[Objective]To systematically assess the public health governance capacity in Zhejiang Province,to conduct an in-depth analysis of its strengths and weaknesses,so as to provide scientific basis and strategic recommendations for further enhancement.[Methods]A systematic collection of policy documents,public information reports,and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted(encompassing a total of 1 263 policy documents,138 pieces of information reports and 631 research articles).Based on the evaluation criteria suitable for public health systems previously developed by the research team,the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated.Additionally,normative gap analyses were employed to identify the strengths and weaknesses.[Results]Zhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points(1 000.0-point maximum).The province has effectively implemented the principle of health first(scoring 698.5 points in the assessment of health-first strategy implementation)and attached sufficient importance to health-related goals(scoring 658.2 points in the scientific rationality of goal setting).However,the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points,the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points,and the coverage of incentive mechanisms scored 286.0 points.[Conclusion]Zhejiang Province has effectively implemented its health first strategy and attached great importance to health targets,but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

Background: With global aging, the burden of tuberculosis (TB) among older adults escalates, yet spatial studies on this group are scarce. In Chongqing, where 18.87% of the population are aged 65 years and older and TB burden is high, controlling older adult TB remains a major challenge. Objective: This study analyzed the spatiotemporal patterns of TB among adults aged 65 years and older in Chongqing, China, to inform local prevention and control strategies. Methods: The study data were obtained from the Tuberculosis Information Management System of China. Global and local spatial autocorrelation analyses were conducted using ArcGIS (version 10.7) to identify high-risk spatial clusters and visualize their distribution. Spatiotemporal scan statistics were performed using SaTScan (version 10.3.2) to detect clusters of TB cases among the older adult population. Statistical significance was set at P<.05. Results: The average annual incidence of TB among older adults in Chongqing was 69.59 per 100,000 population, with peaks occurring in spring and summer. The global Moran I ranged from 0.618 to 0.756 (P<.001 in all cases), indicating significant clustering. Persistent high-risk areas were identified in the northeastern and southeastern parts of Chongqing. Spatiotemporal scan statistics detected 1 most likely cluster (relative risk=3.52, 95% CI 3.37-3.68; log-likelihood ratio=1017.43; P<.001) and 3 secondary clusters. Conclusions: Significant seasonal patterns of TB among older adults were observed in Chongqing. High-risk areas were predominantly concentrated in the northeastern and southeastern parts of the municipality. More targeted public health interventions are imperative.

Background:Burnout and presenteeism are occupational health problems affecting professional stability in the nursing workforce and the quality of healthcare services. Social support is considered to be associated with burnout and presenteeism; however, the symptom-level association patterns among these three constructs remain unclear. This study systematically explored the structural associations and node characteristics among burnout, presenteeism, and social support based on a network analysis approach. Methods:A questionnaire survey was conducted among pediatric nurses in Chongqing, Southwest China, using a convenience sampling method, yielding 876 valid samples. A Gaussian graphical model (GGM) was constructed based on the Spearman correlation matrix, and the regularized partial correlation network was estimated using the EBIC-glasso algorithm. Network structure was computed using R software, and centrality indices, including strength, betweenness, closeness, and expected influence were derived. The accuracy of edge weight and the stability of centrality measures were assessed through 1,000 nonparametric bootstrap samples. Results:Presenteeism was positively correlated with burnout (r = 0.433), social support was negatively correlated with burnout (r = -0.361), and social support was negatively correlated with presenteeism (r = -0.179) (all p < 0.05). The strongest edge weight in the network structure was 0.72. Within the burnout module, D6 showed a strong connection with D5 and was associated with the depersonalization item E1, indicating that emotional exhaustion occupied a core position in the network. Centrality analysis demonstrated that E1 (Strength = 1.173), C11 (Strength = 1.122), and D6 (Strength = 1.112) were influential nodes. D1 and C3 showed the highest betweenness (Bet. = 97), playing bridging roles. Bootstrap results indicated narrow confidence intervals for edge weights, and the strength index maintained correlations >0.70 when 50% of the sample was retained, suggesting acceptable stability for strength-related findings in this sample. Conclusions:There were interactive relationships among burnout, presenteeism, and social support in pediatric nurses. Items related to emotional exhaustion were relevant nodes linking depersonalization and presenteeism, while family and emergency-related support resources played roles within the social support module. Network analysis identified relevant intervention nodes in occupational health and provides a reference for promoting occupational health.

