The inheritance, innovation, and development of traditional Chinese medicine have received high attention from the country. However, the development of grassroots traditional Chinese medicine diagnosis and treatment in China is still uneven, and the operational efficiency of traditional Chinese medicine diagnosis and treatment services in different institutions varies greatly.

By analyzing the operation of traditional Chinese medicine diagnosis and treatment services in grassroots medical institutions in Tianjin in 2021, this study provides a reference for the development of traditional Chinese medicine in grassroots medical institutions.

In 2021, a comprehensive survey method was used to collect relevant data from a total of 270 primary healthcare institutions in 16 administrative regions of Tianjin (Dis1-6 being the six districts within the city, Dis7-10 being the four districts around the city, Dis11 being the Binhai New Area, and Dis12-16 being the five districts in the suburbs), and two methods, BCC and CCR models in Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA), were comprehensively applied to analyze the operational efficiency of traditional Chinese medicine diagnosis and treatment services in institutions from different perspectives. Through literature research, the input indicators of the DEA model were set as the number of traditional Chinese medicine practitioners, the number of traditional Chinese medicine beds, and the number of traditional Chinese medicine diagnosis and treatment equipment; The output indicators were set as traditional Chinese medicine medical income, number of traditional Chinese medicine diagnosis and treatment personnel, number of discharged patients mainly using traditional Chinese medicine, and number of on-site traditional Chinese medicine service personnel. The SFA model was consistent with the indicators set by DEA, except for the addition of total income as an output indicator.

The operation of traditional Chinese medicine diagnosis and treatment services in grassroots medical and health institutions in 7 districts was effective, Dis9 DEA was weakly effective, and DEA was ineffective in 8 districts. There were 8 districts with increasing returns to scale, 7 districts with unchanged returns to scale, and Dis3 showing decreasing returns to scale. There were 8 non DEA effective regions, and all 3 input indicators in each region have redundancy. The phenomenon of insufficient income from traditional Chinese medicine and medical services in the output indicators was more serious in each region. The efficiency of Dis1-6 technology in SFA results (0.733-0.838) was within the high efficiency range; Dis7-10 technology efficiency (0.691-0.912), 3 high efficiency zones and 1 medium efficiency zone; Dis11 technology efficiency of 0.885 was in the high efficiency zone; Dis12-16 (0.399-0.849) had 3 high efficiency zones and 2 medium efficiency zones. The DEA results were basically consistent with the SFA results, indicating that the number of traditional Chinese medicine practitioners had a positive impact on operational efficiency.

The overall operational efficiency of traditional Chinese medicine diagnosis and treatment services in grassroots medical institutions in various districts of Tianjin is relatively low, but the overall development trend is positive and has regional characteristics. Overall, Dis1-6 is better than Dis7-10, and Dis7-10 is better than Dis11-16. Each district should plan reasonably according to the actual situation, avoid excessive resource input and insufficient output, and especially increase support for Binhai New Area and the five districts in the suburbs.

General practitioners with sub-specialties can not only provide high-quality general medical services, but also provide a certain depth of specialized medical services. The combination of general practitioners with sub-specialties of different specialties can provide relatively comprehensive and certain depth of basic medical services for residents in their jurisdictions. Under the situation that the professional service capacity of mental health cannot meet the needs of residents, the necessity of encouraging some general practitioners to develop mental health subspecialties has become increasingly prominent. This article analyzes the necessity of training general practitioners with psychosis subspecialty, the advantages of developing psychosis subspecialty among general practitioners, the obstacles to promoting the development of psychosis sub-expertise of general practitioners in primary care are proposed: the construction of general practitioners training bases for psychosis sub-expertise, the learning platform for general practitioners with psychosis sub-expertise was expanded, construction of sub-specialty teachers of psychosis, policy and financial support, salary and promotion incentive policies, etc., are expected to help general practitioners develop psychosis sub-expertise.

At present, the unbalanced and inadequate development of primary healthcare services does not meet people's growing demand for them in the new era. Identifying the influencing factors and their action paths on the performance of primary healthcare services has always been an issue of common concern in the academic circles.

To clarify the combination of multiple factors and their action paths that affect the performance of primary healthcare services in China, and to provide decision-making basis for further improvement of primary healthcare services.

The study was conducted from November 2022 to August 2023, and the data were obtained from the 2021 China Health Statistics Yearbook and the 2021 China Statistical Yearbook. A fuzzy set qualitative comparative analysis (fsQCA) was conducted with the performance of primary healthcare services in 31 provinces (autonomous regions and municipalities) as the outcome variables, and application of big data, medical technology, government attention, system integration, medical resources and health demand as the conditional variables.

The quality of performance of primary healthcare services is the result of a combination of various factors. The results of configuration analysis show that there are 4 configurations to improve the performance of primary healthcare services, which can be classified into 3 patterns: "technology-environment" "organization-environment" and "technology-organization-environment". Configuration 1: Application of Big Data * - Medical Technology * - Government Attention * - System Integration * Medical Resources. Configuration 2: -Application of Big Data * - Medical Technology * System Integration * Medical Resources * - Health Demand. Configuration 3: Application of Big Data * Medical Technology * System Integration * Medical Resources * Health Demand. Configuration 4: Application of Big data * - Government Attention * System Integration * Medical Resources * Health Demand. (* means "and", - means "non"). The consistency of the four configuration solutions was 0.926, the coverage of the solution was 0.612, the original coverage ranged from 0.314 to 0.396, and the unique coverage was from 0.017 to 0.083. The configurations that improve the performance of primary healthcare services are different in eastern, central and western regions of China.

At present, increasing the investment of medical resources at the grass-roots level is still a universal measure to improve the performance of primary healthcare services in China, but attention should also be paid to effectively combine technological, organizational and environmental (T-O-E) conditions. The action paths of the influencing factors are notably different in the eastern, central and western regions of China. Therefore, regions should choose different action paths based on their own development endowments and conditions, reasonably allocate limited medical resources, improve TOE conditions in a targeted manner, so as to improve the performance of healthcare services and realize the high-quality development of primary healthcare services.

This study provides a review of the current status of service capabilities, strategies for improving service capabilities, and improvement measures of grassroots traditional Chinese medicine clinics in Haizhou District, Lianyungang City. It describes the current work status of grassroots traditional Chinese medicine clinics in the construction of characteristic departments, family doctor contract services, and medical prevention integration. It is found that there are problems in the operation of traditional Chinese medicine clinics, such as uneven resource allocation, non-standard management, insufficient facilities and equipment, and the need to improve service capabilities. A survey and analysis were conducted on the construction of traditional Chinese medicine clinics in 19 grassroots medical and health institutions to identify common and individual problems. Targeted suggestions and improvement st rategies were proposed to enhance the service capabilities of traditional Chinese medicine clinics, form a characteristic of medical prevention integration, and give full play to the functions and roles of grassroots medical care. Residents received high-quality traditional Chinese medicine services in the community.

Since its implementation, residents' electronic health records have achieved phased results. The target of the filing rate in Shenzhen, Guangdong Province has been achieved, and the utilization rate has become the core index of theoptimization management of this work.

To understand the use of electronic health records of residents in Bao'an District, Shenzhen, and to analyze the influencing factors. It provides a basis for improving the utilization rate of health records and optimizing the allocation of community health resources.

As of 2022-12-31, Shenzhen Community Health Service information system had a total of 4 077 665 electronic health records of Bao 'an District residents. 403 700 electronic health records were selected by systematic sampling method, and 401 853 meeting the requirements of the study were selected for analysis.

The utilization rates of health records in 1 year, 2 years and 3 years were 59.30% (238 131/401 853), 74.90% (301 032/401 853) and 80.10% (321 853/401 853). The results of multivariate Logistic regression analysis showed that age, nationality, resident type, marital status, education level, profession, payment methods for medical expenses, duration of filing, as well as whether the health records were signed by a family doctor, the elderly, the hypertension and the diabetes were residents' electronic health records influencing factors of 1, 2 and 3 years use (P<0.05). Among them, compared with residents aged 21-45, the use rate of electronic health records in 1, 2 and 3 years was higher for residents aged 0-1, 2-3 and 4-6 years (OR>1.00, P<0.05) ; the usage rate of electronic health records for residents aged 46-60 and ≥61 years was lower in 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with non-resident residents of Shenzhen, the use rate of electronic health records of residents with permanent residence in Shenzhen was higher at 1, 2 and 3 years (OR>1.00, P<0.05) ; compared with the residents participating in the basic medical insurance for urban employees, the use rate of electronic health records of residents with basic medical insurance, full self-payment and other medical expenses payment methods for urban residents was lower in 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with residents with a filing period of<1 year, the use rate of electronic health records of residents with a filing period of≥1 year was lower at 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with the residents without the corresponding project identification, the 1-year utilization rate of electronic health records with family doctor contract identification, elderly project identification, hypertension project identification, and diabetes project identification was higher[OR (95%CI) was 3.77 (3.70-3.84), 2.73 (2.53-2.94), 4.40 (4.11-4.72), 3.10 (2.78-3.47), P<0.05], respectively, and the 2-years and 3-years usage rates were also higher (OR>1.00, P<0.05) .

The usage rate of electronic health records among residents in Bao'an District has risen compared to previous levels, but there is still potential for further enhancement. Priority should be given to non-elderly people, middle-aged and elderly people identified by the hypertension/diabetes program, and residents who have not signed a family doctor, basic medical insurance for urban residents, payment methods for self-payment and other medical expenses, and non-household registration residents.

The high incidence of chronic diseases is associated with the inadequate knowledge of health and disease risks. At the national level, traditional health education remains popular in community health services. The health education conducted by primary healthcare providers are often limited, and lacks specificity in the content. Additionally, community residents generally show a low enthusiasm for participating in health education. The quality and effectiveness of health education for chronic disease patients need an improvement.

