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1.
Int J Equity Health ; 23(1): 116, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840134

RESUMO

BACKGROUND: PCSK9 inhibitors are a novel class of lipid-lowering drugs that have demonstrated favorable efficacy and safety. Evolocumab and alirocumab have been added to China's National Reimbursement Drug List through the National Drug Price Negotiation (NDPN) policy. This study aims to evaluate the impact of the NDPN policy on the utilization and accessibility of these two PCSK9 inhibitors. METHODS: The procurement data of evolocumab and alirocumab were collected from 1,519 hospitals between January 2021 and December 2022. We determined the monthly availability, utilization, cost per daily defined dose (DDDc), and affordability of the two medicines. Single-group interrupted time series (ITS) analysis was performed to assess the impact of the NDPN policy on each drug, and multiple-group ITS analysis was performed to compare the differences between them. RESULTS: The NDPN policy led to a significant and sudden increase in the availability and utilization of PCSK9 inhibitors, along with a decrease in their DDDc. In the year following the policy implementation, there was an increase in the availability, utilization, and spending, and the DDDc remained stable. The affordability of PCSK9 inhibitors in China have been significantly improved, with a 92.97% reduction in out-of-pocket costs. The availability of both PCSK9 inhibitors was similar, and the DDDc of alirocumab was only $0.23 higher after the intervention. The market share of evolocumab consistently exceeded that of alirocumab. Regional disparities in utilization were observed, with higher utilization in the eastern region and a correlation with per capita disposable income. CONCLUSIONS: The NDPN policy has successfully improved the accessibility and utilization of PCSK9 inhibitors in China. However, regional disparities in utilization indicate the need for further interventions to ensure equitable medicine access.


Assuntos
Anticorpos Monoclonais Humanizados , Custos de Medicamentos , Análise de Séries Temporais Interrompida , Inibidores de PCSK9 , Humanos , China , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/economia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Anticolesterolemiantes/uso terapêutico , Anticolesterolemiantes/economia , Política de Saúde
2.
Front Public Health ; 12: 1406566, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827615

RESUMO

Background: Emerging infectious diseases pose a significant threat to global public health. Timely detection and response are crucial in mitigating the spread of such epidemics. Inferring the onset time and epidemiological characteristics is vital for accelerating early interventions, but accurately predicting these parameters in the early stages remains challenging. Methods: We introduce a Bayesian inference method to fit epidemic models to time series data based on state-space modeling, employing a stochastic Susceptible-Exposed-Infectious-Removed (SEIR) model for transmission dynamics analysis. Our approach uses the particle Markov chain Monte Carlo (PMCMC) method to estimate key epidemiological parameters, including the onset time, the transmission rate, and the recovery rate. The PMCMC algorithm integrates the advantageous aspects of both MCMC and particle filtering methodologies to yield a computationally feasible and effective means of approximating the likelihood function, especially when it is computationally intractable. Results: To validate the proposed method, we conduct case studies on COVID-19 outbreaks in Wuhan, Shanghai and Nanjing, China, respectively. Using early-stage case reports, the PMCMC algorithm accurately predicted the onset time, key epidemiological parameters, and the basic reproduction number. These findings are consistent with empirical studies and the literature. Conclusion: This study presents a robust Bayesian inference method for the timely investigation of emerging infectious diseases. By accurately estimating the onset time and essential epidemiological parameters, our approach is versatile and efficient, extending its utility beyond COVID-19.


Assuntos
Algoritmos , Teorema de Bayes , COVID-19 , Doenças Transmissíveis Emergentes , Cadeias de Markov , Humanos , Doenças Transmissíveis Emergentes/epidemiologia , COVID-19/epidemiologia , COVID-19/transmissão , China/epidemiologia , Método de Monte Carlo , SARS-CoV-2 , Surtos de Doenças/estatística & dados numéricos , Fatores de Tempo , Modelos Epidemiológicos
3.
Front Public Health ; 12: 1389765, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827617

