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Background: This paper reports on a research study that aims to identify and explain barriers to knowledge sharing (KS) in the provision of healthcare referral services in Chinese healthcare organisations. Design: An inductive case study approach was employed, in which 24 healthcare professionals and workers from four healthcare organisations in the province of Hubei, Central China, were interviewed using semi-structured scripts. Results: Through data analysis, 14 KS barriers emerged in four main themes: interpersonal trust barriers, communication barriers, management and leadership barriers, and inter-institutional barriers. A cause-consequence analysis of the identified barriers revealed that three of them are at the core of the majority of problems, namely, the absence of national and local policies for inter-hospital KS, lack of a specific hospital KS requirement, and lack of mutual acquaintance. Conclusions: To resolve KS problems, it is of great importance that healthcare governance agencies, both at the national and regional levels, take leadership in the process of KS implementation by establishing specific and strong policies for inter-institutional KS in the referral process. This paper raises important issues that exceed academic interests and are important to healthcare professionals, hospital managers, and Information communication technology (ICT) managers in hospitals, as well as healthcare politicians and policy makers. [ABSTRACT FROM AUTHOR]

Scarlet fever is an acute respiratory infectious disease and the incidence rate is increasing from 2011 throughout the world. In this paper, the mathematical models are proposed, which incorporate both direct transmissions and indirect transmissions of scarlet fever. The threshold conditions for disease invasion are obtained in terms of the basic reproduction number. The peak value, final size and epidemic time in a seasonal prevalence are investigated numerically. Furthermore, the effects of seasonal fluctuations on disease outbreak are also studied on the basis of real data in China. [ABSTRACT FROM AUTHOR]

Research on the emergency facility location-allocation problem has important theoretical and practical significance for responses to large-scale emergencies. During the actual planning of disaster supply warehouses (DSWs), reconstruction and expansion projects usually need to fully exploit different levels of designated facilities to achieve resource integration. This article presents a hierarchical supplement location-allocation (HSLA) optimization model for DSWs in both the preparedness and response phases to address the above concerns. The model minimizes the total number and cost of DSWs for the facility location problem and the total distance for delivering supplies at all levels for the supply allocation problem. A modified particle swarm optimization algorithm is applied to derive solutions to the HSLA model. The model is demonstrated for the Beijing–Tianjin–Hebei (BTH) region in China. The results show that twelve of the 180 counties, which account for 6.03% of the total area of the BTH region are not covered by county-, prefectural- and provincial-level DSWs. In addition, three sets of optimization schemes for the location-allocation problem for DSWs at the three levels and one final mixed optimal scheme (one county-level DSW, two prefectural-level DSWs, and one provincial-level DSW should be newly built or upgraded in four counties) are suggested based on the supplemental optimization site selection. This model is believed to remain more consistent with the knowledge of DSW planners and policy makers by incorporating the multi-level coverage and supplemental site selection concept into the location-allocation problem. The method can be easily duplicated to expand or build new emergency facilities at different levels in addition to DSWs. The results provide a scientific reference for DSW location-allocation planning in the BTH region. [ABSTRACT FROM AUTHOR]