To explore the effectiveness of individualized health education interventions generated through the application of an information-based knowledge base model on middle-aged and elderly patients with chronic diseases in the community. The findings are expected to provide insights to further enhance the management of community-based chronic diseases.

In 2021, a total of 7 390 patients at the age of 50-70 years with the chronic diseases of hypertension, diabetes, coronary heart disease, and stroke in Beijing Dongcheng District Community Health Service Center were selected as study subjects. A one-year cluster randomized controlled trial was conducted. Patients in both groups received routine follow-up management strategies for chronic diseases, with the preservation of the existing basic public health services for chronic diseases. Those in the intervention group were additionally given individualized health education programs generated through an information-based knowledge base model, including health education prescriptions and individualized health management. Follow-up visits and interventions were conducted every three months, for a total of 12 months. An end-point survey was conducted one year after recruitment. The primary outcome measures were the differences between the baseline and end-point results of the knowledge awareness of chronic diseases, self-management attitudes, self-efficacy, medication adherence, and acceptance of health information technology.

A total of 7 390 patients with the four types of chronic diseases were included in the study, involving 3 673 patients in the intervention group and 3 717 in the control group. There were no significant differences in the age distribution, gender, education level, and employment status between groups (P>0.05). However, there was a significant difference in the type of medical insurance coverage between groups (P<0.05). After the intervention, patients in the intervention group demonstrated significantly higher correct awareness rates of overall disease knowledge, basic knowledge of chronic diseases, diabetes knowledge, coronary heart disease knowledge, and stroke knowledge compared to pre-intervention levels (P<0.05), while that of hypertension knowledge was not statistically significant (P>0.05). In the control group, there were no significant changes in the correct awareness rates of overall disease knowledge, basic knowledge of chronic diseases, hypertension knowledge, diabetes knowledge, or coronary heart disease knowledge before and after the intervention (P>0.05). However, the correct awareness rate of stroke knowledge in the control group was significantly lower after the intervention compared to pre-intervention levels (P<0.05). The scores of the self-management attitude questionnaire, self-efficacy questionnaire, medication adherence questionnaire, and health information acceptance questionnaire in the intervention group were significantly higher than those of the control group after the intervention (P<0.05). Additionally, in the intervention group, the scores on the self-management attitude questionnaire, self-efficacy questionnaire, medication adherence questionnaire, and health information acceptance questionnaire after the intervention were significantly higher compared to pre-intervention levels (P<0.05). In the control group, the scores of the self-efficacy questionnaire and medication adherence questionnaire improved significantly after the intervention compared to pre-intervention levels (P<0.05), while no significant changes in the scores of the self-management attitude questionnaire and health information acceptance questionnaire were detected (P>0.05) .

Knowledge awareness of chronic diseases, self-management attitude, and health information acceptance are more significantly improved in the intervention group than the control group. Both groups showed improvements in self-efficacy and medication adherence following the intervention, especially in the intervention group. Overall, an individualized health education based on an information-based knowledge base model is beneficial for enhancing the health literacy of patients with chronic diseases.

Based on the case of the Central Health Center, the ROCCIPI framework was used to identify and analyze the problems of integrating traditional Chinese medicine (TCM) into grassroots township health centers from seven dimensions. On this basis, it puts forward the strategy of implementing precision strategy, building connotative ability, strengthening TCM awareness and promoting multi-platform communication, in order to better realize the integration of TCM into modern primary health.

Primary healthcare institution undertakes a significant responsibility in medical and health provision. As the medical industry has undergone continuous development, which is evident in the obvious improvement of facilities and medical treatment environment of community health service institutions, and the effectively upgraded health information systems, the public's demand for specialized medical treatment in community health service institutions is becoming increasingly prominent. This article discusses the significance of developing specialized medical technology in community, the connotation of general-specialized combination, as well as the implementation strategies and methods. The article points out that the construction and development of specialized diagnosis and treatment technology in community health service centers can enhance the ability of community general practitioners to practice, improve the level of primary medical care technology, upgrade the level of community health services and meet the public's demand for specialized diagnosis and treatment. The goal of general-specialty integration can be achieved either by developing specialized diagnostic and treatment techniques on the basis of general practice, or by collaborating with higher-level hospitals to introduce a series of specialized techniques. In terms of specific implementation strategies, it is necessary to find appropriate specialized technologies according to the local needs, develop advanced technologies, carry out scientific research around specialized diseases, and build technical resources by opening specialized outpatient clinics, allocating medical conditions, etc., and cultivate community talents along with the four construction work, so as to implement the development strategy of the all-specialized combination of community diagnosis and treatment technologies in the four-plus-one way.

The concept landscape of frailty has evolved from a single dimension which emphasising predominantly physical frailty into a multidimensional concept encompassing physical, psychological and social frailty. Conducting researches on multidimensional frailty armong community-dwelling older adults is an important way to address the current fragmentation of community-based elderly care services and enhance the comprehensive health of this population. In this paper, firstly, we review the evolution of the concept of multidimensional frailty; secondly, classify and describe the multidi. mensional frailty assessment tools that can be applied to community-dwelling older adults; thirdly, analysis the influencing factors of multidimensional frailty in community-dwelling older adults as well as the interactions between the dimensions of frailty, finally, assess the predictive value of multidimensional frailty in community-dwelling older adults in relation to health outcomes. Existing evidences suggest that the multidimensional frailty is found to be the result of a combination of physiological, psychological, and social factors, and that assessing multidimensional frailty in community-dwelling older adults can predict a variety of health outcomes such as disability, disease risk, and mortality, and that the different dimensions of frailty are correlated and interact with each others. However, there is no a standardized tool for evaluating multidimensional frailty in the community-dwelling older adults, and the underlying mechanisms of its occurrence and development have not been clarified. So, the follow-up studies could explore the developmental trajectory of multidimensional debility based on large prospective cohort studies, in order to provide a referable basis for the development of intervention strategies to reverse or delay the frail process in community-dwelling older adults.

There is a significant shortage of general practitioners at primary healthcare institutions in China, and their low job satisfaction is a crucial factor leading to the scarcity of talents.

To understand the job satisfaction and related factors among general practitioners (GPs) from primary healthcare institutions in Chengdu.

From December 2018 to January 2019, a questionnaire survey was conducted on all registered general practitioners working at primary healthcare institutions in Chengdu (n=1 549). The questionnaire included their basic information, job satisfaction, and their suggestions for improving job satisfaction. Multivariate Logistic regression was used to analyze the factors influencing job satisfaction among GPs.

A total of 1 539 valid questionnaires were collected, with an effective response rate of 99.35%. The overall job satisfaction of general practitioners was (114.0±17.2), indicating a "moderate" level. The average score of job workflow dimensions was the lowest (10.6±2.5), indicating "dissatisfaction". Other dimensions scored at a "moderate" level. The scores for salary and welfare dimension were relatively low at (11.8±2.8) and (11.6±2.8) respectively. There were statistically significant differences in overall job satisfaction among GPs of different genders and age groups (P<0.05) ; however, no statistical significance was found among GPs with different educational backgrounds, titles, and years of work experience (P>0.05). The results of multivariate Logistic regression analysis showed that age was a significant factor affecting overall job satisfaction of GPs (P<0.05). GPs aged 30-39 [OR (95%CI) =0.132 (0.035-0.494) ] and 40-49 [OR (95%CI) =0.207 (0.065-0.664) ] had lower job satisfaction compared to those aged 50 and above (P<0.05). A total of 419 individuals made suggestions for improving their job satisfaction, resulting in a total of 427 suggestions. Among these, "improving benefits" ranked the highest (25.53%, 109/427) .

The overall job satisfaction of GPs in primary healthcare institutions in Chengdu is generally moderate, with the least satisfaction regarding workflow and the greatest desire for improved benefits. Age is a factor influencing job satisfaction among GPs. It is recommended to take effective measures to enhance job satisfaction among GPs by addressing their areas of dissatisfaction, such as streamlining workflow and implementing a system of "fair distribution according to work performance".

The professional capacity and infrastructure of general practitioners in grass-roots medical and health institutions in China are relatively weak, and the energy of specialists in general hospitals is limited and resources are abundant. Strengthening the cooperation between general practitioners and specialists can effectively improve the quality of community medical care and promote the health of patients. This paper systematically sorts out the typical practices and experiences of the construction of outpatient clinics of integration of general practice and specialty, and takes the source, connotation, construction path and construction path of the concept of full-specialty combination of outpatient clinics development effectiveness, existing problems and strategic recommendations are elaborated. Point out the challenges that may be faced in the construction of outpatient clinics of integration of general practice and specialty management model. In addition, this paper summarizes the possible challenges of the construction of integrated outpatient clinics, and puts forward five suggestions for the different practice methods of integrated outpatient clinics in different regions: improve the rules and regulations for the construction of outpatient clinics of integration of general practice and specialty, coordinate and unify the outpatient path of outpatient clinics of integration of general practice and specialty, pay attention to the protection of outpatient clinics of integration of general practice and specialty teams, clarify the population of outpatient clinics of integration of general practice and specialty services, and improve the health evaluation system for the outcomes of outpatient clinics of integration of general practice and specialty. In order to provide reference for the country to carry out the construction of outpatient clinics of integration of general practice and specialty in depth. Further expanding the community service function and deepening the cooperation with specialist physicians is an important direction for the future exploration of the construction of outpatient clinics of integration of general practice and specialized health care service. The joint participation and promotion of the government, medical institutions and general and specialist physicians can better promote the construction and development of community general and specialized outpatient clinics.

With the comprehensive implementation of the family doctor system in China, community health service resources have been widely utilized. However, there is a lack of research on the utilization tendency of primary outpatient medical resources for adult diabetic patients using objective medical visit data.

To understand the characteristics of outpatient visits for diabetic patients in the community, analyze the factors influencing frequent visits by patients enrolled in family doctor services, correctly identify the utilization tendency of primary outpatient medical resources by enrolled patients, and provide a basis for promoting the high-quality development of family doctor contract services.

