Potential impact of blood cholesterol guidelines on statin treatment in the U.S. population using interrupted time series analysis.

BACKGROUND: The 2013 ACC/AHA Guideline was a paradigm shift in lipid management and identified the four statin-benefit groups. Many have studied the guideline's potential impact, but few have investigated its potential long-term impact on MACE. Furthermore, most studies also ignored the confounding effect from the earlier release of generic atorvastatin in Dec 2011. METHODS: To evaluate the potential (long-term) impact of the 2013 ACC/AHA Guideline release in Nov 2013 in the U.S., we investigated the association of the 2013 ACC/AHA Guideline with the trend changes in 5-Year MACE survival and three other statin-related outcomes (statin use, optimal statin use, and statin adherence) while controlling for generic atorvastatin availability using interrupted time series analysis, called the Chow's test. Specifically, we conducted a retrospective study using U.S. nationwide de-identified claims and electronic health records from Optum Labs Database Warehouse (OLDW) to follow the trends of 5-Year MACE survival and statin-related outcomes among four statin-benefit groups that were identified in the 2013 ACC/AHA Guideline. Then, Chow's test was used to discern trend changes between generic atorvastatin availability and guideline potential impact. RESULTS: 197,021 patients were included (ASCVD: 19,060; High-LDL: 33,907; Diabetes: 138,159; High-ASCVD-Risk: 5,895). After the guideline release, the long-term trend (slope) of 5-Year MACE Survival for the Diabetes group improved significantly (P = 0.002). Optimal statin use for the ASCVD group also showed immediate improvement (intercept) and long-term positive changes (slope) after the release (P < 0.001). Statin uses did not have significant trend changes and statin adherence remained unchanged in all statin-benefit groups. Although no other statistically significant trend changes were found, overall positive trend change or no changes were observed after the 2013 ACC/AHA Guideline release. CONCLUSIONS: The 2013 ACA/AHA Guideline release is associated with trend improvements in the long-term MACE Survival for Diabetes group and optimal statin use for ASCVD group. These significant associations might indicate a potential positive long-term impact of the 2013 ACA/AHA Guideline on better health outcomes for primary prevention groups and an immediate potential impact on statin prescribing behaviors in higher-at-risk groups. However, further investigation is required to confirm the causal effect of the 2013 ACA/AHA Guideline.

Urban energy performance improvement policy selection in China based on policy effect prediction: An analysis from the dimensions of economy, environment and well-being.

The environmental pollution and social well-being issue caused by the huge energy consumption in cities reflect the urgency of improving urban energy performance from multiple dimensions of economy, environment, and well-being. As a result, various countries and cities have promulgated a series of policies. However, the complexity of the policies makes the categories and utilities need to be further clarified, and the diseconomy caused by the lag of policy effect evaluation makes the focus of policy implementation need to be clear in advance. Therefore, based on public choice theory, this research follows the idea of "prior analysis" and takes Chinese cities as the research object. Firstly, the collected energy performance improvement policies of Chinese cities were analyzed and classified by the content analysis method, and the main utilities of all policies and the specific utilities of each category were summarized. Based on the multiple dimensions of urban energy performance research (namely, economy, environment and well-being dimensions), this research summarized the policy utilities that help to improve the urban energy performance of each dimension, and also preset the policy utility values. Secondly, the effect prediction model for urban energy performance improvement policies in each dimension was constructed by Back-propagation (BP) neural network. Thirdly, the energy performance of Chinese cities in 2020 measured by Data Envelopment Analysis method was taken as the benchmark value, and the energy performance of Chinese cities in 2025 measured by the policy effect prediction model was taken as the comparison value. According to the results of performance improvement, the energy performance improvement policies of Chinese cities were selected respectively from the dimensions of economy, environment and well-being. This research shows that: the energy performance improvement policies of Chinese cities mainly include six categories, namely energy conservation and emission reduction policies, energy development policies, ecological environmental policies, fiscal and tax policies, industrial policies and economic and social policies. It is needed to focus on ecological environmental policies, fiscal and tax policies and industrial policies to improve urban energy performance from the economic dimension. For the environmental dimension, the key and priority policies are ecological environmental policies. Compared with the economic dimension, the focus of implementing policies adds economic and social policies in the well-being dimension. In the implementation of policies, the differences of energy performance among cities can be reduced through multi-feature analysis of cities or regions, appropriate adjustment of specific measures and targets, and improvement of digital information management of urban energy performance. This research can effectively help cities clarify which policies require higher implementation intensity and attention before and during policy implementation, thereby maximizing multi-dimensional urban energy performance.