BackgroundTuberculosis is a major global public health issue. Older adult individuals, due to factors like immunosenescence and comorbidities, are at high risk for TB. Chongqing’s significant aging population poses severe challenges for TB control in this group.ObjectiveThis study is based on the monthly case counts of pulmonary tuberculosis among older adults aged 65 and above in Chongqing from January 2020 to June 2024. It constructs and compares the Seasonal Autoregressive Integrated Moving Average (SARIMA) model, the Nonlinear Autoregressive Neural Network (NNAR) model, and the hybrid SARIMA-NNAR model to predict the monthly number of PTB cases in 2025.MethodsThe study data were extracted from the National Tuberculosis Surveillance System (TBIMS). Data collection and organization for pulmonary tuberculosis cases among individuals aged 65 and above were performed using Microsoft Excel 2019 (Microsoft Corp). Statistical analysis and predictive modeling were conducted using R software, version 4.5.2 (Network Theory Ltd., Bristol, United Kingdom). Data from January 2020 to June 2024 formed the training set, while July to December 2024 data served as the testing set. Model performance was evaluated using Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and Mean Absolute Percentage Error (MAPE).ResultsThe number of pulmonary tuberculosis cases among older adults in Chongqing exhibited distinct seasonal fluctuations, with peaks consistently occurring in March and May each year. On the testing set, the hybrid model achieved the lowest MAE (38.39%) and MAPE (11.77%), whereas the NNAR model produced the lowest RMSE (45.52%). Overall, the hybrid model demonstrated a more balanced performance across evaluation metrics. The forecasted case counts for 2025 maintained a similar seasonal pattern, with projected peaks in March and May.ConclusionThe SARIMA-NNAR hybrid model improves the prediction accuracy of pulmonary tuberculosis case counts in older adults by integrating linear and nonlinear components, providing a scientific basis for optimizing resource allocation and seasonal interventions in Chongqing.

BACKGROUND AND OBJECTIVES:As an emerging retirement model, lifestyle migration is garnering growing interest among China's middle-aged and older adults. However, existing research on the factors influencing willingness to engage in this form of migration remains fragmented and lacks a comprehensive synthesis. RESEARCH DESIGN AND METHODS:Following the PRISMA-ScR guidelines, a systematic search was conducted across CNKI, Wanfang, CQVIP, NSSD, Web of Science Core Collection, PubMed, Embase, and CINAHL Complete databases (from inception to 2026.03). The Population-Concept-Context (PCC) framework guided the inclusion and exclusion criteria, encompassing all studies on retirement relocation intentions and influencing factors among Chinese adults aged 45 and older. Two researchers independently screened the literature and extracted data, with findings synthesized through thematic analysis. RESULTS:26 documents were included (25 Chinese, 1 English), published between 2014 and 2026, covering 16 Chinese provinces, municipalities, or autonomous regions. Most used cross-sectional designs and focused on urban residents (total sample  =  9,452). Willingness rates ranged from 17.6% to 89.08%. Maslow's Hierarchy of Needs was the most widely applied theory. Influencing factors fell into 5 categories: individual characteristics, family and social support, objective conditions of the destination, psychological and behavioral intentions, and institutional and structural constraints. DISCUSSION AND IMPLICATIONS:Existing studies preliminarily uncover the multidimensional mechanisms of travel-based retirement willingness but lack consistent measures and strong theoretical grounding. Future work should strengthen interdisciplinary collaboration, develop localized theoretical models, and address the needs of rural, older adults, and vulnerable populations to advance an inclusive aging care system.10.17605/OSF.IO/5SC2D.

BackgroundHypertension and mental disorders, particularly depression, significantly impact Asia’s older adult. Alleviating depression in older adult hypertensive patients can significantly enhance their quality of life. This study evaluates the mental health status of hypertensive patients over 60 who do or do not provide intergenerational family support.MethodsUsing 2020 CHARLS data, we analyzed 4,851 hypertensive patients aged ≥60. Intergenerational family support was categorized into financial, daily caregiving, and emotional support, with mental health measured via the Chinese CESD-10. Multivariate linear regression and propensity score matching (PSM) assessed mental health changes from different support types. Heterogeneity analysis examined differences across age, gender, education, and urban–rural areas.ResultsCaregiving (β = −0.78, p < 0.01) and emotional support (β = −0.56, p < 0.05) significantly reduced depressive symptoms in older adult hypertensive patients, while financial support showed no significant impact. Sensitivity tests confirmed these results. Subgroup analyses revealed greater benefits for women (emotional support: β = −0.77), rural residents (emotional support: β = −0.59), and those aged ≥75 (caregiving support: β = −2.26).ConclusionNon-material intergenerational support, especially caregiving and emotional involvement, is crucial for alleviating depression in older adult hypertensive patients, whereas financial support has little effect. Policies should prioritize psychosocial interventions over financial aid, particularly for vulnerable groups like women, rural residents, and the older adult aged ≥75.

