基于国际疾病和相关健康问题分类（ICD）编码的疾病负担测算在全球已得到广泛应用，但是目前该类研究多基于西医疾病编码。随着中医药国际化程度的提高，ICD-11纳入传统医学编码，有利于促进中医疾病诊断的完善，利于计算患病率、生存率、服药情况、救治水平，可进一步评价中医病种的疾病负担情况，促进临床诊疗决策及卫生资源的合理配置，从而进一步促进中医药的国际化。但是，ICD-11中传统医学编码不完善，和西医疾病编码、我国中医国家标准之间的映射不足对中医疾病负担测算带来新的挑战。本文立足于疾病负担测算的编码体系，分析了当前中医疾病负担测算研究中的不足、ICD-11纳入传统医学编码后对中医疾病负担测算的影响，并对ICD-11传统医学编码和西医疾病编码、我国新国家标准进行了初步比较，为未来中医疾病负担的测算编码的完善提供参考。提出未来可利用大数据技术促进中医标准化术语和ICD-11传统医学编码、ICD-11传统医学编码和西医疾病编码之间的映射，从而促进中医疾病负担的研究。

Background The 72nd World Health Assembly reviewed and adopted the International Classification of Diseases Eleventh Revision(ICD-11),which for the first time included traditional medicine originating from traditional Chinese medicine(TCM)in its chapter coding,of which the code for wasting thirst disorder is SD71(TM1).At present,wasting thirst disorder is a high clinical prevalence disease,with middle-aged and older adults being the high incidence population,and TCM constitutions bias are risk factors for wasting thirst disorder.There was no research on the burden of TCM diseases and risk factors.Objective Based on the ICD-11 chapter on traditional medicine and the national standards of TCM,the burden of wasting thirst disorder among middle-aged and elderly in Guangzhou was calculated and attributed to the TCM constitutions.The role of TCM constitutions monitoring in health management was evaluated,providing reference for the prevention and treatment of wasting thirst disorder by TCM and the application of constitutions theory.Methods A cross-sectional survey was conducted in 2020 to investigate the prevalence of wasting thirst disorder and the distribution of TCM constitutions among middle-aged and elderly in Guangzhou.The comprehensive theory of Global Burden of Disease(GBD),calculate the years of life lost(YLL),years lived with disability(YLD),and disability adjusted life year(DALY)of wasting thirst disorder in the middle-aged and elderly population in Guangzhou were used to evaluate the disease burden of wasting thirst disorder.Relative risk(RR)was used to assess the risk of different TCM constitutions for wasting thirst disorder in middle-aged and elderly people.Results A total of 1 576 middle aged and older adults in central Guangzhou were surveyed,55 were lost,1 521 valid questionnaires were recovered,and the effective response rate was 96.51%.Among them,782 were male,aged 62(56,69)years;739 were female,aged 62(55,70)years.The prevalence of wasting thirst disorder among middle-aged and elderly people in Guangzhou was 13.08%,with a standardized prevalence of 12.64%.The most distributed constitution among middle-aged and elderly people in Guangzhou were phlegm-dampness constitution,qi-deficiency constitution,and damp-heat constitution;among them,the most distributed constitutions in patients with wasting thirst disorder were phlegm-dampness constitution,yin-deficiency constitution,and qi-deficiency constitution.The DALY rate of wasting thirst disorder burden was 86.46‰,with a YLL rate of 4.86‰ and a YLD rate of 81.60‰.The proportion of single constitution and composite constitution was 48.98%and 51.02%,respectively.Yin-deficiency constitution was the risk constitution of wasting thirst disorder(RR=1.73,P<0.01),which led to a disease burden of 33 092 DALY,with a DALY rate of 10.98,accouting for 12.70%of the disease burden in the middle-aged and elderly population with wasting thirst disorder.In terms of different age groups,phlegm-dampness constitution(RR=1.62,P<0.05)and yin-deficiency constitution(RR=1.80,P<0.05)were risk constitutions in the age group of 60-69 years,in which phlegm-dampness constitution resulted in a wasting thirst disorder burden of 18 530 DALY,with a DALY rate of 18.75 ‰,accounting for 21.63%burden of wasting thirst disorder in this age group;yin-deficiency constitution led to wasting thirst disorder burden of 10 520 DALY,with a DALY rate of 10.65‰,accounting for 12.28%of burden of wasting thirst disorder in this age group;the disease burden caused by the combination of phlegm-dampness constitution and yin-deficiency constitution was 26 780 DALY,with a DALY rate of 27.10 ‰,accounting for 31.26%of the burden of wasting thirst disorder in this age group.For different genders,male phlegm-dampness constitution(RR=2.29,P<0.01)and female yin-deficiency constitution(RR=2.27,P<0.01)were risk constitutions for wasting thirst disorder.The disease burden caused by phlegm-dampness constitution in middle-aged and elderly males was 45 017 DALY,resulting in a DALY rate of 30.96‰,accounting for 36.82%of the burden of wasting thirst disorder in middle-aged and elderly males.The burden of wasting thirst disorder caused by female yin-deficiency constitution was 28 753 DALY,resulting in a DALY rate of 18.43‰,accounting for 20.79%of the burden of wasting thirst disorder among middle-aged and elderly females.Conclusion The prevalence of wasting thirst disorder among middle-aged and older adults aged≥50 in Guangzhou is relatively high,with heavy disease burden.Yin-deficiency and phlegm-dampness constitutions are risk constitutions for wasting thirst disorder in middle-aged and elderly people.TCM constitutions monitoring and management can effectively reduce the burden of wasting thirst disorder.