Reducing carbon emissions at the expense of firm physical capital investments and growing financialization? Impacts of carbon trading policy from a regression discontinuity design.

This study examines the effects of China's carbon trading policy on firm emissions and explores its impact mechanisms through financial and physical asset investments. The empirical analysis utilizes a fuzzy regression discontinuity design based on a sample of 427 industrial firms in China between 2014 and 2019. The results indicate that China's carbon trading policy incentivized firms to increase their financial investments while simultaneously discouraging physical capital investments. These shifts in investment patterns helped firms achieve their emission reduction targets. The study reveals that carbon trading policy in China has contributed to the financialization of firms, resulting in the erosion of firm assets and a decline in their overall competitiveness. Based on these findings, some policy recommendations are put forward.

The effects and drivers of green financial reform in promoting environmentally-biased technological progress.

Promoting green financial reform is an important measure to support environmentally-biased technological progress (EBTP) and achieve sustainable economic and social development. Although China launched a green finance reform and innovation pilot zone (GFRIPZ) policy in 2017, little is known about whether and how such a policy affects EBTP. Based on mathematical deduction, this paper studies the mechanism through which green financial reform influences EBTP. The analysis employs panel data of Chinese prefecture-level cities and a generalized synthetic control method to examine the policy effect of the establishment of GFRIPZ in EBTP. It is found that establishing GFRIPZ significantly promotes EBTP, and that the policy effect shows "ahead-of-policy" and dynamically increasing features. Potential mechanisms reside in the pilot policy's easing of financing constraints and upgrading of industrial structure. Further heterogeneity analyses reveal that great disparities exist in the policy effects of different pilot zones, with a steadily increasing policy effect in Zhejiang and Guangdong, a lagging policy effect in Jiangxi and Guizhou, and an inverse U-shaped policy effect in Xinjiang. Policy effects are much stronger in regions with a higher degree of marketization and a higher level of attention to education. Additional tests of economic performance indicate that the pilot policy, interweaved with its driving effect on EBTP, is conducive to promoting an energy-conservation and low-carbon-energy transition. The findings shed light on applying green financial reform to encourage environment-friendly technological research and development.

Assessment of Regional Differences in the Implementation of the Air Pollution Prevention and Control Action Plan in China.

Air pollution is still an important risk factor that endangers the health of Chinese people, leading the government to implement a series of policies to address air pollution. This study takes the Air Pollution Prevention and Control Action Plan (APPCAP) proposed in 2013 as the object and uses the combined data set of China's 2000-2019 economic panel data and PM2.5 remote sensing data to analyse the implementation effect of the policy by the multiperiod difference-in-differences method, considering regional heterogeneity. The results show that the implementation of the APPCAP significantly reduced the PM2.5 concentration in China, and the effect was stronger in the Yangtze River Delta region. Future governance policies should further consider local characteristics and determine pollution control goals and measures according to local conditions.

[Assessment of prevalence of malnutrition among Chinese primary and secondary school students and analysis of policy effect during the period of the Program for the Development of Chinese Children 2011-2020].