ObjectiveTo analyze the changes in the degree of coordination of China's major epidemic prevention and control efforts before and after the outbreak of the Corona Virus Disease 2019 (COVID-19), so as to explore the impact of epidemic prevention and control measures on coordination dynamics.MethodsA total of 3 864 policy documents related to epidemic prevention and control from January 2000 to December 2020 across 31 provinces (autonomous regions, and municipalities) in China were systematically collected. Contents specific to collaborative and cooperative efforts were extracted, and the extent of interdepartmental coordination were quantified to assess the effectiveness of epidemic prevention and control efforts. Wilcoxon signed-rank test was adopted to statistically analyze the differences between the indicators before and after the epidemic.ResultsThe average overall coordination level for major epidemic prevention and control in 31 provinces (autonomous regions, and municipalities) increased from 43.06% to 97.62%, and the average coordination levels in the eastern, central, and western China soared from 42.29%, 37.50%, and 47.46%, to 98.81%, 96.20%, and 97.46%, respectively, with statistically significant differences (all P<0.05). In terms of department categorization, coordination levels in the professional departments and the key support departments peaked at 100.00%, while other support departments rose to 95.43%, with an increase of 77.15%, 181.85%, and 139.89%, respectively, exhibiting noteworthy statistically significant differences (all P<0.001).ConclusionThe scope of coordination departments of China’s major epidemic prevention and control exists a remarkable surge following the COVID-19 outbreak, notable heightened coordination is particularly observed among the key support departments. Future endeavors should prioritize the roles played by diverse departments in epidemic prevention and control, enhancing both the clarity of departmental responsibilities and the effectiveness of interdepartmental coordination.

ObjectiveTo systematically evaluate the public health governance capacity of 40 cities in Jiangsu, Zhejiang, and Anhui Provinces, providing a scientific evaluation basis for building a "Healthy Yangtze River Delta".MethodsA comprehensive collection of policy documents, public information reports, and research literature related to public health governance capacity in Jiangsu, Zhejiang, and Anhui Provinces was conducted, totaling 6 920 policy documents, 1 720 information reports, and 1 200 literature pieces. Based on the evaluation standards for an appropriate public health system established by the research team, the basic status of public health governance capacity was assessed to identify the strengths and weaknesses of the 40 cities.ResultsIn 2022, the public health governance capacity score for the 40 cities in Jiangsu, Zhejiang, and Anhui Provinces was (562.5±38.0) points. In terms of specific areas, the emergency response field received the highest score of (791.4±49.7) points, while the chronic disease prevention and control field received the lowest score of (368.2±29.6) points. The Jiangsu-Zhejiang-Anhui region has largely achieved the strategic priority of health, gradually improved public health legal regulations, and established a basic organizational framework with a solid foundation for information and data infrastructure. However, challenges still need to be addressed, such as unstable government funding for public health, unclear departmental responsibilities, and barriers to information interoperability.ConclusionThe public health governance capacity of the 40 cities in Jiangsu, Zhejiang, and Anhui Province has been at a moderate level, but disparities have still existed across regions and fields. In the future, while continuing to deepen existing advantages, it is essential to accurately identify the causes of problems, establish a long-term and stable investment mechanism, enhance information connectivity mechanisms, further clarify departmental responsibilities, and promote the achievement of the "Healthy Yangtze River Delta" goal.

