To investigate the integration of healthcare and childcare status in Hunan, China, and toexplore its institutional demand characteristics to promote further integration of healthcare and childcare.

A questionnaire survey was conducted at 257 healthcare institutions and 365 childcare institutions in Hunan, China were investigated in Jun-Sep, 2024. Univariate and multiple response analyses were performed on the data.

A total of 82 healthcare institutions (31.9%) and 244 childcare institutions (66.8%) achieved healthcare and childcare integration. Maternal and child health care institutions served significantly more childcare institutions on average compared to other types of medical institutions(χ²=7.897, P=0.001).The satisfaction level of parents with childcare institutions adopting healthcare and childcare integration was higher than that of institutions that did not adopt integration (81.6% vs.70.2%, χ²=5.992, P=0.014). Among the services provided by healthcare institutions, practitioner training had lowest response rate (16.2%) and popularity rate (63.4%), but childcare institutions showed the maximum demand for it (response rate=24.3%, popularity rate=93.7%).

Maternity and child care institutions have enhanced healthcare and childcare integration, effectively improving parent satisfaction. The services provided by healthcare institutions are not consistent with the practical demand by childcare institutions.

Based on the theoretical framework of the grey system, a combined model suitable for the demand prediction of elderly care service beds is constructed to reveal the future development trend of elderly care service bed resources in different regions of China from the perspective of regional differences, providing decision-making references for optimizing the allocation of elderly care resources and the formulation of related policies.

Researchers construct a combined prediction framework integrating improved models such as the fractional-order grey model and the non-homogeneous discrete grey model. Based on the relevant indicator data of elderly care service beds in the “China Social Statistical Yearbook”, they predict the changing trend of elderly care service bed demand in the four regions of eastern, central, western and northeastern China from 2024 to 2028.

By 2028, the number of elderly care beds in China and its four representative provinces is expected to reach 6 653 258，740 181，572 245，184 002, and 237 566, respectively. The demand for elderly care service beds in the four major regions of the east, central, west and northeast all shows an upward trend. Especially in the east and central regions, the growth is more significant, reflecting the greater elderly care pressure brought about by the intensification of population aging. Although the overall demand in the western and northeastern regions is relatively low, it is also showing a steady upward trend, indicating that the pressure of elderly care in these areas will gradually increase in the future.

The resources of elderly care service beds in various regions of our country will continue to grow in the future. The allocation level of elderly care resources in the eastern region will still be better than that in the central and western regions as well as the northeastern region. This research can better reflect the differential characteristics of elderly care service demands in various regions and provide strong support for the scientific allocation of regional elderly care resources.

To investigate the current status of inpatient health service utilization, rate and equity among middle-aged and elderly people in rural China, and to explore the contribution of each influencing factor to the inequity of inpatient health services utilization.

The concentration index and concentration curve were used to measure and show the equity of inpatient health service utilization among middle-aged and elderly people in rural areas, and used concentration index decomposition methods to conduct a decomposition analysis.

From 2011 to 2020, the inpatient health service utilization rate for middle-aged and elderly people in rural China was 7.36%, 11.41%, 12.97%, 16.90%, and 21.61%, respectively. From 2011 to 2020, the concentration index of inpatient health service utilization rate among middle-aged and elderly people in rural China was 0.154 2, 0.013 4, 0.084 9, 0.043 6, and 0.050 6, respectively. Economic status, region, and age are the main factors affecting the equity of inpatient health services utilization among middle-aged and elderly people in rural areas.

The inpatient health service utilization is mainly concentrated among the economically well-off population. It is of great significance to reduce the inequity of inpatient health service by narrowing the gap between the rich and the poor and regional disparities, paying attention to the elderly and other groups that are vulnerable to health risks, improving the health insurance system and improving the quality of rural health service.

To provide a basis for formulating response strategies under the pilot program of the disease control supervisor system, research on disease prevention risk assessment in medical institutions is conducted.

In the pilot work of the disease control supervisor system in medical institutions, the Delphi method, FMEA, and Borda rank method were used to conduct risk evaluation, and ranking of the likelihood, severity, and detectability of disease prevention risks.

