non-infectious chronic diseases control & prevention in zhabei district jane xiong zhabei...
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Non-infectious Chronic DiseasesNon-infectious Chronic Diseases Control & Prevention in Zhabei DistrictControl & Prevention in Zhabei District
Jane XiongZhabei District CDC, Shanghai, China
Aug 29,2006
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Brief Introduction of Myself (1)Brief Introduction of Myself (1)
Jane XiongJane Xiong
Shanghai Zhabei CDCShanghai Zhabei CDC
2002.4- Community Disease Management2002.4- Community Disease Management
1997.7-2002.4 Anti-epidemic 1997.7-2002.4 Anti-epidemic
2004 M.S. , Epidemiology, Fudan University2004 M.S. , Epidemiology, Fudan University
1997 B.M. , Preventive medicine, Fudan University 1997 B.M. , Preventive medicine, Fudan University
(formerly Shanghai Medical University)(formerly Shanghai Medical University)
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Brief Introduction of Myself (2)Brief Introduction of Myself (2)
Researching on policy supporting for disease control and prevention in community
Researching on how the general team in community health service(CHS) provide rapid, economic, sustained service for residents
Designing the model community's chronic diseases’ standardized and comprehensive management
Designing health promotion for all people in community, developing suitable intervention measures
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Brief Introduction of Myself (3)Brief Introduction of Myself (3)
Surveilling and managing infectious disease in community
Responsible for AIDS defending program, attending program planning, implementing and evaluating
Constructing HIV primary screening lab of Zhabei District
Drafting " Medium and long-term plans of AIDS defending in Zhabei district (2001-2015) "
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Brief Introduction of Zhabei DistrictBrief Introduction of Zhabei District
Northern of central ShanghaiNorthern of central Shanghai
29.18 sq. Km.29.18 sq. Km.
8 communities8 communities
800,000 residents 800,000 residents
150,000 floating people150,000 floating people
≥ ≥ 60 Ages is 19.7%60 Ages is 19.7%
Life expectancy 80.72
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The Order of Death Causes in Zhabei The Order of Death Causes in Zhabei (2000-2005)(2000-2005)
ORDER
2000 2001 2002 2003 2004 2005
CAUSE % CAUSE % CAUSE % CAUSE % CAUSE % CAUSE %
1 38.97 36.57 36.49 39.45 39.10 40.33
2 28.47 29.39 29.12 28.13 28.84 28.53
3 9.54 11.16 11.81 10.58 9.93 10.79
4 5.33 5.13 5.19 5.13 5.19 4.64
5 3.75 4.31 4.08 4.41 4.16 3.38
6 2.20 2.37 2.58 2.24 2.90 2.63
7 2.20 1.94 2.14 1.94 1.40 1.55
8 2.02 1.57 1.09 0.70 1.31 1.06
9 0.97 0.76 0.98 1.08 0.96 0.85
10 0.60 0.71 0.64 0.77 0.77 0.82
endocrinopathy
poisonings and injuries
respiratory system
cancer
circulatory system
neuropathy
urogenital disease
infectious disease and verminosis
digestive system
lunacy
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The Death Rate of Leading Diseases in Zhabei The Death Rate of Leading Diseases in Zhabei (1955-2005)(1955-2005)
0
50
100
150
200
250
300
350
ci rcul atorysystem tumor
respi ratorysystem poi soni ngs andi nj ur i es endocr i nopathy
1960 70 80 90 2000 YEAR
DEATH RATE(1/100,000)
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The Incidence Rate of Main Cancers in Zhabei The Incidence Rate of Main Cancers in Zhabei
(2003)(2003)
ORDER
MALE FEMALE
1 lung cancer 87.23 breast cancer 59.41
2stomach
cancer48.37 lung cancer 39.42
3 liver cancer 33.27stomach
cancer28.56
4 colon cancer 26.84 colon cancer 28.28
5 rectum cancer 21.53 rectum cancer 14.85
1/100,000
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Network of Chronic Diseases Control & Prevention
Shanghai CDC
Zhabei CDC
Planning and organizingInstruction and training
Quality controlStatistic analysis
& evaluation
System of CHS
Chronic Diseases Control & Prevention
in Communities
Hospitals level 2 or 3
DistrictHealth Bureau
Chronic Diseases Registering & Reporting
Other DepartmentsConcerned
Cooperation
DistrictGovernment
Professional guidance
Administration Management
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Center for Community Health Service (CHS)
Workstation of CHS
System of CHS in Zhabei DistrictSystem of CHS in Zhabei District
CommunityGovernment
Other departments
NGOs
Cooperation
Cooperation
Prevention & ControlHealth CarePrimary Medical TreatmentHandicapped HealingHealth PromotionFamily Planning Guiding
director
¥8→30per capita
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Work Station of CHS in Zhabei DistrictWork Station of CHS in Zhabei District
1 Offer health service to 10,000-20,000
CHS general team
General practitioners
Public healthpractitioner
Community nurses
Wal
k 15
-20
Min
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The Strong Points of General Teams The Strong Points of General Teams Convenient shorten the service radius
Advantageous to organize suitable, effective health promotion giving chronic disease patients continuous service
Economic the elementary medicine has kept in community, and the
expenditure is lower The system of CHS has provided a good
platform for community chronic disease prevention, control and management
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Our Works of Chronic Diseases Control & Prevention
What to do?
