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Background: In China, a long waiting time for registration is a common occurrence in many tertiary hospitals. This study aimed to analyze the effects of a comprehensive reservation service for non-emergency registration on appointment registration rate, patient waiting time, patient satisfaction and outpatient volume at the Guangzhou Women and Children's Medical Center.Methods: This was a cross-sectional study. This study investigated the effects of a comprehensive reservation service for non-emergency registration in Guangzhou Women and Children's Medical Center in China starting in October 2015. In total, 2194 patients completed a satisfaction survey administered by the Guangdong Situation Research Center. The content of the questionnaire consisted of six aspects: general impression, service attitude, service quality, hospital environment, price perception and medical ethics. A Likert 5-point rating scale was used in the questionnaire; answers were classified as "very satisfied", "relatively satisfied", "neutral", "unsatisfied" and "very unsatisfied". The method of application was paper-based. T-tests were used to compare the sample means, and chi-square tests were used to compare the rates. A multiple-test procedure was performed to evaluate the differences in the reservation rates during a 12-month period.Results: After the implementation of the comprehensive reservation service for non-emergency registration in our hospital, which has an annual outpatient volume of approximately 4 million, the monthly appointment registration rate increased from (34.95 ± 2.91)% to(89.13 ± 3.12)%,P < 0.01. The patient waiting time was significantly reduced (P < 0.01), and the proportion of patients who believed that the waiting time required improvement was decreased significantly (P < 0.01). Moreover, the third-party evaluation result of outpatient satisfaction significantly improved (P < 0.01). The total hospital outpatient volume decreased(P < 0.01). The outpatient volume of the Department of General Pediatrics decreased.Conclusion: The implementation of the comprehensive reservation service for non-emergency registration in the hospital shortened patient waiting time and improved patient satisfaction, and the outpatient volume was effectively controlled. These results indicated that this program obtained the desired results in a Grade 3A hospital in China. [ABSTRACT FROM AUTHOR]

Background: In China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young womenhave limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing it's uptake among adolescents and young women in Guangzhou, China.Methods: A cross-sectional study was performed from 1st March 2020 to 30th September 2020 using anonymous self-administered questionnaire among 688 women aged 15-24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services.Results: The magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized.Conclusions: The study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged sub-groups of women in the study setting. [ABSTRACT FROM AUTHOR]

Background: Renal replacement therapy was a lifesaving yet high-cost treatment for people with end-stage kidney disease (ESKD). This study aimed to estimate the direct medical costs per capita of ESKD by different treatment strategies: haemodialysis (HD); peritoneal dialysis (PD); kidney transplantation (KT) (in the first year); KT (in the second year), and by two urban health insurance schemes.Methods: This was a retrospective observational cohort study. Data were obtained from outpatient and inpatient claims database of two urban health insurance from Guangzhou City, Southern China. Adult patients with HD (n = 3765; mean age 58 years), PD (n = 1237; 51 years), KT (first year) (n = 117; 37 years) and KT (second year) (n = 41; 39 years) were identified between 2010 and 2012. The primary outcome was the annual per patient medical costs in 2013 Chinese Yuan (CNY) incurred in the outpatient and inpatient sectors. Secondary outcomes were annual outpatient visits and inpatient admissions, length of stay per admission. Generalized linear regression and bootstrapping statistical methods were used for analysis.Results: The estimated average annual medical costs for patients on HD were CNY 94,760.5 (US$15,066.0), 95% Confidence Interval (CI): CNY85,166.6-106,972.2, which was higher than those for patients on PD [CNY80,762.9 (US$12,840.5), 95% CI: CNY 76,249.8-85,498.9]. The estimated annual cost ratio of HD versus PD was 1.17 (95% CI: 1.12-1.25). Among the transplanted patients, the estimated average annual medical costs in the first year were CNY132,253.0 (US$21,026.9), 95%CI: CNY114,009.9-153,858.6, and in the second year were CNY93,155.3 (US$14,810.8), 95%CI: CNY61,120.6-101,989.1. The mean annual medical costs for dialysis patients under Urban Employee-based Basic Medical Insurance scheme were significantly higher than those for patients under Urban Resident-based Basic Medical Insurance scheme (P < 0.001).Conclusions: The direct medical costs of ESKD patients were high and different by types of renal replacement therapy and insurance. The findings can be used to conduct cost-effectiveness research on different types of RRT for ESKD patients that provides economic evidence for health policy design in China. [ABSTRACT FROM AUTHOR]