10 primary and 53 secondary medical institution disease prevention risk indicators have been constructed, and the risk levels have been classified and ranked:the 10 primary risks were ranked from high to low as infectious disease treatment and prevention and disinfection and isolation, infectious disease monitoring and epidemic reporting, medical waste disposal, pathogenic microorganism laboratory biosafety management, organizational management, facility equipment, personnel allocation and capacity building, infectious disease investigation and epidemic control, information construction and application, preventive vaccination, and others; Among the 53 secondary risks, the top 10 risks were in the following order: One person, one use, one disinfection or sterilization of medical devices>Epidemic control of infectious diseases within the institution=Infection control (protection and isolation)=Compliance with laboratory operating procedures>Professional quality and sense of responsibility of personnel=Implementation of pre examination and triage work system=Hand hygiene>Treatment of infectious disease patients>Prevention and control of key infectious diseases>Compliance with infectious disease epidemic reports in accordance with the law.

In the pilot work of the disease control supervisor system, this study comprehensively applied the Delphi method, FMEA, and Borda ordinal value method to evaluate disease prevention risks, enabling more potential disease prevention risks that are easily overlooked to be identified, warned, tracked, and intervened in a timely manner, forming a closed loop and promoting the integration of medical and prevention. This is a new thinking and method that can provide a reference for various regions.

To explore the effect of the DRG payment reform on the quality of healthcare services in a Grade A Tertiary Public Hospital in Xinjiang.

Data were extracted from the inpatient records front pages of basic medical insurance patients admitted to a tertiary Grade A public hospital in Xinjiang between 2020 and 2024. An Interrupted Time Series (ITS) analysis was employed to examine trends in key indicators pre- and post-DRG policy implementation. Indicators spanned three dimensions: in-hospital death (total in-hospital mortality, in-hospital mortality rate of surgical patients, and in-hospital mortality rate of patients with low-risk ICD diseases), patient return (30-day readmission rate), and patient safety (complication rate of surgical patients). The average hospitalization cost and average length of stay were also analyzed to comprehensively evaluate the impact of the DRG policy on the quality of medical services.

No significant trend changes occurred in overall inpatient mortality (β1+β3=-0.000 94, P>0.05), surgical patient mortality (β1+β3=-0.000 07, P > 0.05), 30-day readmission rate (β1+β3=-0.000 13, P>0.05), and surgical complication rates (β1+β3=0.000 07, P>0.05) post-DRG policy implementation. The mortality rate of low-risk ICD diseases (β1+β3=-0.000 03, P<0.05) decreased significantly. After the implementation of the DRG policy, the average length of stay continued to decrease by 0.05 days per month, and the average hospitalization cost continued to decrease by 84.38 yuan per month.

DRG reform has no significant impact on the overall medical quality of the sample hospitals but has a positive effect on reducing the mortality rate of low-risk patients. The DRG policy also has a significant effect on cost control.

To investigate the attitudes of different groups towards the construction of a mechanism for managing the prescription rights of public health physicians in Sichuan Province, with the goal of offering references for policy-making.

Through questionnaires combined with in-depth expert interviews, relevant staff from CDCs, general hospitals, health administrative departments, primary healthcare institutions at various levels in Sichuan Province, and scientific research institutions were surveyed towards the process and management mechanism of granting prescription rights to public health physicians.

The respondents supported granting prescription rights directly to public health physicians who passed the third level hospital training (94.43%) or obtained a physician qualification certificate (93.73%). There were significant differences in the perception of prescription approval departments among different groups. Public health physicians (33.93%) and medical school teachers (42.47%) tended to favor provincial health administrative department approval and empowerment, while clinical physicians (33.74%), health administrative personnel (31.25%), and patients (35.08%) were more supportive of physician practice institution approval and empowerment. In terms of operational mechanism, the survey respondents supported the supervision and management of public health physicians’ prescription rights by county (district) health administrative departments (39.16%), and conduct regular assessments every two years (60.14%).

The granting of prescription rights to public health physicians should be steadily promoted at different levels, institutions, and departments. It is suggested to establish a hierarchical training path and differentiated assessment standards, as well as a dual-track regulatory system of "provincial coordination institutional execution". At the same time, promote legal rights confirmation and closed-loop management mechanisms to ensure the legal and compliant use of prescription rights by public health physicians.