In August 2023, outpatient visit records of adult diabetic patients from 13 community health service centers in Minhang District, Shanghai, for the year 2021 were retrieved. Personal information such as names and contact details were forcibly anonymized, while data on sex, age, enrollment in family doctor services, triggered diagnosis records, frequency of medical treatment, department of medical treatment, and Chinese medicine services during visits were collected. The characteristics of outpatient visits for adult diabetic patients in the community were analyzed, and multiple logistic regression and decision tree models were used to analyze the factors influencing frequent visits by enrolled patients.

There were 66 838 adult patients, resulting in 1 281 972 outpatient records. Among them, 48.96% (32 723) were male; the median age of the patients who visited the hospital was 71 (66, 77) years old; the median number of diagnosis types was 6 (3, 10) ; the median frequency of visits was 15 (9, 26), 10.28% (6 871) of the adult patients frequently visited the hospital for 362 068 times; 1-2 departments were the main ones (60.38%), and 9.33% (6 233) of the patients with≥5 departments involved; 39.53% (26 423) visited Chinese medicine services. During the year, Contracted patients accounted for 92.77% (62 005) of all the patients, while non-contracted patients only accounted for 7.23% (4 833). There were significant differences between contracted patients and non-contracted patients in sex, age, complexity of illness, frequency of medical treatment, department of medical treatment, Chinese medicine service (P<0.05). The results of multivariate Logistic regression analysis showed that sex, age, complexity of illness, department of medical treatment, Chinese medicine service were the influencing factors of frequent visits by contracted patients (P<0.05). The results of decision tree model analysis showed that the complexity of the disease was the most important factor affecting the frequent visits of contracted patients.

The signing rate of adult diabetic patients in community primary clinics in Minhang District of Shanghai was high, the effect of family doctor signing system was remarkable, the aging of adult diabetic patients in community primary clinics was prominent, the contracted patients' condition was more complicated, and the demand for Chinese medicine treatment was stronger. The frequent visits of contracted patients were affected by many factors, especially the complexity of their condition. Therefore, it is suggested that relevant departments identify frequent patients efficiently according to the patients' condition, so as to make more rational use of medical resources in primary clinics.

Shanghai has been implementing the "1+1+1" combined family doctor contract service for nearly a decade, and its effectiveness in promoting graded diagnosis and treatment and guiding residents to seek medical treatment at the grassroots level needs to be verified. Existing related studies mostly focus on the number of visits to primary clinics and patients' willingness to visit primary clinics as key analysis variables. However, these two indicators cannot comprehensively and truly reflect the actual utilization of primary healthcare services by residents.

To investigate the influencing factors of family doctors' signing up for type 2 diabetes patients to see doctors at the grass-roots level, so as to provide a scientific basis for further optimizing the allocation of community health service resources.

In May 2023, 550 patients with type 2 diabetes who have signed a contract with family doctors were selected by random sampling in Jinshanwei Town, Jinshan District, Shanghai. By accessing the medical data of patients enrolled in the regional health information platform in 2022, if the proportion of patients' visits to community health service institutions in that year to the total number of visits is less than 90%, it is considered that the compliance with grassroots medical treatment is poor, and if it is greater than or equal to 90%, it is considered that the compliance with grassroots medical treatment is good. Conduct a "face-to-face" questionnaire survey on the included patients, covering their basic information, disease and treatment status, health policy awareness and service utilization, etc. According to the Anderson model, the indicators are divided into three categories: propensity factors, ability factors, and need factors. The influencing factors of compliance of contracted type 2 diabetes patients with primary care were analyzed by binary logistic regression.

The questionnaire of 508 patients (92.4%) was effectively collected. Among them, 371 cases (73.0%) had good compliance with grassroots medical treatment, and 137 cases (27.0%) had poor compliance. The average scores of patients on the four dimensions of policy awareness, institutional trust, medical expenses, and medical services are (11.0±3.6), (17.6±2.6), (12.8±1.9), and (17.0±2.3) points, respectively. The results of binary Logistic regression analysis showed that the occupation and the nature of residence in the propensity factors, the type of medical insurance, the per capita monthly income of families, the medical service score in the ability factors, and the institutional trust score in the need factors were the influencing factors of type 2 diabetes patients' compliance with grassroots medical treatment (P<0.05) .

The patients with type 2 diabetes didn't have enough knowledge of the service policy signed by family doctors. Higher quality medical services and more reliable institutional trust were the promoting factors for the grassroots medical behavior of contracted residents with type 2 diabetes. It is suggested to strengthen the policy promotion of family doctor contract services, further enhance the capacity of community health services, and optimize the quality of community health services.

Cognitive frailty is a prevalent clinical syndrome in the elderly, with subtypes of reversible and potentially reversible cognitive frailty. It is associated with adverse health outcomes such as falls, disability, and mortality. However, there is limited research on the current prevalence of cognitive frailty subtypes and their influencing factors in the elderly population.

To investigate the current status of cognitive frailty (CF) among community elderly in Beichen District in Tianjin, and to explore the influencing factors of different subtypes of cognitive frailty, so as to provide references for the early identification and intervention of reversible cognitive frailty (RCF) .

From June to August 2023, totally 3 916 community residents in Beichen District, Tianjin were recruited with convenience sampling, and a face-to-face questionnaire survey was conducted using the demography questionnaire, FRAIL Frailty Scale, the Brief Mental Status Examination Scale (MMSE), and the Subjective Cognitive Decline Questionnaire (SCD-Q9) to assess the incidence of different types of cognitive frailty and analyze the influencing factors among older people using a multivariate Logistic regression model.

Among 3 916 participants, 679 (17.34%) with RCF and 440 (11.24%) with PRCF. There were significantly differences in CF prevalence among the elderly with different genders, ages, educational backgrounds, sleep disorders, the prevalence of various types of chronic illnesses, exercise, smoking histories, drinking histories, the number of medications used for chronic illnesses, and hemoglobin levels (P<0.05). Multifactorial Logistic regression analysis showed that with no cognitive frailty as a control, being female (OR=2.186, 95%CI=1.713-2.791), age≥70 years (OR=3.056, 95%CI=2.519-3.708), smoking (OR=1.753, 95%CI=1.431-2.146), having a sleep disorder (OR=1.275, 95%CI=1.046-1.555), low hemoglobin levels (OR=1.531, 95%CI=1.026-2.284), and≥3 medications for a chronic condition (OR=2.168, 95%CI=1.490-3.156) were associated with a higher risk of RCF, and exercise (OR=0.459, 95%CI=0.382-0.551) was associated with a lower risk of RCF (P<0.05) ; being female (OR=1.941, 95%CI=1.465-2.573), age≥70 years (OR=1.830, 95%CI=1.460-2.292), drinking (OR=2.270, 95%CI=1.734-2.970), having a sleep disorder (OR=1.996, 95%CI=1.557-2.560), stroke (OR=2.114, 95%CI=1.026-4.355), low hemoglobin levels (OR=1.991, 95%CI=1.288-3.078), and ≥3 medications for a chronic condition (OR=1.626, 95%CI=1.050-2.518) were associated with a higher risk of PRCF, and exercise (OR=0.522, 95%CI=0.423-0.644) was associated with a lower risk of PRCF in the aged (P<0.05) .

The prevalence of reversible and potentially reversible cognitive frailty is high among the elderly in the community of Beichen District in Tianjin. It is recommended to add the assessment of CF into community physical examinations and implement multidimensional effective strategies to delay the onset and progression of CF.

Hypertension as a risk factor can significantly increase the morbidity and mortality of cardiovascular and cerebrovascular diseases, and effective control of hypertension is the key to prevent and treat cardiovascular diseases.

Collect literature on the evaluation of the effectiveness of hypertension management models in China. Evaluate the management effects of different models and provide a reference for further optimization of hypertension management models.

Using StataSE-64, a network Meta-analysis of the 18 included hypertension management model papers was performed using blood pressure control rates as an evaluation metric. The models included five models: joint hospital-community management, community management, hospital treatment management, general management, and combined Internet management.

Joint hospital-community management, community management, hospital management, and combined Internet management are all effective for hypertension control. The order is joint hospital-community management ≈ combined Internet management> hospital treatment management>community management>blank control. Among them, the joint hospital-community management model has significant effect on hypertension control; the joint hospital-community management model and combined Internet management has similar effect; and hospital management has better effect than community management.

In order to improve the hypertension management model, the construction of hospital-community-family management model in primary health care institutions should be promoted, and the combination of chronic disease management model and combined Internet model should be guided to strengthen the whole-life, whole-cycle management of chronic disease patients.

20%-30% of individuals with Preserved Ratio Impaired Spirometry (PRISm) will develop chronic obstructive pulmonary disease (COPD). However studies on characteristics of PRISm in China remain limited.

To analyze factors associated with PRISm, and to explore the difference in the distribution of risk factors between individuals with PRISm and COPD.

This study was conducted as part of health management in Shanghai communities. Elderly individuals over 60 years old from 11 communities in Putuo District, Shanghai, who participated COPD screening from July 2022 to June 2023, were surveyed and underwent lung function tests. A total of 876 participants were initially included, but 141 were excluded due to incomplete questionnaire information or poor lung function test quality, resulting in 735 valid subjects. According to the "Guidelines for Graded Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease" and GOLD 2024, participants were classified into three subgroups based on post-bronchodilator lung function: COPD group (FEV₁/FVC < 70%), PRISm group (FEV₁%Pred< 80% and FEV₁/FVC≥ 70%), and normal lung function group. Multivariate Logistic regression analyses were conducted to identify factors associated with COPD and PRISm, using normal lung function as the control.