Objective To understand the epidemiologic trends and factors influencing the prevention and control of pulmonary tuberculosis with diabetes mellitus(PTB-DM)in Chongqing city,and to provide a basis for reducing the risk of comorbidities and improving patient outcomes in the region.Methods Data on PTB-DM patients registered in Chongqing city from 2016 to 2022 were extracted from the National Tuberculosis Information Management System.Descriptive analysis was used to analyze disease trends and demographic characteristics.Chi-square test was used to compare between groups.Multivariate unconditional logistic regression was used to analyze factors influencing patient outcomes.Joinpoint regression model was used to analyze disease trends.Results From 2016 to 2022,the average registration rate of PTB patients in Chongqing city was 49.38/100 000,with a decreasing trend(average annual percentage change[AAPC]=-10.70％,95％confidence interval[95％CI]:16.16％-5.63％).The average registration rate of PTB-DM patients was 2.9/100 000,with an increasing trend(AAPC=14.38％,95％CI:7.08％-23.73％).Enrolled PTB-DM were predominantly male,older,referred,had delayed medical visits,and had positive pathogen detection results.Among the outcomes of PTB-DM patients,successful treatment accounted for 80.85％and adverse outcomes accounted for 19.15％.The average annual treatment success rate was 82.01％.Joinpoint regression analysis showed a decreasing trend in the patients'treatment success rate.Multivariate unconditional logistic regression analysis showed that ethnic minorities(odds ratio[OR]=0.744,95％CI:0.633-0.874),0-24 years old(OR=0.217,95％CI:0.051-0.922),25-39 years old(OR=0.540,95％CI:0.398-0.734),40-54 years old(OR=0.488,95％CI:0.416-0.572),55-64 years old(OR=0.709,95％CI:0.607-0.828),initial treatment(OR=0.648,95％CI:0.531-0.791),and with negative pathogen detection results(OR=0.576,95％CI:0.489-0.677)were protective factors against adverse outcomes in PTB-DM patients.Living in southeast Chongqing(OR=1.560,95％CI:1.218-1.999)and being referred for treatment(OR=1.289,95％CI:1.080-1.539)were risk factors for adverse outcomes in PTB-DM patients.Conclusions The co-morbidity trend of PTB-DM in Chongqing city is obvious.Treatment and management factors,such as diagnostic route,delayed medical visits and management methods,have an impact on the treatment outcomes of PTB-DM patients.

Objective To analyze the change in service capacity against major epidemics before and after coronavirus disease 2019(COVID-19)in China for the promotion of the capacity.Methods Via systematic search on the official websites and the law documents website of Peking University(PKULAW),we collected totally 1 756 policy documents relevant to major epidemic prevention and control issued during 2002-2020 by government departments and professional public health institutions in 31 provincial-level administrative divisions of China.Contents about the coverage and assessability of service capacity of major epidemic prevention and control were extracted from the documents and indexes for evaluating national and regional coverage and assessability were calculated based on the extracted contents.Paired signed-rank test was used to analyze changes in the indexes before and during COVID-19 epidemic.Results The coverage of major epidemic prevention and control services has reached 100％in the Chinese mainland in 2019.In comparison to those in 2019 before the emergence of COVID-19 epidemic,the national assessability indexes(％)for service capability of major epidemic prevention and control of pre-,ongoing-and post-stage increased in 2020 by 29.78％(65.59％vs.50.54％),17.54％(72.04％vs.61.29％)and 4.34％(38.71％vs.37.10％).the assessment index for service capability of major epidemic prevention and control of pre-stage increased from 78.79％to 89.39％for eastern region and that of ongoing-stage increased from 65.00％to 76.67％for western region(both P＜0.05);but there was no significant increase in regional assessment index for service capability of major epidemic prevention and control of post-stage.The national assessment index for service capacity of major epidemic prevention and control of whole process increased significantly from 66.00％in 2019 to 73.78％in 2020 after the emergence of COVID-19 epidemic(P＜0.001).Conclusion The overall service capacity of major epidemic prevention and control has improved after the emergence of COVID-19 epidemic in the Chinese Mainland but the service capacity needs to be improved in central and western regions;in addition,the post-event assessment on the service capacity should be concerned for the promotion of the service capacity.

