Introduction Amid sudden public health crises, preserving the well-being and optimal working states of frontline healthcare professionals is imperative for efficaciously managing the emergences. However, there is a paucity of research investigating the health status of frontline healthcare professionals through the perspective of work-family conflict. This study sought to elucidate the complex interrelations between work-family conflict, work engagement, job burnout, and self-rated health among public health emergency responders within the context of the COVID-19 pandemic.Methods A convenience sampling method was employed to survey 1,309 public health emergency responders at the Jilin Provincial Center for Disease Control and Prevention. An online survey was administered utilizing a self-constructed questionnaire. The hypothesized relationships between the variables were tested using structural equation modeling.Results The direct impact of work-family conflict on self-rated health is not significant. The association between work-family conflicts and self-rated health was significantly mediated by work engagement and job burnout, respectively. Meanwhile, work engagement and job burnout had a chain mediating effect on work-family conflict and self-rated health.Conclusion Work-family conflict plays a critical role in shaping the health and work status of public health emergency responders during public health crises. Organizations and managers should, in their workplace management practices, focus not only on work-related factors but also give due consideration to family-related factors. Supportive policies, including family-friendly initiatives, should be developed to safeguard the health and work engagement of public health emergency responders.

Participation by patients with chronic diseases under primary health care requires more attention to achieve effective disease management and better health outcomes. In 2016, China proposed accelerating the establishment of a system of family doctors (FDs) and strengthening doctor-patient communication to better meet residents’ health service needs. This study aimed to describe perceived participation in primary health care among patients with chronic diseases in northeastern China and explore the impact of FD contract services and patient’s trust on patients’ perceived participation. A cross-sectional survey of 847 patients with chronic diseases in 16 primary healthcare institutions was conducted in Jilin Province, China. Among all participants, 453 patients reported signing up for FD contract services (62.93%). The perceived participation of patients with chronic diseases was at a low level (mean = 6.71 and SD = 3.35). After controlling for sociodemographic variables and health-related variables, FD contract services directly and indirectly influenced patients’ perceived participation. The patient’s trust was a mediator in the relationship between FD contract services and perceived participation. This study confirmed the valuation of family doctor contract services and provided a theoretical basis for the formulation of primary health service policies. Health organizations should continue to enhance the capacity of primary health services and attract more chronic disease patients to contract with FD teams, thereby enhancing doctor-patient trust and increasing patient’s participation in primary health care.

目的:了解吉林省基层医疗卫生机构居民就诊满意度现状,分析卫生资源及服务能力因素对居民就诊满意度的影响,为提升基层卫生机构居民就诊满意度、改善卫生服务质量提供参考.方法:对吉林省12家基层医疗卫生机构及其就诊居民进行问卷调查,通过描述性分析、单因素分析和多重线性回归对居民满意度的影响因素进行分析.结果:居民就诊满意度总均分为(3.78±0.45),医疗机构卫生资源服务能力指标中就诊医疗机构医护比、工作年限≥20年卫生技术人员所占比例、辖区内每万服务人口的家庭医生团队数、基本药物配备比例对居民满意度有显著影响(P<0.05).结论:基层医疗机构卫生资源及服务能力因素会对居民就诊满意度产生影响,提示应进一步落实分级诊疗和国家基本药物制度,建设家庭医生团队,完善卫生人力资源配置,进而提高居民就诊满意度.

目的:探究居民感知服务质量的潜在类别,分析其与基层卫生服务利用关系,为改善基层医疗机构服务质量,提升居民基层卫生服务利用提供理论依据.方法:对吉林省基层医疗机构就诊的1344名居民进行问卷调查,采用潜在剖面分析的方法对居民感知卫生服务质量进行分类,利用二分类logistic回归分析研究居民感知服务质量与基层卫生服务利用的关系.结果:居民感知服务质量分为高、中、低3个潜在类别组,分别占总人数的15.8％,71.0％和13.2％.在控制人口学特征后,感知服务质量潜在类别组是居民过去一年就诊次数和持续就诊时长的影响因素,高感知服务质量组的居民就诊次数更多、持续就诊时长更长(P<0.05).结论:感知服务质量是居民选择利用基层卫生服务的重要因素,基层医疗机构需要不断增强服务能力,提髙卫生服务质量,从而促使居民选择基层医疗机构就诊.

