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There is now a growing interest in early-life influences on adult diseases in China. A number of birth cohorts have been established. This systematic review provided a better understanding of the development of mother–baby cohorts in China. Systematic review. We conducted a systematic review for research or profile papers in English/Chinese that reported data from mother–baby cohorts in mainland China, with ≥1y follow-up after birth. We identified 315 papers, corresponding to 31 cohorts from 19 provinces/megacities. All cohorts started in 1999–2017 (21 after 2010) and were set up with broad objectives or specific scientific focus. The baseline sample size varied, from <500 to >300,000 mothers. A majority of cohorts were initiated during pregnancy and followed children to <10y, only six to adolescence and none into adulthood. These cohorts mostly collected samples from mothers and babies, in addition to using interviews/questionnaires to collect information about pregnancy, birth and child health. Most cohorts were recruited from a single province/city. The large western region was understudied. Mother–baby cohorts have developed rapidly in China, but usually with a short follow-up duration. Extending the follow-up of children and developing cross-cohort collaboration will increase the diversity, size and coverage of the sample, allow studying early influences on life-course health and identify targets for early intervention in the Chinese population. [ABSTRACT FROM AUTHOR]

The aim of this paper is to track the whereabouts of basic old-age insurance (BOI) contribution subsidies. Little research has paid attention to the misalignment between the implementation objects of subsidy policies and the actual beneficiaries. In recent years, local governments in China have followed a contribution subsidy policy to help persons with disabilities (PWDs) with lower life expectancies. This study applied an actuarial model to calculate the leakage rate of the BOI contribution subsidy. The primary data are from the life tables of the entire population and PWDs in K province in China in 2015. It was found that, under different booking interest rates, 35.27%–61.26% of the contribution subsidy for PWDs in the individual account will be inherited by their heirs, and under different discount rates, 18.21%–68.74% in the pooling account will be enjoyed by non-disabled participants. The policy of BOI contribution subsidy for PWDs failed to account for the shorter average life expectancy and the lower average income of PWDs and would result in a welfare loss for PWDs. Therefore, it was suggested that it should be replaced by a non-contributory pension policy for PWDs. • Track the whereabouts of basic old-age insurance (BOI) contribution subsidies. • Built an actuarial model to calculate the leakage rate of contribution subsidy. • 35%–61% of the contribution subsidy for PWDs will be inherited by their heirs. • 18%–69% in the pooling account will be enjoyed by non-disabled participants. [ABSTRACT FROM AUTHOR]

Ex post moral hazard, the additional healthcare utilization induced by health insurance, can be decomposed into an efficient portion generated by the income effect and an inefficient portion caused by the substitution effect, which has been discussed theoretically, but few studies have provided evidence of the efficient moral hazard. In 2016, the Chinese government launched the consolidation of urban and rural resident health insurance at the national level. After the consolidation, insurance benefits for nearly 800 million rural residents got improved. This paper uses a nationally-representative sample of 30,972 individuals from the China Health and Retirement Longitudinal Study (2011–2018) and adopts a 2-step empirical approach with the difference-in-differences method and the fuzzy regression discontinuity design to estimate the efficient moral hazard in the consolidation among rural residents. We find that the price shock contained in the consolidation increases inpatient care utilization, and the corresponding price elasticity is between −0.68 and −0.62. Further analysis shows that the efficient moral hazard resulting in welfare gains accounts for 43.33%–66.36% of the additional healthcare utilization. These findings highlight the necessity of evaluating the efficient moral hazard when analyzing the cost-benefit of health insurance reform. • We provide rare evidence of the efficient moral hazard effect in health insurance. • We focus on low-income groups from developing countries. • We use a 2-step empirical approach to estimate the efficient moral hazard effect. • The efficient moral hazard generated by income effect accounts for 43.33%–66.36%. [ABSTRACT FROM AUTHOR]

This study analyzed the relationship between parents' son preference in a person's childhood and their health when they become older, and tested whether childhood educational opportunities, health level, and care resources play mediating roles in this relationship. China has entered a stage of aging population. The health of the elderly determines whether the government can successfully cope with the challenges brought about by the aging of the population. Chinese people are deeply influenced by Confucianism. The concept of "son preference" is related to residents' parenting strategies. Then, if one's parents exhibit a son preference in their childhood, will it affect one's health in old age? Based on the data of China Health and Retirement Longitudinal Study collected in 2014, this paper uses the least square method to analyze the impact of parents' preference in childhood for boys on the health of the elderly, and uses Karlson-Holm-Breen (KHB) to analyze the mediating effects of childhood educational opportunities, health level and care resources. This study found that parents' preference for boys had a positive impact on the health of male children when they became elderly but had a negative impact on the health of female children when they became elderly. Childhood educational opportunities, health level, and care resources mediated this relationship. It is necessary to analyze the impact of parents' preference for sons in one's childhood on the health of elderly, and intervene the adverse factors affecting the health, to improve the health level and quality of life of the elderly. • Parents' preference for boys had a significant impact on older people's health. • The effect relies on the mediating role of childhood education, health, and care resources. • The idea of prioritizing boys over girls be changed, to improve the health level of the elderly. [ABSTRACT FROM AUTHOR]