RESUMO

Background: While health inequality has been the focus of past scholarly discussions, COVID-19's outbreak and spread have provided a new arena for discussing health inequality, particularly in the context of urban-rural disparities in China. This paper explores the impact of COVID-19 on urban-rural health inequality, and the roles played by socioeconomic status and social capital. Methods: A cross-sectional observational collected data on demographics, mental health, socioeconomic status, and social capital. An online survey was administered from August 27 to August 30, 2020, and, 1936 valid samples were received. Mental health was measured using the Brief Symptom Inventory (BSI-18). This study applied the ordinary least squares regression (OLS) model, and data analysis was performed using STATA. Results: There were 1936 participants, with an equal distribution of genders. Multiple regression analysis showed that the mental health levels of rural youth were superior to those of urban youth (p = 0.049), especially when the epidemic was not severe (p = 0.013). Socioeconomic status had a significant positive promotion effect on mental health (p = 0.008), but the interaction effect between socioeconomic status and the urban-rural divide indicated that the promotion effect of socioeconomic status on the mental health of urban youth was greater than that of rural youth (p = 0.04). Social capital had a significant positive promotion effect on mental health (p = 0.000), and the interaction effect indicated that this promoting effect did not differ between urban and rural areas (p > 0.05).


Assuntos
COVID-19 , Saúde Mental , População Rural , Capital Social , População Urbana , Humanos , China/epidemiologia , Masculino , Feminino , COVID-19/epidemiologia , COVID-19/psicologia , Estudos Transversais , População Rural/estatística & dados numéricos , Adolescente , População Urbana/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Adulto Jovem , Inquéritos e Questionários , Disparidades nos Níveis de Saúde , Adulto , Classe Social , Fatores Socioeconômicos
4.
Front Public Health ; 12: 1358604, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827619

RESUMO

Objective: In recent years, there has been a significant increase in research using ecological momentary assessment (EMA) to explore suicidal thoughts and behaviors (STBs). Meanwhile, concerns have been raised regarding the potential impacts of frequent and intense STBs assessments on the study participants. Methods: From November 2021 to June 2023, a total of 83 adolescent and young adult outpatients (Mage = 21.0, SDage = 6.3, 71.1% female), who were diagnosed with mood disorders, were recruited from three psychiatric clinics in China. Smartphone-based EMA was used to measure suicidal thoughts three times per day at randomly selected times. We examined the change of suicidal thoughts in each measurement and within 1 day to evaluate potential adverse effects using Bayesian multilevel models. Results: The 3,105 effective surveys were nested in 83 participants (median follow-up days: 14 days). The results of two-level models indicated that suicidal thoughts decreased during the monitoring period. However, this effect varied among different individuals in the two-level model. Conclusion: Our findings did not support the notion that repeated assessment of suicidal thoughts is iatrogenic, but future research should continue to investigate the impact of frequent assessment on suicidal thoughts, taking into account individual differences and utilizing larger sample sizes.


Assuntos
Avaliação Momentânea Ecológica , Ideação Suicida , Humanos , Feminino , Masculino , Adolescente , Adulto Jovem , China , Adulto , Teorema de Bayes , Inquéritos e Questionários , Smartphone , Transtornos do Humor
5.
Front Public Health ; 12: 1376406, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827620

RESUMO

Introduction: China has experienced unprecedented transformations unseen in a century and is gradually progressing toward an emerging superpower. The epidemiological trends of digestive diseases in the United States (the US) have significant prescient effects on China. Methods: We extracted data on 18 digestive diseases from the Global Burden of Diseases 2019 Data Resource. Linear regression analysis conducted by the JoinPoint software assessed the average annual percentage change of the burden. We performed subgroup analyses based on sex and age group. Results: In 2019, there were 836.01 and 180.91 million new cases of digestive diseases in China and the US, causing 1558.01 and 339.54 thousand deaths. The age-standardized incidence rates of digestive diseases in China and the US were 58417.87/100,000 and 55018.65/100,000 respectively, resulting in age-standardized mortality rates of 81.52/100,000 and 60.88/100,000. The rates in China annually decreased by 2.149% for mortality and 2.611% for disability-adjusted life of year (DALY). The mortality and DALY rates of the US, respectively, had average annual percentage changes of -0.219 and -0.251. Enteric infections and cirrhosis and other chronic liver diseases accounted for the highest incidence and prevalence in both counties, respectively. The burden of multiple digestive diseases exhibited notable sex disparities. The middle-old persons had higher age-standardized prevalence rates. Conclusion: China bore a greater burden of digestive diseases, and the evolving patterns were more noticeable. Targeted interventions and urgent measures should be taken in both countries to address the specific burden of digestive diseases based on their different epidemic degree.