A total of 735 individuals aged 60~81 were included. COPD and PRISm were observed in 157 (21.36%) and 113 (15.37%) participants, respectively. COPD-SQ scores were highest in the COPD group (20.46±4.53), followed by the PRISm group (19.04±4.41) and lowest in the normal lung function group (18.03±4.26) with statistically significant differences (P<0.001). Univariate analysis showed that the PRISm group had higher proportions of males, smokers, individuals with frequent wheezing, chronic bronchitis and hypertension compared to the normal lung function group (P<0.05). Compared to COPD patients, the PRISm group had lower proportions of males, smokers, individuals with symptoms of wheezing or coughing after exercise, and those with a history of emphysema, but a higher prevalence of hypertension (P<0.05). Multivariable Logistic regression analyses revealed that increasing age, male gender, higher smoking levels, insufficient physical activity, frequent wheezing, wheezing or coughing after exercise, family history of COPD or bronchial asthma, and history of bronchial asthma or emphysema were associated with COPD (P<0.05). In contrast, higher smoking levels, insufficient physical activity, frequent wheezing, chronic bronchitis, and hypertension were associated with PRISm (P<0.05) .

PRISm is a high-risk state between COPD and normal lung function, sharing similar associated factors with COPD such as age, smoking states, physical activity, symptoms and comorbidities. However, the COPD-SQ score and the predictive performance of multivariable logistic regression model for lung function status were significantly lower for PRISm compared to COPD. Hypertension was an independent associated factor for PRISm, but not for COPD, suggesting a potential risk of cardiovascular disease independent of COPD. Further research is warranted to verify the role of PRISm characteristics in disease progression.

For a long time, pediatric resources in China have been mainly concentrated in large hospitals, and the pediatrics of primary health institutions are weak. Studies about the current situation of pediatric construction and service provision in primary health institutions are mainly concentrated in a few developed areas, and studies about the latest progress in the whole country are not found.

To analyze the construction and service provision of pediatrics in primary health institutions in China.

From January to February 2022, 6 406 primary health institutions were surveyed using stratified sampling and the self-made questionnaire was used to collect relevant data on pediatric construction, pediatric human resource allocation, pediatric essential drugs, major equipment allocation, pediatric service provision in all sampled primary health institutions in 2021. Descriptive analysis and multiple linear regression analysis were used to analyze the influencing factors of the number of pediatric consultations and the rate of child health management in primary health institutions by Stata 15.0.

31.41% (1 488/4 737) and 39.07% (652/1 669) of township health centers and community health centers independently set up pediatrics, respectively. On average, the number of general practitioners providing services for children and pediatric practitioners in township health centers was (1.33±2.52) and (0.94±1.71), respectively, and the number of community health centers was (1.95±3.80) and (1.26±2.06), respectively. The proportion of institutions equipped with 1-3 kinds of pediatric essential drugs in township health centers and community health centers was relatively high, which were 38.91% (1 843/4 737) and 40.85% (694/1 669), respectively. Except CT, the equipped rates of automatic biochemical instrument, DR and B-ultrasound are more than 80%. The results of multiple linear regression analysis showed that the types of institutions, the total number of employees, the actual number of beds, independent pediatricians, the number of pediatric practitioners, the number of general practitioners providing pediatric services, the contract rate of children and the number of drugs were the influencing factors of pediatric clinical service provision (P<0.05). Region, the total number of employees, and the children contract rate were the influencing factors of the children health management rate in primary health institutions (P<0.05) .

The pediatric department of primary health institutions is insufficient and there is a certain shortage of manpower, medicine, and equipment resulting in insufficient clinical services for children and differences between urban and rural areas, and the integration of clinical service and prevention still needs to be implemented.

Community rehabilitation has much in common with primary health care. While providing primary health care for key groups, primary health care institutions will be of great significance if they can accurately provide rehabilitation services to people in need, reduce their degree of dysfunction, improve their quality of life, and realize the functional positioning of "rehabilitation at the grassroots level". This paper focuses on the coordinated development of community rehabilitation and primary health care, proposes several strategies in service delivery, service cooperation, and service financing, in order to provide references for the expansion of rehabilitation capabilities in primary health care institutions, and hopes to contribute to higher general public health standards and reduced medical expenditures.

First contact in the primary care setting and the development of a gatekeeping system are crucial for the implementation of a hierarchical medical system. Additionally, the implementation of first contact in the primary care setting depends on the serving capacities of primary care practitioners.

This study aims to assess the capabilities of primary care general practitioners in diagnosing and managing common diseases, referral practices, and evidence-based practice; and to explore their training needs to inform demand-driven training programs in Hunan Province.

From April to May 2023, a convenience sampling method was used to recruit primary care general practitioners who participated in the residency training or general practitioner transfer training at Xiangya Hospital, Central South University. A self-developed questionnaire consisting of four sections was used, covering basic characteristics, self-assessment of the capabilities for common diseases diagnosis and treatment, and evidence-based practice, and demands for capabilities improvement. Questionnaire Star platform was used to collect data, and descriptive analysis was used to present the results.

A total of 337 valid questionnaires were collected from each prefecture-level city and autonomous prefecture in Hunan Province, with 128 coming from community health service centers and 209 from township health institutions. The differences in gender, age, professional title, years of service at the grassroots level, and staffing status between general practitioners in township health institutions and community health service centers are all statistically significant (P<0.05). The results show that 75.1% (253/337) of participants consider themselves competent in the diagnosis and treatment of common diseases; 16.6% (56/337) of participants reported a lack of competence in certain diseases, with the top six including depression[89.3% (50/56) ], stress incontinence[69.6% (39/56) ], dementia[66.1% (37/56) ], stroke[53.6% (30/56) ], co-morbidities[51.8% (29/56) ]and tuberculosis[46.4% (26/56) ]. These findings consistent between community and township respondents. Furthermore, 71.8% (242/337) of participants reported being unfamiliar with referral practices. 73.0% (246/337) of participants indicated limited knowledge of evidence-based practice, and 85.8% (247/288) of participants have limited use of evidence-based practice. Additionally, 77.2% (260/337) of participants lacked sufficient knowledge of clinical practice guidelines; 90.8% (306/337) of participants rarely consulted guidelines when facing decision-making difficulties, mainly because they felt guidelines could not address complex cases[50.0% (153/306) ], were unclear on how to search for guidelines[43.1% (132/306) ]and the resources available for retrieving guidelines[34.3% (105 /306) ]; participants mainly obtain the guidelines through the WeChat official account[72.5% (237/327) ] and databases such as the China National Knowledge Infrastructure [50.2% (164/327) ]. 97.0% (327/337) of participants expressed a demand for training to improve their capabilities, suggesting that training should be tailored to the specific needs of primary care institutions[60.8% (205/337) ]; the preferred approaches are advanced training in higher-level hospitals[71.3% (233/327) ]and primary care institutions with high diagnostic and treatment capabilities[56.3% (184/327) ]; the preferred training programs are on standardized treatment of common diseases[78.0% (263/337) ]and multiple coexisting diseases[69.4% (234/337) ].

The majority of primary care general practitioners in Hunan Province consider themselves competent in the treatment of common diseases, but some are relatively incompetent in diseases such as depression, stress urinary incontinence, dementia, stroke, co-morbidities and tuberculosis; the majority of participants need to improve their capabilities in standardized referral, evidence-based practice, retrieval and application of clinical practice guidelines, suggesting that these items could be focus of training. The primary care general practitioners have a high demand for training, they prefer to engage in advanced training in high level institutions, and training in standardized treatment of common diseases and multiple coexisting diseases is needed. The training programs should be individualized based on the demands of primary care institutions.

Hospice care service has been practiced deeply in our country. Many cities have taken primary medical and health institutions as the prime places to carry out hospice care, such as in Shanghai. The main community hospice care service are provided by the teams which are composed of general practitioners and nursing staff. Meanwhile, there is still a lack of unified assessment standards and requirements for the abilities of community medical staff.

Based on the actual situation hospice care service, this study compilies an evaluation tool for the hospice care service ability of medical staff in community health service centers and conducts a research of the reliability and validity.

From June 2022 to March 2023, through literature review, qualitative interview and two rounds of Delphi expert consultation, the project was tested by a questionnaire and analyzed. 1 281 medical staff of community health service centers in Pudong New Area, Shanghai, China, were surveyed from 2023-04-01 to 2023-05-12. A questionnaire survey which was covering general information, knowledge and experience of hospice service. Hospice service competence evaluation tool and humanistic care competence scale were conducted to test the reliability and validity of the hospice service, and a multiple linear regression analysis was used to explore the influencing factors of hospice service competence.

Through literature search analysis and qualitative interviews with experts, 49 initial entries were formed. The Delphi expert consultation method invited a total of 15 authoritative experts in Shanghai who study and carry out hospice services, in which the expert authority coefficient was 0.87, and the Kendall harmony coefficient of the overall index system was 0.624 (P<0.01), and the evaluation tools for the 50 entries were finally formed after two rounds of Delphi expert consultation. A total of 1 300 questionnaires were distributed in the questionnaire survey part, and 1 284 questionnaires were recovered, the effective recovery rate of the questionnaires was 98.77% (1 284/1 300). The reliability coefficient of standardized evaluation tools was 0.993 with Cronbach's α coefficient. The data of Spearman-Brown's broken half reliability was 0.935, that means the overall reliability coefficient is good. Besides, KMO value was 0.987, Bartlett spherical value was 119 119.104, P<0.001, indicating that the scale had a good validity and was suitable for factor analysis. Factor analysis showed that the factor loading of all items was≥0.4 and the commonality was >0.2, so all 50 items were retained. Four common factors were selected, and the cumulative variance contribution rate was 86.517%. Correlation analysis showed that there was a significant positive correlation between the total score of the hospice care service ability evaluation tool constructed in this study and the total score of the humanistic care scale (r=0.819, P<0.001), indicating that the evaluation tool had a good calibration correlation validity. The results of multiple linear regression analysis showed that: gender, education, years of working in the community, whether or not they experienced the death of a relative, whether or not they experienced hospice training, the length of hospice service work, and whether or not they were willing to engage in hospice service were the influencing factors of hospice service competence (P<0.05) .

