To analyze the level of knowledge, attitude, and practice about COVID-19 among Chinese residents, noninterventional and anonymous survey was carried out with an online questionnaire. Among the survey respondents (n = 619), 59.9% were female, 61.1% were from 18 to 30 years of age, and 42.3% held an undergraduate's degree. The mean scores for each scale were as follows: perceived knowledge (36.3 ± 6.1), attitude (29.4 ± 4.7), practice (44.1 ± 4.8), total score (109.7 ± 13.2), barrier (0.2 ± 0.7), and cognition and behavior change score (8.5 ± 1.4). Perceived knowledge, attitude, practice, total score, and cognition and behavior changes were significantly and positively correlated, whereas barrier was negatively correlated with those scales (P < 0.001). Linear regressions revealed that those respondents who were medical professionals, civil servants, employees of state-owned enterprises and public institutions, and had relatively higher level of education were associated with a higher perceived knowledge score, attitude score, practice score, and total score. Higher mean cognition and behavior change score was associated with company employees (8.8 ± 1.3). More than half of the respondents (51.4%) were optimistic about the government's interventional measures. The respondents in China had good knowledge, positive attitude, and active practice toward COVID-19, yet, it is advisable to strengthen nationwide publicity and focus on the target undereducated population by means of We-Chat, microblog, website, and community workers for better control effect.

Abstract Background Outcomes derived from longitudinal self-reported health-related quality of life measures can be confounded by response shift. This study was aimed to detect response shift among patients with hypertension attending a community-based disease management program. Methods 240 consecutive consulting or follow-up patients with diagnosed hypertension were recruited. The Short Form 36-item Health Survey was self-administered at 12 community health service stations at baseline and four weeks after attending the program. The 4-step structural equation modeling approach assessed response shift. Results Data from 203 (84.6%) patients were eligible for analyses (mean age 65.9 ± 10.8 years, 46.3% female). The results showed uniform recalibration of social functioning ( $${\upchi}_{\mathrm{SBdiff}}^{2}$$ χ SBdiff 2 (1) = 22.98, P < 0.001), and non-uniform recalibration of role limitations due to physical problems ( $${\upchi}_{\mathrm{SBdiff}}^{2}$$ χ SBdiff 2 (1) = 8.84, P = 0.003), and bodily pain ( $${\upchi}_{\mathrm{SBdiff}}^{2}$$ χ SBdiff 2 (1) = 17.41, P < 0.001). The effects of response shift on social functioning were calculated as “small” (effect-size = 0.35), but changed the observed changes from improvement (effect-size = 0.25) to slight deterioration (effect-size = -0.10). After accounting for the response shift effect, the general physical health of participants was improved (effect-size = 0.37), while deterioration (effect-size = -0.21) in the general mental health was also found. Conclusions Recalibration existed among patients with hypertension attending the disease management program. The interventions in the program might act as a catalyst that induced the response shift. We conclude that response shift should be considered in hypertension research with longitudinal health-related quality of life data.

Objective To analyze the medical service capacity of primary healthcare in Zhejiang province since the ongoing healthcare reform and put forward suggestions. Methods Key indicators of healthcare resources and medical service utilization from 2009 to 2015 reflecting the primary healthcare were identified,for a quantitative analysis in terms of the structure-process-outcome dimensions. Results In terms of structural service capacity,the average headcount growth rate of primary healthcare′s technical personnel was 5. 7% per year; the personnel competence structure kept improving; the hospital beds at primary institutions and their ratio among all were slightly decreased,with better devices and informatization. In terms of procedural service capacity,the proportion of primary institutions with contract-based services amounted to 89. 9%,with the standard contract signing rate up to 18. 8%. In terms of consequential service capacity,the average growth rate of the number of outpatient visits at primary institutions was 6. 3%. The amount and proportion of inpatients were slightly decreased,while the hospital bed utilization ratio was increased slightly. Conclusions It is necessary to further strengthen the training and introduction of primary healthcare professionals. The functional orientation of hospitals at various levels should be clarified, encouraging contract-signing of general practitioners, promote the medical insurance payment reform featuring the capitation payment at primary level,and improve the income distribution and incentive mechanism.

目的 对我国县级妇幼保健机构的卫生资源配置进行评价,探索优化资源配置的措施和途径,为卫生规划和深化卫生改革提供政策建议.方法 用数据包络分析方法,对全国27个省(自治区)的县级妇幼保健资源配置的横向及纵向效率进行相对有效性评价.结果 浙江、江苏、江西和广西等4个省份的县级妇幼保健资源配置效率呈相对有效;2005-2011年和2013年的规模报酬均递增,2014年卫生资源配置效率相对有效,规模效率不变.结论 建议加强区域卫生规划,适当调整县级妇幼保健资源配置结构和规模.

Objective To examine the occupational stability,training needs and capacity building requirements of the general practitioners purposely trained to work in rural communities,for improvement of policies regarding their training and issues related. Methods There counties were selected by stratified random sampling, where general practitioners graduated from such training completed an anonymous questionnaire. Focus group interviews were made to officials of the local Health and Family Planning Commission,those of primary healthcare institutions,and general practitioners themselves. Results The of the 190 valid questionnaires recovered, male accounted for 34. 2% and female 65. 8%. These general practitioners were mostly satisfied with their working environment, social status, work stress and job achievement,yet with lower satisfaction with their salary and availability of medical devices. Consideration of resignation was reported by only 5. 3% of them,with more males than females. As high as 63. 2% of them prefer to work in hospitals of county level. 91. 1% of them held it as necessary to participate in standard resident training,and 98. 4% held it as necessary to have on-job training. 94. 7% of them have participated in further education to gain a bachelor degree in medicine. Conclusions These doctors were found with high stability to work in rural communities and low turnover intention. Further studies are required to encourage these general practitioners to serve rural communities in a long term, and to improve the standard resident training mechanism,and their career development.

目的:对浙江省各地市卫生资源的数量、种类及分布进行评价,为在“十三五”期间缩小区域性差异,改善浙江省卫生资源可及性等问题提供参考依据.方法:引入集聚度的概念对浙江省卫生资源进行评价,分析不同地市间城乡卫生资源的集聚度. 结果:(1)经济发达地区的卫生资源的地理可及性和公平性要优于经济欠发达地区.(2)杭州市的卫生资源集聚度明显高人口集聚度,卫生资源相对过剩,温州、台州等地的卫生资源则相对不足,丽水和舟山市的卫生资源较均衡.(3)大部分地市的医生集聚度要高于护士的集聚度,部分地市护士配置不足更为显著.(4)除杭州和温州外,大部分地市的卫生资源配置逐年趋近于最优.结论:为了促进浙江省卫生资源配置的合理性,应进一步提高丽水、衢州等经济欠发达地市的卫生资源可及性,改善护理人员在不同地市间分布的合理性,并科学设置资源配置标准,提高卫生资源布局的公平性.