Background China is one of the countries with a high global burden of tuberculosis (TB). Chongqing is the most populous city in southwestern China and one of the provinces with a high degree of aging. This study aimed to analyse the delays in consultation and diagnosis of elderly patients with tuberculosis in Chongqing, to explore the reasons behind these delays, and to propose strategies to address these problems. Methods Based on the TB data extracted from the China Tuberculosis Management Information System from 2016 to 2022, TB patients aged ≥ 65 years with complete registration information who were currently residing in Chongqing Municipality during the 7-year period from 2016 to 2022 were selected. One-way c2 test and multifactorial logistic regression were used to analyse the factors affecting delay in consultation and delay in the healthcare system among elderly TB patients. Results. A total of 29,337 patients were included in this study. Between 2016 and 2020, there was a decreasing trend in both consultation delays and healthcare system delays in Chongqing. The median time of visit delay was 36 (15, 91) visit delay rate was 76.1%; the median time of healthcare system delay was 1 (1, 6) and healthcare system delay rate was 12.4%. Women (OR = 1.15,95%Cl:1.077,1.227), elderly TB patients who belonged to a mobile population (OR = 1.157,95%Cl:1.031,1.297) with comorbidities (OR = 1.084,95%Cl:1.026,1.145) were at higher risk of visit delay. Unemployed (OR = 1.349,95%Cl:1.198,1.520) and retired (OR = 1.820,95%Cl:1.641,2.019), mobile (OR = 1.445,95%Cl:1.272,1.642), with comorbidities (OR = 1.113,95%Cl:1.04,1.20), and Older TB patients who were first seen in the main urban area (OR = 1.721,95%Cl:1.566,1.891) were more likely to experience delays in the healthcare system. Conclusions Both TB visit delays and healthcare system delays have improved in Chongqing, but TB visit delays are still more prominent in the elderly population. To effectively address this problem, it is particularly important to strengthen health education efforts for the elderly population and key TB target groups, to enhance the professional capacity of primary health care institutions in TB screening, and to promote the in-depth application of Internet technology in TB prevention and control. The implementation of these measures will be of inestimable value in reducing delays in patient consultation and optimising the response efficiency of the healthcare system.

ObjectiveTo analyze changes in the coverage of incentive measures for promoting major epidemic prevention and control in documents published by governmental and professional departments in the Chinese Mainland before and after coronavirus disease 2019 (COVID-19) epidemic of 2020.MethodsThrough systematically searching websites of government departments and professional institutions in 31 provincial-level administrative divisions (PLADs) of the mainland of China, we retrieved totally 3 864 documents (including laws, regulations, standards, rules, proposals, plans, and guidelines) relevant to major epidemic prevention and control published from 2000 through 2020. The paragraphs related to incentive and disciplinary measures for promoting the containment of major epidemic were extracted to calculate region- and institution-specific coverage of the measures in the retrieved documents. Wilcoxon paired rank sum test was adopted to evaluate differences in the coverage of the established measures before and after COVID-19 epidemic of 2020 among various economic regions and administrative/professional institutions. ResultsThe average coverage of disciplinary measures for the retrieved documents increased from 74.19% before 2020 to 76.34% in 2020, with a significant increase of 2.90% (P < 0.05); while, the average coverage incentive measures was 22.85% for the documents published in 2020, significantly increased in comparison with no incentive measure presented in all the documents published before 2020 (P < 0.001). Compared to those before 2020, the national average combined coverage of incentive and disciplinary measures increased significantly by 11.83%, 30.77%, 42.11%, and 89.66% in 2020, for the documents published by administrative departments, public health institutions, health care institutions, and primary health care institutions, respectively; the national average coverage increased from 37.10% before 2020 to 49.60% in 2020 for the documents published by all the institutions, with an increment of 33.70%; and for the documents published by all the institutions in the PLADs of eastern, central and western region, the coverage increased significantly by 47.47%, 27.54% and 25.00% (all P < 0.05). ConclusionAfter COVID-19 epidemic of 2020, the coverage of incentive and disciplinary measures for promoting major epidemic prevention and control increased significantly in the documents published by governmental and professional departments in the mainland of China and the increase was much higher for the coverage of incentive measures.

Background At present, chronic non-communicable diseases have become the major diseases affecting people's health in China. Most of the studies on resource allocation for chronic disease prevention and control are status quo surveys or equity analyses, and there is a lack of representative indicators for evaluating the results. Objective To analyze the changes of the appropriateness of resource allocation for chronic disease prevention and control in Chongqing, and to explore its impact on the effectiveness of chronic disease prevention and control. Methods In accordance with the principle of " exhaustiveness ", this study systematically collected all the literature in the field of chronic diseases in Chongqing from 2010 to 2021 published on the websites of the government, the Health and Planning Commission and its related departments, as well as on open databases such as the CNKI and the Web of Science, and a quantitative analysis was made on the appropriateness of resource allocation for the prevention and control of chronic diseases. After the systematic collection of information, this study was respectively carried out from the four secondary indicators and thirteen tertiary indicators of the appropriateness of resource allocation for chronic disease prevention and control, which was derived from the quantitative standards previously constructed by the research group. The "five-point scale" method was used to semi-quantitatively score the severity of the problem (0 points indicate that there is no problem, 5 points indicate that the problem is very serious) and the scores were further calculated to determine the appropriateness of resource allocation. Correlation analysis and linear regression were used to analyze the influence of the appropriateness of resource allocation on the prevention and control of chronic diseases. Results From 2010 to 2021, the appropriateness of resource allocation for chronic disease prevention and control in Chongqing has increased from 6.64% to 27.57%; the appropriateness of human resource allocation has increased from 36.49% to 46.59%, the appropriateness of financial resource allocation has increased from 41.06% to 50.28%, the appropriateness of material resource allocation has increased from 41.40% to 42.96%, and the appropriateness of information resource allocation has increased from 5.73% to 24.09%. Among them, the appropriateness of financial and material resource allocation is significantly negatively correlated with the premature mortality rate of chronic diseases in Chongqing, with correlation coefficients of -0.722 and -0.586, respectively. Conclusion The appropriateness of resources allocation for the prevention and control of chronic diseases in Chongqing has been increasing year by year, but it is still at a lower level in general, and the main reason restricting its development lies in the relatively low information resources allocation; it is important to expedite the enhancement of the appropriateness of resources allocation to cope with the rapid increase of the number of chronic disease cases.

