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Introduction: Over the last decade, the emergence and spread of personalized medicine (PM) have defined a substantial revolution in healthcare. In principle, healthcare system sustainability is challenged by the investments required for research and development, as well as the adoption of PM techniques in routine clinical care. The "Integrating China in the International Consortium for Personalized Medicine" (IC2PerMed) EU-funded project aims to integrate China into the "International Consortium for Personalized Medicine" (ICPerMed). IC2PerMed aims to align the EU and China's research agendas in this field to enable a swift development of approaches in the EU and China with strong leverage upon EU-Chinese collaborations. Methods: Within this project, we first mapped relevant policies on PM in both the EU and China, and then we involved European and Chinese experts in PM in workshops and Delphi surveys in order to identify relevant priorities for the implementation of PM in sustainable healthcare. Results: As a result of this process, we identified nine overarching priorities, each addressing specific aspects of the sustainability of healthcare systems and PM implementation, with the main goal of supporting policymakers in integrating PM approaches in the EU and China. Discussion/conclusion: The implementation of PM in health systems is appealing in terms of improved accuracy in diagnostics, treatment, and prevention of disease, as well as reduction of the side effects resulting from inefficient use of drugs. Research, development, and implementation of needed techniques require time and resources that can slow the adoption of PM in healthcare systems. The nine priorities we identified address some of the most critical points, trying to lay the foundations for a comprehensive approach. [ABSTRACT FROM AUTHOR]

SUBSTANTIAL evidence documents the benefits of peer support provided by community health workers, lay health advisors, promotores de salud, and others. The papers in this supplement, all supported by the Peers for Progress program of the American Academy of Family Physicians Foundation, contribute to the growing body of literature addressing the efficacy, effectiveness, feasibility, reach, sustainability, and adoption of peer support for diabetes self-management. They and additional papers supported by Peers for Progress contribute to understanding how peer support can be implemented in real world settings. Topics include examination of the peers who provide peer support, reaching the hardly reached, success factors in peer support interventions, proactive approaches, attention to emotions, peer support in behavioral health, dissemination models and their application in China, peer support in the patient-centered medical home, research challenges, and policy implications. [ABSTRACT FROM AUTHOR]

This paper examines the resource mismatch in China's healthcare sector from 2010 to 2019. We use structural efficiency to measure the resource mismatch in the healthcare industry (0.2–0.7). We find that an increase in the proportion of private hospitals decreases the healthcare resource mismatch across provincial regions. This ameliorative effect is evident in non-coastal as well as central provinces. In addition, we also find that an increase in the proportion of private hospitals leads to a greater supply of healthcare resources and the number of healthcare services, which in turn better meets the healthcare needs of local residents and decreases the healthcare resource mismatch between regions in each province. [ABSTRACT FROM AUTHOR]

Objective: Doctor–patient trust, especially patients' trust in doctors, represents patients' compliance with doctors' behavior and may affect patients' choice of medical treatment behavior. This paper aims to delve into the profound impact of doctor–patient trust on the hierarchical diagnosis and treatment system. Additionally, it formulates corresponding policy suggestions for reforming this system from a practical perspective, offering a useful reference for the development of both the theory and practice of China's healthcare protections. Methods: In this paper, the rank‐dependent expected utility theory was used to construct a tripartite evolutionary game model of hierarchical diagnosis and treatment system for observing the interactions and behaviors between superior hospitals, primary hospitals, and patients under different levels of doctor–patient trust. Meanwhile, descriptive statistics and binary logistic regression methods were used in empirical research for revealing the specific mechanism. Results: When the doctor–patient trust is at a high level, it is easier for each participant in the hierarchical diagnosis and treatment system to choose cooperative strategies, thus enabling the system to operate smoothly. Specifically, the medical level of healthcare institutions exerts a significantly positive impact on the level of doctor–patient trust and concurrently, an enhanced level of doctor–patient trust promotes patients' adherence to the hierarchical diagnosis and treatment system when making healthcare choices. Conclusions: Doctor–patient trust is a significant bridge connecting medical institutions and patients. It is an important factor to realize the orderly operation of hierarchical diagnosis and treatment system. To attain the objective of strengthening doctor–patient trust and fostering the smooth functioning of the hierarchical diagnosis and treatment system, it is essential to capitalize on policy mechanism to motivate healthcare service providers to enhance their medical capabilities and gradually guide patients to make healthcare choices in an orderly manner according to the system design. [ABSTRACT FROM AUTHOR]

