A simple validated scoring system to predict mortality in medical patients with precise 'intervention-calling scores' has been developed.

PURPOSE We report a study on the developmental status of human resource staffi ng and service functions of community health services (CHS) in China and offer recommendations for improving the CHS in the future.METHODS A study questionnaire was completed by 712 CHS organizations distributed in 52 cities and districts in all areas of China using a multilevel stratifi ed randomized sampling method. Data were collected on the backgrounds, human resources, and service functions of CHS organizations. RESULTSWe found that 68.2% of doctors and 86.5% of nurses employed in CHS centers have low-level medical training. The doctor-nurse ratio in CHS centers is 1.2 to 1 and in CHS stations is 1.3 to 1. More than 50% of CHS organizations have developed on-the-job training programs, causing cost trends for staff training to increase. Although the delivery of basic clinical services and public health services is steadily increasing, 58.6% of stations are open less than 12 hours per day. Health records are established in a high proportion of CHS organizations. Two kinds of health education-general public health education, and personal education for specifi c problems-have been adopted by more than 92% of CHS centers and 90% of CHS stations.CONCLUSIONS Desired functions for CHS organizations have been partially achieved. Training for doctors and nurses engaged in CHS should be promoted and improved as quickly as possible. Training in basic clinical services and management of noncommunicable chronic diseases should be strongly promoted. Changes in government policies should be pursued to promote effective support for the development of CHS.

The introduction of an electronic alerting PSS did not lead to a reduction in mortality when adjusted for severity of illness defined by physiological variables. Predictive performance was not enhanced by the addition of biochemical variables and co-morbidities.

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