Long-term care needs and hospitalization costs with long-term care insurance: a mixed-sectional study.

Background: With the rapid aging of the population, the health needs of the older adult have increased significantly, resulting in the frequent occurrence of the "social hospitalization" problem, which has led to a rapid increase in hospitalization costs. This study investigates whether the "social hospitalization problem" arising from the long-term care needs can be solved through the implementation of long-term care insurance, thereby improving the overall health of the older adults and controlling the unreasonable increase in hospitalization costs. Methods: The entropy theory was used as a conceptual model, based on data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. The least-squares method was used to examine the relationship between long-term care needs and hospitalization costs, and the role that long-term care insurance implementation plays in its path of influence. Results: The results of this study indicated that long-term care needs would increase hospitalization cost, which remained stable after a series of tests, such as replacing the core explanatory variables and introducing fixed effects. Through the intermediary effect test and mediated adjustment effect test, we found the action path of long-term care needs on hospitalization costs. Long-term care needs increases hospitalization costs through more hospitalizations. Long-term care insurance reduces hospitalization costs. Its specific action path makes long-term care insurance reduce hospitalization costs through a negative adjustment of the number of hospitalizations. Conclusion: To achieve fair and sustainable development of long-term care insurance, the following points should be achieved: First, long-term care insurance should consider the prevention in advance and expand the scope of participation and coverage; Second, long-term care insurance should consider the control in the event and set moderate levels of treatment payments; Third, long-term care insurance should consider post-supervision and explore appropriate payment methods.

Cyber-infrastructure and epidemic precautionary policy: evidence from China.

Introduction: The application of technology supported by cyber infrastructure has emerged as a critical factor influencing city management. This study aims to investigate whether the development of cyber infrastructure can enhance cities' confidence in responding to potential epidemic threats in the context of COVID-19. Methods: China serves as a good example for both COVID-19 management and smart city construction. We take advantage of a special time point, the 2022 Chinese New Year, to observe cities' precautionary epidemic policies. We utilize choice models and data from 188 Chinese cities to examine the impact of internet coverage on the degree of policy relaxation. Results: We found that cities with higher internet coverage tend to adopt looser policies. In the benchmark regression, for every 1 percentage point increase in internet coverage, the likelihood of implementing loose measures increases by 0.9 percentage points. This result remains robust across different classifications of policies. We also addressed potential endogeneity issues by using the instrumental variables method. Discussion: Our study indicates that effective management of epidemics in the modern era requires not only the utilization of traditional medical resources but also the incorporation of new city features, such as information technology infrastructure.

Socioeconomic deprivation, medical services accessibility, and income-related health inequality among older Chinese adults: evidence from a national longitudinal survey from 2011 to 2018.

BACKGROUND: Health inequality poses a challenge to improving the quality of life of older adults as well as the service system. The literature rarely explores the moderating role of medical services accessibility in the association between socioeconomic deprivation and health inequality. OBJECTIVE: This study examines the socioeconomic deprivation and medical services accessibility associated with health inequality among older Chinese adults, which will contribute to the medical policy reform. METHODS: Using data from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyse 14,232 older adults. This paper uses a concentration index (CI) to measure the income-related health inequality among the target population and employs a recentered influence function-concentration index-ordinary least squares (RIF-CI-OLS) model to empirically analyse the correlation between socioeconomic deprivation and health inequality among older Chinese adults. Based on the correlation analysis, we discuss the moderating effect of medical services accessibility. RESULTS: We find that health inequality exists among older Chinese adults and that the relative deprivation in socioeconomic status (SES) is significantly associated with health inequality (ß∈  [0.1109,  0.1909], P < 0.01). The correlation between socioeconomic deprivation and health inequality is moderated by medical services accessibility, which means that an increase in medical services accessibility can weaken the correlation between socioeconomic deprivation and health inequality. CONCLUSION: China needs an in-depth reform of its medical services accessibility system to promote the equitable distribution of medical services resources, strengthen medical costs and quality management, and ultimately mitigate the SES reason for health inequality among older Chinese adults.

Grandchild care, inadequate medical insurance protection, and inequalities in socioeconomic factors exacerbate childhood obesity in China.

