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Background Positive results for clinical outcomes should be not only statistically significant, but also clinically significant. The minimum clinically important difference (MCID) is used to define the minimum threshold of clinical significance. The anchor-based method is a classical method for ascertaining MCID. This study aimed to summarise the design of the anchors of the anchor-based method by reviewing the existing research and providing references and suggestions. Method This study was mainly based on literature research. We performed a systematic search using Web of Science, PubMed, CNKI, Wanfang, and VIP databases. Two reviewers independently screened titles and abstracts to identify relevant articles. Data were extracted from eligible articles using a predefined data collection form. Discrepancies were resolved by discussion and the involvement of a third reviewer. Result Three hundred and forty articles were retained for final analysis. For the design of anchors, Subjective anchors (99.12%) were the most common type of anchor used, mainly the Patient’s rating of change or patient satisfaction (66.47%) and related scale health status evaluation items or scores (39.41%). Almost half of the studies (48.53%) did not assess the correlation test between the anchor and the research indicator or scale. The cut-off values and grouping were usually based on the choice of the anchor types. In addition, due to the large number of included studies, this study selected the most calculated SF-36 (28 articles) for an in-depth analysis. The results showed that the overall design of the anchor and the cut-off value were the same as above. The statistical methods used were mostly traditional (mean change, ROC). The MCID thresholds of these studies had a wide range (SF-36 PCS: 2–17.4, SF-36 MCS: 1.46–10.28), and different anchors or statistical methods lead to different results. Conclusion It is of great importance to select several types of anchors and to use more reliable statistical methods to calculate the MCID. It is suggested that the order of selection of anchors should be: objective anchors > anchors with established MCID in subjective anchors (specific scale > generic scale) > ranked anchors in subjective anchors. The selection of internal anchors should be avoided, and anchors should be evaluated by a correlation test.

Background Sub-health which is the state between health and disease is a major global public health challenge. As a reversible stage, sub-health can work as a effective tool for the early detection or prevention of chronic disease. The EQ-5D-5L (5L) is a widely used, generic preference-based instrument while its validity in measuring sub-health is not clear. The aim of the study was thus to assess its measurement properties in individuals with sub-health in China. Methods The data used were from a nationwide cross-sectional survey conducted among primary health care workers who were selected on the basis of convenience and voluntariness. The questionnaire was composited of 5L, Sub-Health Measurement Scale V1.0 (SHMS V1.0), social-demographic characteristics and a question assessing the presence of disease. Missing values and ceiling effects of 5L were calculated. The convergent validity of 5L utility and VAS scores was tested by assessing their correlations with SHMS V1.0 using Spearman’s correlation coefficient. The known-groups validity of 5L utility and VAS scores was assessed by comparing their values between subgroups defined by SHMS V1.0 scores using the Kruskal–Wallis test. We also did an analysis in subgroups according to different regions of China. Results A total of 2063 respondents were included in the analysis. No missing data were observed for the 5L dimensions and only one missing value was for the VAS score. 5L showed strong overall ceiling effects (71.1%). The ceiling effects were slightly weaker on the “pain/discomfort” (82.3%) and “anxiety/depression” (79.5%) dimensions compared with the other three dimensions (nearly 100%). The 5L weakly correlated with SHMS V1.0: the correlation coefficients were mainly between 0.2 and 0.3 for the two scores. 5L was yet not sensitive in distinguishing subgroups of respondents with different levels of sub-health, especially the subgroups with adjacent health status ( p  > 0.05). The results of subgroup analysis were generally consistent with those of the full sample. Conclusions It appears that the measurement properties of EQ-5D-5L in individuals with sub-health are not satisfactory in China. We thus should be cautious to use it in the population.

Objective Evaluate the impact of digital integrated health platforms on diabetes patients' health in Tianjin. Method Analyzed data from 2,883 patients under Tianjin’s digital integrated health platform using descriptive statistics and Probit regression. Results Chronic disease management significantly reduced fasting glucose by 1.68%, postprandial glucose by 3.4%, and HbA1c by 0.45%. High-compliance patients experienced greater reductions, including a 5.55% decrease in fasting glucose. Conclusion Digital health platforms effectively improve glycemic control, especially with high patient compliance, supporting their broader implementation in chronic disease management.