Background With the change of disease spectrum and the development of modern medical model,traditional Chinese medicine(TCM)is playing an important role in disease prevention,health care and rehabilitation.It is necessary to further promote the development of prevention of disease in TCM and vigorously promote the unique role of TCM in maintaining and promoting people's health.However,popularization and education of the concept of prevention of disease in TCM among community residents remains unclear.Objective To understand the overall awareness,trust,and adoption behavior of prevention of disease in TCM of community residents in Guangzhou,and explore the influencing factors of community residents'trust in prevention of disease in TCM services.Methods From April to August 2022,a stratified cluster sampling method was used to interview 652 community residents from 12 streets in 4 administrative regions of Guangzhou city based on geographic location(central city,urban-rural areas,and suburbs)and economic factors by questionnaires.The survey included residents'basic information,awareness and access to knowledge of prevention of disease in TCM,as well as their demand,utilization and trust in it.The influencing factors of community residents'trust in prevention of disease in TCM services were explored by binary Logistic regression analysis.Results Among the 652 community residents,67.79%(442/652)were aware of prevention of disease in TCM,77.91%(508/652)trusted prevention of disease in TCM services,69.63%(454/652)had received traditional TCM physiotherapy,and only 6.59%(43/652)had received prevention of disease in TCM services more than 4 times in the past year.Univariate correlation analysis showed that age(χ2=9.218),household type(χ2=19.356),marriage status(χ2=2.490),occupation(χ2=17.889),and medical insurance payment type(χ2=13.516)were influencing factors of residents'trust in prevention of disease in TCM services.Binary Logistic regression analysis showed that household type(non-agricultural,agricultural to resident,and non-agricultural to resident)was an influential factor for community residents'trust in prevention of disease in TCM services(OR=2.646,5.593,10.502).Conclusion The overall awareness(67.79%)and trust(77.91%)of prevention of disease in TCM among community residents in Guangzhou are relatively high,but the actual number of services received is insufficient,with a phenomenon of knowledge-attitude-practice separation.Community residents with non-agricultural household type have a higher level of trust,while those with agricultural household type have a lower level of trust.During popularization and services of prevention of disease in TCM,it is necessary to fully utilize the residents'preferred forms,as well as to target specific groups,so as to cultivate the health habits of prevention of disease in community residents.