Investigator-Initiated Trials (IITs) have seen substantial growth in China, particularly in drug and medical device research. IITs are initiated by investigators addressing clinical needs without focus on product registration or marketing, thereby offering flexibility for advancing clinical practices. Despite their potential, IITs in China face challenges, including regulatory ambiguities, funding limitations, quality control issues, and inconsistencies in ethical review processes. This paper examines the current IIT landscape, identifies major obstacles, and proposes solutions, including regulatory reforms, funding increases, ethical review standardization, and international collaboration, to enhance IITs' effectiveness and impact on Chinese clinical research. [ABSTRACT FROM AUTHOR]

With the aging population, the financial burdens associated with chronic diseases continue to escalate. Among various management strategies, family physician contracting stands out as a significant initiative aimed at addressing this challenge, officially introduced in China in 2016. However, current research has given relatively little attention to the economic benefits of family physician contracting in developing countries. This paper evaluates the economic effect of family physician contracting by employing microdata of patients with chronic diseases at the Yuyuantan Community Health Service Center, Haidian District, Beijing, from January 2019 to May 2021. This research contributes to the theoretical discourse in healthcare services by introducing a modified Anderson model. The empirical findings demonstrated that family physician contracting effectively reduced healthcare costs for patients with chronic diseases. Notably, the effect of family physician contracting on healthcare costs was more pronounced among patients with chronic diseases aged less than 65 years. At the same time, it is inferred that expediting the reform of the health insurance payment system, coupled with the promotion of family physician contracting services, would enhance the wellbeing of patients with chronic diseases. This research offers valuable insights into the ongoing and future development of family physician contracting in developing countries. [ABSTRACT FROM AUTHOR]

China's multilevel medical education system generates tremendous physician human capital heterogeneity. This paper attempts to take advantage of the differences level of doctors' human capital to reveal the relationship between healthcare service mismatch and doctors' human capital using the DRGs data of a province in China. This paper found that: first, a higher level of physician human capital (PHC) in hospitals significantly increases the mismatch of medical services; second, there is a complementary effect between doctors' human capital and medical care accessibility, which significantly increases the degree of healthcare service mismatch, and these conclusions still hold after controlling the endogeneity and a series of robustness tests. Third, the mismatch effect is more significant in surgery than that of in internal medicine departments and the mismatch effect is stronger in county hospitals than that of provincial hospitals. Therefore, both patients' great confidence in superior medical services and the heterogeneity of PHC contribute to the mismatch of medical services in China. [ABSTRACT FROM AUTHOR]

The article reports on the call for papers about the state of medical care and health in China, which will be featured in the weekly issue dedicated to health care and research in China that will start in October 2016.

This study examines performance of provincial health‐care system in China, using a dynamic network data envelopment analysis (DEA) approach. We focus on efficiency improvements both within provincial health‐care system and within two separate internal sub‐divisions. The administration division engages in financial management while the medical care division provides medical care services. Then there are two main results. First, the average overall efficiency score of provincial health‐care system is 0.9316 from 2010 to 2017. Second, the productivity progress in administration division is lower than that in medical care division, and the technical advances contribute most of the productivity progress. The research gap and the innovation of this paper lie in three aspects: First, this paper opens the black box of health production function and use the network DEA to analyze Chinese provincial health‐care system and its inner two constructs. Second, this paper discusses the efficiency scores as well as dynamic changes in one model. Finally, this paper tries to reveal the regional heterogeneity of static efficiency as well as the dynamic efficiency changes. [ABSTRACT FROM AUTHOR]