OBJECTIVE: To evaluate the change of prevalence of malnutrition among Chinese primary and secondary school students and to analyze the policy effect during the period of the Program for the Development of Chinese Children 2011-2020 (PDCC 2011-2020). METHODS: The data of Chinese students aged 7 to 18 years were extracted from 8 successive cross-sectional surveys of the Chinese National Survey on Students ' Constitution and Health (CNSSCH) from 1985 to 2019. Malnutrition of students was evaluated according to the screening standard for malnutrition of school-age children and adolescents. The changes of prevalence of malnutrition among primary and secondary school students were described by gender, urban and rural areas, age group and province, from 2010 to 2019. The Joinpoint regression model was used to analyze the trajectory of the prevalence of malnutrition among students aged 7 to 18 years from 1985 to 2019, so as to evaluate the policy effect of the PDCC 2011-2020. RESULTS: The prevalence of malnutrition among primary and secondary school students in China decreased from 12.7% in 2010 to 8.5% in 2019. The prevalence of malnutrition among boys and girls, urban and rural students, and students of all age groups showed a continuous downward trend (Ptrend < 0.001) from 2010 to 2019. From 2010 to 2019, 27 of the 31 provinces (autonomous regions and municipalities) saw a significant decrease in the prevalence of malnutrition among primary and secondary school students. Joinpoint regression model showed that the prevalence of malnutrition among Chinese primary and secondary school students continued to decline from 1985 to 2019, but 2010 was the turning point in the downward trend. From 1985 to 2010, the prevalence of malnutrition among primary and secondary school students decreased by an average of 2.4% per year (95%CI: 1.9%-2.8%, P < 0.001), and the downward trend accelerated after 2010, with an average annual decline of 4.3% (95%CI: 2.4%-6.2%, P < 0.001). CONCLUSION: The prevalence of malnutrition among primary and secondary school students in China continued to decline from 2010 to 2019, achieving the goal of controlling the prevalence of malnutrition among primary and secondary school students in the PDCC 2011-2020. The PDCC 2011-2020 may have played an important role in improving the malnutrition among primary and secondary school students. However, the problem of malnutrition among primary and secondary school students still exists, and it is still necessary to adhere to the coverage and financial support of the nutrition improvement plan in areas with high incidence of malnutrition.

Assessing the implementation effect of Shanghai's compulsory municipal solid waste classification policy.

Waste treatment is a problem faced by cities all over the world. In recent years, China, as a developing country, regards the municipal solid waste (MSW) classification as one of the important strategies to deal with the MSW problem. The previous MSW classification policies in China were all only advocacy in nature. It was not until January 2019 that the "Regulations on the Management of MSW in Shanghai" was officially promulgated as China's first compulsory MSW classification policy, marking the beginning of an era of compulsory MSW classification in China. How effective is the implementation of Shanghai's compulsory MSW classification policy 18 months after its implementation and can developing countries continuously and effectively implement compulsory MSW classification policies? These are important issues of concern to the government, academia, and the public. This paper establishes a three-stage DEA model to evaluate the implementation effect of the compulsory MSW classification policies in Shanghai during the period of February 2019 and July 2020. The study found that the average efficiency of the compulsory MSW classification policy in Shanghai reached 0.906 during the study period, indicating that the policy was executed reasonably well. However, there are only 5 months in 18 months that the policy was fully effective (reaching efficiency level 1), suggesting that there is still room for improvement. The main reason for not being able to achieve full effectiveness in some months is attributed to scale efficiency. At the same time, the general public budget revenue and expenditure of environmental variables have positive and negative impacts on the policy implementation effect in Shanghai. The research results can provide experience for China to comprehensively implement the compulsory MSW classification policy in the future and can also provide valuable case study information for cities in other developing countries to implement the compulsory MSW classification policy.

Quantitative evaluation of the joint disease prevention and control policy in China using the difference-in-difference method.

