With the development of society and the improvement of people's living standards, health issues are receiving increasing attention. The aging population and the high incidence of chronic diseases have made health management an urgent problem that needs to be addressed. Primary healthcare institutions, as the "main battlefield" for residents' health, play a crucial role in health management. However, in the current implementation of health management, primary healthcare institutions still face numerous challenges, and their proactivity remains unclear.
To understand the current implementation status of health management in primary healthcare institutions in Shanghai and to discuss strategies for enhancing the implementation of proactive health-oriented health management.
From February 2023 to May 2023, a survey was conducted on 33 primary healthcare institutions in Shanghai. The survey aimed to understand the implementation of health management, assessment of high-risk factors and disease screening, execution of health education and information dissemination, coordination of health management resources and functional services, as well as the status of online health management services and health monitoring. Additionally, interviews were conducted with institution heads to gather information on implementation difficulties and suggestions.
The research results showed that all participating institutions carried out health management for chronic disease patients, with 93.9% (31/33) covering key populations, 72.7% (24/33) involving rehabilitation populations, and 54.6% (18/33) including healthy populations. A total of 81.8% (27/33) of institutions utilized health data platforms, with the main functions including contract management, health record management, data querying, and health indicator management. Furthermore, 97.0% (32/33) of institutions conducted high-risk factor assessments and disease screenings, as well as follow-up, diagnosis, and management. The majority of institutions carried out health education and information dissemination activities through various platforms. Additionally, 87.9% (29/33) of institutions collaborated with other units to implement health management projects, providing diverse functional services. About 63.6% (21/33) of institutions offered online services, and 42.4% (14/33) were equipped with health monitoring devices. Managers believed that primary healthcare institutions and their staff have significant advantages in implementing proactive health-oriented management, but they also face challenges due to a lack of policy and financial support.
Primary healthcare institutions in Shanghai have made positive progress in implementing proactive health-oriented management. However, comprehensive measures are still needed to address existing challenges, in order to further improve the quality and efficiency of health management services and better meet the health needs of residents.
Type 2 diabetes is a major public health problem that jeopardizes the health of the population in China. The prediabetic state population is a huge reserve force for diabetes, for which appropriate intervention can prevent or delay diabetes, but community health management is ineffective at this stage.
To investigate the problems and influencing factors in community health management practice in prediabetic state, and propose systematic and operable strategies and recommendations on health management measures.
A systematic search was conducted from March to April 2023 to retrieve literature related to community health management of prediabetes in CNKI, Wanfang Data, CQVIP, PubMed, and Web of Science. The key informant interviews based on multiple perspectives were conducted from April to May 2023 in Shanghai communities, hospitals, and CDCs, which included 20 community health service center staff, health administrators, clinical endocrinologists, CDC health management staff, diabetes patients or prediabetes and their family members, and people with diabetes risk factors. The interviews content covered the current status of community health management of prediabetes, related attitudes and perceptions of prediabetes, and acceptance of relevant services. Fishbone diagram analysis were used for data analysis to sort out the hierarchy between the problems related to community health management of prediabetes.
14 relevant literature were eventually included to summarize 22 existing problems in community health management of prediabetic state based on literature and interviews, derive the problems in 4 dimension: patients, intervention scope, service ability and information system, and propose 8 influencing factors: disease risk perception level, self-management skill level, funding budget, work experience, workload, service accessibility, electronic health record construction level and information sharing scope level.
The prediabetic state population is an important target of community health management, and the process of policy change reflects the strengthening of attached to the them, but multiple sources of evidence prove that it is still a weak link at present. In view of the problems in the current practice, it is necessary to improve the knowledge, skills and other management capabilities of community health service personnel, optimize the information system platform based on the medical treatment combination, and further develop a more feasible and continuous health management model for prediabetic state integrating screening, management and intervention.
The imbalance between the supply and demand of pediatric medical resources and health management services in our country has been a long-standing issue, primary healthcare institutions are particularly prominent in this context. How to achieve integration and optimization of pediatric medical resources at the grassroots medical and health institutions is an urgent problem that needs to be addressed. This article primarily summarizes and analyzes the concept and framework of integrated health management services for children, including children's health assessment, early intervention, long-term follow-up, and case studies and practical experiences. Through a review of domestic and international literature, it concludes feasible models of integrated health services for children. This review suggests that integrated health management services have broad potential and promising applications, providing personalized and efficient health management and intervention for children.