Assuntos
Doenças do Sistema Digestório , Humanos , China/epidemiologia , Estados Unidos/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Doenças do Sistema Digestório/epidemiologia , Doenças do Sistema Digestório/mortalidade , Adulto , Idoso , Adolescente , Lactente , Incidência , Criança , Pré-Escolar , Adulto Jovem , Efeitos Psicossociais da Doença , Recém-Nascido , Idoso de 80 Anos ou mais , Anos de Vida Ajustados por Deficiência
6.
Environ Geochem Health ; 46(6): 211, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38833063

RESUMO

Excellent air quality is important for China to achieve high quality economic development. The paper analyses the spatial and temporal distribution characteristics of the air quality index (AQI) in 288 Chinese cities, and further investigates the driving factors affecting air quality using the spatial Durbin model (SDM) based on the panel data of 288 Chinese cities from 2014 to 2021. The results of the study show that: (1) China's air quality level has improved in general, but there are large differences in air quality between regions; (2) China's AQI has significant spatial positive autocorrelation, and the Moran's scatter plot shows a high-high and low-low agglomeration; (3) The driving factors of air quality have different effects, and regional heterogeneity is obvious. Some developed regions in China have already crossed the inflexion point of the environmental Kuznets curve (EKC); promoting industrial upgrading and reducing pollutant emissions can significantly improve urban PM2.5 concentrations; and the "Three-Year Strategy for Conquering the Blue Sky War" policy has lowered the AQI in North China and improved PM2.5 concentrations nationwide. Based on the above findings, the paper puts forward corresponding policy recommendations.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Cidades , Monitoramento Ambiental , Material Particulado , Análise Espaço-Temporal , China , Poluição do Ar/análise , Poluentes Atmosféricos/análise , Material Particulado/análise , Monitoramento Ambiental/métodos
7.
JAMA Netw Open ; 7(6): e2412886, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38837161

RESUMO

Importance: Recent changes in China's social medical insurance reimbursement policy have impacted the financial burden of patients with phenylketonuria (PKU) for special foods. However, whether this policy change is associated with their blood phenylalanine (PHE) concentration is unclear. Objective: To investigate the association between the reimbursement policy and blood PHE concentration in patients with PKU. Design, Setting, and Participants: This cohort study measured the blood PHE concentrations of 167 patients with PKU across 4 newborn screening centers in China from January 2018 to December 2021. The reimbursement policy for special foods for patients with PKU at 2 centers was canceled in 2019 and restored from 2020 onwards. In contrast, the other 2 centers consistently implemented the policy. Data were analyzed from September 10 to December 6, 2023. Exposures: The implementation and cancelation of the reimbursement policy for special foods of patients with PKU. Main Outcomes and Measures: The blood PHE concentration was regularly measured from 2018 to 2021. A 1-sided Z test was used to compare the mean of the blood PHE concentration between different years. Results: Among 167 patients with PKU (mean [SD] age, 84.4 [48.3] months; 87 males [52.1%]), a total of 4285 measurements of their blood PHE concentration were collected from 2018 to 2021. For patients at the center that canceled the reimbursement policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (5.73) mg/dL, significantly higher than 4.84 (4.11) mg/dL in 2018 (P < .001), 5.06 (5.21) mg/dL in 2020 (P = .006), and 4.77 (4.04) mg/dL in 2021 (P < .001). Similarly, for patients at the other center that canceled the policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (3.43) mg/dL, significantly higher than 5.34 (3.45) mg/dL in 2018 (P = .03), 5.13 (3.15) mg/dL in 2020 (P = .003), and 5.39 (3.46) mg/dL in 2021 (P = .03). On the contrary, no significant difference was observed between any of the years for patients at the 2 centers that consistently implemented the policy. Conclusions and Relevance: In this cohort study of patients with PKU from multiple centers, the implementation of the reimbursement policy for special foods was associated with controlling the blood PHE concentration. Special foods expenditure for patients with PKU should be included in the scope of long-term social medical insurance reimbursement.