Objective To construct an evaluation index system in accordance with the practical implementation of county-level medical treatment and prevention integration in China,and to provide guiding principles and evaluation tools for its scientific development.Methods Using the rainbow model as a theoretical foundation,a theoretical framework and a pool of candidate indicators for evaluating county-level medical-preventive integration were established through policy analysis and literature review.The Delphi method and analytic hierarchy process(AHP)were used to determine the index system and corresponding weights.Results The response rates for the two rounds of expert consultation were 87％and 100％,respectively,with an average authority coefficient of 0.79.The coordination coefficients of the expert opinions were 0.222 and 0.359(both P＜0.05).After two rounds of expert consultation,an evaluation index system was established,which included 6 first-level,15 second-level,and 37 third-level indicators.Conclusions The construction of the index system was guided by appropriate theoretical principles,followed scientific methodology,adhered to systematic procedures,maintained rigorous processes,and produced reliable results to promote and enhance the development and sustainability of county-level medical-preventive integration in China.

Objective To examine the variation in clearly documented assignment of departmental responsibilities for major epidemic prevention and control in the Chinese mainland before and after the outbreak of COVID-19.Methods Official policy documents related to major epidemic prevention and control issued by administrative agencies of 31 provincial level administrative divisions from 2000 through 2020 were systematically retrieved online from websites of the agencies.The extracted information on the coverage,clarification and assessability of the assigned departmental responsibilities for major epidemic prevention and control were analyzed;T-test and paired rank sum test were adopted in statistical analysis.Results Based on relevant information extracted from the 3 864 policy documents retrieved,the nationwide average proportion of the departments with officially assigned responsibility versus all departments at provincial level increased significantly from 80.93％(18.61/23.00)in 2019 to 89.62％(20.61/23.00)in 2020(P＜0.05);the average proportion of the departments with the assessable responsibility versus all departments with the assigned responsibility increased from 26.16％(4.81/18.61)to 30.93％(6.39/20.61)and the average proportion of the departments with the specified responsibility versus all departments with the assigned responsibility also increased significantly from 44.00％to 54.58％;but the average proportion of the departments with clearly specified responsibility was not significantly improved.In 2020,the nationwide average proportion of the provincial departments with officially assigned responsibility increased significantly to 87.10％and 20.97％for the professional departments and the key support departments(P＜0.05),while the proportion for other support departments was not significantly different from that in 2000.Conclusion The degree of clearly documented assignment of departmental responsibilities for major epidemic prevention and control in China has been significantly improved after the outbreak of COVID-19 epidemic but the assessability of the assigned departmental responsibilities need to be improved.