In this study, it proofs that the questionnaire tool for evaluating the ability of community health service center medical staff is scientific, reliability, and validity, and can be used to evaluate the various abilities of community general practitioners in hospice care services.

With the promotion of "strengthening the primary health" measures, the number of primary health professionals in China has increased significantly, but there is still a gap between the ability of primary care physicians and basic medical needs of residents.

To understand the current situation, characteristics and deficiencies of Chinese primary care doctors' community rehabilitation service ability, so as to provide scientific basis for making countermeasures to improve ability.

The method of multi-stage stratified sampling combined with typical sampling was adopted to carry out an online questionnaire survey on doctors in primary health institutions in Jiangsu province, Anhui province, Henan province, Chongqing City and Gansu province. The current situation of community rehabilitation service ability of primary care physicians was evaluated from four aspects: rehabilitation function evaluation, rehabilitation medical service, traditional Chinese medicine health guidance and traditional Chinese medicine physiotherapy.

A total of 8 374 questionnaires were analyzed. Among the primary doctors surveyed, 4 697 cases (56.1%), 6 396 cases (76.4%), 5 833 cases (69.7%) and 4 834 cases (57.7%) were equipped with the ability of rehabilitation function assessment, rehabilitation medical services, TCM health guidance and TCM physiotherapy, respectively. Moreover, the abilities of primary doctors in rural areas were better than that in urban areas, and the difference was statistically significant (P<0.05). There were statistically significant differences in the rates of rehabilitation medical service guidance, traditional Chinese medicine health care guidance and traditional Chinese physiotherapy ability of primary doctors in different ages, educational qualifications, and positions (P<0.05). The pairwise comparison results showed that in terms of age. In terms of assessment ability of rehabilitation function, doctors under 30 years old and over 60 years old had a higher rate than those 30-<45 years old and 45-<60 years old (P<0.016), and doctors 45-<60 years old had a higher rate than those 30-<45 years old (P<0.016). The rate of rehabilitation medical service guidance ability of primary doctors under 45 years old was lower than that of primary doctors over 45 years old (P<0.016). The ability rate of doctors under 30 years old to provide TCM health care guidance and TCM physiotherapy was lower than that of 30-< 45 years old, 45-< 60 years old and over 60 years old (P<0.016), and the ability rate of doctors 30-<45 years old was lower than that of 45-< 60 years old and over 60 years old (P<0.016). The ratio of doctors aged 45-<60 years old was lower than that of doctors aged over 60 years old (P<0.016) .The ability rate of primary doctors with high school/secondary school education or below was higher than that of college degree and bachelor degree (P<0.016), and the ability rate of junior college degree doctors was higher than that of bachelor degree (P<0.016). The possessing rate of general practitioners was higher than that of rural physicians and practicing (assistant) physicians (P<0.016), and the possessing rate of rural physicians was higher than that of practicing (assistant) physicians (P<0.016). The rate of basic doctors in TCM post possessing TCM health care guidance and TCM physiotherapy ability was higher than that in clinical post and other post (P<0.016), and the rate of clinical post possessing was higher than that in other post (P<0.016). The rate of comprehensive ability of rehabilitation medicine was higher than that of traditional Chinese medicine (P<0.05) .

The ability of community rehabilitation was insufficient on the whole, and the ability of traditional Chinese medicine rehabilitation was relatively weak. It is necessary to improve the construction of the tiered diagnosis and treatment system, promote primary care physicians' experience and abilities. Also to strengthen the joint training of traditional Chinese medicine rehabilitation and modern Western medicine rehabilitation techniques, complete the training and construction of primary rehabilitation personnel, so that they can assume the responsibility of community rehabilitation.

To support the advancement of the "Healthy China" policy, is paper delves into the significance of interprofessional collaboration between health social workers and general practitioners in the primary healthcare setting. With a focus on three vital areas, including the synergy of complementary professional knowledge, integration with hospitals and communities, and the expansion of social health research, particularly in strengthening the public health emergency response system and boosting medical alliances. Synergistic efforts between health social workers and general practitioners can serve as a vital component in promoting nationwide health initiatives and fostering healthier societies. Furthermore, this paper proposes countermeasures to address the key challenges surrounding health social work.

Under the background of the promotions concept change from "disease-centered" to "health-centered", Zhejiang province takes the lead in building a future community health scenario for the whole population and the whole life cycle, providing a "Zhejiang model" for the comprehensive reform of grassroots health care. It is of great theoretical significance and practical value to construct a set of scientific and effective service quality evaluation index system for future community health scene.

The purpose of this study is to construct a service quality evaluation index system for future community health scenes in Zhejiang province, aiming to provide a reference for improving the capabilities and quality of community health services and advancing the achievement of public health objectives.

Employing the SERVQUAL theory model, an initial indicators pool was developed through policy analysis, literature review, and field research. From October to December 2023, a two-round Delphi expert consultation method was used to refine the indicators, and the Analytic Hierarchy Process (AHP) was applied to determine the weights and composite weights of each indicator.

A total of 17 experts participated in both rounds of consultation, among which 12 (70.6%) hold senior titles; 15 (88.2%) have 10 or more years of work experience; and there are 5 (29.4%) managers and medical staff from future community. The positivity level of the experts in both rounds was consistently rated at 1.0, with authority coefficients of 0.862 and 0.842, respectively, and the degree of expert consensus increased round by round. The final constructed indicator system includes 5 primary indicators, 13 secondary indicators, and 36 tertiary indicators, and the weights for the primary indicators—tangibles, reliability, assurance, responsiveness, and empathy were 0.168, 0.180, 0.240, 0.174 and 0.238, respectively. For the secondary indicators, the weights for venue facilities, digital equipment, Service Provision, Health Monitoring, Service Efficiency, Service Accessibility, Crisis Prevention and Emergency Rescue Capability, Professional Skills, Activity Organization, Smart Platform Maintenance, Service Attitude and Emotional Support, Service Effectiveness and Personalized Services were 0.399, 0.601, 0.672, 0.328, 0.487, 0.171, 0.342, 0.410, 0.416, 0.174, 0.284, 0.323 and 0.393 respectively.

The indicator system constructed in this study, which is an effective tool for conducting evaluation of future community health scenario, is scientifically reliable and exhibits a degree of systematization, innovation, operability and practical value. It is hoped to provide a reference to fomulate relevant policies and targeted improvement strategies.

Responsiveness is a key goal in evaluating the performance of the health system, and is also an essential basis for improving the capacity of primary health services. Currently, many studies confuse the concepts of responsiveness and satisfaction, and the evaluation of responsiveness is not comprehensive enough, focusing on the level of responsiveness but ignoring its distribution.

To understand the responsiveness evaluations of community health services among residents of different ages in Zhejiang province and to analyze its influencing factors.

Utilizing the method of purposive sampling and convenience sampling, six community health service centers in Hangzhou and Taizhou, Zhejiang province, were selected as the investigation sites from July to August 2022 to assess the responsiveness scale of outpatient residents. The weights of the eight components of responsiveness recommended by the WHO were used to calculate the overall level and distribution of responsiveness. Univariate analysis and multiple linear regression were used to explore the influencing factors on the responsiveness level among residents of different ages.

The score of responsiveness for community health services in Zhejiang was (8.31±1.04) points, and the responsiveness distribution index was 0.13; residents of different age groups expressed their higher satisfaction with the dimensions of dignity and social support, with scores of (8.60±1.24) points and (8.63±1.20) points, respectively. In contrast, the dimensions of selectivity and autonomy received lower ratings, with scores of (7.96±1.56) points and (8.04±1.34) points, respectively. Household registration was an influencing factor for responsiveness evaluation of community health services among young people, while education level and monthly income were influencing factors for responsiveness evaluation among middle-aged individuals (P<0.05) .

The overall level of community health service responsiveness in Zhejiang province is good, and the distribution is more balanced. More attention should be paid to the demand and responsiveness of community health services among young people with urban household registration and middle-aged people with a college/bachelor's degree or above. Primary care community health service centers still need to improve in providing patients with access to information about health service plans and the freedom to choose community doctors/nurses, thereby better satisfying the reasonable healthcare service demands of residents.

Community health service center is the main gatekeeper for breast cancer screening, while its efficacy of screening is difficult to guarantee for the re-striction of screening process by various factors.

To analyze the focus issue of breast cancer screening program in the real world and explore corresponding solutions.

A mixed-methods convergent design was used to collect quantitative and quali-tative data. In the quantitative study, typical sampling method was used to select one community health service center in each of the four districts of Tianjin as the investigation institution from April 2021 to November 2022, accidental sampling method was used to select age-eligible women within 3 km of the four institutions as resident survey respondents, so as to explore the issues existing in the on-site operation of breast cancer screening. In the qualitative study, 9 residents, 12 physicians participating in the screening and 4 leaders were selected through purposive sampling from June to November 2022 for semi-structured in-terviews. The grounded theory was used to analyze the interview content, and the grounded theory framework of the focus issues of breast cancer screening was plotted. Combined with literature and typical investigation data, a mixed methods study was conducted to determine the focus issues of breast cancer screening.

The quantitative study showed that in the advocacy work, the promotion method is traditional, the awareness rate and participation rate of residents was 46.3% (143/309) and 32.4% (100/309) , respectively; in the screening work, the institutions invested different human and material resources, and the average waiting time of screening residents accounted for 62.2% (40.5/65.1) of the total time; in the follow-up and referral work, the invested human and material resources were little, the mammography referral compliance of residents was 29.9% (59/197) . The qualitative study showed that a total of 38 comprehensive open codes were formed in the interview and converged into 10 axial codes and 3 core codes, including advocacy organization, screening organization, follow-up and referral. The mixed methods study showed that 3 focus issues were identified in final, including how to improve residents' participation rate, how to ensure adequate human and material resources in screening institutions, and how to improve residents' mammography referral compliance.