Assuntos
Reembolso de Seguro de Saúde , Fenilalanina , Fenilcetonúrias , Humanos , Fenilcetonúrias/sangue , Fenilcetonúrias/economia , Fenilcetonúrias/dietoterapia , Fenilalanina/sangue , China , Masculino , Feminino , Reembolso de Seguro de Saúde/estatística & dados numéricos , Triagem Neonatal/economia , Triagem Neonatal/métodos , Recém-Nascido , Pré-Escolar , Criança , Alimentos Especializados/economia , Estudos de Coortes , Lactente
8.
BMC Health Serv Res ; 24(1): 707, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840074

RESUMO

BACKGROUND: Medical service efficiency is an important indicator for measuring the equity of medical services. Therefore, this study primarily focuses on investigating the spatiotemporal domain to explore both spatial and temporal characteristics, as well as influencing factors that affect medical service efficiency across diverse provinces in China. METHODS: The super Epsilon-based Measure (EBM) unexpected model has previously been utilized to quantify energy eco-efficiency, carbon emission efficiency, and green development efficiency. However, limited studies have applied this method to assess the efficiency of healthcare services. Therefore, this study investigates the application of the super-EBM-unexpected model in evaluating medical service efficiency, and further integrates spatial econometric models to explore the influencing factors of medical service efficiency and aims to identify potential avenues for improvement. RESULTS: The average efficiency of medical services in the 31 provinces of China ranges from 0.6 to 0.7, indicating predominantly low efficiency values. However, economically developed coastal areas exhibit relatively high efficiency levels above 1. Conversely, regions with relatively lower levels of economic development demonstrate lower efficiency rates at approximately 0.3. Evidently, substantial regional disparities exist. For the influencing factors, the enhancement of residents' living standards can effectively foster the medical service efficiency, while residential living standards of nearby areas can also exert an impact in this region. The influence of educational attainment on medical service efficiency exhibits a significant inhibitory effect. CONCLUSIONS: The majority of China's 31 provinces exhibit suboptimal medical service efficiency, with notable regional disparities. Future policy initiatives should be tailored to address the unique challenges faced by regions with lower levels of economic development, prioritizing enhancements in both the efficacy and quality of their healthcare systems.


Assuntos
Eficiência Organizacional , Análise Espaço-Temporal , China , Humanos , Modelos Econométricos
9.
Int J Equity Health ; 23(1): 115, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840102

RESUMO

BACKGROUND: Since 2020, China has implemented an innovative payment method called Diagnosis-Intervention Packet (DIP) in 71 cities nationwide. This study aims to assess the impact of DIP on medical expenditure, efficiency, and quality for inpatients covered by the Urban Employee Basic Medical Insurance (UEBMI) and Urban and Rural Residents Basic Medical Insurance (URRBMI). It seeks to explore whether there are differences in these effects among inpatients of the two insurance types, thereby further understanding its implications for health equity. MATERIALS AND METHODS: We conducted interrupted time series analyses on outcome variables reflecting medical expenditure, efficiency, and quality for both UEBMI and URRBMI inpatients, based on a dataset comprising 621,125 inpatient reimbursement records spanning from June 2019 to June 2023 in City A. This dataset included 110,656 records for UEBMI inpatients and 510,469 records for URRBMI inpatients. RESULTS: After the reform, the average expenditure per hospital admission for UEBMI inpatients did not significantly differ but continued to follow an upward pattern. In contrast, for URRBMI inpatients, the trend shifted from increasing before the reform to decreasing after the reform, with a decline of 0.5%. The average length of stay for UEBMI showed no significant changes after the reform, whereas there was a noticeable downward trend in the average length of stay for URRBMI. The out-of-pocket expenditure (OOP) per hospital admission, 7-day all-cause readmission rate and 30-day all-cause readmission rate for both UEBMI and URRBMI inpatients showed a downward trend after the reform. CONCLUSION: The DIP reform implemented different upper limits on budgets based on the type of medical insurance, leading to varying post-treatment prices for UEBMI and URRBMI inpatients within the same DIP group. After the DIP reform, the average expenditure per hospital admission and the average length of stay remained unchanged for UEBMI inpatients, whereas URRBMI inpatients experienced a decrease. This trend has sparked concerns about hospitals potentially favoring UEBMI inpatients. Encouragingly, both UEBMI and URRBMI inpatients have seen positive outcomes in terms of alleviating patient financial burdens and enhancing the quality of care.