Background It is necessary to examine doctors working with illness from a professional point of view, because it is not only related to their occupational health, but more importantly, will affect the treatment effect of patients and the overall medical level of the hospital. The purpose of this study was to explore the relationship between doctors’ presenteeism and job burnout, and to identify other factors that are associated with presenteeism. Methods A cross-sectional survey involving doctors (except for primary doctors) was conducted in China. Using one item measure about presenteeism and a 15-item Chinese version of the BMI-GS questionnaire, this study investigated prevalence of doctors’ presenteeism and job burnout, and determined the relationship between presenteeism and job burnout by logistical model. Results Relationship between presenteeism and job burnout were explored, and the influence of work factors were evaluated. The survey was completed by 1376/1547 hospital doctors, with a response rate of 88.9%. Presenteeism was reported by 30.7% of participants. Using MBI-GS, 86.8% of all doctors had moderate job burnout and 6.0%( n  = 82) were severe job burnout. Logistic regression analysis showed that doctors with medium, high degree of emotional exhaustion and high degree of cynicism were more likely to practice presenteeism (all p  < 0.05). In addition, two other work-related factors, including the doctors’ department and position, were also likely to relate with presenteeism (all p  < 0.05). Conclusions By examining the relationship between presenteeism and job burnout, this study determined that there is indeed a significant correlation between the two. This result has a certain reference value for the development of work health, especially presenteeism and job burnout theory, and also makes a certain contribution to the relevant research literature.

Background In the prevention and treatment of hypertension, patient education is an important measure to improve the awareness rate and control rate of patients. The professional and geographical advantages of community pharmacists enable them to play an important role in the patient education in hypertension. The purpose of this study was to understand the situation of patient education in hypertension conducted in Chinese community pharmacies, and put forward measures according to the problems. Methods A multi-stage competitive sampling by convenience was used to select community pharmacists working in community pharmacies in China for the study. Based on KAP theory, the first draft of the questionnaire was designed and the Delphi method was used to improve the questionnaire and a pre-study was conducted to test the reliability of the questionnaire. In January 2020, electronic questionnaires were distributed to 143 community pharmacists in Chinese community pharmacies. SPSS24 software was used for descriptive statistics and subgroup analysis of data. Results One hundred and eight valid questionnaires were collected, and the efficiency rate was 75.5%. Most of the respondents were younger than 30 years old (98.1%), and had bachelor’s degree (95.4%). In terms of knowledge, only 15.7% considered themselves \"very good\" and even 10.2% considered themselves \"very bad\". Only 35%-55% of respondents answered correctly for patient education content that requires more specialized knowledge, such as treatment and medication. Respondents generally had a positive attitude on the effect of hypertension patient education, but slightly less recognition of their role in patient education. In terms of practice, programs related to patient education have been conducted to different degrees. More than 30% of the community pharmacists interviewed implemented them occasionally or never. Conclusions Despite a positive attitude, most of the respondents did not have a high level of knowledge or practice. In China, more research evidence and new guidelines are needed to emphasize the importance and responsibilities of community pharmacists. Continuing education should be certificated at the national level and meet the various needs of community pharmacists. And salary incentives can be tried to motivate them.

Diabetes imposes a substantial economic burden on patients worldwide, and various national healthcare insurance systems adopt different payment methods to mitigate medical costs. However, the impact of insurance payment methods on patient health remains unclear. This study uses the reform of per capita payment for diabetes in Tianjin, China, as a quasi-experiment to investigate the effects of insurance payment methods on diabetes complications. The results indicate that the experimental group exhibited a significant reduction in vascular complications compared to the control group. The incidence of peripheral neuropathy, peripheral vascular disease, diabetic nephropathy, retinopathy, cardiovascular disease, and diabetic foot decreased significantly, with these effects becoming more pronounced over time. Moreover, compared to the control group, the incidence rates of complications in retired individuals were lower than those in employees within the experimental group.

To assess the health utility value (HUV) of Rheumatoid Arthritis (RA) patients and its influencing factors in China. A cross-sectional survey was conducted in 8 tertiary hospitals across four capital-cities. The demographic characteristics, patient-reported outcomes including the HUV got by EQ-5D-5L, clinical characteristics, and clinician-reported outcomes of 171 RA patients were collected both from themselves and their physicians. Both the univariate and multivariate analyses were used to assess the potential factors of EQ-5D-5L HUV of the patients. The mean age of the patients was 50.7 years, with female being 64.9% (n = 111). The mean HUV and EQ visual analogue scale score of all patients were 0.586 and 47.3, respectively. The univariate analysis showed that the patients who were female, older, living in rural areas, with lower education level, advanced disease stage, higher the patient's assessment of arthritis pain visual analogue scale (PtAAP-VAS), the patient's global assessment of disease activity visual analogue scale (PtGADA-VAS), and the Physician’s global assessment of disease activity visual analogue scale (PhGADA-VAS) scores had significantly lower EQ-5D-5L HUVs. The multivariate analysis further suggested that older age, female, higher body mass index and higher PtGADA-VAS score were statistically significantly related to lower HUVs. The study provided the HUVs for RA patients with different characteristics and outcomes, which could be used in the economic evaluation of interventions for the RA patients. The identified factors could also assist the health care managing and improving the health-related quality of life on RA patients.

