Coordinated care delivery is faced with various challenges to carry out in China,which are major decisions to make for decision makers,including how to push forward,how to deliver resources, services and patients to primary institutions,and how to ease the difficulties and affordability of seeing doctors.Based on analysis of roadblocks in coordinated care delivery in China,the authors provided near-term and long-term policy recommendations on the system,including how to build a scientific and reasonable healthcare delivery system,coordinated care delivery by stages,building incentives and constraint mechanisms,and enhancing public awareness and patient-doctor education.

Concept of coordinated care delivery is clearly defined,before a comparative analysis is made between such a concept and the integrated care delivery concept which is popular overseas and similar.On such basis,a theory framework is established for building and implementing such care delivery in line with the integrated theory of care delivery systems.Coordinated care delivery system now in place in China aims at rationally delivering medical resources,services and patients to primary institutions,by means of efficiently distributing resources and service systems and integrating care delivery flows,thus offering patients with cost effective and appropriate services and optimizing the care delivery system.

Atrial Fibrillation ; pathology ; Humans ; Peptidyl-Dipeptidase A

Analyzed in the paper is the present development of medical rehabilitation service system in Beijing,Changsha,and Urumqi,in an effort to identify key measures,and discover problems found with the policy environment and system building.Based on such findings,the authors proposed such measures as developing policies and regulations, optimizing resource allocation, strengthening training of rehabilitation personnel and greater publicity.

Objective To explore the level of serum transforming growth factor-β1 (TGF-β1) in patients with prehypertension and impaired fasting blood glucose.Methods A total of 180 healthy subjects with matched age and sex was divided into 3 groups:group A (blood pressure ＜ 120/80 mmHg and fasting blood glucose ＜6.1 mmoVL),group B (prehypertension and fasting blood glucose ＜6.1 mmol/L),group C (prehypertension and 6.1 mmol/L≤ fasting blood glucose ≤7.0 mmol/L).There were 60 subjects in every group.Serum TGF-β1 was measured by Enzyme-Linked Immunosobent Assay (ELISA),fasting blood glucose,triglyceride,total cholesterol,low-density lipoprotein cholesterol ( LDL-C),high-density lipoprotein cholesterol ( HDL-C),Uric Acid ( UA),body mass index (BMI) were determined.Results The level of serum TGF-β1 in group B and C was higher in that in group A( t =2.071,and 2.147,P ＜0.05 ).The level of serum TGF-β1 was higher in group C than group B,but no significant difference was observed ( P ＞0.05).The pearson correlation analysis showed there was a significant correlation between TGF-β1 and systolic blood pressure ( r =0.279,P =0.047).Conclusions The level of serum TGF-β1 was higher in patients with prehypertention which may mediate the target organ damage caused by the prehypertention.

Aged ; Aged, 80 and over ; Candidiasis ; complications ; microbiology ; Coal Mining ; Esophagitis ; complications ; microbiology ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; microbiology

Objective To explore whether an individual' s intention to gamble varied across different types of gambling. Methods A total of 373 Macau students completed a questionnaire survey on intention to gamble dealing with thirteen types of gambling,and exploratory factor analyses were conducted. Results The analyses showed two factors that had eigenvalues greater than one and explained a total of 59. 455 percent of the variance,with the largest factor explaining 32.59 percent. Participants' intentions to gamble were relatively lower in gambles of low counterparty with mean scores varying from ( 1.62 ± 1.13 ) to ( 2.20 ± 1.35 ), while the intentions were higher in gambles of high counterparty with mean scores varying from ( 2.34 ± 1. 39 ) to ( 3.02 ± 1.55 ). Conclusion Respondents' degree of intention to gamble was highly domain-specific, varying with the type of gambling.An individual' s intention to gamble is not consistent across all content domains, which implied that a potential gambler is not necessarily intended to gamble in all types of gambling.

Authors described the patterns,core measures and mechanisms of coordinated care delivery in the localities and analyzed initial outcomes of this practice.It is found that such practice has optimized distribution of regional healthcare resources,implemented first visit to primary institutions, and the care delivery to separate emergency from outpatient service.In addition,the paper analyzed problems found in localities in terms of policy,public hospitals and primary institutions,and proposed elements required for coordinated care delivery system to succeed,such as enhanced policy support, enhanced multi-departmental coordination,and public hospital reform to explore feasible approaches.

This paper summarized practices and experiences of other countries in coordinated care delivery system building,and described the care delivery systems used in various healthcare fundraising patterns.It is found that most countries have defined duties and service coverage of healthcare institutions at all the levels and measures to ensure rational patient flow.In the end,the paper concluded found experiences of these countries and inspirations for China.

Objective To provide references for building the medical rehabilitation system in China by learning the progress and compliance of rehabilitation departments construction at tertiary hospitals. Methods Comparative and quantitative methods were used for dynamic analysis qualitative interview to learn the index compliance of the hospitals in question in 201 1-2012.Results Compared with 201 1, average days of stay of the rehabilitation departments declined in general,yet with insufficient therapists;introduction of early rehabilitation intervention was but 57.1%,and the functional assessment rate of rehabilitation service was less than satisfactory.Conclusion Lack of manpower,varying levels of medical rehabilitation services,and neglect for functional assessment were found to be the main problems in construction of medical rehabilitation departments for the time being.