Background: The early initiation of antiretroviral therapy (ART) for people living with HIV (PLWH) benefits both individuals and societies. However, little is known about the intention to initiate ART among PLWH in China in the context of a scaling-up of treatment or how the recommendations of healthcare workers affect this intention.Methods: A total of 451 ART-naïve PLWH were recruited from communities in Guangzhou, China for this study. Data were collected by trained physicians via face-to-face interviews. Logistic regression models were fitted for the data analyses.Results: Of the participants, 93.8% were male, 72.7% were infected via homosexual behaviour and 68.5% reported an intention to initiate ART. In the latter category, 77.8, 41.9 and 20.0% of respondents received strong recommendations to initiate ART from healthcare workers at the Centres for Disease Control and Prevention (CDC), community healthcare centres and non-governmental organisations (NGOs), respectively. After adjusting for potential confounders, depression, anxiety and strong recommendations from healthcare workers at the CDC and NGOs correlated significantly with ART intention. In the adjusted final hierarchical logistic regression model, the duration of infection [multivariate odds ratio (ORm) = 0.30, p < 0.001], route of HIV infection (ORm = 0.18, p < 0.01), infection status of the current spouse/regular sex partner (ORm = 0.21-0.23, p < 0.01), anxiety (ORm = 2.44-2.65, p < 0.05) and strong recommendations from CDC physicians (ORm = 3.67, p < 0.01) or NGOs workers (ORm = 3.67, p < 0.01) were independently associated with the ART intention, whereas a recommendation from a community healthcare centre physician was not.Conclusions: In Guangzhou, the prevalence of ART intention was below the 90-90-90 targets. Further studies aimed at an in-depth understanding and encouragement of health care workers' perceptions regarding early ART are warranted as a means of scaling up new ART strategies. [ABSTRACT FROM AUTHOR]

Background: Stroke remains a major global health problem. In China, stroke was the leading cause of death and imposed a large impact on the healthcare system. This study aimed to examine the hospitalization costs by five stroke types and the associated factors for inpatient costs of stroke in Guangzhou City, Southern China.Methods: This was a prevalence-based, cross-sectional study. Data were obtained from urban health insurance claims database of Guangzhou city. Samples including all the reimbursement claims submitted for inpatient care with the primary diagnosis of stroke from 2006 to 2013 were identified using the International Classification of Diseases codes. Descriptive analysis and multivariate regression analysis based on the Extended Estimating Equations model were performed.Results: A total of 114,872 hospitalizations for five stroke types were identified. The average age was 71.7 years old, 54.2% were male and 60.1% received medical treatment in the tertiary hospitals, and 92.3% were covered by the urban employee-based medical insurance. The average length of stay was 26.7 days. Among all the hospitalizations (average cost: Chinese Yuan (CNY) 20,203.1 = $3212.1), the average costs of ischaemic stroke (IS), subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH), transient ischaemic attack (TIA), and other strokes were CNY 17,730.5, CNY 62,494.2, CNY 38,757.6, CNY 10,365.3 and CNY 18,920.6, respectively. Medication costs accounted for 42.9, 43.0 and 40.4% of the total inpatient costs among patients with IS, ICH and TIA, respectively, whereas for patients with SAH, the biggest proportion of total inpatient costs was from non-medication treatment costs (57.6%). Factors significantly associated with costs were stroke types, insurance types, age, comorbidities, severity of disease, length of stay and hospital levels. SAH was linked with the highest inpatient costs, followed by ICH, IS, other strokes and TIA.Conclusions: The costs of hospitalization for stroke were high and differed substantially by types of stroke. These findings could provide economic evidence for evaluating the cost-effectiveness of interventions for the treatment of different stroke types as well as useful information for healthcare policy in China. [ABSTRACT FROM AUTHOR]