Background Chongqing, the most populous city in Southwest China. This study aims to examine the equity of health resource allocation in Chongqing using the latest statistics, analyse possible shortcomings and propose strategies to address these issues. Methods This cross-sectional study used healthcare resource, population, area and gross domestic product data from the Seventh National Census Bulletin of Chongqing, the National County Statistical Yearbook, the Chongqing Municipal Bureau of Statistics and the Chongqing Health Statistical Yearbook 2022. We also studied the equity of health resource allocation in Chongqing by using the Gini coefficient, Lorenz curve and Theil index, and used the Analytical Hierarchy Process and Technique for Order of Preference by Similarity to Ideal Solution (AHP-TOPSIS) method to comprehensively evaluate the health resources in the four major regions of Chongqing. Results The Gini coefficient of health resources in Chongqing in 2021 was the highest when allocated according to geographical area, between 0.4285 and 0.6081, both of which exceeded 0.4, and the Gini coefficient of medical equipment was the highest and exceeded 0.6. The inter-regional Theil index of each resource was greater than the intraregional Theil index, and the contribution of inter-regional differences ranged from 64.83% to 80.21%. The results of the AHP-TOPSIS method showed that the relative proximity between health resources and ideal solutions in four regions of Chongqing ranged from 0.0753 to 0.9277. Conclusion The allocation of health resources in Chongqing exhibits pronounced inequities, particularly in the distribution of medical equipment according to geographical area. Moreover, there exists a substantial gap in the equity of health resource allocation among the four regions of Chongqing. As such, this study emphasises the need for Chongqing, China, to prioritise the equitable allocation of health resources and increase consideration of geographic factors. Implementing measures to promote equitable allocation of health resources, particularly in geographic terms, is critical.

ObjectiveTo evaluate the current status of hypertension prevention and control management operation mechanisms in Chinese mainland, explore the impact of their improvement on hypertension prevention and control effects, and provide a reference for enhancing hypertension prevention and control management. MethodsPolicy documents related to hypertension prevention and control from January 1 2000 to December 31, 2018 in 31 provinces (municipalities and autonomous regions) in Chinese mainland were collected. The current status of hypertension prevention and control management operation mechanisms in Chinese mainland was systematically evaluated according to the appropriate public health system evaluation model and standard. A logistic regression model was used to analyze the impact of the improvement of management operation mechanisms on hypertension prevention and control effects. ResultsIn 2018, the appropriateness of hypertension prevention and control management operation mechanisms in Chinese mainland was 43.68%, with an increase of 21.64% compared to 2000, but there was still a gap of 48.61% from the appropriate standard. Among them, the appropriateness of coordination and incentive mechanisms was the lowest (14.03%), and the appropriateness of planning and evaluation mechanisms was the highest (63.04%). In terms of specific positioning, the coverage of medium and long-term plans (100.00%) and the completeness of content and form (94.45%) were relatively high, while the feasibility of management mechanisms was only 9.76%. The results of logistic regression analysis showed that the improvement of management operation mechanisms helped control blood pressure in hypertensive patients (OR = 1.012, P = 0.007) and maintain the stability of patients’ blood pressure (OR = 1.010, P = 0.029). Conclusion From 2000 to 2018, the construction of hypertension prevention and control management mechanisms in Chinese mainland tended to be improved, effectively promoting the improvement of hypertension prevention and control management levels. However, it is still necessary to further establish and improve coordination and incentive mechanisms and clarify the division of departmental responsibilities.

Objective To analyze changes in target setting for emergency response to major disease epidemics in China before and after the coronavirus disease 2019(COVID-19)pandemic,summarize strengths and weaknesses in target setting,and provide a basis for improving target setting for emergency response to major disease epidemics in China.Methods We systematically retrieved a total of 3 864 policy documents(including plans,laws and regulations,and work programs)related to the prevention and control of major epidemics issued by government agencies of 31 provincial-level administrative divisions(PLADs)in Chinese mainland from 2000 to 2020.Relevant target content was extracted and the degree of consistency between emergency response targets for major diseases and public demand was calculated(the newly added targets are calculated on a cumulative basis from the precious year,and no value is assigned for duplicates).Paired rank sum tests were used to statistically test for differences in indicators before and after the epidemic.Results The consistency between the overall goal of emergency response to major disease epidemics and public needs in China increased from 79.7％ by 2019(before COVID-19)to 91.3％ in by 2020(after COVID-19),with an increase of 14.6％ ,and the region-specific consistency increased from 81.2％ to 93％ for the eastern region and from 78.3％ to 90.1％ for the western region,with an increase of 14.5％ and 15.1％ ,respectively,and a significant difference between the regions(P＜0.05).National consistency between the primary prevention goal of emergency response to major disease epidemics and public needs increased from 36.9％ to 46.4％ ,with a significant difference between the periods before and after the COVID-19 epidemic(P＜0.05);there were no significant differences between periods in consistency between the secondary and tertiary prevention goals of emergency response to major disease epidemics and public needs at either the national or regional level.Conclusion Consistency between emergency response goals for major disease epidemics and public needs in China has increased,either at the national or regional level,especially for primary prevention goals.

