Asia Pacific Journal of Public Health

Shenzhen in China has undergone rapid economic development over the years. The purpose of this study was to investigate disease development trends among women and children inpatients in Shenzhen. A maternal and child health care hospital in Futian District was chosen for this retrospective study. The data were collected from 55 246 inpatients’ information from 2003 to 2012 and were classified into gynecological and pediatric diseases. Descriptive analysis was conducted with Microsoft Excel 2007. The results showed that the number of inpatients had increased year by year, and the constituents of disease had been substantially changed in the study period. More interventions and large-scale studies are needed to improve maternal and child health care in Shenzhen.

The objective of this study was to estimate the prevalence and determinants of passive smoking in pregnancy and to examine its association with an earlier age of menarche in offspring. This retrospective study enrolled 751 students 8 to 20 years old in Shanghai selected by stratified cluster sampling. Data were obtained through structured self-administered questionnaires and physical examinations. It was found that daughters with maternal tobacco exposure experienced relatively earlier menarche and had shorter cycle lengths, although both findings were not statistically significant. The unadjusted odds ratio for prenatal tobacco smoke exposure on the relatively earlier onset of menarche was 1.84 (95% confidence interval = 1.05-3.22) compared with no exposure, and the associations remained statistically significant after adjusting for birth weight, birth length, maternal age of menarche, and present height and weight. In conclusion, our study provides limited evidence supporting the hypothesis that maternal passive smoking during pregnancy leads to an earlier age of menarche of daughters.

This study aims to explore the association between early sex initiation and subsequent unsafe sexual behaviors and risks among Chinese female undergraduates. Of 4769 participants, 863 (18.1%) reported ever having sexual intercourse. The mean age of sexual debut was 19.3 (±1.7) years. Females initiating sex earlier were more likely to have first sex with men who were not their “boyfriends” and less likely to take contraception, to use a condom at first encounter, to use contraception consistently in past year, and/or to use condom consistently during the course of a sexual intercourse. They were more likely to have multiple lifetime and concurrent sexual partners, to report pregnancy, and be diagnosed with sexually transmitted diseases. Comprehensive early sex education should be advocated for young people, not only teaching knowledge of physical health but also providing practical skills training for making them consciously delay start of sexual activity or protecting themselves during sexual intercourse.

In China, more and more female college students engage in premarital sex. Few seek reproductive health services, increasing their risk for unintended pregnancy and reproductive tract infections (RTIs). The present study aims to explore the prevalence and sex-related risk factors of premarital pregnancy and RTIs among female undergraduates in China. A total of 4769 females were recruited using randomized cluster sampling and anonymously completed questionnaires. Of the 4,769 females, 863 (18.1%) reported ever having sexual intercourse, 17.5% of which had become pregnant, and 22.7% had contracted RTIs. Younger age or not using a condom at first sex and having multiple sex partners contributed to premarital pregnancy. Majoring in arts, being from less-developed regions of China, having multiple partners, and self-reported pregnancy contributed to RTIs. Findings suggest importance of sexual health education among undergraduates, especially women from less-developed regions of China and/or majoring in arts.

The purpose of this study was to explore direct economic burden and its influencing factors in patients with hepatitis B virus (HBV) related diseases. Time phasing continuous sampling was used to select patients from August 1, 2012, to December 31, 2012, in 3 county hospitals of 3 model regions in Jiangsu Province, China. A total of 436 outpatients and 196 inpatients were observed. The average direct economic burden of HBV-associated admission was US$107.11 for outpatients, and drug fees accounted for 74%; the burden was US$3193.47 for inpatients, and the direct medical costs accounted for 96%. Multivariate linear regression analysis showed that drug fee, examination fee, and antiviral therapy were influencing factors for outpatients, while hospitalization stay, drug ratio, and patient’s age were influencing factors for inpatients. It can be concluded that the direct economic burden of patients with HBV-related diseases was high compared to their household income. Measures should be taken to reduce the economic burden of patients.

The purpose of this research was to study the components, influencing factors, and their changing trend in a Chinese hospital, so as to reduce the economic burden of inpatients with type 2 diabetes. Data were collected from 7487 cases. There were 4368 inpatients with type 2 diabetes during 2002-2012 in a Chinese hospital. Multivariate linear regression analysis was performed to explore the influencing factors of hospitalization costs. The number of inpatients and their hospitalization costs had increasing trends in the study period. The medicine, test, and examination charges were the main sources of total costs. Longer hospital stays, older ages, and more times of hospitalization led to higher medical costs. Actions should be taken on all fronts to control the rapidly increasing trend of hospitalization costs and to reduce hospital stays and the number of times of hospitalization to reduce the economic burden of diabetic inpatients.

This study aims to research the factors influencing the hospitalization costs of patients with type 2 diabetes, so as to provide some references for reducing their economic burden. Based on the Hospital Information System of a 3A grade hospital in China, we analyzed 2970 cases with type 2 diabetes during 2005-2012. Both the number of inpatients and the hospitalization costs had increased in the study period. Using multiple linear regression analysis, we found that patients in Urban Employee Basic Medical Insurance had higher costs than those in New Rural Cooperative Medical Scheme. We also found hospitalization costs to be higher in male patients and older patients, patients who stayed more days at hospital and who had surgeries, patients who had at least 1 complication, and patients whose admission status was emergency. After standardizing the regression coefficients, we found that the hospital stay, the forms of payment, and presence of complications were the first 3 factors influencing hospitalization costs in our study. In conclusion, the hospitalization costs of patients with type 2 diabetes could be influenced by age, gender, forms of payment, hospital stay, admission status, complications, and surgery. Medical workers in the studied region should take actions to reduce the duration of hospital stay for diabetic patients and prevent relevant complications. What is more, medical insurance needs further improvement.