The efficacy of breast cancer screening is influenced by advocacy organization, screening organization, follow-up and referral. It is necessary to rationally allocate resources to ensure adequate human and material resources for screening institutions; innovate promotion methods, expand coverage of promotion and improve residents' health literacy, participation rates and mammography referral compliance, to ensure the substantial progress of breast cancer screening and provide reference for opti-mizing the efficacy of breast cancer screening.

The level and quality of diagnosis and treatment of Helicobacter pylori (Hp) infections in Shanghai's community health service institutions is unclear, and there is a lack of systematic evaluation and monitoring.

To understand the current status of diagnosis, treatment and management of Hp infection in community health centers in Shanghai, to evaluate the quality of diagnosis and treatment, and to explore the problems and improvement measures.

A questionnaire was distributed to a total of 249 community health centers in 16 administrative districts of Shanghai and 3 875 general practitioners (GPs) working in the community health centers from May to June 2022 to investigate the standardization of prescriptions for the eradication of Hp infections in the community health centers, the detection of Hp infections, the provision of drugs for the eradication of Hp infections, the management of Hp infections, the difficulties of Hp infections in the treatment of Hp infections, as well as the knowledge of community-based GPs on the diagnosis and treatment of Hp infections.

The result of the prescription eradication program for Hp infection in primary health care facilities in Shanghai was only 32.0 percent correct. The proportion of health service centers with the ability to conduct Hp infection testing in primary healthcare institutions in Shanghai is high, nearly 80.0%. Most of the community health service centers were able to equip the basic medicines needed for the eradication of Hp, but the rate of bismuth equipment was low, 54.6%. The rate of Hp diagnosis and treatment standard supervision was 80.0%. The demand for the training of standardized diagnosis and treatment of Hp infections was high, accounting for 66.7%. The main difficulties in Hp infection diagnosis and treatment were incomplete drug provision, insufficient doctor's diagnosis and treatment ability and insufficient equipment. Community general practitioners do not have enough basic knowledge about the diagnosis and treatment of Hp infection.

The capacity to conduct Hp testing needs to be further strengthened in primary care organizations in Shanghai, especially in remote community health service centers, including the purchase of more Hp-related testing equipment and reagents, and the completion of related medications needed for the eradication of Hp. In addition, it is necessary to further strengthen the standardized diagnosis and treatment training of Hp infection for community health centers, improve the diagnosis and treatment ability of general practitioners on Hp infection, and at the same time, strengthen the supervision of Hp diagnosis and treatment standardization, so as to further improve the diagnosis and treatment ability of community general practitioners on Hp infection.

At present, Beijing has formulated a series of performance management policies for community health service centers, most of which focus on assessment and have not yet formed a performance management system. At the same time, there are still many problems in performance management considering the actual work of the centers. On the basis of the original internal performance appraisal system, this study improved the performance management in view of the existing problems, formed a set of performance management system applicable to the district community health service center, provided a reference for the community health service centers to establish a scientific performance management system in the future, and promoted the development of community health service work.

To explore the effect of performance management in community health service center.

In 2019, this group conducted a baseline survey on the current status of performance management in terms of center position setting, assessment indicators and weights, performance feedback and improvement in 18 community health service centers in Tongzhou District, Beijing. The Delphi expert consultation method was used to determine the evaluation indicators of the implementation effect of performance management, and the Internal Performance Management Manual of Community Health Service Centers (hereinafter referred to as the Manual), which contains 6 first-level indicators (number of services, service utilization, service quality, medical staff performance evaluation, patient satisfaction, and target management) and 34 second-level indicators, was finally determined. 2021, the evaluation of the application effect of the Manual was carried out (number of services, service utilization, service quality, medical staff performance evaluation, patient satisfaction, and target management) .

The service quantity, service utilization and service quality of key work in 2020 were improved compared with those of the previous year, except for the family doctor contract rate and the real physical examination rate of the elderly, which were slightly lower than the regional average level, other indicators were higher than the regional level; performance management evaluation: Medical staff believed that the salary and workload were relatively matched and very matched increased by 29.8%; the cognition of center development goals, department development goals and individual work priorities increased by 15.6%, 13.2% and 2.6% respectively; the assessment indicators were in line with the actual work increased by 20.6%; reasonableness of index weight value and the secondary performance distribution of departments and stations increased by 19.4% and 8.3% respectively; the incentive that is strong increased by 18.3%; the performance improvement effect increased by 18.1% significantly; the overall satisfaction with performance management increased by 11.8%. Resident satisfaction: satisfaction with chronic disease management, children's health management, medical staff's technical level, and medical treatment results improved to varying degrees. Year-end assessment of district level: except for 1 center whose ranking remained unchanged, the rest of the centers were all improved. Salary: annual per capita incomes of on-the-job workers, doctors, nurses, and preventive and public health personnel increased by 5.2%, 7.6%, 8.4%, and 10.4% respectively, which was forty seven, eighty seven, forty four and thirty nine thousand higher than that of the whole region.

After the demonstration of community health service centers with different economic development levels, the application effect of the performance management system is remarkable, which improves the quantity and quality level of key work in the community, enhances the enthusiasm and service ability of medical staff, and then improves the satisfaction of patients, and it has certain promotion value. However, the number of centers that apply performance management system is limited and the time is short, so it is necessary to expand the application scope and continue to track the application situation in the future.

Community health service institutions play an important role in the protection of people's health, the application of community traditional Chinese medicine services can significantly improve the quality of life for the patients, and alleviate the problems of the accessibility and affordability for the health care. The bliometric analysis on traditional Chinese medicine services in community health service institutions can provide a basis and direction for further improving the capacity of community traditional Chinese medicine services.

To explore the development process, research hotspots and frontiers of traditional Chinese medicine services provided by community health service institutions in China based on the bibliometric analysis and scientific knowledge mapping analysis.

On January 1, 2023, CNKI, Wanfang Data and VIP were searched for relevant literature from inception to 2022-12-31. Excel software was used for the statistical analysis of annual publication volume, source journals and source institutions, CiteSpace 6.1.R6 software was used for the research collaborative network of institutions, clustering analysis and burst analysis of keywords. Frequency analysis and co-occurrence network analysis of authors and keywords were carried out with VOSviewer software.

A total of 920 papers were included, as for their sources, 270 journals and 38 universities were involved, represented by Journal of Traditional Chinese Medicine (80 articles), Beijing University of Chinese Medicine and Guangzhou University of Chinese Medicine (14 articles) with the highest number of articles. A total of 449 research institutions were involved, and the institution with the highest number of articles was Beijing University of Chinese Medicine (23 articles). SHI Yongxing (27 articles) and BAO Yong (18 articles) were the top 2 authors. Twelve clusters could be formed by the co-occurrence analysis of authors, and there was close collaboration among authors within the same cluster, but a wide collaborative network had not been formed yet. A total of 1 252 keywords were involved in this study, forming 13 clusters labeled with "Traditional Chinese Medicine" and "Community", etc. Researches on "constitution of traditional Chinese medicine" and "diabetes mellitus" are expected to become frontiers in this field.

Traditional Chinese medicine services in community health service institutions in China is in a period of stable development, however, there are still deficiencies in the richness of research methods, formation of collaborative networks with greater influence and scale. It is necessary to strengthen cooperation among community health service institutions, as well as the cooperation between universities and community health service institutions, by combining multidisciplinary research methods.

In the new era, the health needs of residents are constantly increasing, and how community health services adapt to the needs of the times and achieve comprehensive transformation urgently needs to be answered. Firstly, the article reviewed the development process of community health service (CHS) in China and found that it is functionally defective. Secondly, the article summarized the challenges faced by the optimization of CHS in China and pointed out that the current health needs of the population are undergoing structural changes. Finally, the article proposed the optimization paths of CHS in China in terms of changing the focus of work, improving the sense of value for contracted doctors and the sense of achievement for residents, building a collaborative and complementary CHS network, and establishing a demand-oriented health information platform.

The urban community health service centers in China have developed for nearly 20 years, but there is a lack of systematic research on their development, progress made, and existing problems.

To propose suggestions for the high-quality development of urban community health services centers in China by analyzing their development situation.

In October 2022, 50 community health service centers were selected from 13 provinces in the eastern, central and western regions by convenience sampling method. A self-developed research questionnaire based on the key core indicators for the assessment of urban community health services centers included two parts of basic data and evaluation content. Basic data included jurisdictional area, number of employees, number of outpatient visits, etc; the evaluation content included 4 gradeⅠindicators (institutional configuration, service function, service mode, and service support), 13 GradeⅡindicators and 33 GradeⅢindicators. The data of year 2006 (or the first year of the hospital's establishment and data) and 2021 were compared, and the survey results were reported in through "sojump".

(1) Basic data: the number of community health service centers established before 2006 were 24 (accounting for 48.00%), and 26 after 2006 (accounting for 52.00%) ; comparing the year of 2006 or the first year of establishment, and the year of 2021, the number of employees was 67.00 (40.00, 101.00) and 94.00 (62.00, 162.00) respectively; the number of outpatient visits was 39 324.00 (22 620.00, 118 384.00) and 106 259.00 (44 999.00, 225 851.00) respectively; the total score of the questionnaire was 36.50 (28.13, 46.00) and 69.00 (56.38, 76.00), respectively. (2) The median scores of Grade I indicators institutional configuration, service mode and service function in 2021 were all higher than those in 2006 or the first year of establishment. The relative scoring rate of Grade I indicators in 2021, institutional configuration was 77.27% (25.50/33.00), service mode was 61.84% (23.50/38.00), service function was 76.92% (10.00/13.00), service support was 47.37% (9.00/19.00). The median score of structure area in the institutional configuration indicators was 0; among the service function indicators, the relative scoring rate of the diagnosis and treatment of common and chronic diseases in the community, and the inpatient service content were all 100.00%; the relative scoring rate of inpatient bed utilization rate was 25.00% (1.00/4.00). (3) Score of GradeⅡ、Ⅲ evaluation indicators of service function, service mode, and service support: The median score of public health items in service function increased from 2.00 points in 2006 or the first year of establishment to 9.50 points in 2021. The differences were statistically significant (P<0.05) in different years, with a relative scoring rate of 59.38% (9.50/16.00) in 2021; the relative scoring rate of resource integration in service mode was 100.00% in 2021. Among the service support indicators, the median scoring of general practitioners, public health practitioners and scientific research tasks all were 0; there was statistically significant difference (P<0.05) in the distribution of scores of general practitioners and scientific research tasks in different years.