To understand the status of physical activity, cognitive impairment, depression, and their comorbidity in elderly people in Chengdu, Sichuan, and to explore the association between physical activity and the comorbidity of cognitive and depressive disorders.

A cluster sampling method was used to select 8 108 elderly individuals in Chengdu. The Chinese version of the Physical Activity Scale for the Elderly, the Short Form of the Geriatric Depression Scale, and the Mini-Mental State Examination were used for evaluation. Binary logistic regression analysis was conducted to examine the association between different dimensions of physical activity, sedentary behavior, and the comorbidity.

The study found that 2 195 participants (27.3%) had cognitive impairment, 802 participants (9.9%) had depression, and 303 participants (3.8%) had both cognitive impairment and depression. The elderly engaging in more than 150 minutes of moderate-intensity household chores per week, more than 150 minutes of moderate-intensity leisure exercises, or more than 210 minutes of transportation-related physical activity per week were significantly negatively correlated with comorbidity. On the other hand, sitting for more than 480 minutes per day was significantly positively correlated with comorbidity.

Participation in physical activity among the elderly is significantly associated with the comorbidity of cognitive and depressive disorders. Promoting moderate-intensity household chores, leisure exercises, and transportation-related physical activities, while reducing sedentary behavior, can help prevent the occurrence of comorbidity.

To investigate the association between night-time sleep duration and new-onset frailty among middle-aged and elderly individuals in China, and to examine the mediating effect of depression levels on this relationship, thereby providing evidence for the prevention of frailty in this population.

Using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) surveys in 2011, 2013, and 2015, we employed logistic regression models to analyze the relationship between night-time sleep duration, depression levels, and frailty among middle-aged and older adults. Restricted cubic splines were utilized to examine the non-linear association between night-time sleep duration and frailty. A causal mediation model was employed to examine the mediating effect of depression severity between night-time sleep duration and new-onset frailty.

Among 7 582 participants, the frailty prevalence was 21.2%. For each additional hour of night-time sleep duration, depression scores decreased by 0.36 points, with an OR (95% CI) for frailty incidence of 0.92 (0.89-0.96). Conversely, for each 1-point increase in depression severity, the OR (95% CI) for frailty incidence was 1.08 (1.07-1.10). A significant non-linear relationship existed between night-time sleep duration and new-onset frailty (P=0.004). Depression mediated the association between night-time sleep duration and new-onset frailty, with an OR (95% CI) of 0.972 (0.966-0.979), accounting for 35.2% of the mediated effect.

Shortened night-time sleep duration increases the likelihood of new-onset frailty among middle-aged and elderly Chinese adults, with depressive symptoms partially mediating this association.

To investigate the association between Cardiovascular Health (CVH) and cognitive function trajectories.

Data were obtained from five waves (2011-2020) of the China Health and Retirement Longitudinal Study (CHARLS), including participants aged ≥45 years. CVH was assessed using six indicators: tobacco exposure, sleep, body mass index (BMI), non-high-density lipoprotein cholesterol (non-HDL-C), blood glucose, and blood pressure. Group-based trajectory modeling was applied to identify trajectories of cognitive function, and multinomial logistic regression was used to evaluate the association between CVH and cognitive function trajectories.

A total of 5 774 participants was included. Four cognitive trajectories were identified: low-declining, medium-declining, medium-stable and high-stable. Compared with the high-stable group, each one-point increase in CVH score was associated with a reduced risk of entering the low-decline, medium-decline, and medium-stable groups by approximately 1.4%, 0.8%, and 0.5%, respectively (all P<0.01). Tobacco exposure, sleep, and blood pressure were consistently associated with cognitive trajectories (P<0.05), while BMI and non-HDL-C showed significance in selected comparisons.

CVH in middle-aged and older adults is positively associated with cognitive function trajectories. Tobacco exposure, sleep, BMI, non-HDL-C, and blood pressure emerge as key influencing factors. Enhancing CVH, especially through midlife strategies focusing on modifiable lifestyle behaviors and metabolic indicators within an integrated “heart-brain prevention” framework, may represent a promising avenue to mitigate or delay cognitive decline.