1.Healthcare institution resilience and the influencing factors during infectious disease outbreaks
Yaqun FU ; Jiawei ZHANG ; Bing HAN ; Quan WANG ; Zheng ZHU ; Zhijie NIE ; Yiyang TAN ; Qing LIU ; Xiaoguang LI ; Jing GUO ; Rongmeng JIANG ; Li YANG
Journal of Peking University(Health Sciences) 2025;57(3):529-536
Objective:To analyze the association between healthcare workers mental health,institu-tional supplies and facilities,inter-organizational coordination during infectious disease outbreaks,and the healthcare institution resilience.Methods:An online questionnaire survey was conducted among the healthcare workforce from 146 institutions in Beijing from January 13,2023 to February 9,2023,and a total of 1 434 eligible respondents were included.The sample comprised 408 responses from tertiary hos-pitals,117 from secondary hospitals,and 909 from primary care institutions.The resilience indicator for healthcare institutions was defined as the degree to which medical services met patient demands,with in-fluencing factors including physical factors,such as material shortages and facility space adaptation or ex-pansion,organizational factors such as information sharing and patient referral,and psychological factors were evaluated using job satisfaction(extrinsic satisfaction,intrinsic satisfaction),burnout(emotional exhaustion,depersonalization,reduced personal accomplishment),and depression status.Ordered mul-ticlassification Logistic regression was used to examine the impact of various factors on the degree to which healthcare services met patient needs;additionally,demographic factors that might influence institutional resilience were controlled.Results:During the emergency response phase,93%of hospitals maintained the capacity to meet patient needs,though tertiary hospitals demonstrated significantly higher rates of service inadequacy(21.05%).Material shortages were reported across all institutions,with tertiary hos-pitals experiencing more frequent multi-item shortages.Inter-institutional collaboration patterns revealed substantial variation:87.50%of primary care facilities,42.86%of secondary hospitals,and 31.58%of tertiary hospitals.Healthcare workers across all levels reported mild depressive symptoms and moderate-to-severe burnout levels.Regression analysis showed high satisfaction(overall satisfaction β=0.04,ex-trinsic satisfaction β=0.06,and intrinsic satisfaction β=0.08),low degree of job burnout(emotional exhaustion β=-0.04,depersonalization β=-0.07 and reduced personal accomplishment β=0.01),low degree of depression(β=-0.06)were significantly associated with higher healthcare institution re-silience.In addition,material shortages were significantly associated with lower resilience,and renova-tion and expansion of treatment spaces,and information sharing,were all associated with higher resilience.Demographic factors(age,gender,marital status,educational background,etc.)had no sig-nificant impact on resilience.Conclusion:Mental health status significantly influences healthcare institu-tion resilience.As human resources constitute the core asset of healthcare institutions,strategic optimiza-tion of workforce allocation and psychological support interventions can effectively strengthen resilience.Moreover,healthcare institution resilience is positively impacted by orderly material supply chains,timely resource distribution,and adaptive reconfiguration of clinical spaces.Finally,facilitating information sharing also enhances institutional resilience.
2.Healthcare institution resilience and the influencing factors during infectious disease outbreaks
Yaqun FU ; Jiawei ZHANG ; Bing HAN ; Quan WANG ; Zheng ZHU ; Zhijie NIE ; Yiyang TAN ; Qing LIU ; Xiaoguang LI ; Jing GUO ; Rongmeng JIANG ; Li YANG
Journal of Peking University(Health Sciences) 2025;57(3):529-536
Objective:To analyze the association between healthcare workers mental health,institu-tional supplies and facilities,inter-organizational coordination during infectious disease outbreaks,and the healthcare institution resilience.Methods:An online questionnaire survey was conducted among the healthcare workforce from 146 institutions in Beijing from January 13,2023 to February 9,2023,and a total of 1 434 eligible respondents were included.The sample comprised 408 responses from tertiary hos-pitals,117 from secondary hospitals,and 909 from primary care institutions.The resilience indicator for healthcare institutions was defined as the degree to which medical services met patient demands,with in-fluencing factors including physical factors,such as material shortages and facility space adaptation or ex-pansion,organizational factors such as information sharing and patient referral,and psychological factors were evaluated using job satisfaction(extrinsic satisfaction,intrinsic satisfaction),burnout(emotional exhaustion,depersonalization,reduced personal accomplishment),and depression status.Ordered mul-ticlassification Logistic regression was used to examine the impact of various factors on the degree to which healthcare services met