Figure 1
Construction of the integrated health-care system in Luohu District, Shenzhen City.
Table 1
The screening strategies in large-scale screening program.
| STRATEGIES | SCREENING OBJECTIVES | SAMPLING APPROACH | TESTING APPROACH | QUARANTINE REQUIREMENT |
|---|---|---|---|---|
| High-risk population | Close contacts of the index case, such as cohabiting family member, colleague, etc. | Single sampling | Daily nucleic acid test and once serological antibody test | 14 days of centralized isolation in designated hotels |
| Sub-high-risk population | The cohabiting family members of the index case’s close contacts and neighbor in living or working place of the index case | Single sampling | At least 2 times of nucleic acid test and once serological antibody test | 7 days in centralized medical observation points + 7 days at home |
| Community screening population | Residents in screening area, customers have been to the supermarket, etc. | Pooled sampling | Nucleic Acid Test | 0 |
| Accessible service | Inconvenient people, such as the elderly and the disabled | Depends | Nucleic Acid Test | 0 |
| Environmental sampling | External environment and product samples within screening areas | Single sampling | Nucleic Acid Test | – |
Figure 2
The flow chart of large-scale screening program conducted by the Hospital Group.
Table 2
The cost breakdown of the large-scale screening program.
| ITEMS | AMOUNT (THOUSAND CNY) | PROPORTION AMONG TOTAL COSTS (%) |
|---|---|---|
| Labor cost | 9,766.20 | 29.1 |
| Personnel cost (Daily salary) | 5,266.20 | 53.9 |
| Temporary wage subsidy | 4,500.00 | 46.1 |
| Material cost | 6,367.67 | 19.0 |
| Medical protective supplies | 3,427.10 | 53.8 |
| Sampling supplies | 2,750.00 | 43.2 |
| Logistics supplies | 190.57 | 3.0 |
| Inspection cost | 16,732.10 | 49.8 |
| Hospital Group’s self-inspection cost a | 3,727.10 | 22.3 |
| Outsourcing inspection cost b | 13,005.00 | 77.7 |
| Informationization cost | 551.52 | 1.6 |
| Information equipment c | 422.87 | 76.7 |
| Wireless network card d | 127.48 | 23.1 |
| Software developments e | 1.18 | 0.2 |
| Other costs | 176.00 | 0.5 |
| Transportation fee | 40.00 | 22.7 |
| Accommodation fee | 136.00 | 77.3 |
| Total | 33,593.49 | 100 |
[i] Note: a The composition of self-inspection cost comprised labor cost in inspection department, equipment depreciation fee for inspection, and the relevant inspection materials costs. The self-inspection in this study was not in line with the charge standard in hospitals, which was calculated according to the actual costs that happened instead of the charging fee set by the local government in hospitals.
b The outsourcing inspection cost was calculated from the unit price and discount provided by the third inspection parties. The final cost is based on the actual number of outsourcing specimens.
c The information equipment includes laptop, scanner, barcode printer, server and storage. The period of depreciation of laptops and PDA equipment was 6 years, and the cost was included according to the actual working hours (10 days) in the cost calculation, namely, 31.88 CNY/10 days for each laptop, and 925.93 CNY/10 days for each server and storage.
d The wireless network card is disposable consumables.
e It was expected that the available period of this software system was 6 years, and the cost was included according to the actual working hours (10 days) in the cost calculation. In addition, since the system was developed by the Hospital Group, the maintenance work was undertaken by the staff within the Hospital Group and there was no breakdown of maintenance cost, so the maintenance cost was not included in this study.
Table 3
Screening program inspection cost breakdown and demographic characteristics of inspected populations.
| INSPECTION APPROACH | NUMBER OF SPECIMENS | INSPECTION COST (THOUSAND CNY) | INSPECTION COST PER CAPITA (CNY) | PROPORTION IN THE TOTAL NUMBER OF SPECIMENS | PROPORTION OF TOTAL INSPECTION COST |
|---|---|---|---|---|---|
| Hospital Group’s self-inspection | 163,322 | 3,727.1 | 22.82 | 37.4% | 22.3% |
| Variables | Descriptive statistics | ||||
| Age (year old) | 34.44 ± 14.07 | ||||
| Gender | Male | 50.33% | |||
| Female | 49.67% | ||||
| Native place distribution (inside vs. outside) | Luohu District | 3.46%: 96.54% | |||
| Shenzhen City | 10.82%: 89.18% | ||||
| Guangdong Province | 49.95%: 50.05% | ||||
| Outsourcing inspection | 273,778 | 13,005.0 | 47.50 | 62.6% | 77.7% |
| Variables | Descriptive statistics | ||||
| Age (year old) | 32.89 ± 15.23 | ||||
| Gender | Male | 51.02% | |||
| Female | 49.98% | ||||
| Native place distribution (inside vs. outside) | Luohu District | 3.76%: 96.24% | |||
| Shenzhen City | 11.58%: 89.42% | ||||
| Guangdong Province | 55.00%: 45.00% | ||||
| Total | 437,100 | 1,673.21 | 38.28 | 100.0% | 100.0% |
Figure 3
The internal governance structure of Hospital Group and its relationships with governments and relevant departments.