The efficiency of provincial government health care expenditure after China's new health care reform.

OBJECTIVE: We aim to estimate the total factor productivity and analyze factors related to the Chinese government's health care expenditure in each of its provinces after its implementation of new health care reform in the period after 2009. MATERIALS AND METHODS: We use the Malmquist DEA model to measure efficiency and apply the Tobit regression to explore factors that influence the efficiency of government health care expenditure. Data are taken from the China statistics yearbook (2004-2020). RESULTS: We find that the average TFP of China's 31 provincial health care expenditure was lower than 1 in the period 2009-2019. We note that the average TFP was much higher after new health care reform was implemented, and note this in the eastern, central and western regions. But per capita GDP, population density and new health care reform implementation are found to have a statistically significant impact on the technical efficiency of the provincial government's health care expenditure (P<0.05); meanwhile, region, education, urbanization and per capita provincial government health care expenditure are not found to have a statistically significant impact. CONCLUSION: Although the implementation of the new medical reform has improved the efficiency of the government's health expenditure, it is remains low in 31 provinces in China. In addition, the government should consider per capita GDP, population density and other factors when coordinating the allocation of health care input. SIGNIFICANCE: This study systematically analyzes the efficiency and influencing factors of the Chinese government's health expenditure after it introduced new health care reforms. The results show that China's new medical reform will help to improve the government's health expenditure. The Chinese government can continue to adhere to the new medical reform policy, and should pay attention to demographic and economic factors when implementing the policy.

[Application and enlightenment of formative assessment in the innovation and development of higher education in basic medical science].

Formative assessment aims at cultivating and improving students' comprehensive qualities and abilities. It acquires and analyzes the dynamic changes of students' learning process through flexible and diverse assessment methods. The assessment contents cover multiple aspects including knowledge, abilities, attitudes, literacy, etc., which help teachers and students to formulate practical and efficient improvement strategies and to meet the inherent needs of students for comprehensive development. This review describes the connotation of formative assessment and summarizes its application in higher education of basic medical science in China. The existing shortcomings and the reasonable advice are proposed. We also introduce our experience in the application of formative assessment in pathophysiology education. This review will provide reference and enlightenment for the reform and innovation of the assessment system in higher education of basic medical science.

The effectiveness of formative assessment in pathophysiology education from students' perspective: a questionnaire study.

Current interdisciplinary medical training calls for reforms and innovations in the assessment of pathophysiology education. Formative assessment is used to monitor student learning to provide ongoing feedback that can improve both learning and teaching. Beginning in 2016, we implemented a formative assessment composed of case-based multiple-choice questions (MCQs) for all students in all majors. In 2017, case study questions began to be employed in the formative assessment, and student-set, case-based questions were further introduced. Aiming to gather the students' suggestions and feedback on the mixed-method assessment, we conducted a survey on aspects such as the effectiveness of the assessment, assessment content and completion, opinions on student-set questions, and the impact on pathophysiology learning for students from 2017 to 2019. In addition, we compared students' semesterly final scores with those of previous students and evaluated the relationship between formative and summative assessment scores. The results for 1,277 students clearly showed that the reformed formative assessment system was well received by the students. The students thought that the formative assessment not only allowed for the provision of real-time feedback on the effectiveness of teaching and learning but also nurtured self-motivation, the development of analytical and problem-solving skills, and collaborative efforts. Both the semesterly final scores and the proportions of students scoring in higher score ranges increased after the implementation of the formative assessment, and the summative assessment scores were positively related to the formative assessment scores. Consequently, the reformed formative assessment system significantly improved the quality of pathophysiology education.

Stock assessment and management implications of an endemic fish, Oxygymnocypris stewartii, in the Yarlung Zangbo River in Tibet, China.

BACKGROUND: Oxygymnocypris stewartii is an endemic species only inhabiting the middle and upper reaches of the Yarlung Zangbo River and its tributaries at altitudes above 3600 m in the Qinghai-Tibet Plateau and has suffered a continuous decline of population size owing to anthropogenic disturbance. However, little is known about the stock status of this species and how to protect it. In this study, we evaluated the population status of O. stewartii and investigated two management policies including the minimum age limits and seasonal closure in the Yarlung Zangbo River. RESULTS: Estimates of the total mortality rate were 0.35 year-1 for females and 0.65 year-1 for males. The natural mortality rates were estimated as 0.10 and 0.22 year-1 for females and 0.12 and 0.29 year-1 for males using two empirical methods. The O. stewartii population may be in near full exploitation under the current harvesting strategy in the Yarlung Zangbo River, with a high chance of recruitment failure in the future. Although both minimum age limits and seasonal closure could be effective measures to conserve the O. stewartii stock, it was proposed that aseasonal closure was implemented each year from September to December according to the complexity of the application and the effects on the income of local fishermen and on the biological invasion. CONCLUSIONS: The stock of O. stewartii may bein near full exploitation under the current harvesting strategy, with a high chance of recruitment failure in the future. Our results indicated that the imposition of the seasonal closure from September to December might be the effective measure to conserve the O. stewartii population.

Risk assessment and sources of polycyclic aromatic hydrocarbons in agricultural soils of Huanghuai plain, China.

The profiles and sources of polycyclic aromatic hydrocarbons (PAHs) were analyzed in 227 agricultural surface soils from the Huanghuai plain, China. The total concentrations of 16 PAHs varied from 15.7 to 1247.6 µg/kg, with an average of 129.5 µg/kg. Compared with pollution level and carcinogenic potential risk in other research, the soil PAH concentrations in this study fell within low to middle level. Unexpectedly, a significant correlation was not observed between the PAH concentration in soils and the corresponding content of the soil organic matter. This is partly interpreted for our sampling sites located in agricultural area where fresh input of organic fertilizers is expected. Principal component analysis-multiple linear regression suggests that low temperature combustion, coal combustion and traffic emissions could be the primary PAH contributors in soils from the Huanghuai plain, accounting for 46.7 percent, 42.1 percent and 11.2 percent of PAH concentrations, respectively.

Quality of life and cost for patients with premature ventricular contractions by radiofrequency catheter ablation.

OBJECTIVE: To evaluate the quality of life (QoL), health-care resource utilization, and cost for the patients with premature ventricular contractions (PVCs) by radiofrequency catheter ablation (RFCA). METHODS: RFCA was performed in 58 patients with symptomatic PVCs that were refractory/easy to medication. A 24-hour ambulatory electrocardiographic monitoring, QoL, health-care resources utilization, and cost were assessed at a screening visit and 3 and 12 months after RFCA. RESULTS: RFCA was successfully performed in 56 patients (96.6%). This resulted in a significant improvement in the QoL at 3 and 12 months after the procedure. There were no major complications related to the procedure. Nine patients (15.5%) had residual arrhythmia. Seven of them underwent repeated ablation with successful results. It also improved the QoL and reduced health-care resource utilization and cost. CONCLUSIONS: RFCA is a safe and effective treatment for PVCs, and it is a viable alternative to drugs in the presence of disabling symptoms.