OBJECTIVE:To probe into the effects of carrying out"Prescription Set"self-help service in cooperative medical care clinic service in countryside in lessening the economical burden of peasants patients and enabling more people benefited from the basic health care.METHODS:Targeting at the common diseases in clinic service of the health center,for each of which at least3kinds of treatment plans prescription in different prices were worked out,to make the peasants patients choose the prescription freely.RESULTS&CONCLUSION:The outpatient number has increased significantly while medical expenses on prescriptions of outpatients decreased significantly in the primary level hospitals and community clinics through the practice of"Prescription Set"self-help service.

BACKGROUNDWe aimed to improve the sensitivity of immunochemical fecal occult blood test (I-FOBT) to screen colorectal neoplasm among average-risk adults.

METHODSThis is a diagnostic cohort study. All health examination participants receiving a single qualitative I-FOBT and a screening colonoscopy from January 2010 to June 2011 were included. Stool specimens were collected for I-FOBT before colonoscopy. Using pathology as gold standard, significant colorectal neoplasm was defined as advanced adenoma or malignancy.

RESULTSA total of 1 007 health examinees were identified. Fifty-five (5.5%) had borderline positive (+/-) I-FOBT, while 38 (3.8%) had positive I-FOBT. Twenty-four (2.4%) had advanced adenoma, and five (0.5%) had carcinoma. Using borderline positive I-FOBT as cutoff value, the sensitivity and specificity for significant colorectal neoplasm were 34.5% (95% confidence interval (CI) 19.9%-52.7%) and 91.5% (95% CI 89.6%-93.1%), respectively. If combined with advanced age, high blood pressure (BP), and abdominal obesity, a fulfillment of either two criteria further increased the sensitivity to 72.4% (95% CI 54.3%-85.3%) with a specificity of 68.8% (95% CI 65.8%-71.6%).

CONCLUSIONThe sensitivity of a single qualitative I-FOBT for the detection of significant colorectal neoplasm can be increased by coupling with age, BP, and abdominal obesity.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; diagnosis ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Occult Blood ; Sensitivity and Specificity ; Young Adult