Assuntos
Gastos em Saúde , Pacientes Internados , Seguro Saúde , Humanos , Gastos em Saúde/estatística & dados numéricos , China , Seguro Saúde/economia , Pacientes Internados/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Projetos Piloto , Análise de Séries Temporais Interrompida , Masculino , Feminino
10.
PLoS One ; 19(6): e0302845, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38833455

RESUMO

An increase in a currency internationalization levels can positively impact its credibility in international economic activities, and expand the effective demand and optimize the supply structure for the country's financial service trade. In this way, a state can improve its financial service trade competitiveness in the international market. This study builds a vector autoregressive model based on time-series data of China-US financial services trade from 2010 to 2021, analyzes the impact of different quantitative indicators of RMB internationalization on this trade from the impulse response results, and validates the conclusions using various inspection methods. The results show that the increase in RMB internationalization helps to narrow the China-US financial services trade balance, but with a significant lag. And this effect is heterogeneous in different dimensions, demonstrated by the fact that the development of overseas RMB securities business is more important for the level of RMB internationalization to narrow the China-US financial services trade balance. Finally, among the specific measures to improve its financial services trade, China should focus on developing the international competitiveness of the traditional RMB deposit and loan financial sector, while the competition in the overseas market for high value-added financial businesses must also not be neglected. Furthermore, China needs to implement more targeted RMB internationalization development policies at different levels in the future to provide high-quality financial services to the rest of the world and aid in the economic recovery of the world in the "post-pandemic" era.


Assuntos
Comércio , Internacionalidade , China , Comércio/economia , Modelos Econômicos , Competição Econômica , Humanos , Administração Financeira
11.
PLoS One ; 19(6): e0304967, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38837962

RESUMO

Second-hand luxury goods feature both characteristics of luxury products like perceived value including social, emotional, and quality value, and second-hand goods like price-performance ratio. Enlarging the second-hand luxury market is of significance to protect the environment and save rare and valuable natural resources, and thus investigating the determinants of purchase intention is meaningful. From the perspective of the psychology of consumers, the influence of factors related to consumers (recycling awareness, subjective norms, attitudes, perceived behavioral control) and products (perceived value, price-performance ratio) on the intention to buy second-hand luxury goods is explored in this study through an online survey with Chinese consumers as a sample. The results are analyzed using the structural equation model (SEM) and show that consumers' attitudes, perceived behavioral control, and recycling awareness will promote the intention of purchasing second-hand luxury goods, and the perceived value and price-performance ratio of second-hand luxury goods also have a positive impact on the purchase intention. However, there is no significant relationship between subjective norms and purchase intention. In addition, this study also explores the interrelationship between constructs and draws corresponding conclusions, providing references for the subsequent development of the second-hand luxury market.


Assuntos
Comportamento do Consumidor , Intenção , Humanos , Masculino , Feminino , Adulto , China , Inquéritos e Questionários , Pessoa de Meia-Idade , Atitude , Adulto Jovem , Reciclagem/economia , Comércio , População do Leste Asiático
12.
PLoS One ; 19(6): e0304364, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38837978