Background The approval of the International Classification of Diseases 11th Revision (ICD-11) has for the first time included a chapter about traditional medicines that includes TCM. Disease weight (DW) is a weight coefficient that quantifies the health loss caused by non-fatal diseases and injuries, and is an important parameter to measure the burden of disease. Objective Based on the traditional medicine chapter of ICD-11, this study investigates the DW of wasting thirst disorder, which provides a reference for the measurement of TCM disease burden, and lays a foundation for establishing a statistical network that is consistent with international standards and reflects TCM health service information. Methods From June 1, 2020 to June 1, 2021, the Visual Analogue Scale (VAS) method was adopted to conduct a survey on the DW of each lower category of wasting thirst disorder among clinical Chinese medicine practitioners and healthy people. The EQ-5D-3L with VAS scale was adopted to conduct a DW survey among patients. In addition, the survey results were demonstrated with expert intentions. Results The survey on DW of wasting thirst disorder among TCM practitioners shows that the DWs were 0.300 (0.185, 0.380) for wasting thirst disorder involving the upper-jiao, 0.430 (0.368, 0.568) for wasting thirst disorder involving the middle-jiao, 0.585 (0.510, 0.738) for wasting thirst disorder involving the lower-jiao, and 0.725 (0.660, 0.908) for consciousness loss caused by wasting thirst disorder. The survey on DW of wasting thirst disorder among patients shows that the VAS conversion weights of patients were 0.310 (0.225, 0.373) for diabetes involving the upper-jiao, 0.395 (0.335, 0.453) for wasting thirst disorder involving the middle-jiao, 0.445 (0.360, 0.513) for wasting thirst disorder involving the lower-jiao, and 0.590 (0.550, 0.698) for consciousness loss caused by wasting thirst disorder;the investigator assigned weights are 0.152 (0, 0.311) for wasting thirst disorder involving the upper-jiao, 0.240 (0, 0.275) for wasting thirst disorder involving the middle-jiao, 0.380 (0.186, 0.622) for wasting thirst disorder involving the lower-jiao, and 0.484 (0.311, 0.814) for consciousness loss caused by wasting thirst disorder. The survey on DW of wasting thirst disorder among healthy people shows that the DWs were 0.210 (0.150, 0.390) for wasting thirst disorder involving the upper-jiao, 0.345 (0.260, 0.510) for wasting thirst disorder involving the middle-jiao, 0.425 (0.313, 0.748) for wasting thirst disorder involving the lower-jiao, and 0.640 (0.380, 0.898) for consciousness loss caused by wasting thirst disorder. There were significant differences between the DWs by different methods of wasting thirst disorder involving the upper-jiao, wasting thirst disorder involving the middle-jiao, wasting thirst disorder involving the lower-jiao, and consciousness loss caused by wasting thirst disorder (H=153.883, 76.561, 34.575, 74.014, P<0.001). There were significant differences between VAS DW for traditional Chinese medicine practitioner survey, patient VAS conversion DW, investigator assignment DW, and VAS DW for healthy population survey involved by three jiao of wasting thirst disorder and consciousness loss caused by wasting thirst disorder (H=10.543, 35.692, 19.924, 16.327, P<0.05). Through expert intention argumentation, the method of calculating DWs for wasting thirst disorder according to the classification of wasting thirst disorder involving the upper-jiao, wasting thirst disorder involving the middle-jiao, wasting thirst disorder involving the lower-jiao, and consciousness loss caused by wasting thirst disorder under the standardized framework was agreed upon. Experts qualitatively agreed that the DW of wasting thirst disorder involving the upper-jiao, wasting thirst disorder involving the middle-jiao, wasting thirst disorder involving the lower-jiao, and consciousness loss caused by wasting thirst disorder gradually increased. And they basically agreed with the DW in the investigation of traditional Chinese medicine practitioners. Conclusion A preliminary exploration was conducted to investigate the DW of wasting thirst disorder, using the VAS method and the EQ-5D-3L, based on the ICD-11 chapter on traditional medicine and the national standards of traditional Chinese medicine, providing a reference for calculating the burden of traditional Chinese medicine diseases. The research results have been supported by expert intention analysis. The DW of wasting thirst disorder in Guangzhou is relatively heavy, and attention should be paid to the loss of healthy life years caused by disability in wasting thirst disorder, to improve the quality of life of patients.

目的 了解广州市2008-2019年伤害死亡特征及疾病负担情况,为当地制定伤害防控措施提供参考.方法 测算伤害死亡率、早死寿命损失年(YLL)、伤残寿命损失年(YLD)和伤残调整寿命年(DALY),评估广州市居民伤害的死亡特征和疾病负担状况,采用年度变化百分比(APC)和平均年度变化百分比(AAPC)分析死亡率及疾病负担的变化趋势.结果 2008-2019年广州市伤害粗死亡率为27.38/10万,标化死亡率为27.82/10万.伤害死亡前10位死因分别为跌倒、道路伤害、自残、异物吸入、溺水、中毒、接触机械力、药物治疗的副作用、人际暴力和其他意外伤害.广州市居民伤害DALY率为9.26‰,YLL率为4.53‰,YLD率为4.73‰.伤害DALY率前5位死因依次为跌倒(4.12‰)、道路伤害(2.76‰)、自残(0.74‰)、溺水(0.29‰)、异物吸入(0.26‰).男性伤害DALY率为10.87‰,女性为7.64‰.5～14岁的DALY率最低(3.20‰),80岁及以上年龄段的DALY率最高(47.03‰).2008-2019年广州市伤害DALY率呈上升趋势(AAPC=9.41,P＜0.05).结论 广州市伤害死亡和疾病负担呈上升趋势,需进一步加强防控.跌倒、道路伤害、自残是伤害防控的重点死因;男性、高龄老人是伤害防控重点人群.

