Objective:To analyze the influencing factors of patient loyalty in internet diagnosis and treatment, for references for improving the service quality and promoting the sustainable development of internet diagnosis and treatment.Methods:In November 2023, a simple random sampling method was used to select patients who had received internet diagnosis and treatment as the survey objects and conduct a questionnaire survey on performance expectations, effort expectations, social influence, promotion conditions, price values, patient trust and patient loyalty. By establishing an unified theory of acceptance and use of technology model of influencing factors of patient loyalty in internet diagnosis and treatment, the hypotheses were put forward. The structural equation model (SEM) test and mediation effect test were used to verify the hypothesis path and variable mediation effect, and explore the influencing factors of internet patient loyalty.Results:A total of 1 800 patients were included in this study, including 1 188 patients(66.0%) who received internet diagnosis and treatment≥3 times/month. According to the SEA test, performance expectations ( β=0.296, P<0.001), social influence ( β=0.146, P=0.014), promotion conditions ( β=0.366, P<0.001), price values ( β=0.452, P=0.017), and patient trust ( β=0.459, P<0.001) had a direct positive impact on patient loyalty; Social influence ( β=0.147, P<0.001) and promotion conditions ( β=0.084, P<0.001) had a direct positive impact on patient trust. According to the mediation effect test, patient trust partially mediated the relationship between social influence and patient loyalty ( β=0.071, P=0.018), as well as the relationship between promoting conditions and patient loyalty ( β=0.748, P=0.041). Conclusions:Performance expectations, social influence, promotion conditions, price values, and patient trust had a positive impact on patient loyalty, among which social influence and promotion conditions could enhance patient loyalty by strengthening patient trust. It was suggested that relevant institutions should focus on the service quality of internet diagnosis and treatment, further improve performance expectations, expand social impact, improve promotion conditions and regulate price values, so as to enhance the patient loyalty, promote the wide application and rapid development of internet diagnosis and treatment.

Objective:To investigate the current situation and analyze the influencing factors of job satisfaction of infectious disease physicians in Jiangsu Province.Methods:From April to May 2021, a stratified random sampling method was used to select 10 municipal level infectious disease hospitals in Jiangsu province. An electronic questionnaire survey was conducted on the infectious disease physicians of these hospitals using an online questionnaire platform. The questionnaire mainly included the job satisfaction scale developed by Greenhaus and Wormley, and a self-designed job satisfaction influencing factor scale based on resource conservation theory. At the same time, semi-structured interviews were made with relevant insiders on such issues as salary and benefits, and career development among others. Descriptive analysis was conducted on the questionnaire data, while single factor analysis and multiple linear regression analysis were used to identify the factors that affect their job satisfaction, and the results of the interviews were studied with Colaizzi 7-step analysis.Results:A total of 457 valid questionnaires were recovered. The job satisfaction score of infectious disease physicians was (3.38±0.76). The results of univariate analysis showed significant differences in job satisfaction scores among infectious disease physicians of different ages, educational backgrounds, professional titles, and positions. The results of multiple linear regression analysis showed that salary and benefits ( B=0.141, P<0.001), work environment ( B=0.128, P<0.001), leadership support ( B=0.112, P=0.014), development security ( B=0.117, P<0.001), self-efficacy ( B=0.084, P=0.045) and social support ( B=0.285, P<0.001) were both influencing factors of their job satisfaction. The interview results identified such problems as low salary, insufficient salary security, large gap in social security levels between in-staff and off-staff physicians, and insufficient career development potential. Conclusions:The job satisfaction of infectious disease physicians in Jiangsu Province was found at an average level. It is recommended that the government increase the investment in personnel expenses for infectious disease physicians, optimize the salary and benefits structure, pay attention to the career development needs of middle-aged and young physicians, and care about the social relationship needs of infectious disease physicians to improve their job satisfaction.

Objective:To understand the incidence of esophageal cancer in population at high risk in Yangzhong of Jiangsu province.Methods:Cluster random sampling method was conducted to select several natural villages from the high risk area of esophageal cancer in Yangzhong during 2011-2017. Local residents aged 40-69 years were selected as the target population and a total of 14 687 persons were diagnosed esophageal cancer by endoscopy and pathology.Results:Precancerous lesions were detected in 341 persons, with the detection rate as 2.32 % (341/14 687). Among them, there were 234 (1.59 %) cases with mild and 107 (0.73 %) cases with moderate esophageal hyperplasia. There were 77 positive cases with esophageal hyperplasia and the detection rate was 0.52 %. Among these positive cases, 41 showed severe esophageal hyperplasia/carcinoma in situ (0.28 %), with another 19 as early esophageal cancer (0.13 %) and 17 with invasive carcinoma (0.12 %). The overall early detection rate of positivity through active screening was 77.92 % (60/77), with trends of upwarding and then downwarding. The detection rate of esophageal lesions in men was higher than that in women ( P<0.05), but without significant gender specific differences seen in the detection rates of early esophageal cancer or invasive carcinoma ( P>0.05). The detection rates of all lesions other than invasive carcinoma, gradually increased with age ( P<0.05). The detection rate of invasive carcinoma reached the highest (0.39 %, 10/2 547) in the age group of 60-years and slightly decreased in the age group of 65-years old. Conclusions:Considerable numbers of patients with cancer and precancerous lesions in groups at high-risk can be found through the screening program for esophageal cancer, suggesting that the screening program is of great significance in improving the survival rate and quality of life. Attention should be paid to men, with elderly groups in particular, at high-risk in order to increase the detection rate of early cases.