Emergent infectious diseases represent a real threat to global health, but their harmful effects can be reduced by implementing appropriate response policies. According to the panel data of 10 provinces in Northern China from 2009 to 2018, the disease prevention and control policy jointly implemented in the Beijing-Tianjin-Hebei region in 2013 was regarded as a 'quasi-natural experiment'. However, this policy has not yet been sufficiently evaluated. In this paper, we used the difference-in-difference method to quantitatively evaluate the net effects of applying the joint prevention and control policy against regional key notifiable infectious diseases. The results revealed that the joint disease prevention and control policy had a significant limiting effect and a time lag on the incidence rate of key infectious diseases. In conclusion, this policy is beneficial to the effective prevention and control of infectious diseases, which provides supporting evidence to interpret and improve the joint disease prevention and control mechanisms.

Cash support vs. tax incentives: The differential impact of policy interventions on third births in contemporary Hungary.

Following steep falls in birth rates in Central and Eastern European countries during the economic and institutional restructuring of the early 1990s, governments made substantial efforts to stop or at least reduce the fertility decline. In Hungary, parents with three or more children could benefit from specific new policy measures: the flat-rate child-rearing support paid from the youngest child's third to eighth birthdays (signalling recognition of stay-at-home motherhood) and a redesigned and upgraded tax relief system. However, the success of these policy measures, if any, is difficult to detect in aggregate statistics. Analysing data from the Hungarian Generations and Gender Survey, we rely on event history methods to examine the policies' effects on third birth risks, especially among different socio-economic groups. The results indicate that while the child-rearing support increased third birth risks among the least educated, the generous tax relief had a similar effect for parents with tertiary education.

Policy effect of the Clean Air Action on green development in Chinese cities.

The Clean Air Action is considered an important measure to control air pollution. Despite extensive studies on the benefits or the cost of the Clean Air Action, the overall effect of such an action on green development is largely unknown. This paper tries to fill this gap. Based on panel data of 278 Chinese cities, this paper begins with the construction of a comprehensive indicator, namely green production efficiency, to reflect the green development over the period 2011 to 2016, we then implement the quasi-difference-in-differences framework to identify the policy effect of the Clean Air Action on green development. The following findings are obtained: (1) The Clean Air Action has enhanced the green development of Chinese cities, especially in areas with relatively high reduction target and rich resource endowment; (2) The dynamic analysis reveals that the positive effect of the Clean Air Action on green development presents an intensifying trend with time. This paper provides new insights to understand the Clean Air Action, based on these findings, we propose that future policies should focus on the transformation of overall green development and take full account of regional heterogeneity.

Sedimentary record of microplastics in coastal wetland, eastern China.

Microplastic (MP) dynamics can reflect history of plastic production and waste management in nearby areas. However, the stratigraphy of MPs in coastal wetlands and their link to policy and economic pattern changes are currently unclear. Here, MP stratigraphic records in sediment core from coastal wetlands in Yancheng, China, were used to reconstruct plastic pollution history. Neural network models simulated how policy intervention and economic development affected MP accumulation over time. We showed that MP abundance curves with boundaries from 1920 to 2019 had four stages. MP growth slowed or even decreased in the mid-to-late 1980s due to improved waste management and wastewater treatment since the late 1980s. Human activities were the primary factor affecting MP abundance and shape, followed by sediment properties. We predict that the environmental impact of MPs will continue to increase in the next decade. Current plastic policy measures focus on predictable waste emissions, but hidden sources like clothing fibers and tire wear that significantly contribute to MP pollution require further attention.

Effects of seasonal management programs on PM2.5 in Seoul and Beijing using DN-PMF: Collaborative efforts from the Korea-China joint research.