The sustainable development of urban community health service centers is reflected in the gradual improvement of the relative scoring rate of institutional configuration, service function, service mode and service support. But the area of structure, inpatient service capacity and personnel ratio are seriously insufficient and the growth is very slow, which has become a constraint on the development of community health service centers.

The number of patients with chronic diseases in the community of China is increasing annually. Family doctor contract service is an important way to promote people's health in China, and long-term family doctor contract will help to improve the continuity of health management and the treatment outcomes. Analyzing patient demand for long-term family doctor contract is critical to the advancement of family medicine services in China.

To investigate the demand for long-term family doctor contract among community patients in Beijing Chaoyang Distrct and analyze its influencing factors, so as to provide a theoretical basis for achieving high quality family medicine services.

Using continuous enrollment, 500 patients who were enrolled in family doctor contract service at Baliqiao community health service center, Taiyanggong community health service center and Jiangtai community health service center in Chaoyang District, Beijing from January 2020 to January 2021 were included as the study subjects and categorized into the agreement group (those willing to sign long-term contracts) and the refusal group (those unwilling to sign long-term contracts). Data on patient demographics, chronic diseases, educational level, income status, medical expenses, health status, distance from home to the community health service center, compliance, living arrangements, and other indicators were collected through online system retrieval of health records and supplemented by questionnaire surveys from January 2020 to January 2021. From January to March 2021, a questionnaire survey was conducted to collect general information, service quality evaluation, and willingness to sign long-term family doctor contracts. The SERVQUAL scale was designed based on literature retrieval, expert consultation, and preliminary open-ended questionnaire survey results to evaluate the quality of family doctor services. Scores were assigned for expected quality, perceived quality, and importance, ranging from 1 to 5. Expectation scores and perception scores were used to calculate the service quality (SQ) score, and the latter was used to correct importance and calculate the corrected SQ (cSQ) score. Multivariate Logistic regression analysis was used to explore the influencing factors of the demand for long-term family doctor contract services.

A total of 500 questionnaires were distributed, and 423 were collected, including WeChat platform (73, 17.2%), offline questionnaire (190, 44.9%) and telephone interview (160, 37.8%), the validity rate was 84.6%. Among the respondents, 283 belonged to the agreement group (66.9%), and 140 belonged to the refusal group (33.1%). The average score for the SERVQUAL scale was -0.54, with perceived and expected average scores of 3.98 and 4.52, respectively. Statistically significant differences were observed in the cSQ scores and average scores for each dimension between the two groups (P<0.05). The results of multivariate Logistic regression analysis showed that distance from home to the community health service center (OR=1.077, 95%CI=1.013-1.145, P=0.018), compliance (OR=0.291, 95%CI=0.137-0.617, P=0.001), living alone (OR=4.132, 95%CI=1.997-8.550, P<0.001), and cSQ (OR=0.983, 95%CI=0.980-0.986, P<0.001) were independent influencing factors for patients' willingness to sign long-term family doctor contracts.

The corrected family doctor service quality, distance from home to community health service center, living arrangements, and compliance are independent factors influencing patients' willingness to sign long-term family doctor contracts. The SERVQUAL scale can effectively evaluate family doctor service quality and aids in developing strategies for improving family doctor services.

As aging process continues to accelerate in China, multimorbidity have become a major public problem that threatens the health of the entire population. In the current context of "Healthy China 2030", the health management of patients with multimorbidity needs to be urgently addressed.

To understand the preferences influencing the choice of community health services for patients with multimorbidity, explore the willingness to pay (WTP) of patients, so as to provide recommendations for improvements to the existing community health service system for chronic diseases.

Patients with multimorbidity were randomly selected from eight community health service centers in Chengdu during the period from May to August 2022 as survey subjects. General patient data and preferences related to discrete choice experiments were collected through on-site questionnaire surveys. Based on different types of comorbidities, patients with type 2 diabetes combined with hypertension, hypertension combined with coronary heart disease, type 2 diabetes combined with hypertension and coronary heart disease were categorized into ClassⅠ, ClassⅡ, and ClassⅢ. Regression analysis was conducted using mixed Logit model to analyze the preferences of multimorbidity patients for community health services, and to quantitatively analyze their WTP for community health services.

A total of 360 questionnaires were distributed and 296 valid questionnaires were recovered, with a valid recovery rate of 82.7%. ClassⅠpatients (β=3.260, 95%CI=2.610 to 3.910), ClassⅡpatients (β=3.697, 95%CI=2.612 to 4.781), and ClassⅢpatients (β=3.220, 95%CI=2.271 to 4.169) expressed the strongest preference for services with high accessibility to drugs, followed by appointment referral services and traditional Chinese medicine (TCM) services. Regarding physician types and prescription service duration, both ClassⅠpatients (β=0.971, 95%CI=0.585 to 1.357) and ClassⅡpatients (β=0.686, 95%CI=0.176 to 1.197) preferred services with extended prescription services, while ClassⅢpatients (β=0.804, 95%CI=0.196 to 1.413) preferred services provided by general practitioners (β=0.804, 95%CI=0.196 to 1.413). ClassⅠpatients (β=-0.049, 95%CI=-0.057 to -0.041), ClassⅡpatients (β=-0.040, 95%CI=-0.051 to -0.029), and ClassⅢpatients (β=-0.037, 95%CI=-0.048 to -0.027) preferred services with lower out-of-pocket expenses. The results of the regression analysis of WTP for patients with different chronic comorbidity types showed that the WTP of all 3 types of patients was related to their level of preference for each attribute, with ClassⅠ, ClassⅡ, and ClassⅢpatients all had the highest WTP for a high level of drug accessibility, which were RMB 66.77/month, RMB 91.97/month, and RMB 85.95/month, respectively.

Patients with multimorbidity exhibit significant preferences for six attributes considered in this study (physician type, TCM service, prescription service duration, drug accessibility, appointment referral, and monthly out-of-pocket costs). Drug accessibility is the most important attribute influencing multimorbidity patients' health service preferences. It is recommended to target patients' specific needs accurately, improve appointment referral services, establish standards for the management of chronic diseases in the community, and accelerate the integration of TCM into the prevention and treatment of chronic diseases in the community.

It is of great significance to clarify the characteristics of the main population served by community health service institutions for the precise reform of community health service institutions in the next step.

To provide accurate data support for the next reform policy formulation and adjustment by analyzing the characteristics of the beneficiary population in terms of curative care expenditure (CCE) in community health service institutions in Beijing before and after the comprehensive reform.

The basic data of this study was obtained from the basic database of total health expenditure accounting in Beijing from 2016 to 2019, and other data was obtained from Beijing Health Statistical Yearbook, Beijing Health Financial Statistics Annual Report, and Beijing Health Expenditure Accounting Report from 2016 to 2019. The multi-stage stratified cluster sampling was adopted to select community health service institutions, and the annual out-patient data and in-patient data were included from HIS system. System of Health Accounts 2011 (SHA 2011) was used to calculate and analyze the situation of the beneficiaries of community health service institutions.

The CCE of community health service institutions in Beijing increased from 12.181 billion yuan to 22.245 billion yuan with an average annual increase of 19.07% from 2016 to 2019. The CCE of middle-aged and elderly patients over 40 years age accounted for more than 92% over the years, and CCE of patients in the age groups of 60s and 80s increased rapidly, with an average annual growth rate of 24.08% and 25.84%, respectively. Among the CCE, endocrine, nutritional and metabolic diseases, abnormal symptoms, signs and test results, circulatory system diseases accounted for the highest proportion. The CCE of endocrine, nutritional and metabolic diseases, nervous system diseases, abnormal symptoms, signs and test results increased rapidly, with an average annual growth rate of 40.11%, 48.40% and 32.43%, respectively.

The effectiveness of hierarchical diagnosis and treatment has begun to emerge after the comprehensive reform. Community medical service resources in Beijing are mainly consumed by middle-aged and elderly patients and patients with chronic non-communicable diseases such as endocrine and circulatory diseases. The comprehensive reforms guided more middle-aged and elderly people and patients with chronic diseases to community health service institutions. Community health service institutions should improve their service capacities in many aspects, such as service capacity, human resource, chronic disease management and medical consortium construction, to consolidate and maintain the effectiveness of the reform.

The hypertensive population has a large base in China, and its preventive and treatment measures rely mainly on the chronic disease management service program within the National Basic Public Health Service. However, current studies have shown low utilization rate of it, so it is of great significance for improving the participation of the National Chronic Disease Management Service and health level in the hypertensive population to conduct a survey of participants to determine the factors affecting their treatment adherence.

To investigate and analyze the current status and influencing factors of treatment adherence of hypertension management services within the National Basic Public Health Service, and provide reference for improving treatment adherence in hypertensive patients.

A total of 295 participants of hypertension management services in the community served by a community healthcare center in Guangzhou City from June to September 2022 as the study subjects by using a multi-stage sampling method. The General Information Questionnaire and the Emotional Balance Scale (positive and negative emotions) were used to investigate the basic information of the study subjects, and the Hypertension Treatment Adherence Scale was used to investigate the current status of treatment adherence among the study subjects. Multivariate Logistic regression analysis was used to explore the influencing factors of treatment adherence to the National Chronic Disease Management Service in the hypertensive population, and the influence of the combined positive and negative emotion status on treatment adherence to the National Chronic Disease Management Service in the hypertensive population.

