Clinical Competence ; standards ; Education, Medical ; standards ; Humans ; Physicians ; standards

OBJECTIVETo investigate the qualifications and current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in China and to provide a reference for developing relevant policies.

METHODSWork reports and questionnaires survey were used to investigate the qualifications of all medical and health institutions and certified doctors for providing occupational disease diagnosis in China and their acceptance and diagnosis of occupational disease cases from 2006 to 2010. The rate for the work reports was 100%, and the response rate for the questionnaires was 71.0%.

RESULTSBy the end of 2010, in the 31 provincial-level regions (excluding Hong Kong, Macao, and Taiwan) in China, there had been 503 medical and health institutions which were qualified for providing occupational disease diagnosis, including 207 centers for disease control and prevention, accounting for 41.2%, 145 general hospitals, accounting for 28.8%, 69 enterprise-owned hospitals, accounting for 13.7%, and 64 institutes or centers for occupational disease prevention and control, accounting for 12.7%; 4986 certified doctors got the qualification for providing occupational disease diagnosis, with 9.4 certified doctors on average in each institution, and there was 0.65 certified doctor per 100 000 employees. In addition, 16.5% of the institutions got all the qualifications for diagnosing 9 occupational diseases, and 17.1% of the institutions got the qualification for diagnosing one occupational disease. Each certified doctor accepted diagnosis of 16.8 cases of occupational diseases on average every year.

CONCLUSIONA national occupational disease diagnosis network has been established in China, but the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors. It is essential to further strengthen the development of regional qualified medical and health institutions and training of qualified doctors.

Accountable Care Organizations ; standards ; China ; Occupational Diseases ; diagnosis ; Physicians ; standards

PURPOSE: The present study was aimed to determine whether endoscopist specialty is associated with high-quality endoscopy. MATERIALS AND METHODS: We prospectively collected endoscopy quality related data based on the Endoscopy Quality Rating Scale (EQRS) of 277 endoscopy units in a hospital setting from the National Cancer Screening Program of Korea in 2009. Gastroenterology medical professors (n=154) from university hospitals visited each endoscopy unit and graded the unit according to the EQRS. The scores from the EQRS were analyzed and compared in relation to endoscopy training during residency and endoscopy subspecialist certification. RESULTS: After excluding data from 3 endoscopy units, EQRS data from 274 endoscopy units were analyzed: 263 esophagogastroduodenoscopy (EGD) screening units and 90 colonoscopy screening units. There were no significant differences in the scores of EQRS with respect to endoscopy training during residency (p=no significance), except for scores of EGDs for "Facility and Equipment" (p=0.030). However, EQRS scores were significantly higher in the endoscopy units where endoscopy subspecialists performed the endoscopies than those where Endoscopy Subspecialists did not perform the endoscopies (p<0.05, except p=0.08 for the "Process" criteria of EGD). CONCLUSION: Endoscopist specialty is an important determinant of high-quality endoscopy in Korea.
Endoscopy/*standards ; Endoscopy, Digestive System/standards ; Humans ; Korea ; Medicine/*standards ; Physicians/*standards

OBJECTIVETo analyze the influence of knowledge about hypertension and clinical competence among physicians in district and community hospitals on management of hypertensives.

METHODSQuestionnaire investigation was used in 9 district and community hospitals in Chaoyang and Haidian district, including 181 physicians and 204 patients with hypertension.

RESULTS(1) The hospitals involved were divided into two groups according to our evaluation on the knowledge of hypertension and clinical competence of physicians. Four hospitals were graded as high-score group and 5 hospitals as low-score group. (2) There was no significant difference on physicians' evaluation between district and community hospitals. There was higher proportion of hypertensives with instructed physical exercises, reducing salt ingestion, psychological balance and weight reduction in district hospitals than those in community ones. (3) The proportion of hypertensives who were examined with funduscopy, ambulatory pressure and instructed with physical exercises, reducing salt ingestion and weight reduction in high-score group was obviously higher than that in low-score group. The control rates of blood pressure, on the days of examination during lastest check-up or the past three months, were significantly higher in high-score group than in low-score group (P < 0.05).

CONCLUSIONKnowledge of hypertension and clinical management competence among physicians in district and community hospitals did influence the management of hypertension and education of physicians and thus should be increased.

Clinical Competence ; standards ; Delivery of Health Care ; standards ; Directive Counseling ; standards ; Education, Medical ; standards ; Hospitals, Community ; classification ; standards ; Humans ; Hypertension ; diagnosis ; therapy ; Patient Care ; standards ; Physicians ; standards

OBJECTIVETo evaluate the necessity, scientificity, and feasibility of the drafted Practice Guidelines on Prevention and Treatment of Hypertension for Primary Care Physicians.

