Enhancing pooling levels strengthens the risk resilience of healthcare insurance: a case study of basic medical insurance fund operations data in Gansu, China.

BACKGROUND: In China, enhancing the pooling levels of basic health insurance has consistently been regarded as a pivotal measure to promote the refinement of the healthcare insurance system. From 2020 to 2022, the widespread outbreak of COVID-19 posed new challenges to China's basic health insurance. METHODS: The research utilizes Data Envelopment Analysis (DEA), Malmquist index assessment, and fixed-effects panel Tobit models to analyze panel data from 2020 to 2022, assessing the efficiency of basic health insurance in Gansu Province. RESULTS: From 2020 to 2022, the average overall efficiency of the municipal pooling of Basic Medical Insurance for Urban and Rural Residents was 0.941, demonstrating a stable trend with a modest increase. The efficiency frontier regions have expanded from 5 (35.71%) to 7 (50%). Operational efficiency exhibited a negative correlation with per capita hospitalization expenses and per capita fund balance but a positive correlation with per capita accumulated fund balance and reimbursement rates for hospitalized patients. In 2021, compared to 2020, the county-pooling Basic Medical Insurance for Urban Employees saw a decline of 0.126 in overall efficiency, reducing the efficiency frontier regions from 8 to 3. However, from 2021 to 2022, the municipal-coordinated Basic Medical Insurance for Urban Employees experienced a 0.069 increase in overall efficiency, with the efficiency frontier regions expanding from 3 to 5. Throughout 2020 to 2022, the operational efficiency of the Urban Employee Basic Medical Insurance showed a consistent negative correlation with per capita fund balance. CONCLUSION: From 2020 to 2022, the overall operational performance of basic health insurance in Gansu Province was satisfactory, and enhancing the pooling level is beneficial in addressing the impact of unforeseen events on the health insurance system.

Photodegradation of malachite green under simulated and natural irradiation: kinetics, products, and pathways.

In this work photodegradation rates and pathways of malachite green were studied under simulated and solar irradiation with the goal of assessing the potential of photolysis as a removal mechanism in real aquatic environment. Factors influencing the photodegradation process were investigated, including pH, humic acid, Fe(2+), Ca(2+), HCO3(-), and NO3(-), of which favorable conditions were optimized by the orthogonal array design under simulated sunlight irradiation in the presence of dissolved oxygen. The degradation processes of malachite green conformed to pseudo first-order kinetics and their degradation rate constants were between 0.0062 and 0.4012 h(-1). Under solar irradiation, the decolorization efficiency of most tests can reach almost 100%, and relatively thorough mineralization could be observed. Forty degradation products were detected by liquid chromatography-mass spectrometry, and thirteen small molecular products were identified by gas chromatography-mass spectrometry. Based on the analyses of the degradation products and calculation of the frontier electron density, the pathways were proposed: decomposition of conjugated structure, N-demethylation reactions, hydroxyl addition reactions, the removal of benzene ring, and the ring-opening reaction. This study has provided a reference, both for photodegradation of malachite green and future safety applications and predictions of decontamination of related triphenylmethane dyes under real conditions.