RESUMO

Reducing carbon emission intensity is crucial for achieving sustainable development. Carbon emission intensity is expressively affected by the issuance of green bonds. Thus, it is imperative to assess the influence of green bond issuance on carbon emissions and examine their correlation. Such research holds great potential to expedite the overhaul and modernization of businesses and to construct a circular economy system. This paper uses the spatial Durbin model to draw empirical conclusions by using data from 26 provinces in China between 2016 and 2021. Firstly, under different spatial matrices, it has been analyzed that an increase of 1% in the issuance of green bonds leads to a reduction of 0.306% or 0.331% in carbon emission intensity. It shows that green bonds have the potential to substantially reduce carbon intensity. Additionally, the intensity of emissions in the current period is driven by the intensity of emissions in the previous period. Secondly, the analysis of mediated transmission suggests that green bonds can ultimately reduce carbon emission intensity by changing the energy consumption structure or improving the efficiency of green technology innovation. Thirdly, the analysis of heterogeneity shows that the inhibitory effect of green bond issuance on carbon emissions is stronger in less economically developed regions than in economically developed regions. There is a significant inhibitory effect of green bond issuance in neighboring provinces on local carbon emission intensity. This effect is present only in provinces in less economically developed regions and not in economically developed regions.


Assuntos
Carbono , Carbono/química , Carbono/análise , China , Desenvolvimento Sustentável
13.
PLoS One ; 19(6): e0304973, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38838022

RESUMO

Cities are commonly recognized as the immediate hinterland of ports and play a crucial role in fostering the sustainable development of ports. Therefore, it is imperative to investigate the influence of cities on ports. By employing panel data from 2001 to 2021 for both ports and cities in the Bohai Rim region, this study examines the spatial spillover effect of urban economy on port efficiency using the spatial error model (SEM). The findings show that urban economies have a significant spatial spillover effect on port efficiency, but this effect diminishes across different spatial matrices. In particular, the geographical matrix demonstrates a stronger spatial spillover effect of the urban economy on port efficiency. These research findings help to establish a collaborative mechanism for port-city development and provide useful insights for government management decision-making.


Assuntos
Cidades , Humanos , China , Desenvolvimento Sustentável/economia
17.
Front Public Health ; 12: 1361015, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841658

RESUMO

Introduction: Over the past decade, against the dual background of population aging and mobility, the older adult/adults floating population has become a new type of mobile group in China, continually congregating in large cities, posing significant challenges to the socio-economic development, eldercare services, and public management of these metropolises. Shanghai, as a mega-city and the economic center of the China, is typically representative of the national population. Methods: Based on the dynamic monitoring data of Shanghai's floating population in 2018, this research uses mathematical statistics and binary Logistic regression models. Objective: This research analyzes the demographic characteristics and health status of the older adult/adults floating population in Shanghai in the new era and reveals its primary influencing factors. Results and discussion: (1) A prominent contradiction in the scale and structure of the older adult/adults floating population, with widowed and low-educated mobile older adult/adults requiring attention. (2) There is a lack of health knowledge, and the proportion of local reimbursement is low. Over 90% of migrant older adult/adults self-assessed their health (with a very few unable to care for themselves), far higher than the proportion of older adult/adults who are not sick (injured) or uncomfortable (actually healthy), which exceeds 70%. The health status of migrant older adult/adults deteriorates with age, and those who have never attended school and live alone have the worst health status. (3) Older adult/adults people with advanced age and low educational levels are at risk of health issues, while a better living environment can reduce the risk of illness in the older adult/adults floating population. Low family income, poor housing affordability, and the medical burden brought about by illness can easily lead to older adult/adults floating populations falling into the trap of older adult/adults poverty, and older adult/adults people from central regions and those who migrate along have difficulty adapting to city life, leading to poor self-assessed health. Meanwhile, community/enterprise health education helps to enhance the health protection awareness of the older adult/adults floating population. Finally, based on the governance concept of "mobility publicness," several public management and service optimization strategies for social support for the older adult/adults floating population in Shanghai are proposed.


Assuntos
Nível de Saúde , Migrantes , Humanos , China/epidemiologia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Migrantes/estatística & dados numéricos , Adulto , Idoso de 80 Anos ou mais , Fatores Socioeconômicos
18.
Front Public Health ; 12: 1358730, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841673

RESUMO

Introduction: The synergy of green taxation, public health expenditures, and life expectancy emerges as a compelling narrative in the intricate symphony of environmental responsibility and public well-being. Therefore, this study examine the impact of green taxation on life expectancy and the moderating role of public health expenditure on the said nexus, particularly in the context of China, an emerging economy. Methods: Statistical data is collected from the National Bureau of Statistics of China to empirically examine the proposed relationships. The dataset contains provincial data across years. Results: Using fixed-effect and system GMM regression models alongwith control variables, the results found a positive and statistically significant influence of green taxation on life expectancy. Moreover, public health expenditures have a positive and statistically significant partial moderating impact on the direct relationship. Discussion: These findings suggest that the higher cost of pollution encourages individuals and businesses to shift to less environmentally harmful alternatives, subsequently improving public health. Moreover, government investment in the health sector increases the availability and accessibility of health facilities; thus, the positive impact of green taxation on public health gets more pronounced. The findings significantly contribute to the fields of environmental and health economics and provide a new avenue of research for the academic community and policymakers.