METHODSDerivative Dolphe Method was used to collect the responses from 50 experts in hypertension or related fields within the nation. An evaluation score of 1 to 5 was given to each item for selection, 1 for highly disagreed and 5 for highly agreed. The mean, standard deviation (SD) and coefficient of variance (CV) of the scores were calculated.

RESULTS(1) 90% experts responded to the evaluation sheet. (2) The mean score were above 4 for the five out of the six items related to necessity, the SD varied from 0.51 to 1.05, and the CV from 0.11 to 0.30. (3) Among the 28 items related to scientificity and rationality, the mean score was above 4 for 25 items and was between 3.5 and 4 for other three items. The CV was generally lower than 0.35. (4) Among the seven items related to feasibility, the mean score for five of them was lower than 4, and the CV varied from 0.21 to 0.33.

CONCLUSIONThe results indicate that the necessity and scientificity of the most content of the guidelines are confirmed by the invited experts.

Clinical Competence ; standards ; Humans ; Hypertension ; therapy ; Peer Review ; methods ; standards ; Physicians, Family ; Practice Guidelines as Topic ; standards ; Practice Patterns, Physicians' ; standards ; Reproducibility of Results ; Surveys and Questionnaires

Evidence-Based Medicine ; Integrative Medicine ; standards ; Medicine, Chinese Traditional ; standards ; Practice Guidelines as Topic ; standards ; Practice Patterns, Physicians' ; standards

Based on the optimum clinical evidence, consulting the international guide, the outstanding guidelines of acupuncture clinical practices is formulated in order to promote the process of acupuncture modernization and internationalization. According to consensus of experts, using the questionnaire method, integrating the characteristics and requirements for acupuncture clinical practices, the guidelines reflect the characteristics of acupuncture, for instance, applicability, inheritance, holism, and the discipline characteristics. Thus, the guidelines will standardize the treatments in acupuncture clinical practices, strengthen medical service quality management, control medical costs, and promote the process of acupuncture modernization and internationalization.
Acupuncture Therapy ; standards ; Humans ; Practice Guidelines as Topic ; Practice Patterns, Physicians' ; standards

Three features of ethics review in Chinese medicine (CM) and integrative medicine (IM) were put forward in this paper. It is consistent with the principles of ethical review in Western medicine; it has to be compliant with the laws of CM and IM; emphasis should be laid on the review of clinical practice facts and experience. Three problems were pointed out. The characteristics of CM and IM are not distinctive enough, operation procedures need to be refined and effectiveness remains to be improved. Based on the mentioned above, seven measures were proposed to improve the level and quality of ethics review in CM and IM, including better brand awareness, considerable tolerance, treatment based on disease differentiation and syndrome differentiation, scientific review and toxicity and side effects of CM, perfection of the ethics review system, reasonable procedures of ethics review and more specialized ethics review workers.
Ethics ; Humans ; Integrative Medicine ; ethics ; standards ; Medicine, Chinese Traditional ; standards ; Practice Patterns, Physicians'

No abstract available.
Gynecology/*organization & administration/*standards ; Humans ; Patient Escort Service/*organization & administration/*standards ; Physical Examination/*methods/*standards ; Physicians/*ethics ; Sex Factors

Objectives To learn the echocardiography skills of intensivists after receiving a basic critical care echocardiography training course, and investigate factors that may influence their performance. Methods We completed a web-based questionnaire that assessed the skills in ultrasound scanning techniques of intensivists who took a training course on basic critical care echocardiography held in 2019 and 2020. Mann-Whitney test was used to analyze the factors which might affect their performance on image acquisition, recognizing clinical syndrome, and measuring the diameter of inferior vena cava, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral.Results We enrolled 554 physicians from 412 intensive care units across China. Among them, 185 (33.4%) reported that they had 10%-30% chance of being misled by critical care echocardiography when making therapeutic decision, and 34 (6.1%) reported that the chance was greater than 30%. Intensivists who performed echocardiography under the guidance of a mentor and finished ultrasound scanning more than 10 times per week reported significant higher scores in image acquisition, clinical syndrome recognition, and quantitative measurement of inferior vena cava diameter, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral than those without mentor and performing echocardiography 10 times or less per week respectively (all P < 0.05).Conclusion The skills in diagnostic medical echocardiography of Chinese intensivists after a basic echocardiographic training course remain low, and further quality assurance training program is clearly warranted.
Humans ; Clinical Competence ; East Asian People ; Echocardiography/standards* ; Stroke Volume ; Ventricular Function, Left ; Self-Assessment ; Physicians/standards* ; Internal Medicine/standards*