A total of 310 valid questionnaires were distributed, 295 valid questionnaires were recovered, with a validity rate of 95.2%; the total score of the Hypertension Treatment Adherence Scale was (94.24±8.67), of which the score of medication adherence was (21.06±2.45), medication malpractice was (31.33±3.90), tobacco and alcohol management was (8.44±1.88), and management of daily life was (33.41±4.61), with good adherence rate of 52.2% (154/295) ; the positive emotion score in the Emotional Balance Scale was (3.76±1.02), and the negative emotion score was (2.63±1.12) ; the results of multivariate Logistic regression analysis showed that gender, age, BMI, education level, blood pressure control, self-perceived physical condition, satisfaction with the point of care, more positive emotions and less negative emotions were the influencing factors for good treatment adherence to the National Chronic Disease Management Service in the hypertensive population (P<0.05) ; treatment adherence to the National Chronic Disease Management Service in the hypertensive population with a combined status of more positive and less negative emotions was 15.867 times higher than that of less positive and more negative emotions (P<0.05), and the treatment adherence with the combined status of more positive and more negative emotions was 5.114 times higher than that of less positive and more negative emotions (P<0.05) .

There is still room for improving treatment adherence to the National Chronic Disease Management Service for hypertensive patients. In addition to objective factors such as gender and age, there is also a need to focus on the emotional management, feedback effect of the treatment and the experience of patients in community healthcare canters.

Difficult problems such as poor diagnosis and treatment capacity of diabetes in the community, low screening rate of complications, low standardized monitoring rate of blood glucose, and low rate of blood glucose compliance are the problems that general practitioners need to think about and solve when carrying out management of diabetes patients. It is necessary to explore and innovate the standardized management mode of diabetes in the community for making general practitioners become specialists in the general practice and achieve "precision management combining general care and specialty care".

To understand the management effect of diabetes "1358 model" on community diabetes patients based on "precision management combining general care and specialty care".

A total of 212 patients with diabetes who visited the outpatient clinic at the Hongkou District North Bund Street Community Health Service Center from May to July 2020 and had signed a contract with the community general practitioner were selected as the research subjects and divided into 106 cases in the control group and 106 cases in the intervention group by the random number table method. The patients in the control group received routine follow-up management, and the patients in the intervention group received the "1358 model" of diabetes based on "precision management combining general care and specialty care". One year after the intervention, the cognitive and behavioral levels of diabetes, the attainment of key indicators and the experience of visiting community health centers were compared between the two groups.

There was no statistically significant difference in the cognition and behavior related to diabetes management and the attainment rate of key indicators between the two groups (P>0.05). After intervention, the proportions of patients in the intervention group who monitored FPG within 1 month, monitored 2 hPG within 1 month, carried out comprehensive blood glucose monitoring within 1 month, monitored HbA_1c within 6 months, carried out self-monitoring of blood glucose, recorded a blood glucose diary, standardized the use of medication, followed the doctor's advice on diet, screened for peripheral vascular complications within 1 year, screened for urinary albumin/creatinine within 1 year, screened for carotid artery plaques within 1 year, screened for the inner ocular fundus within 1 year were higher than those of the control group, and the difference was statistically significant (P<0.05) ; however, there was no significant difference in the proportions of patients with regular exercise and weekly foot examination between the two groups (P>0.05). After the intervention, the rates of FPG attainment, HbA_1c attainment and ABC composite attainment of patients in the intervention group was higher than those of the control group, and the difference was statistically significant (P<0.05) ; however, there was no statistically significant difference in the 2 hPG attainment rate between the two groups (P<0.05). The proportions of patients who thought that the community diagnosis and treatment capacity was good, the community drugs basically met the demand, the community had testing equipment for blood glucose-related indexes, the community could solve the basic health problems, the community could carry out screening for complications, the community consultation and guidance for specialized diseases was convenient in the intervention group were higher than those of the control group, and the difference was statistically significant (P<0.05) .

The "1358 model" of diabetes based on "precision management combining general care and specialty care" is of positive significance in promoting and improving patients' health beliefs, standardizing blood glucose monitoring behavior, improving the rate of compliance with key indicators, and enhancing community medical experience, which can be promoted and applied in the community. This model may break through the bottleneck of insufficient resources of diabetes specialty in the community, and further improve the management level and service connotation of diabetes specialty of general practitioners.

Urban community health services are key to promoting the high-quality development of community health. However, previous studies have seldom explored the evolutionary logic and development trend of community health service policies. It is difficult to provide a comprehensive answer to the questions of the generation, evolution and trend of community health service policies in China.

To understand the current status, evolutionary logic and trend of community health service policies, in order to provide intellectual reference for promoting the high-quality development of community health services and implementing the hierarchical diagnosis and treatment system.

The Central People's Government website, National Health Commission, relevant official provincial websites, CNKI, China Community Health Association and other platforms were searched from December 2019 to March 2022 for community health service reform related policies published at national level (n=98) from January 1997 to March 2022. The included policies were analyzed with the help of the policy orientation analysis model.

The policy changes in urban community health services of China have gone through four stages since 1997, including initial exploration centered on the transformation and frame construction (from 1997 to 2002), normative construction focusing on the bottom of the public health network (from 2003 to 2008), prosperous development focusing on the mechanism reform (from 2009 to 2016), and deepening reform centered on quality improvement and empowerment (from 2017 to 2022). The changes in community health service policies in China follows the following evolutionary logic, including the dynamic mechanism from marketization to professionalization and social community linkage governance, target orientation from scale expansion to internal quality improvement, policy discourse changing from predominantly economics-based discourse to multiple tools coordination.

Community health service policies should promote the innovation of the dual collaborative governance framework and mechanism, strengthen the coordination among professional systems and their effective synergistic linkage with the social community governance systems; promote community value-based health care and trust-based health care with health as the core, establish and improve evaluation standards for the capacity and quality of specialized primary care; promote the diversified application and matching of policy tools to adapt to the diversified needs of community health and wellness interests.

Community health services play an effective role in delaying the progression of diabetes and managing diabetes complications. Previous studies have suggested that the subjective experiences of visits to community health centers by patients with diabetes contributes to their improved health outcomes. However, few studies have evaluated the correlation of glycemic control outcomes with specific service processes and objective experiences of programs received by diabetic patients in the community health service centers.

To explore the correlation between the community health service experiences and glycemic control outcomes in patients with diabetes mellitus.

A cross-sectional survey design and multi-stage, cluster random sampling method was used to select six community health service centers in the central urban area of Guangzhou, with one family doctor team randomly selected from each center. A total of 336 patients with diabetes who visited the corresponding family doctor teams from September to November 2019 were recruited as the study subjects. A questionnaire was conducted to collect baseline information, fasting plasma glucose (FPG) level, and Primary Care Assessment Tool (PCAT) scores. The glycemic control outcomes of patients were assessed based on the FPG level, and their experiences of community health services were assessed based on the PCAT scores. Logistic regression models were used to evaluate the effect of community health service experiences on glycemic control outcomes in diabetic patients.

The glycemic control rate of the included diabetic patients was 73.2% (246/336). The total PCAT score and the scores for each dimension of PCAT with good glycemic control outcomes were higher than those of patients with poor glycemic control outcomes, and the difference was statistically significant (P<0.05). The results of multivariate Logistic regression showed an effect of total PCAT score on glycemic control outcomes in diabetic patients〔OR (95%CI) =0.12 (0.06, 0.23) 〕, as well as the scores for each dimension of PCAT (P<0.05). The results of subgroup analysis showed that for diabetic patients with different genders, types of health insurance and hypertension history, the total score of PCAT had an effect on the glycemic control outcomes (P<0.05) .

Community health service experience is a protective factor for the glycemic control outcomes of diabetic patients. Enhancing community health service experience is of great significance for improving the glycemic control outcomes in patients with diabetes.

Community traditional Chinese medicine (TCM) service is an important step in promoting the construction of Healthy China. There are abundant academic research results in the field of community TCM service in China, but there is a lack of collation of these research results. Systematically sorting out the relevant literature in the field of community TCM service by using the method of bibliometrics can provide a macroscopic understanding of the research progress and hotspots in this field and reference for future research.

To sort out the hotspots and development trends of community TCM service research in China by using bibliometric methods.

On May 2 in 2022, CNKI, Wanfang Data Knowledge Service Platform and VIP were searched for relevant research literature on community TCM service research in China from January 2000 to April 2022. By using CiteSpace software, the visual analysis of the co-occurrence of authors included in the literature, keywords co-occurrence, clustering, timeline distribution, and burst terms were performed and the relevant graphs were plotted.

A total of 1 440 papers were included, and the publication volume of community TCM services in China showed an overall increasing trend, with 75 papers (5.2%) published in 2000—2005, 382 papers (26.5%) in 2006—2011, and 983 papers (68.3%) in 2012—2022. The top three authors in the publication volume were Shi Yongxing (25 articles), Bao Yong (16 articles), and Liu Deng (14 articles). The top 5 high-frequency keywords in terms of centrality were "TCM" "Chinese medicine" "community" "general practitioner" and "general practice". The keyword clustering analysis formed 12 cluster labels, and the top three clusters by scale were "community" "TCM" and "general practitioner". The timeline distribution suggested that clusters such as "community" "TCM" "general practitioner" and "TCM nursing" were research hotspots in this field. From the perspective of burst terms, "family doctor" has the highest burst value (8.07), and "elderly people" "diabetes" "family doctor" "medical consortium" "general practice of TCM" and the "integrated medical care and elderly services" are future research directions.

The current status of community TCM service in China, development of TCM general practitioners and community TCM nurses, and the improvement of TCM service capabilities of community health care institutions are research hotspots. In the future, more attention will be paid to the digital compact TCM medical consortium based on the Internet platform and the contracted family doctor service model with the participation of TCM general practitioners, so as to better utilize the characteristics and advantages of community TCM services in integrated medical care and elderly services.