diagnosis,the calculation of prevalence,survival,medication use,and treatment levels of TCM disease,which can further evaluate the disease burden of TCM diseases,promote medical decision making and rational allocation of health resources,thus further promoting the internationalization of TCM. However,the imperfection of TCM codes in ICD-11 and inadequate mapping between it and Western medicine codes,our national standards for TCM has also brought new challenges to the measurement of TCM disease burden. Based on the coding system of disease burden,this paper reviewed the deficiencies in the current research on the calculation of disease burden of TCM,and the impact of ICD-11 inclusion of TCM codes on the calculation of disease burden of TCM,made a preliminary comparison among the TCM codes and Western medical codes in ICD-11 and new national standard codes in China,to provide reference for the improvement of the calculation and coding of TCM disease burden. It is proposed that in the future,big data technologies can be used to facilitate the mapping between standardized TCM terms and ICD-11 TCM codes,ICD-11 TCM codes and Western medical codes,thus facilitating research on the burden of disease in TCM.

  • Diabetes in China:Burden Analysis between 1990 and 2019 and Incidence Prediction between 2020 and 2030

    Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-03-28 Cooperative journals: 《中国全科医学》

    Abstract: Background  Diabetes is highly prevalent in China,the prevention and treatment of it and its related complications need a lot of medical resources. Local reports have revealed that although the mortality of diabetes is declining,the burden of diabetes is still increasing. Objective  To understand the epidemiological characteristics and burden of diabetes in China from 1990—2019,forecast the incidence of diabetes in China from 2020 to 2030,to provide data for evaluating and formulating diabetes-related prevention and treatment policies and measures. Methods  In August 2022,this study used data from the Global Burden of Disease Study 2019. Temporal trends of the incidence,mortality,disability-adjusted life years(DALY),years of life lost(YLL),and years lost due to a disability(YLD) of diabetes in China from 1990 to 2019 were described. The Bayesian-age-period-cohort analysis was used to predict the incidence of diabetes in China from 2020 to 2030. Results  Compared with 1990,in 2019,the crude prevalence of diabetes increased to 265.45/100 000,with an increase of 63.12%,the standardized prevalence of diabetes increased to 204.31/100 000,with an increase of 15.93%,the crude mortality rate of diabetes increased to 12.16/100 000,with an increase of 105.41%,and the standardized mortality rate of diabetes increased to 9.44/100 000,with an increase of 2.61%. The YLL rate decreased from 204.71/100 000 in 1990 to 178.45/100 000 in 2019. The YLD rate increased from 260.74/100 000 in 1990 to 316.30/100 000 in 2019. The DALY rate increased from 465.46/100 000 in 1990 to 494.76/100 000 in 2019. Compared with 1990,the DALY rate of diabetes increased by 21.08% in males and decreased by 6.68% in females. The YLL rate,YLD rate and DALY rate increased with age in 2019. According to the prediction of the standardized incidence of diabetes in China from 2020 to 2030,the overall standardized incidence of diabetes would present a decreasing trend during the period,and the standardized incidence of diabetes in 2030 would decrease by 11.45% in men and 18.60% in women compared with 2020. Conclusion  The burden of diabetes in China is still heavy,with a large number of illness cases and decreased cases,mainly manifested by a high burden caused by diabetes-related disability. Attention should be paid to early prevention of diabetes to reduce the occurrence of complications. The disease burden of males and middle-aged and elderly people is heavy,so sufficient attention should be paid to them. Although the predicted diabetes incidence will reduce between 2020 and 2030,the number of patients is still increasing,so the prevention and control of diabetes should not be slack.