BackgroundThe global situation regarding the prevention and control of pulmonary tuberculosis (PTB) remains challenging. With the ongoing aging population and the increasing prevalence of chronic diseases, the epidemic of comorbid pulmonary tuberculosis and diabetes mellitus (PTB-DM) presents challenges to PTB control. We conducted this study given that current research on PTB-DM has primarily focused on clinical medicine and immunology, with limited reports on the true prevalence of population-wide PTB-DM in specific regions, as well as the heightened risk of PTB-DM co-prevalence due to aging and the high prevalence of DM in Chongqing, Southwest China.MethodsThis retrospective study used PTB case data from the PTB Information Management System within the China Information System for Disease Control and Prevention (CISDP). The medical records of 112,592 PTB patients registered in Chongqing from 2016 to 2022 were extracted. After excluding patients with incomplete records, those not residing in Chongqing, and individuals still undergoing treatment, a total of 108,003 PTB patients were included in the study. The trend in PTB-DM incidence was analyzed using the Joinpoint regression model, and population and clinical characteristics of patients were described using frequencies (n) and percentages. Chi-squared test and Fisher’s exact tests was used to compare groups, and multivariable logistic regression model with stepwise backward elimination based on the Wald test was used to examine risk factors for adverse treatment outcomes.ResultsFrom 2016 to 2022, the incidence rate of PTB in southwest China showed a decreasing trend (AAPC = -10.22, 95% CI: −11.49% ~ −8.94%), while the incidence rate of PTB-DM increased rapidly (AAPC = 14.25, 95% CI: 11.35% ~17.23%). The proportion of PTB-DM among PTB cases increased from 2.96 to 12.28%. PTB-DM patients were characterized by a higher proportion of males and older adult individuals, the age range of the patients was 11 ~ 100 years, with a mean age of 58.21 ± 12.02 years, with multiple positive aetiological results, and lower rates of proactive medical consultation. Among PTB-DM patients, successful outcomes accounted for 80.85%, while unsuccessful outcomes accounted for 19.15%. Although the number of PTB-DM patients with successful treatment outcomes increased overall (AAPC = 12.22, 95% CI: 10.30% ~14.16%), the failure rate showed a gradual upward trend (AAPC = 14.18, 95% CI: 6.53% ~ 27.67%). Older age, retreatment, referral, and multiple positive aetiological results were risk factors for adverse treatment outcomes among PTB-DM patients.ConclusionThe study presents the true prevalence of PTB-DM comorbidity in the general population of Southwest China, revealing a significant upward trend in its prevalence and a higher risk of adverse outcomes among PTB-DM patients. Future efforts should focus on the prevention and control of PTB-DM comorbidity, with early screening and standardized treatment for high-risk groups such as the older adult, as well as implementing comprehensive and effective treatment and management measures for patients.

Background: Timely bystander cardiopulmonary resuscitation is the key to improving the survival rate of out-of-hospital cardiac arrest. Civil servants are potential bystander CPR providers. This study aimed to explore civil servants' willingness to implement CPR in Chongqing, identify the influencing factors and mechanisms affecting civil servants' willingness to perform CPR, and then seek countermeasures to improve civil servants' willingness to implement CPR. Methods: We introduced the theory of perceived risk into the theory of planned behavior, developed a 7-point Likert scale based on the extended theory of planned behavior, and conducted a questionnaire survey on civil servants in Chongqing, China. Descriptive statistical analysis and one-way ANOVA were employed to explore respondents' willingness and differences. Structural equation modeling was used to analyze the relationship between attitude, subjective norm, perceived behavioral control and perceived risk and respondents' willingness to implement CPR. Results: A total of 1235 valid questionnaires were included for analysis. 50.1 % of respondents were willing to implement CPR. Male, over 40 years old, living with the elderly, having previous experience performing CPR on another person, and having higher CPR knowledge scores were associated with a more positive willingness to perform CPR. Attitude, subjective norm and perceived behavioral control had significant positive effects on willingness, and the standardized regression coefficients were 0.164, 0.326 and 0.313, respectively. The perceived risk has a significant negative effect on willingness, and the standardized regression coefficient was -0.109. The four latent variables accounted for 44.2 % of the variance in the willingness of civil servants to implement CPR. Conclusions: The willingness of civil servants in Chongqing to implement CPR needs to be improved, and the countermeasures to enhance the subjective norm and perceived behavioral control of civil servants should be emphasized, such as developing a social support network for rescuing conduct, establishing regular training mechanisms and improving the practical applicability and popularization of the Chinese-style "Good Samaritan Law" etc., to improve the willingness of civil servants in Chongqing to implement CPR.