How to do? Information Garthering and Patients Finding
Health promotion
Patient Management
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Information Gathering and Patient RegisteringInformation Gathering and Patient Registering
Risk factors
High risk people
Patients
Community diagnosis
health records
Surveillance
Intervention strategy
Following-up
Epidemiology
Free medical
examination
Other ways
Clinic Screening
System of CHSReporting
Quality controlAnalysis
Evaluation
Zhabei CDC
Feedback
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Quality controlAnalysis
Evaluation
Cancer Finding and Registering
Hospitals level 2 or 3 in zhabei
Inputing information & reporting to CDC
Zhabei CDC
Prevention&health care section
In-patient DepartmentOut-patient DepartmentEmergency Department
Filling in Cancer ReportCards of New Patients
Information DepartmentAssistant Department
(CT/Pathology/…)Other Department
Cooperation
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Information Interchange with other CDC
Health Services for Cancer Patients in Communities
Zhabei CDC CDC of Other 18 Districts
Shanghai CDC
Interchange the Cancer Report Cards by Patients’ Address
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Public Health InterventionPublic Health Intervention
Policy intervention
Education intervention
Improve environmentsupporting ability
Health screening Biologic
prevention
Detect earlierBiologic Barrier
Idea changed
Health belief & behavior
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Intervention (1)Intervention (1)
The theme of Cancer control and prevention Week 1999~2005
2006 Proper diet, cancer prevention 2005 Health life, cancer prevention 2004 Delivering cancer prevention knowledge to communities 2003 Detect earlier, diagnose earlier and treat earlier 2002 Health life says “no” to cancer 2001 Preventing cancer scientifically and treating standardly 2000 Preventing cancer correctly 1999 Cancer can be prevented and cured
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Intervention(2)Intervention(2)
CounselingCounseling
LectureLecturePosterPoster
PamphletPamphlet
Cancer Week(4.15-21) Activity
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Intervention(3)Intervention(3)
Diabetes boardDiabetes board
““I Know My Own blood Pressure”I Know My Own blood Pressure”
Community Sports MeetingCommunity Sports Meeting
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Intervention(4)Intervention(4)
Measuring blood pressure for every patient aged≥35 when he/she goes to hospital for the first time every year
Strictly implementing the policy made by shanghai health bureau
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Intervention(5)Intervention(5)
Organizing a professional union Professional training Keeping from physical & mental
pressure Instructing family members
offering help to patients
The 1st Cancer Helping Center in Shanghai
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Patient ManagementPatient Management
General teams of CHS
Different level managementfrom diagnosis to death
Chronic disease management system
Quality controlProfessional guiding
Statistic analysis& evaluation
feedback
Genera
l m
anagem
ent
Fam
ily sickb
ed
Hosp
ice
Hospital Level 2 or 3
deteriorating mending
Zhabei CDC
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My goal in EHIBMy goal in EHIB
To know the model about community disease control &
prevention in U.S.A
To make some progress on community health
promotion’s planning, practicing and evaluation