Objective: To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods: From 2009 to 2015, 31 natural villages with high-incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub-district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost-effectiveness analysis and cost-benefit analysis, were performed to evaluate the current screening schemes. Results: The mean age of all respondents were (53.60±8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high-grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness-cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.

Objective To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods From 2009 to 2015, 31 natural villages with high?incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub?district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost?effectiveness analysis and cost?benefit analysis, were performed to evaluate the current screening schemes. Results The mean age of all respondents were (53.60 ± 8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high?grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness?cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.

Objective To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods From 2009 to 2015, 31 natural villages with high?incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub?district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost?effectiveness analysis and cost?benefit analysis, were performed to evaluate the current screening schemes. Results The mean age of all respondents were (53.60 ± 8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high?grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness?cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.

Objective To analyze the importance and necessity of patient public education, and to explore its contents and approaches. Methods From September to October 2017, 2224 medical workers and patients from 9 tertiary public hospitals among southern, central and northern Jiangsu province were surveyed with the self-designed questionnaire. Demographic data of respondents and their views related to patient public education topics were surveyed. Descriptive analysis and chi-square test were used to analyze the data. Results Some patients were irrational in their cognition of patients′ obligations, risk of disease, expectation of curative effect, and responsibility for medical malpractice. 19. 9％ of them held that"patients were vulnerable groups who should not carry much obligations". Some of them were found with obvious negative emotions and unhealthy psychological characteristics. 54. 4％ of the medical workers held that"psychological conflicts among the various roles of patients lead to various behavioral contradictions", which obviously affected their medical work. Conclusions Patient public education can be an important approach to avoid irrationality of patients when they see doctors. Patient public education is an education activity against irrational cognition, psychology and behavior of the patients at large. It requires an orchestrated effort by the governments, schools, hospitals among other stakeholders.

Objective: This paper aims to evaluate the poverty impact incurred by out-of-pocket payment (OOP) on rural residents in the selected remote minority-inhabited areas in western China both in 2011 and 2014. Methods: Under China's national poverty line, poverty headcount ratio and poverty gap were estimated from two rounds of household survey in 2011 and 2014, respectively. The Pan's Parade was also pictured. Results: In 2011, the poverty headcount ratios before and after the OOP were 31.07% and 51.70%;and the poverty impact was 20.63%. The impact of average poverty gap and mean positive poverty gap was 284.24 Yuan and 183.73 Yuan, respectively. In 2014, the poverty headcount ratios before and after the OOP were 29.40% and 44.66%;and the poverty impact was 15.26%. The impact of average poverty gap and mean positive poverty gap was 242.68 Yuan and 240.41 Yuan, respectively. Conclusion: Poverty headcount ratio and average poverty gap were reduced in the area of interest within the current study, but the mean positive poverty gap was increased. New rural cooperative medical scheme needs to be further adjusted for improving the insured individual's benefits. Low-income group should be paid more attention to eliminate impoverishment incurred by OOP.

Objective: In order to better understand the influencing factors of vertical rural health services integration and put forward policy suggestions for its sustainable development.Methods: 288 residents were investigated through questionnaire survey in three sample areas of Jiangsu province in August 2015.Results: In this study, 4 common factors have been found, namely organizational management, incentive mechanism, policy and supporting measures, as well as information sharing and business communication.The overall scores given by health managers, doctors and nurses, and public healthcare professionals were 0.03, 0.04 and-0.02 respectively.Conclusions: Therefore, in order to succeed, it is very necessary to introduce targeted supporting policies, establish a mutual communication mechanism, and make an effective incentive mechanism.

During the process of China’s healthcare reform, the concept of “costly access to health care” has been discussed for quite a long time. However, big data indicates that a small number of patients (5%) account for disproportionate costs ( approximately 50%) . “Costly access to health care” may not be a ubiquitous perceived prob-lem for all residents. In this paper, the concept“high-need patient” will be introduced and the characteristics of the population will be analyzed. According to the healthcare reform experience from the international perspective, this paper proposed healthcare strategy for Chinese high-need patients and policy recommendations for China’s healthcare reform.