• Risk perception of COVID-19 negatively correlated to willingness to help. • Interpersonal alienation partially mediated the link between risk perception of COVID-19 and willingness to help. • Expressive suppression moderated the associations between interpersonal alienation and willingness to help. Previous studies have revealed that situational risk factors have a significant influence on the willingness to help. Amidst the COVID-19 pandemic, maybe risk perception of COVID-19 is also correlated to the willingness to help. This study examined the mediating effect of interpersonal alienation and the moderating effect of cognitive reappraisal and expressive suppression in the relationship between risk perception of COVID-19 and willingness to help. Data from a large sample of Chinese college students (N = 2, 163) completed the measures of risk perception of COVID-19, willingness to help, interpersonal alienation, emotion regulation strategies including cognitive reappraisal and expressive suppression. The results indicated that the risk perception of COVID-19 negatively correlated to willingness to help. Interpersonal alienation partially mediated the link between risk perception of COVID-19 and willingness to help. College students' expressive suppression moderated the associations between interpersonal alienation and willingness to help. And who adopted more expressive suppression, the connection between interpersonal alienation and willingness to help was weaker compared to students who reported less expressive suppression. But cognitive reappraisal did not moderate the relationship between risk perception of COVID-19 and interpersonal alienation. Implications of the present paper for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

Informal payment for medical services is a common phenomenon in China. Patients make informal payments, in cash or in kind, to physicians in addition to official charges billed for medical services. This paper assesses the associations between patients' perceptions of the physician as an agent for the patient's interests (physician agency problem) and informal payment behavior. Using data of 24,000 and 6700 rural households respectively from the Health Development of Rural China Program database (collected in 2008) and Ningxia data source (collected in 2015), we find that patients' concern about physician agency problems is significantly associated with informal payments. The data shows that patients are more likely to make informal payments when they show low trust towards their physicians. For example, in the surgical cases, among patients who strongly distrusted the physicians, 17.9% (95% confidence interval [CI]:]: 13.5, 22.3) initiated informal payments, compared to 8.0% (95% CI: 5.1, 10.9) who expressed "strong trust" in their physicians. Poor communication was also significantly associated with an increase in the informal payment rate. For example, in the non-surgical setting, among the patients who rated the physicians' explaining skills as "poor," 5.9% (95% CI: 5.0, 6.9) of them made informal payments, significantly higher than the patients who rated "excellent" (of whom 1.8% made informal payments 95% CI, 0.9, 2.7). In this study, we provide an explanation for this finding: patients may initiate informal payments to physicians in order to mitigate the physician agency problem. It suggests that to mitigate informal payments, improving alignment between doctors' incentives and patients' interests would be essential. • Informal payments were directly related to patients' concerns about physicians' behavior. • Patients were more likely to make informal payments when they showed low trust towards their physicians. • Poor communication between patients and physicians was related to informal payment rate. • Informal payment might be viewed as an effort by the patients to align the physicians. [ABSTRACT FROM AUTHOR]

Techno-stressors stemming from the use of information technology (IT) have become a major source of stress in the modern workplace. While research shows that techno-stressors negatively affect employees' work attitudes and performance, little is known about their effects on employees' non-work lives. This research investigates the impact of techno-stressors on work-life balance and examines job self-efficacy as a buffer of this negative impact via the attenuating effect of emotional exhaustion. We conducted two survey studies. Study 1 collected data through a paper-and-pencil survey from 316 IT workers in a northern China IT company. Study 2 replicated and strengthened Study 1 by collecting longitudinal data through an online survey platform from 646 southern China female workers across diverse occupations. The results showed that techno-stressors negatively affected work-life balance, but job self-efficacy buffered employees from this negative effect by reducing their emotional exhaustion. Our findings extend understanding of techno-stressors' effects on individuals' non-work domains and shed light on how to cope with techno-stressors. • Techno-stressors are becoming major sources of stress in the modern workplace. • Techno-stressors negatively affect work-life balance. • Employees with high job self-efficacy suffer less from techno-stressors. • The buffering role of job self-efficacy works through lowering emotional exhaustion. [ABSTRACT FROM AUTHOR]

There is an increasing interest in using ordinal data collection methods, such as the best-worst scaling (BWS), to develop preference-based tariffs (value sets) for health-related quality of life instruments, yet the evidence on their performance is limited. This paper proposed to use an anchored BWS technique (in which the state of "death" served as an anchoring state) to directly develop a utility weight that lies on a scale anchored at 0 = death and 1 = full health for the Simplified Chinese version of the Short Form 6 Dimension version 2 (SF-6Dv2). An online panel from the general population of Mainland China completed an online survey between 20th July and 19th August, 2019 and 463 respondents were included in the main analysis. The Conditional Logit (CL) model, which assumes a homogeneous preference, as well as a Hierarchical Bayes (HB) model, which accounts for preference heterogeneity, were used to analyze the BWS data. The model performances were evaluated based on monotonicity and model-fit statistics. The majority of respondents indicated that the BWS questions were easy to understand and complete. Initial analyses suggested that the best and worst choices should not be pooled together. Based on model fit statistics of separated estimations and previous literature on health state valuation studies using BWS, the best choices were used for developing the final algorithm. The HB estimates were found to have better model performance than the CL estimates. This study provides an essential insight into using an anchored BWS approach in health state valuation. Furthermore, it demonstrates the advantage of using HB compared to the traditional CL model in producing preference values. • An anchored best-worst scaling technique has been used to develop preference weights directly. • Accounting for individual heterogeneity leads to a better model fit. • Incorporating respondents' views of attribute importance can improve model performance. • A Chinese online-panel-based scoring algorithm for SF-6Dv2 is developed. [ABSTRACT FROM AUTHOR]