South Korea and China have implemented increasingly stringent mitigation measures to reduce the health risks from PM2.5 exposure, jointly conducting a ground-based air quality observation study in Northeast Asia. Dispersion normalized positive matrix factorization (DN-PMF) was used to identify PM2.5 sources in Seoul and Beijing and assess the effectiveness of the seasonal management programs (SMPs) through a comparative study. Samples were collected during three periods: January-December 2019, September 2020-May 2021, and July 2021-March 2022. In Seoul, ten sources were resolved (Secondary nitrate: 8.67 µg/m3, 34 %, Secondary sulfate: 5.67 µg/m3, 22 %, Motor vehicle: 1.83 µg/m3, 7.2 %, Biomass burning: 2.30 µg/m3, 9.1 %, Residual oil combustion: 1.66 µg/m3, 6.5 %, Industry: 2.15 µg/m3, 8.5 %, Incinerator: 1.39 µg/m3, 5.5 %, Coal combustion: 0.363 µg/m3, 1.4 %, Road dust/soil: 0.941 µg/m3, 3.7 %, Aged sea salt: 0.356 µg/m3, 1.4 %). The SMP significantly decreased PM2.5 mass concentrations and source contributions of motor vehicle, residual oil combustion, industry, coal combustion, and biomass burning sources (p-value < 0.05). For Seoul, the reduction effects of the SMPs were evident even considering the influence of the natural meteorological variations and the responses to COVID-19. In Beijing, nine sources were resolved (Secondary nitrate: 12.6 µg/m3, 28 %, Sulfate: 8.27 µg/m3, 18 %, Motor vehicle: 3.77 µg/m3, 8.4 %, Biomass burning: 2.70 µg/m3, 6.0 %, Incinerator: 4.50 µg/m3, 10 %, Coal combustion: 3.52 µg/m3, 7.8 %, Industry: 5.01 µg/m3, 11 %, Road dust/soil: 2.92 µg/m3, 6.5 %, Aged sea salt: 1.63 µg/m3, 3.6 %). Significant reductions in PM2.5 mass concentrations and source contributions of industry, coal combustion, and incinerator (p-value < 0.05) were observed, attributed to the SMP and additional measures enforced before the 2022 Beijing Winter Olympics. Unlike comparing PM2.5 mass concentration variations using conventional methods, investigation of the source contribution variations of PM2.5 by using DN-PMF can provide a deeper understanding of the effectiveness of the air quality management policies.

Effects of transparent online open procurement on prices, volumes, and costs of medicines: an interrupted time series study in Ningxia, China.

Objectives: To assess the effects of the transparent online open procurement arrangement on the prices, volumes, and costs of medicines in Ningxia, China. Methods: Data were extracted from the Ningxia pharmaceutical procurement platform, covering 16 months of purchase orders (December 2019 to March 2021) prior to the implementation of the transparent online open procurement policy and 20 months of purchase orders after the implementation of the policy (April 2021 to November 2022). Interrupted time series (ITS) analysis was performed to evaluate the effects of the transparent online open procurement policy on the prices, volumes, and total costs of the purchase orders. Results: After implementation of the transparent online open procurement policy, the average price of purchased medicines showed a declining trend by 0.012 Yuan per month, while the total volume of purchase orders declined at a rate by 1.741 million per month measured by the smallest formulation units and the total costs of the purchase orders decreased at a rate by 5.525 million Yuan per month. Conclusion: The transparent online open procurement policy resulted in reduced prices, lowered volumes, and lowered total costs of purchased orders of medicines.

The impact of centralized band purchasing of pharmaceuticals on innovation of Chinese pharmaceutical firms: an empirical study based on double difference models.

In 2018, China began to gradually promote the pilot policy of centralized band purchasing of medicines. Implementing this policy has resulted in a significant decrease in drug prices. However, there needs to be a clear consensus on the impact and mechanism of action on the innovation of pharmaceutical companies. Therefore. Taking the data of Chinese Shanghai and Shenzhen A-share pharmaceutical listed companies from 2016 to 2022 as a sample, this paper empirically investigates the impact of the centralized banded purchasing policy of drugs on the innovation of pharmaceutical enterprises by using a double difference model and further analyzes the mechanism of its action. The results show that implementing the centralized banded purchasing policy can promote pharmaceutical enterprises' innovation input and output, which is robust under the parallel trend and placebo tests. Further exploring the impact mechanism of the centralized band purchasing policy on pharmaceutical enterprises' innovation, it can be found that it promotes innovation inputs through three channels: government subsidies, enterprise profits, and operating income. In addition, the impact of centralized band purchasing on enterprise innovation is heterogeneous in terms of region, enterprise nature, and scale. Therefore, the positive effects of the centralized band purchasing policy on promoting innovation in pharmaceutical enterprises should be fully recognized, and enterprise heterogeneity should be taken into account when implementing the policy. This study provides empirical evidence on the implementation effect of the centralized banded purchasing policy and provides lessons for continuously optimizing the policy to promote the high-quality development of pharmaceutical enterprises.