Background The disease burden of esophageal cancer is high in China, more and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer. Objective To understand trends in esophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019, and provide data to inform the development of public health policies and interventions. Methods Global burden of disease 2019 (GBD 2019) data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019. Mortality, disability adjusted life years (DALYs) , years of life lost (YLLs) , and disability adjusted life years (YLDs) were used to assess the disease burden of esophageal cancer attributable to tobacco in China. Joinpoint regression software and age-period-cohort modeling methods were applied to analyze the trends of disease burden and mortality with age, period and cohort. the Bayesian-period-cohort analysis (BAPC) was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030. Results From 1990 to 2019, the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76 400 to 123 900, with an increase of 62.17%, and the standardized mortality rate declined from 9.30/100 000 to 6.20/100 000, with a decrease of 33.33%; the DALYs rose from 1 972 500 person-years to 2 822 600 person-years, with an increase of 43.10%, and the DALYs rate decreased from 220.50/100 000 to 134.47/100 000, with a decrease of 39.02%. In terms of gender, the disease burden of esophageal cancer attributable to tobacco was mainly caused by males, with 117 700 deaths and a standardized mortality rate of 12.82/100 000 in 2019 due to tobacco-attributable esophageal cancer in males, compared to 0.62 million deaths number and a standardized mortality rate of 0.63/100 000 in females. In 2019, the number of esophageal cancer deaths attributable to tobacco among Chinese residents peaked in the age group of >69-74 years, while DALYs peaked in the age group of >64-69 years, at 23 000 and 510 300 cases, respectively. The mortality rate continued to increase with age, especially after 50 years of age. The results of Joinpoint regression analysis showed that the average annual percent change (AAPC) of esophageal cancer mortality attributable to tobacco was -1.4%〔95%CI (-1.6%, -1.2%) 〕 in China from 1990 to 2019, with -3.3%〔95%CI (-3.6%, -2.9%) 〕 for females, and -1.3%〔95%CI (-1.4%, -1.1%) 〕 for males; the AAPC for DALYs rate was -1.7%〔95%CI (-1.9%, -1.5%) 〕, with -3.7%〔95%CI (-4.0%, -3.4%) 〕 for females and -1.5%〔95%CI (-1.7%, -1.3%) 〕 for males. Analysis of the age-period-cohort model of mortality from esophageal cancer attributable to tobacco showed a negative net offset of -1.690%〔95%CI (-2.024%, -1.354%) 〕. It is expected that the number of deaths and mortality rate from tobacco-attributable esophageal cancer among Chinese residents will be relatively stable with a small decrease from 2020 to 2030, with mortality rates declining from 12.64/100 000 in 2020 to 12.63/100 000 in 2030 for males, and from 0.6/100 000 in 2020 to 0.46/100 000 for females. Conclusion Mortality rate and DALYs rate due to tobacco-attributable esophageal cancer among Chinese residents increased and then declined from 1990 to 2019. The burden of disease due to tobacco-attributable esophageal cancer is mainly caused by males in term of gender, by middle-aged and elderly people by age, which should be given sufficient attention. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer will be stable and slightly decreasing from 2020 to 2030.

本文通过归纳、分析当前我国城乡居民基层中医药卫生服务利用的研究现状,提出我国促进基层中医药卫生服务利用,优化基层中医药卫生服务质量的建议.建议从健全服务体系,完善中医药卫生服务内部供给机制;优化宏观环境,破除中医药卫生服务利用的外部壁垒;紧扣群众需求,发挥中医药服务的特色优势;摆脱空间依赖,促进"互联网+"中医药的健康发展等四方面展开阐述,以期为基层中医药卫生健康工作的开展带来启示.