Background Clinical pharmacists always work as the pivotal role in the process of facilitating the proper use of drug. Based on the person-environment fit theory, the availability of facilities required in pharmaceutical service may influence pharmacists’ performance, but which of them may have positive or negative impact remains unclear. Objectives This study aims to analysed the quantitative association of the availability of pharmaceutical facilities provided in Chinese hospitals and clinical pharmacists’ work performance to assist hospitals formulating plans of the improving pharmaceutical working conditions to enhance clinical pharmacists’ performance. Method Demonstrated by the panel of expert and literature review, the questionnaire for administrators and clinical pharmacists of secondary and tertiary hospitals in China was formed. Then a mixed sampling was adopted to gather data on information of the participants, as well as evaluation indexes of the availability of facilities and clinical pharmacists’ work performance. Results Overall, 625 questionnaires distributed to administrators of hospitals and 1219 ones distributed to clinical pharmacists were retrieved. As for the Pharmaceutical facilities, while the increased availability of Traditional Chinese medicine pharmacy ( p  = 0.02) has a significantly positive impact on clinical pharmacists’ performance, the great availability of the preparation room ( p  = 0.07) negatively influences their work performance. Conclusion Improving the availability of facilities that significantly influence clinical pharmacists’ work performance possibly reduce their workload, enhance their efficiency and further promote progress in pharmaceutical service.

Background Air pollution affects residents’ health to varying extents according to differences in socioeconomic status. However, there has been a lack of research on whether air pollution contributes to unfair health costs. Methods In this research, data from the China Labour Force Dynamics Survey are matched with data on PM2.5 average concentration and precipitation, and the influence of air pollution on the health expenditures of residents is analysed with econometric methods involving a two-part model, instrument variables and moderating effects. Results The findings reveal that air pollution significantly impacts Chinese residents’ health costs and leads to low-income people face health inequality. Specifcally, the empirical evidence shows that air pollution has no significant influence on the probability of residents’ health costs ( β  = 0.021, p  = 0.770) but that it increases the amount of residents’ total outpatient costs ( β  = 0.379, p  < 0.006), reimbursed outpatient cost ( β  = 0.453, p  < 0.044) and out-of-pocket outpatient cost ( β  = 0.362, p  < 0.048). The heterogeneity analysis of income indicates that low-income people face inequality due to health cost inflation caused by air pollution, their total and out-of-pocket outpatient cost significantly increase with PM2.5 ( β  = 0.417, p  = 0.013; β  = 0.491, p  = 0.020). Further analysis reveals that social basic medical insurance does not have a remarkable positive moderating effect on the influence of air pollution on individual health inflation ( β  = 0.021, p  = 0.292), but supplementary medical insurance for employees could reduce the effect of air pollution on low-income residents’ reimbursed and out-of-pocket outpatient cost ( β =-1.331, p  = 0.096; β =-2.211, p  = 0.014). Conclusion The study concludes that air pollution increases the amount of Chinese residents’ outpatient cost and has no significant effect on the incidence of outpatient cost. However, air pollution has more significant impact on the low-income residents than the high-income residents, which indicates that air pollution leads to the inequity of medical cost. Additionally, the supplementary medical insurance reduces the inequity of medical cost caused by air pollution for the low-income employees.

Background Functional decline and high disease prevalence increases medication needs among older adults, making medication safety a pressing concern. Yet older adults often face limited access, uneven quality, and comprehension barriers. This study investigates medication information sources and associated factors among older adults in Nanjing, China, to guide improved dissemination and safety strategies. Methods A questionnaire survey based on the Comprehensive Model of Information Seeking (CMIS) was conducted among older adults in Nanjing, China. Descriptive statistics assessed use of seven medication information sources, and binary logistic regression identified factors associated with source selection. Results Among 165 participants, 90.3% used multiple sources in the past six months, averaging 4.7 per person. Doctors (86.7%), non-professional interpersonal networks (68.5%), and professional medical materials (66.1%) were most common, whereas internet use was lowest (32.1%). Higher perceived information-seeking ability significantly increased use of the internet (OR = 2.90), professional materials (OR = 2.68), doctors (OR = 4.46), pharmacists (2.21), nurses (OR = 2.40), and traditional media (OR = 2.37). Source characteristics also influenced choices: information quality affected doctors (OR = 19.33), pharmacists (OR = 2.39), and nurses (OR = 3.16); comprehensibility influenced pharmacists (OR = 2.67), nurses (OR = 3.16), traditional media (OR = 3.01), non-professional interpersonal networks (OR = 4.75), and professional medical materials (OR = 5.40); accessibility was associated with traditional media (OR = 3.33) and non-professional interpersonal networks (OR = 5.61); and credibility strongly predicted non-professional interpersonal networks use (OR = 19.69). Medication experience and perceived utility were additional predictors. Conclusion Older adults in China rely on doctors, professional medical materials and heavily on non-professional interpersonal networks, with limited use of internet sources. Enhancing physician–family communication, improving source content, and strengthening health information literacy may improve medication information access and safety.