Effects of air environmental audit on reducing air pollutant emissions: evidence from China.

In order to mitigate air pollution, governments have implemented various active measures for air pollution prevention and control, among which the air environmental audit is an essential supervision initiative of air environmental regulation policy. This study aims to focus on and investigate the role of air environmental audit in national governance systems by collecting panel data on air environmental audits and air pollutant emissions from 261 prefecture-level cities across China between 2004 and 2018. Using difference-in-differences (DID) models, we empirically analyzed the policy effects of air environmental audits on reducing air pollutant emissions. The results indicate that air environmental audits have a significant impact on reducing air pollutant emissions, which is robust under multiple scenarios, including propensity score matching and placebo tests. The effect of air environmental audits varies significantly among different air pollutants, with the most significant and rapid effect observed on PM2.5 concentration, while industrial sulfur dioxide and industrial smoke (dust) emissions exhibit a time lag. Moreover, the promotion effect of air environmental audits on air pollution control displays strong heterogeneity based on local economic levels, initial environmental quality, and government competition. Therefore, it is of great significance to intensify the implementation of air environmental audits for air pollution control and to promote and improve the audit work according to pollutant classification and local conditions, thereby fully leveraging the audit's role and further improving air quality continuously.

Carbon emissions trading scheme and regional total factor carbon productivity: based on temporal-spatial dual perspectives.

The carbon emissions trading scheme (CETS) in China is an important market-based environmental policy mechanism for decreasing carbon emissions. This paper calculates the total factor carbon productivity (TFCP) based on data from 275 cities in China from 2007 to 2020 using the DEA method and investigates the impact of the CETS on regional TFCP using the differences-in-differences (DID) method, all against the backdrop of carbon peaking and carbon neutrality. The research findings reveal that CETS has consistently improved TFCP in pilot cities, and this conclusion has held up following a number of robustness tests. Temporal heterogeneity experiments demonstrate that as implementation time increases, the enhancing effect takes on an inverted "U-shaped" structure with a 7-year effective lifetime. Spatial heterogeneity studies reveal that as one moves away from the pilot cities, the policy effect on surrounding cities' TFCP is inhibited, followed by facilitation. CETS policies can influence regional TFCP through the effects of green innovation and industry upgrading, according to mediation mechanism testing. We present policy recommendations based on the research findings for meeting the "dual" carbon goals and strengthening the carbon trading mechanism.

Impact of China's National Centralized Drug Procurement Policy on pharmaceutical enterprises' financial performance: a quasi-natural experimental study.

Introduction: In China, the interest relationship between pharmaceutical enterprises and medical institutions has harmed the healthy development of pharmaceutical enterprises. In November 2018, the National Centralized Drug Procurement (NCDP) policy was published. The NCDP policy severs the interest relationship and significantly impacts on pharmaceutical enterprises's financial performance. Methods: Using the implementation of China's National Centralized Drug Procurement (NCDP) policy as a quasi-natural experiment, this study evaluated the impact of participation in the NCDP policy on pharmaceutical enterprises' financial performance. We developed a difference-in-difference model to estimate the change in financial performance after NCDP implementation, based on financial data on Chinese listed pharmaceutical enterprises. Results: We found that the bid-winning enterprises' financial performance significantly improved after participating in NCDP. This may be related to lower costs, market share expansion, and increased research and development investment by the bid-winning enterprises. Discussion: To further promote the high-quality development of pharmaceutical enterprises in China, the government should expand the variety of drugs on the NCDP list (NCDP drugs), while improving the drug patent protection system and the policies to support the bid-winning enterprises.