patient needs;additionally,demographic factors that might influence institutional resilience were controlled.Results:During the emergency response phase,93%of hospitals maintained the capacity to meet patient needs,though tertiary hospitals demonstrated significantly higher rates of service inadequacy(21.05%).Material shortages were reported across all institutions,with tertiary hos-pitals experiencing more frequent multi-item shortages.Inter-institutional collaboration patterns revealed substantial variation:87.50%of primary care facilities,42.86%of secondary hospitals,and 31.58%of tertiary hospitals.Healthcare workers across all levels reported mild depressive symptoms and moderate-to-severe burnout levels.Regression analysis showed high satisfaction(overall satisfaction β=0.04,ex-trinsic satisfaction β=0.06,and intrinsic satisfaction β=0.08),low degree of job burnout(emotional exhaustion β=-0.04,depersonalization β=-0.07 and reduced personal accomplishment β=0.01),low degree of depression(β=-0.06)were significantly associated with higher healthcare institution re-silience.In addition,material shortages were significantly associated with lower resilience,and renova-tion and expansion of treatment spaces,and information sharing,were all associated with higher resilience.Demographic factors(age,gender,marital status,educational background,etc.)had no sig-nificant impact on resilience.Conclusion:Mental health status significantly influences healthcare institu-tion resilience.As human resources constitute the core asset of healthcare institutions,strategic optimiza-tion of workforce allocation and psychological support interventions can effectively strengthen resilience.Moreover,healthcare institution resilience is positively impacted by orderly material supply chains,timely resource distribution,and adaptive reconfiguration of clinical spaces.Finally,facilitating information sharing also enhances institutional resilience.
3.Progress in research of economic evaluation of non-pharmaceutical interventions for COVID-19 prevention and control
Yaqun FU ; Jingyu ZHAO ; Peien HAN ; Li YANG ; Tao REN ; Siyan ZHAN ; Liming LI
Chinese Journal of Epidemiology 2022;43(7):1030-1037
Objective:To understand the research progresses of economic evaluation of non-pharmaceutical interventions (NPIs) both at home and abroad, and provide reference for economic evaluation of NPIs using real-world data in China.Methods:The literature retrieval was conducted by searching Chinese and English databases to indude papers about economic evaluation of NPIs and integrated NPIs published from January, 2020 to December, 2021, and the results were analyzed comprehensively.Results:A total of 30 Chinese and English literatures about economic evaluation of NPIs for COVID-19 prevention and control were included; including 7 papers about nucleic acid and testing and screening, 6 papers about individual prevention and protection measures, 12 papers about integrated implementation of individual prevention and protection, social distancing, nucleic acid or antigen testing, community screening and symptom screening, as well as close contact tracing and isolation/quarantine, and 5 papers about contain strategies, such as lockdown. This study found that personal protection, social distancing, and testing-tracing-isolation measures were cost-effective; however, different combinations of NPIs might lead to different results. Moreover, the cost of lockdown was high, which might cause huge economic burden.Conclusions:Most NPIs are cost-effective except lockdown, while the cost-effectiveness of the integrations of NPIs at different levels and in different scenarios needs to be further evaluated. It is necessary to carry out economic evaluation of integrated NPIs and the combination of NPIs with other interventions, such as vaccination and medication, based on real-world settings in China.
4.Mechanisms of plasmid-mediated quinolone resistance in Proteus mirabilis from urine
Caiqian LIANG ; Qinglei KONG ; Yongmei FU ; Yaqun FENG ; Xiaoyan YANG
The Journal of Practical Medicine 2017;33(24):4152-4155
Objective To investigate the prevalence of plasmid-mediated quinolone resistance(PMQR) in Proteus mirabilis clinical isolated from urine. Methods Antimicrobial susceptibility test was performed using the microdilution method.And PMQR gene qnrA,qnrB,qnrC,qnrD,qnrS,aac(6′)-Ib-cr,qepA were amplified by PCR,then the PCR positive products were sequenced to identify their genotypes. Results In 41 strains of Proteus mirabilis from urine,the resistant rates to ciprofloxacin and levofloxacin were 41.5% and 29.3%,respec-tively.Among all clinical isolates,qnrA1 gene was detected in 2 strains,qnrB2 gene in 3 strains.PMQR gene qn-rB,qnrC,qnrD,qnrS,aac(6')-Ib-cr and qepA were not detected in all strains.Conclusions Clinical isolates of Proteus mirabilis from urine carry PMQR genes.The prevalent principal genotypes are qnrA1 and qnrB2 in these iso-lates.They are related to low levels resistance toquinolone.

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