Background Diabetes is highly prevalent in China，the prevention and treatment of it and its related complications need a lot of medical resources. Local reports have revealed that although the mortality of diabetes is declining，the burden of diabetes is still increasing. Objective To understand the epidemiological characteristics and burden of diabetes in China from 19902019，forecast the incidence of diabetes in China from 2020 to 2030，to provide data for evaluating and formulating diabetes-related prevention and treatment policies and measures. Methods In August 2022，this study used data from the Global Burden of Disease Study 2019. Temporal trends of the incidence，mortality，disability-adjusted life years（DALY），years of life lost（YLL），and years lost due to a disability（YLD） of diabetes in China from 1990 to 2019 were described. The Bayesian-age-period-cohort analysis was used to predict the incidence of diabetes in China from 2020 to 2030. Results Compared with 1990，in 2019，the crude prevalence of diabetes increased to 265.45/100 000，with an increase of 63.12%，the standardized prevalence of diabetes increased to 204.31/100 000，with an increase of 15.93%，the crude mortality rate of diabetes increased to 12.16/100 000，with an increase of 105.41%，and the standardized mortality rate of diabetes increased to 9.44/100 000，with an increase of 2.61%. The YLL rate decreased from 204.71/100 000 in 1990 to 178.45/100 000 in 2019. The YLD rate increased from 260.74/100 000 in 1990 to 316.30/100 000 in 2019. The DALY rate increased from 465.46/100 000 in 1990 to 494.76/100 000 in 2019. Compared with 1990，the DALY rate of diabetes increased by 21.08% in males and decreased by 6.68% in females. The YLL rate，YLD rate and DALY rate increased with age in 2019. According to the prediction of the standardized incidence of diabetes in China from 2020 to 2030，the overall standardized incidence of diabetes would present a decreasing trend during the period，and the standardized incidence of diabetes in 2030 would decrease by 11.45% in men and 18.60% in women compared with 2020. Conclusion The burden of diabetes in China is still heavy，with a large number of illness cases and decreased cases，mainly manifested by a high burden caused by diabetes-related disability. Attention should be paid to early prevention of diabetes to reduce the occurrence of complications. The disease burden of males and middle-aged and elderly people is heavy，so sufficient attention should be paid to them. Although the predicted diabetes incidence will reduce between 2020 and 2030，the number of patients is still increasing，so the prevention and control of diabetes should not be slack.

Objective To understand the current situation and changing trends of cardiovascular diseases mortality and burden in Guangzhou. Methods The data on cardiovascular diseases were obtained through the death registration system in Guangzhou to calculate the mortality, years of life lost（YLL）, years lived with disability（YLD）, and disability-adjusted life years（DALY）. The changing trends of disease burden were analyzed using annual percentage change（APC） and average annual percentage change（AAPC）. Results From 2008 to 2019, the standardized mortality rate of cardiovascular disease in Guangzhou increased from 67.64 to 147.25 per 100 000, the DALY rate increased from 8.43 to 21.85 person-years per 1000, the YLL rate increased from 7.5 to 19.5 person-years per 1 000, and the YLD rate increased from 0.93 to 2.35 personyears per 1 000. All indicators, with an overall upward trend, shared a trend connecting point in 2012（AAPC=7.74%, 7.68%,7.69%, and 6.75%, all P ＜0.05）. Mortality, YLL, and DALY rates were higher in men than in women, also with faster increase. The burden of cardiovascular diseases showed obvious rising trends with increasing age. In terms of specific disease,stroke and ischemic heart disease caused a higher burden. Conclusion Guangzhou is facing grim situation of cardiovascular disease prevention and control. Interventions for men and the middle-aged and elderly groups should be strengthened, with a focus on the prevention of ischemic heart disease and stroke. Preventive measures for other types of cardiovascular diseases should also be improved.

As an important carrier for integrating county-based medical and health resources, county-based close-knit medical communities are a necessary path to improve the hierarchical diagnosis and treatment system. At present, the construction of county-based close-knit medical communities in economically underdeveloped areas is still in the preliminary exploration stage. This study analyzes the dilemma faced by county-based medical communities, and clarifies the concept of precise governance theory. Based on the precise construction practice of the county-based medical community in Heping County Guangdong Province, this study summarizes the value and experience of precisely constructing county-based close-knit medical communities in underdeveloped areas.