This study evaluates health status among elderly residents in urban China and medical insurance schemes for them. A total of 931 urban elderly individuals aged 60 years or above in 3 cities were interviewed. The survey gathered data on individual sociodemographic characteristics, self-reported health status, chronic disease diagnoses, use of and expenditure related to health care services, satisfaction with medical insurance, and so on. The prevalence of chronic disease was 79.1% among the respondents, and medical expenditure on chronic disease per patient was 4656 Yuan in half a year. Over the 2 earlier weeks, 27.4% of respondents had felt sick, and 63.5% of them had had outpatient visits; 29.5% of respondents had been hospitalized in the past year. Among different groups, the inpatient reimbursement rate ranged from 45.5% to 81.2%, and the outpatient reimbursement rate was between 4.1% and 100%. The health care demand had not been met for many elderly individuals because of the lack of general outpatient coverage in the basic medical insurance scheme.

This study was undertaken to uncover the challenges faced by village doctors in providing basic public health services (BPHS) in western rural areas of China. This field research for BPHS, with 12 managers and 82 village doctors of county Y in Guizhou province, was conducted in July 2012 using a combination of random and purposive sampling methods. Quantitative and qualitative methods were applied for data collection. EpiData 3.1, SPSS 15.0, and NVivo 10.0 were used to analyze the data. The results showed that the main challenges in delivering BPHS include heavy workload, poor working conditions, low income, lack of social security, and insufficient cooperation from rural residents. The Chinese government officials and policy makers can consider these challenges and focus on improving the quality and equity of BPHS by developing relevant strategies.

The general practitioner (GP) system has been widely applied around the world and experimented with in Shanghai, China. To analyze some of the influencing factors on patient-GP contracts, we developed a questionnaire and conducted site investigations in 2011 and 2012 to 1200 patients by random sampling from 6 pilot community health service (CHS) centers in Pudong, Shanghai. The t test, χ² test, factor analysis, and logistic regression analysis were used to analyze the data. The factors influencing patients’ contract behavior were age (OR = 1.03; 95%CI = 1.02-1.04), education level (OR = 0.83; 95% CI = 0.75-0.93), social interaction of social capital (OR = 1.34; 95% CI = 1.15-1.56), acceptance of first contact in community (OR = 3.25; 95% CI = 2.07-5.12), the year of investigation (OR = 2.58; 95% CI = 1.92-3.47), and the exposure to publicity (OR = 1.60; 95% CI = 1.39-1.85). Elderly patients formed a focus group to sign contracts with GPs. To increase trust in GPs by patients, it is recommended to improve the level of CHSs, strengthen publicity, and cultivate social capital among patients.

The aim of this study was to describe the retention in care and examine the factors affecting it among people living with HIV and AIDS (PLWHA) in Changsha City, China. Data on treatment, care, and their retention of all registered 822 PLWHA in Changsha Center for Disease Control and Prevention were analyzed. The retention rate had shown 58.1% among this sample. With logistic regression analysis, retention in care was significantly related to education level (senior high school vs university: odds ratio [OR] = 0.471, 95% confidence interval [CI] = 0.237-0.937), CD4 count (<50cells/mm³ vs >500cells/mm³: OR = 2.659, 95% CI = 1.816-28.760), and initiation of antiretroviral therapy (No vs Yes: OR = 0.362, 95% CI = 0.180-0.550). In conclusion, the intervention to improve retention in care for PLWHA in Changsha is warranted, especially for those who have lower education level, for those who have higher baseline CD4 count, and for those who have not initiated antiretroviral therapy.

The purpose of the study was to investigate the noise pollution situation and the resulting adverse effect on residents’ health in Luzhou, China, to provide data for noise pollution prevention policies and interventions. Four different functional areas (commercial, construction, residential, and transportation hub areas) were chosen to monitor noise level for 3 months. The survey was performed by questionnaire on the spot on randomly selected individuals; it collected data on the impact of noise on residents’ health (quality of sleep, high blood pressure, subjective feeling of nervous system damage, and attention) as well as the knowledge of noise-induced health damage, the degree of adaptation to noise, and their solutions. The noise levels of residential, commercial, transportation, and construction areas exceeded the national standards (P < .001). Sleep quality, prevalence of hypertension, and attention in transportation hub areas were significantly different from those in the other 3 areas (P < .05); only 24.46% of people knew the health hazards associated with noise; 64.57% of residents have adapted to the current noise environment. Most of them have to close the doors and windows to reduce noise. The noise pollution situation in Luzhou, China, is serious, especially the traffic noise pollution. Residents pay less attention to it and adopt single measures to reduce the noise. We should work toward the prevention and control of traffic noise and improve the residents’ awareness to reduce the adverse health effects of noise.

The purpose of this study was to validate the applicability of our proposed disease-specific questionnaire to Cantonese coronary heart disease (CHD) patients. During the investigation from August 2010 to March 2012, 1000 Cantonese inpatients were recruited. The reliability of the scale was judged by the internal consistency, and the content and construct validity were assessed by using Pearson correlation and confirmatory factor analysis, respectively. Results showed that the Cronbach’s α coefficient for the whole scale and most domains/facets were larger than .70 (.59 to .93). Most items had moderate to strong Pearson correlations with their respective facets (r > 0.50). Confirmatory factor analysis showed that the indices for goodness of fit were nearly acceptable. Overall, the QLICD-CHD scale has adequate psychometric properties when applied to Cantonese CHD patients.