[Impact of primary care oriented outpatient benefit package design in new rural cooperative medical system on hypertension outpatient services utilization].

OBJECTIVE: To study the impact of primary care oriented outpatient benefits package design of outpatient services coverage and ladder reimbursement of county, town and village levels in the new rural cooperative medical system (NRCMs) on hypertension outpatient services utilization. METHODS: The panel data of treatment and control groups in 2009 and 2011 before and after the policy reform were drawn from the household survey data of the innovative payment system project. The difference in difference (DID) method was used for data analysis. The outcome indicators included the utilization of outpatient services of patients with self-reported hypertension and their main treatment locations. RESULTS: The primary care oriented outpatient benefit package design in the NRCMs reduced the probability of no treatment in the latest three months of hypertension by 10.2 percent points. Meanwhile, it increased the probability of choosing village clinic as the preferred location by 15.7 percent points. CONCLUSION: Primary care oriented outpatient benefits package design lead patients with hypertension to use the nearest outpatient services at low risk of disease.

[Social determinants of chronic disease in a working population in China].

OBJECTIVE: To identify the social determinants of chronic disease in China. METHODS: Cross sectional data of working population aged from 18 to 60 years were drawn from the database of Chinese Family Panel Studies (CFPS) 2010. Logistic regression model was used for analyzing the difference of chronic conditions prevalence among the self-evaluated social status, income, education, working organizations and properties and management positions, respectively. RESULTS: The highest and higher groups of subjective social status, the least and higher groups of education, low-income group had a higher probability of suffering from chronic diseases. In terms of the nature of jobs, the farmers and the self-employed had a higher risk of suffering from chronic diseases than those employed by other formal sectors. The people engaged in the management were also with a higher risk. CONCLUSION: Income, education, nature and content of jobs are the social determinants of chronic diseases in China. All these determinants need to be considered during the policy-making aimed to improve health equity.

[Empirical analysis of relationship between scales and outputs of inpatient services of public comprehensive hospitals in Beijing area].

OBJECTIVE: To analyze the relationship between scale and outputs of inpatient services of public general hospitals. METHODS: Data on hospital scales and outputs were drawn from Beijing Health Statistics Annuals and the Database of Inpatient Record administered by Beijing Health Bureau. The outputs of inpatient services were measured, risk-adjusted by Beijing Diagnosis Related Groups (BJ-DRGs). Based on the Cobb-Douglas production function, regression analysis was used to evaluate the contribution of manpower and material resources to the changes in outputs of hospitals on different scales, respectively. RESULTS: Public general hospitals with 200-800 beds were at the stage of economical scale. In the 200-500-bed hospitals, investment of both human and material resources contributed to output changes. In the 501-800-bed hospitals, output changes were positively correlated with manpower input, but not with material resources. CONCLUSION: In the specific environment in Beijing, medium-sized hospitals are appropriate when the government plan to build hospitals mainly focused on inpatient services. The larger the scale of hospitals is, the more important is the manpower imput. The personnel system reform for public hospitals is urgent.