背景　糖尿病是一种慢性代谢性疾病，已成为威胁我国居民健康的慢性疾病之一。目的　了解1990-2019年我国糖尿病流行特征和疾病负担情况，为评价和制定糖尿病相关防治政策和措施提供数据借鉴。方法　利用2019年全球疾病负担研究结果，描述1990-2019年我国糖尿病的发病、死亡、伤残调整寿命年（DALY）、早死寿命损失年（YLL）、伤残寿命损失年（YLD）的变化和年龄分布特点，并采用贝叶斯-时期-队列分析（BAPC）方法对2020-2030年中国糖尿病的发病率进行预测。结果　2019年我国糖尿病粗发病率为265.45/10万，标化发病率为204.31/10万，相对于1990年分别增长63.12%、15.93%；粗死亡率为12.16/10万，标化死亡率为9.44/10万，分别增长105.41%、2.61%。YLL率呈现下降趋势，YLD率、DALY率呈上升趋势。男性糖尿病疾病负担均高于女性，并且增长幅度快于女性；糖尿病疾病负担随年龄的增长而增长；2020-2030年间，我国人群糖尿病发病率呈现下降趋势。结论　我国糖尿病疾病负担仍然较重，发病及死亡人数较多，疾病负担表现为由伤残导致的疾病负担较高，应关注糖尿病的早期预防，减少并发症的发生；男性、中老年人群疾病负担较重，应对该人群给予足够的重视。

Population Medicine considers the following types of articles:• Research Papers -reports of data from original research or secondary dataset analyses.• Review Papers -comprehensive, authoritative, reviews within the journal's scope.These include both systematic reviews and narrative reviews.• Short Reports -brief reports of data from original research.• Policy Case Studies -brief articles on policy development at a regional or national level.• Study Protocols -articles describing a research protocol of a study.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.

目的:以DRGs为代表的按病种付费改革已成为当前医疗保障改革的主要方向,完善中医按病种付费有助于深化医保支付方式改革,优化中医医疗服务的资源配置.方法:文章从中医医保支付方式改革的现状及现行中医DRGs实践中存在的问题,试探讨未来中医医疗机构推动DRGs按病种付费等相关工作的实施途径.结果与结论:中医DRGs的实践需要遵循中医药的发展规律,重视中医临床路径研究、科学遴选中医优势病种,构建中医医疗机构与医保机构间的价格谈判机制,规范中医院病案首页和疾病诊断编码,加强中医医疗机构建设,设立中医按病种付费改革专项资金,以助推中医药事业的传承与创新发展.

目的:我国高血压疾病的患病率近年来呈快速上升趋势,对其疾病经济负担进行测算有助于政府合理规划现有卫生资源,进一步完善医疗保障体系,切实减轻疾病对于高血压患者个人、家庭和社会造成的经济影响.方法:利用Stata16.0对数据进行清洗筛选,通过Spss21.0对数据进行统计分析,使用二步模型法和人力资本法对2018年深圳市高血压疾病的直接经济负担和间接经济负担进行测算.结果:深圳市2018年高血压疾病经济负担为31.225亿元,其中,直接经济负担为28.605亿元,间接经济负担为2.62亿元,约占深圳市GDP的0.13％.结论:深圳市高血压的疾病经济负担较重,且呈现上升趋势;门诊的经济负担高于住院,药品费用占比较高.建议加强社区慢性病防治网络建设,完善医保监督体系,加强医院内部管理等.

医联体建设是国家医改的重点内容.近几年国家在不断推进中医医联体建设,以提高中医药医疗及服务水平,满足居民需求.综合医院中医科是整个中医药事业的重要组成部分,在促进中医药事业繁荣发展,为广大人民群众的健康提供优质、全面的医疗服务方面发挥着重要作用.作者对综合医院中医科发展现状进行分析,探讨了基于医联体资源整合模式下综合医院中医科建设发展思路.

目的 分析广州市2015-2019年急性心肌梗死(AMI)死亡率与疾病负担现况及其变化趋势,并测算其早死概率,为广州市制定急性心肌梗死的预防策略提供实证依据.方法 通过获取死亡数据和人口数据,计算死亡率及早死概率以了解广州市急性心机梗死死亡特征,并通过测算伤残调整寿命年(DALY)、伤残所致生命年损失(YLD)和早亡所致生命年损失(YLL)衡量疾病负担.结果 2015-2019年广州市居民急性心肌梗死粗死亡率由2015年32.16/10万上升至2019年41.21/10万,标化死亡率由22.29/10万上升至28.02/10万,早死概率为0.98％,年均增长率9.28％,YLL率、YLD率分别为3.50、0.17人年/千人,DALY率为3.67人年/千人.男性早死概率和疾病负担高于女性,随着年龄增长,广州市急性心肌梗死疾病负担加重.结论 关注老龄化影响对广州市急性心肌梗死的影响,并加强对男性和60岁及以上老年人等重点人群的干预.