Implementation effect of China's green finance pilot policy based on synthetic control method: a green innovation perspective.

In order to develop green finance and realize the coordinated development of the environment and economy, China established green finance reform and innovation pilot zones in 2017. Green innovation has problems such as low financing utilization rate and lack of market competitiveness. The green finance pilot policies (GFPP) based on government management provide solutions to these problems. It is of great significance to measure and provide feedback on the implementation effect of GFPP in China for policy-making and green development. This article focuses on the influence of the construction of GFPP by using the five pilot zones as the study area and constructs the green innovation level indicator. Based on the synthetic control method, it chooses provinces that do not carry out the pilot policy as a control group. After that, assign weights to the control region to fit a synthetic control group with resembling characteristics to simulate the five pilot provinces without implementing the policy. Then, compare it with its current policy effect and highlight the policy implementation effect on green innovation. The placebo test and robustness test were conducted to prove the reliability of the conclusions. The results show that since the implementation of GFPP, the level of green innovation in the five pilot cities has shown an overall rising trend. Furthermore, we found that the balance of credit and investment in science and technology has a negative moderating effect on the implementation of GFPP, while the per capita GDP has a significant positive moderating effect.

The effect of the two-child policy on cesarean section in China: Identification using difference-in-differences techniques.

BACKGROUND: China has one of the highest rates of cesarean section in the world. One of the possible reasons for such high rates was China's one-child policy. Relaxation of the one-child policy might be associated with a reduction in the rate of cesarean section. OBJECTIVES: To assess the effect of China's universal two-child policy on cesarean section rates using patient-level data from one large municipal-level obstetrics and gynecology hospital in Shanghai, East China. DATA SOURCES: The study used inpatient hospital records data on all infants delivered between January 1, 2013 and May 31, 2018 at the Shanghai First Maternity and Infant Hospital, which is one of the largest obstetrical hospitals in China. STUDY DESIGN: A quantitative study design with difference-in-differences (DID) estimation techniques were used to control for socio-economic and health-related factors in order to identify the impact of the universal two-child policy on cesarean section rates in China. Moreover, DID analysis stratified by maternal migrant status and age were conducted. RESULTS: Analysis of 133,358 deliveries suggests that China's universal two-child policy resulted in a statistically significant reduction in cesarean section rates from 49.5 to 43.3 per 100 deliveries over the study period. CONCLUSION: Our findings suggest that the significant reduction in cesarean section rates may be due to a shift in health risk perceptions resulting from the relaxation of the one-child policy when mothers consider the possibility of having a second child. Health education on the risk of repeat cesarean section in pregnant women should be enhanced.

Positive Factors for Return to Work After Accidents: Health Awareness, Consultation with Doctors, and Personal Characteristics of Workers.

Background: Industrial accidents can determine the overall level and quality of the work environment in industries and companies that contribute to national economic development. Korea has transformed the country from an international aid recipient to a donor country, but it has ranked first among the Organisation for Economic Co-operation and Development member countries in the number of fatal industrial accidents. Little has been known about the policy effects in terms of the workers' insurance for their industrial accidents and rehabilitation. This study raises two research questions about the influence of workers' personal characteristics and vocational rehabilitation services on their return to workplaces. Methods: The study implements weighted logistic regression analysis using propensity score matching. This research utilizes the relevant dataset (3,924 persons) of Korea's industrial accident and insurance. Results: The findings show that the level of workers' awareness of health recovery and their counseling for rehabilitation by physicians had positive effects on their return to work. Environmental factors such as workers' job stability at the time of industrial accidents and the temporal effects of industrial accidents (e.g., the level of disability, their age) had negative impacts on their return to work. Conclusions: These findings have policy implications that the concentration of rehabilitation services for patients who have been mildly affected by industrial accidents would be effective in the short and medium term. The findings also highlight the necessity of ongoing policies about workers' vocational recovery with concrete evidence about policy impacts.