This study examines the influences of grandchild care and medical insurance on childhood obesity. Nationally representative longitudinal data-from the China Family Panel Studies 2010-2020-of 26,902 school-age children and adolescents aged 6-16 years and China's new reference standard ("WS/T586-2018") are used to identify a child's obesity status. Using binary mixed-effects logistic regression models and the Blinder-Oaxaca decomposition method, this study explores the roots of obesity inequalities and finds that at least 15% of Chinese children aged 6-16 were obese in the 2010s. The logistic regression analysis results indicate that grandchild care, public medical insurance, and commercial medical insurance are key risk factors of child obesity. However, the influences are heterogeneous in different groups: Grandchild care and public medical insurance increase urban-rural obesity inequalities because of a distribution effect, and grandchild care may also exacerbate children obesity inequalities between left-behind and non-left-behind children owing to the event shock of parental absence. Inequalities in socioeconomic status (SES) factors such as income, education, and region also cause obesity inequalities. These results indicate that child obesity and its inequalities are rooted in multidimensional environmental inequalities, including medical protection policies and its benefit incidence; intergenerational behavior and family SES factors; and urban-rural and left-behind risk shocks. This study provides new evidence for the development of population-based interventions and equitable medical insurance policies to prevent the deterioration of child obesity among Chinese school-age children and adolescents.

The effectiveness of travel restriction measures in alleviating the COVID-19 epidemic: evidence from Shenzhen, China.

With the expansion of the global novel coronavirus disease (COVID-19) pandemic, unprecedented interventions have been widely implemented in many countries, including China. In view of this scenario, this research aims to explore the effectiveness of population mobility restriction in alleviating epidemic transmission during different stages of the outbreak. Taking Shenzhen, a city with a large immigrant population in China, as a case study, the real-time reproduction number of COVID-19 is estimated by statistical methods to represent the dynamic spatiotemporal transmission pattern of COVID-19. Furthermore, migration data between Shenzhen and other provinces are collected to investigate the impact of nationwide population flow on near-real-time dynamic reproductive numbers. The results show that traffic flow control between populated cities has an inhibitory effect on urban transmission, but this effect is not significant in the late stage of the epidemic spread in China. This finding implies that the government should limit international and domestic population movement starting from the very early stage of the outbreak. This work confirms the effectiveness of travel restriction measures in the face of COVID-19 in China and provides new insight for densely populated cities in imposing intervention measures at various stages of the transmission cycle.

Evaluation and Analysis for Chinese Medical Alliance's Governance Structure Modes Based on Preker-Harding Model.

OBJECTIVE: Analyze and evaluate the typical four medical alliance's governance modes in China, and construct a set of medical alliance's governance mode that adapt to the current status of medical resource allocation in China. THEORY AND METHODS: We used interview-based case studies to investigate the four most representative medical alliance modes in China, and conducted in-depth analysis and discussion of key incentives affecting medical alliances under the guidance of the Preker-Harding model framework. RESULTS: The results show that the essence of the relationship between the government as the owner and the medical alliance is the entrustment and adjustment of power and responsibility; the government as a regulator has a normative and universal regulation of the medical alliance; the reform of the medical alliance requires the government to clarify the functional positioning of the medical alliance and determine a reasonable compensation system. CONCLUSION: China should establish the "Positive Triangle" model of medical alliance's governance, this medical security model provides patients with various types of medical services in a horizontal dimension, covering a variety of difficult disease treatments in a vertical dimension.

Health Privacy Information Self-Disclosure in Online Health Community.

The scarcity of medical resources is a fundamental problem worldwide; the development of information technology and the Internet has given birth to online health care, which has alleviated the above problem. The survival and sustainable development of the online health community requires users to continuously disclose their health and privacy. Therefore, it is a great practical significance to find out the factors and mechanisms that promote users' self-disclosure in the online health community. From the perspective of individual and situation interaction, this study constructed influencing factors model of health privacy information self-disclosure. Finally, we collected 264 valid samples from the online health community through online and offline questionnaire surveys and then use the SPSS20.0 and AMOS21.0 to conduct exploratory factor analysis, confirmatory factor analysis, scale reliability and validity analysis, and structural equation model analysis. The main findings are as follows: trust in websites and trust in doctors reduce the privacy concern. The privacy trade-off will not occur when trust is enough to offset the privacy concerns caused by personalized services, reciprocity norms, and other factors. Second, reciprocity norms are inevitably compulsive, which will increase privacy concerns. However, based on voluntariness, reciprocity norms can enhance user trust. Third, service quality caused by personalized services not only enhance the social rewards of users but also eliminate the privacy concern. Fourth, users' health privacy attention and information sensitivity are too high to decrease the influence of user' privacy concerns on personal health privacy information disclosure. The conclusions of this paper will help us to supplement privacy calculus theory and the application scope of the attention-based view. The proposed strategy of this article can be used to stimulate the information contribution behavior of users and improve the medical service capabilities in online health community.