目的 分析我国疾病负担研究的态势.方法 2021年6月18日检索中国学术期刊全文数据库建库至检索日的疾病负担文献,用普赖斯定律确定高被引文献,用Excel 2019统计分析被引、年份、期刊、作者、机构、关键词、基金,用高频关键词共词聚类确定研究趋势.结果 检出高被引文献282篇,分别被引16～446次,累计被引13381次,篇均被引47.45次;文献数1998—2007年由3篇犬牙递增至峰值27篇,2009—2018年由14篇递增至22篇后逐年减至4篇;文献来自90种期刊和14所院校学位论文,《中国卫生经济》的文献数和总被引频次最多;文献作者919人、署名1181次,总合作率85.11％,署名数作者金水高最多、是第二名龚幼龙的1.50倍;作者机构203个,其中院校占31.53％、疾控中心占25.62％,21个核心发文机构中院校占76.19％、疾控中心占19.05％,中国疾病预防控制中心和复旦大学居署名文献数、折合文献数前2位;涉及关键词337个、908次,"疾病负担""疾病经济负担""经济负担""伤残调整寿命年""伤残调整生命年"的使用频次居前5位;高频关键词聚类分析示,目前研究主要集中在慢性病、公共健康、肿瘤等领域,多基于"疾病状态"和"有形负担",常用伤残调整寿命年来计算;109篇文献获基金149项次,其中国家和部级资助占36.92％、省市资助占45.64％.结论 CNKI数据库疾病负担高被引文献呈现数量"双峰"出现、以《中国卫生经济》等为权威期刊、以院校和疾控中心为核心发文机构、以金水高等为代表团队、以伤残调整寿命年计算疾病经济负担为主要角度、以国家部委和省市资助为主的特征,但关键词使用不够规范,尚需突出维健负担、主观负担等研究.

文章通过研究广州中医药大学的公共事业管理专业人才培养方案和实际情况,找出广州中医药大学公共事业管理专业在人才培养目标、专业方向、课程设置和实践教学中存在的不足,结合现有的资源,提出创新人才培养模式,调整课程结构,发挥中医药特色,增设健康保险专业方向,重视实践教学等建议.

目的 了解2017-2019年广州市糖尿病死亡特征、早死概率及疾病负担情况,为制定糖尿病防治干预措施提供参考.方法 以2017-2019年广州市死亡登记数据和人口监测数据为基础,计算糖尿病的粗死亡率、标化死亡率、早死概率、早死损失寿命年(Years of Life Lost,YLL)、伤残损失寿命年(Years Lived with Disability,YLD)和伤残调整寿命年(Disability Adjusted Life Year,DALY).结果 2017-2019年广州市居民的糖尿病粗死亡率为13.78/10万,标化死亡率为8.16/10万.糖尿病早死概率为0.47％,年均增长速度为-3.18％.糖尿病DALY率、YLL率、YLD率分别为3.52、1.50、2.02人年/千人.男性、女性居民每千人口因糖尿病分别损失3.92、3.12个DALY.居民糖尿病死亡率及DALY率均随着年龄的增加逐渐升高,60岁以上居民是糖尿病死亡高发人群.结论 糖尿病给广州市居民带来较重的疾病负担,应加强糖尿病的防控工作,针对重点人群的主要死因进行干预.

目的:探索全球金融危机背景下妇幼健康指标的短期与长期变化趋势,为进一步提升妇幼健康水平提供参考.方法:基于1991-2018年宏观时间序列数据,在考虑宏观经济指标的前提下,采用自回归分布滞后模型(ARDL)与误差修正模型(ECM)进行分析.结果:长期来看,金融危机虚拟变量仅对5岁以下儿童死亡率具有显著影响,回归系数为-7.332.短期来看,新生儿死亡率在全球金融危机当期及滞后一、二期的回归系数皆为负值,但5岁以下儿童死亡率、婴儿死亡率及孕产妇死亡率的回归系数会在滞后一期或滞后二期时由正转负.结论:全球金融危机背景下,妇幼健康水平既有积极变化又有消极变化,且在短期内经历了一个从恶化到改善的过程,国内经济回暖及新医改的开展都可能是导致出现这种变化的原因.