Assuntos
Gastos em Saúde , Expectativa de Vida , Impostos , China , Humanos , Impostos/estatística & dados numéricos , Impostos/economia , Gastos em Saúde/estatística & dados numéricos , Saúde Pública/economia
19.
Front Public Health ; 12: 1363764, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841669

RESUMO

Alleviating health inequality among different income groups has become a significant policy goal in China to promote common prosperity. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) covering the period from 2013 to 2018, this study empirically examines the impact of Integrated Medical Insurance System (URRBMI) on the health and health inequality of older adult rural residents. The following conclusions are drawn: First, URRBMI have elevated the level of medical security, reduced the frailty index of rural residents, and improved the health status of rural residents. Second, China exhibits "pro-rich" health inequality, and URRBMI exacerbates health inequality among rural residents with different incomes. This result remains robust when replacing the frailty index with different health modules. Third, the analysis of influencing mechanisms indicates that the URRBMI exacerbate inequality in the utilization of medical services among rural residents, resulting in a phenomenon of "subsidizing the rich by the poor" and intensifying health inequality. Fourth, in terms of heterogeneity, URRBMI have significantly widened health inequality among the older adult and in regions with a higher proportion of multiple-tiered medical insurance schemes. Finally, it is suggested that China consider establishing a medical financing and benefit assurance system that is related to income and age and separately construct a unified public medical insurance system for the older adult population.


Assuntos
Disparidades nos Níveis de Saúde , Seguro Saúde , População Rural , Humanos , China , População Rural/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Estudos Longitudinais , Idoso , Masculino , Pessoa de Meia-Idade , Feminino , Benefícios do Seguro/estatística & dados numéricos , Benefícios do Seguro/economia , Fatores Socioeconômicos
20.
Front Public Health ; 12: 1344718, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841676

RESUMO

Background: The spread of Covid-19 and resultant infection prevention strategies have disturbed the life routine of Chinese young adults, led to reduced physical activity (PA), prolonged screen time (ST) and inadequate sleep duration (SP), and made immense influence on their mental health (MH) and quality of life (QoL). E-Health literacy (EHL) can enable citizens to use available online information to respond to the highly complex information environment and make appropriate health decisions. Objective: This study aims to examine associations between adhering to 24-h movement (24HM) guidelines and MH and QoL among young adults, as well as to identify any mediating or moderating role of EHL in these associations. Methods: 1742 young adults (20.03 ± 1.54 years old, 68.6% females) from north and south China completed self-report measures of 24HM (PA, ST and SP), health indicators (MH and QoL), EHL and demographic information through an online survey between 4 Apr and 16 Jun 2022. Generalized linear mixed models were applied for data analysis. Results: Results showed that adhering to PA, ST and SP guidelines were all positively connected with QoL while MH was associated with adhering ST or SP guidelines. Adhering to more of 24HM guidelines was linked to better MH and QoL. EHL significantly mediated the association of guideline adherence and QoL and moderate that of guideline adherence and MH. Conclusion: This is the first study to investigate the role of EHL on the associations between 24HM and MH as well as QoL during the Covid-19. The findings may contribute to further empirical research or intervention that aims to promote MH or QoL among young adults more effectively or provide valuable references for developing relevant strategies or policy of health promotion or public health events in China.


Assuntos
COVID-19 , Exercício Físico , Fidelidade a Diretrizes , Letramento em Saúde , Saúde Mental , Qualidade de Vida , Humanos , Feminino , Masculino , Adulto Jovem , China , COVID-19/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Inquéritos e Questionários , Tempo de Tela , Adulto , Adolescente , Sono
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