BACKGROUND The Chinese government has taken many incentives to promote the implementation of the family doctor (FD) contract service; however, whether primary health care providers establishing a strong relationship with patients that shapes their loyalty is still unknown. Under this circumstance, drawing the public attention to patient loyalty in primary care and clarifying the underlying mechanism of loyalty is imperative to the development of primary care. OBJECTIVE To analyse the effect of patient perceived involvement on patient loyalty in primary care, investigate the mediating role of patient satisfaction, and explore the moderating role of the FD contract service on the relationship between patient perceived involvement and patient loyalty. METHODS A cross-sectional questionnaire survey of patients in primary health facilities was conducted in Jilin province of China. Participants comprised 1334 patients selected via a multi-stage sampling method. RESULTS Patient perceived involvement not only had a direct positive impact on patient loyalty but also had an indirect effect on patient loyalty via patient satisfaction. Furthermore, for patients who contracted with FDs, patient perceived involvement had a higher direct effect and indirect effect on patient loyalty when compared with patients who did not contract with FDs. CONCLUSIONS Our findings suggest that health managers should encourage patients to participate in medical visits to improve patient satisfaction. Additionally, customised and tailored health services that meet individuals' specific needs and preferences should be designed and implemented to attract more patients to contract the FD contract service.

目的:了解长春市2015-2017年恶性肿瘤住院病例的疾病构成及顺位情况,为恶性肿瘤的防治提供合理的依据.方法:收集长春市2015-2017年全部各级各类医院的住院病案首页信息,运用描述性统计法对不同年份、性别和年龄的所有主要诊断为恶性肿瘤的住院病例的疾病构成及顺位情况进行描述.结果:消化器官恶性肿瘤住院病例排在首位;肺癌、甲状腺癌分别位于男性、女性恶性肿瘤住院病例的第一位,也是不同年龄段恶性肿瘤住院病例的首位;乳腺癌、女性生殖系统恶性肿瘤是女性高发恶性肿瘤.结论:应根据恶性肿瘤在不同性别、年龄人群的发生特征,有针对性地加强对恶性肿瘤危险因素的预防,做好疾病筛查、监测与治疗,以减少恶性肿瘤造成的危害.

目的:探讨COPD患者Charlson合并症指数(CCI)对其住院时间、住院费用及院内死亡的影响,为COPD精细化医保付费和控费提供理论依据.方法:收集吉林省某市2015-2017年COPD住院患者的病历首页信息.采用χ2检验和非参数检验分析COPD住院患者不同CCI分组的人口学和疾病特征,采用多重线性回归分析CCI对住院天数和住院费用的影响,并通过Poisson回归分析CCI对院内死亡的影响.结果:婚姻状况、年龄、是否手术、是否转科、入院病房、住院次数等对CCI有显著影响(P<0.05),CCI≥2分组相比0-1分组住院时间更长,住院费用更多,院内死亡率更高;控制单因素分析有统计学意义的变量后,CCI仍是影响COPD患者住院时间、住院费用及院内死亡的因素,高CCI评分与较差预后有关(P<0.05).结论:CCI与COPD患者住院时间、住院费用及院内死亡显著相关.应大力加强COPD患者的筛查,强化基层医疗卫生机构对COPD患者的慢性病管理,从而减轻COPD及合并症带来的疾病负担.

目的:了解吉林省医疗卫生资源的配置及公平性状况,为优化医疗卫生资源配置和区域卫生发展规划提供参考依据.方法:对吉林省2018年医疗卫生资源的配置状况进行统计描述;利用基尼系数和泰尔指数分析吉林省医疗卫生资源配置的公平性.结果:按人口配置,吉林省全省及其东、中、西部地区医疗卫生资源的基尼系数均在0.2以下,总泰尔指数在0.140-0.280之间,区域间差异贡献率为53.7％-66.1％;按地理配置,吉林省东、中、西部地区基尼系数均在0.4以下,吉林省的总泰尔指数在0.939-1.208之间,区域间差异贡献率为49.0％-58.1％.结论:吉林省医疗卫生资源配置不均衡,按人口数量配置的公平性优于按地理面积配置,公平性差异主要来源于区域间差异.