Objective To construct a prediction model for risks of cardio-cerebrovascular disease (CVD) in 5 years for newly diagnosed type 2 diabetic patients in China.Methods We collected from an official chronic disease prevention and control project 2 899 participants newly diagnosed as diabetic who were free from CVD events.Cox proportional hazards regression model was used to construct a 5-year CVD risk model.Calibration and goodness of fit test were applied.External validation based on Shandong Multi-center Health Management Large Database was adopted to assess the stability of model.Results a total of 228 first CVD events were recorded in the derivation cohort during an average follow-up of 4.7 years (16.86/1 000 person-year).The 6 variables included age,gender,systolic pressure,low-density lipoprotein,high-density lipoprotein and family history of CVD.In the derivation cohort,the area under the receiver operating characteristic curve (AUC) for the Cox model and scoring model was 0.678 (95％ CI:0.660-0.695) and 0.663 (95％ CI:0.648-0.680),respectively.In the external validation,the AUC for the Cox model and scoring model was0.640 (95％CI:0.608-0.676) and0.631 (95％ CI:0.600-0.661),respectively.Conclusion We have established a model to predict the 5-year risks of CVD in Chinese type 2 diabetic patients,which can be used for the early intervention of CVD among type 2 diabetic patients in residential communities.

Objective To construct prediction models to estimate the risks of developing type 2 diabetes mellitus (T2DM) in 3 years among the health management population in mainland China.Methods Non-diabetic people aged 20 to 75 years at the baseline were chosen from Shandong Multi-center Longitudinal Cohort for Health Management to compose our cohort.Cox's proportional hazards regression model was adopted to build T2DM prediction model.The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictability of the model.Ten-fold cross-validation was adopted to test the stability of the model.Results During the follow-up of 3.68 ± 2.8 years,1,624 cases of new-onset diabetes occurred.The incidence density of male and female was 15.00‰ and 10.83‰,respectively.The risk factors for the male model included age,body mass index (BMI),fasting plasma glucose (FPG),triglyceride,alanine aminotransferase (ALT),and white blood cell (WBC) count.The risk factors for the female model included age,FPG,triglyceride,high density lipoprotein cholesterol (HDL-C),and ALT.The AUC of the male model and female model was 0.795 (95％ CI:0.764-0.827) and 0.707 (95％ CI:0.654-0.759),respectively.Conclusion The male and female prediction models we constructed have high predictability and reliability among the health management population.

Public health grant transfer payment is an important policy to improve public health in China.The public health grant should not only accord with the demand of raising fund requirement of grass-root public health service;but also be restricted to the public finance system.The research situation of public health transfer payment is summarized in health and fields from different point views.New study ideas are proposed from interdisciplinary point views.

OBJECTIVE By exploring and analyzing the resource allocation of community health services in Tianqiao,Jin'an;We can provide a sound scientific basis for establishing the standard of regional health planning and resource allocation in the future.METHOD Every health service in Tianqiao obtained questionnaires,which include:'Monitoring Schedule of Community Health Service in City','Monitoring Schedule of Community Health Service Center'and'Monitoring Schedule of Community Health Service Station',RESULTS(1)There are on average three health service stations in each street or town,and 78.6% of them are brought into the medical insurance for urban workers.(2)Collocation of human resource:there are 810 people working in Health Service,in which the health personnel account for 76.3%.And the doctor-nurse ratio is 1:0.75.While,few of them have been trained well;and the support from higher-up is not sufficient.(3)Equipment allocation:The hardware device is fully equipped and thus it comes to a good medical environment.(4)Financial resources:The finance is improving gradually,and the fund investment on community health service has been increased by six times.CONCLUSION It is better to plan the community health resource as a whole,and preferentially boost the whole quality of medical personnel in health service.Furthermore,steady mechanism of health human resource and reimbursement mechanism for community health service need to be built up.At the same time,the equipments should be adjusted when it is necessary.

我国正处于医改变革时期,医疗保险制度的发展正在不断地完善,本文介绍了我国医疗保险制度的发展历程,现行的基本框架,并对当前医保制度存在的问题进行了分析.