Objective: This paper investigates how the public–private partnership (PPP) functions in the care provision for older people in Guangdong, China, particularly for ageing‐in‐place programs. Methods: Three cities with diversified PPP forms of care provision for older people were chosen as case studies. Focus groups were conducted in these cities for the local authorities and care homes involved in the partnerships. Results: Three forms of PPP, including private sector involvement for the ownership, construction, and operation of the facilities delivering care services, were identified. The public–private co‐constructed and privately run model with greater private sector involvement may lead to higher quality care in one specific program. The publicly constructed and privately run program is widely used in many cities, advancing the expansion of ageing‐in‐place programs in more communities. These PPPs reflect flexible and practical collaboration between the public and private sectors at the local level in the Chinese context. Conclusions: PPP have accelerated the development of a better care system for older people, mainly in terms of more affordable and higher‐quality care options for the public. They are also a feasible solution for the local government due to more cost‐effective and sustainable care provisions than previous publicly provided programs. The specific forms adopted are primarily associated with the scale of home care provision for ageing‐in‐place and the local government's financial capacity. Despite increasing private sector involvement, the public sector retains its crucial role in delivering care services targeting ageing in China. [ABSTRACT FROM AUTHOR]

In the past few years, drones have been adopted as a novel delivery tool towards medical supplies, improving delivery service efficiency due to fast speed and neglection of geographical limitations. However, the flight endurance of a battery‐operated drone is limited for long‐distance medical supplies delivery operations. Recharging stations, as a kind of drone facility, allow multiple stops for drones to supplement the power to overcome the flight‐range limitations. This paper studies drone‐assisted long‐distance medical supplies delivery with recharging stations in rural communities by a mixed integer linear programming model. To illustrate the applicability of this model and explore the key factors influencing delivery efficiency of medical supplies, a case study from China is conducted. The results indicate that enhancements on the speed of a truck or a drone can yield considerable delivery cost reduction. In addition, drone‐recharging technology advances can improve delivery efficiency of medical supplies in rural communities. [ABSTRACT FROM AUTHOR]

As a crucial component of hierarchical diagnosis and treatment systems, medical alliances in China are responsible for promoting the downward allocation of high-quality medical resources. Remote consultation, as an essential means to achieve this goal, is of practical importance in the realization of resource sharing between hospitals within medical alliances in China. The existing research on the construction of remote consultations within medical alliances has achieved fruitful results in both theory and practice. However, the establishment of remote consultation involves many factors, and the current research mainly focuses on the influence of traditional economic profit and loss on the construction of remote consultation. In view of the practical problems existing in the operation of medical and health services in China, such as the need to improve the capacity of primary medical and health services and the poor sinking effect of high-quality medical resources, it is of great importance to systematically study the promotion strategy of the construction of remote consultation within the medical alliance to build a reasonable order of medical treatment. Therefore, by determining the logical path formed by the remote consultation channel and on the basis of traditional profit and loss parameters, this paper fully considers the relevant influence of the resource sinking utility caused by the remote consultation channel. The stability of the evolutionary system is analyzed, and a numerical simulation is used to explore the impact of key parameters on system evolution. The research results indicate that the establishment of a remote consultation system between hospitals at different levels is primarily influenced by factors such as the initial proportion of the establishment strategy chosen by both parties, the establishment cost, the distribution proportion of the government subsidy, the distribution proportion of the economic benefit, and the effectiveness proportion in the utility derived from the downward allocation of resources and reputational damage. The findings suggest that moderate to high levels of reputation loss do not significantly influence the final decision-making process for either party. Government subsidies can have an impact on hospital decision-making in the early stages, and in the long term, the resource sinking utility is more appealing than the economic benefits. To a certain extent, this study enriches the related research on remote consultation and the sinking of high-quality medical resources, provides reliable theoretical and method support for the sinking of high-quality medical resources, promotes the construction of remote consultation in medical alliances in China, and provides a decision-making reference and basis for the government and health administrative departments to formulate relevant policies. [ABSTRACT FROM AUTHOR]

Background: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. Methods: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. Results: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. Conclusions: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. What does this paper contribute to the wider global clinical community?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Healthy China strategy is an important development objective of the 14th Five-Year Plan and Vision 2035 in China, while health service use in rural China has been a weak link in this strategy. OBJECTIVE: Nowadays, people's health service use will be influenced by digital technology due to the arrival of the Digital Age, and that is the reason why our interest is to discuss the effect of digital life on health service use among rural residents. METHODS: We use the data from the China Family Panel Studies (CFPS) 2020 to examine the effect of digital life on health service use among rural residents, and we use Instrumental Variables method to control the endogenous problem and use KHB model to discuss the mechanism of this effect. RESULTS: It was found that digital life has increased the health service use among rural residents significantly, and this result has been verified by robust test and Instrumental Variables method. Besides, digital life can increase health service use through the information channel effect and the health literacy effect indirectly. Moreover, digital life has a more significant impact on the residents with low social capital, low physical capital and low social trust, which represents the inclusivity of digital life. CONCLUSION: The results of our paper will be helpful to examine the effect of the digital policy on promoting the health service use in rural China, and our findings will provide evidence of how to use digital life to enhance health service use among rural residents. Based on this, the government should take measures to eliminate the digital divide between urban and rural areas by promoting the level of digital life among rural residents, paying more attention to the digital literacy development among them, and forging ahead toward the great goal of the Healthy China under the Digital Age. [ABSTRACT FROM AUTHOR]

In order to better understand the current situation of Chinese public sports, this paper studies Chinese public sports. According to SATI3.2 statistics, 71 newsletters have published a total of 903 articles, of which 40 newsletters have one article, 19.7% of the newsletters have 2-9 books, and 17 magazines have more than 10 issues. The results show that by measuring data, we can better understand the current state of China's public services. This paper uses the method of bibliometric analysis to sort out and summarize the policies, characteristics, hotspots, and trends of China's public service field under the social network environment. The survey shows that the education sector has paid less for public entertainment in recent years. The research direction is system, equity, government procurement, interest, capital allocation, strategy, and supply chain. This paper highlights that the shortcomings of public sports research in our country: "public sports services" and "public sports services" are not integrated; there are many macrostudies on public service sports but few microstudies; there is no track and field research for special public groups. This paper puts forward research guidance for China's public sports services and, at the same time, strengthens the research on public services of different products of rural sports development, strengthens the research on the intelligence of sports public services, and strengthens the research on the role of public sports. Governments at all levels support and strengthen research on public sports service standards, strengthen research on public sports performance measurement measures, and strengthen public sports balance research. [ABSTRACT FROM AUTHOR]

The aim of the study is to assess the feasibility of Drugs Rational Usage Guideline System (DRUGS)-supported clinical pathway (CP) for breast carcinoma, cataract, inguinal hernia and 2-diabetes mellitus whether the application of such a system could improve work efficiency, medical safety, and decrease hospital cost. Four kinds of diseases which included 1773 cases (where 901 cases using paper-based clinical pathways and 872 cases using DRUGS-supported clinical pathways) were selected and their demographic and clinical data were collected. The evaluation criteria were length of stay, preoperative length of stay, hospital cost, antibiotics prescribed during hospitalization, unscheduled surgery, complications and prognosis. The median total LOS was 1 to 3 days shorter in the DRUGS-supported CP group as compared to the Paper-based CP group for all types ( p < 0.05). Totel hospital cost decreased significantly in the DRUGS-supported CP group than that in Paper-based CP group. About antibiotics prescribed during hospitalization, there were no statistically differences in the time of initial dose of antibiotic and the duration of administration except the choice of antibiotic categories. The proportion of DRUGS-supported clinical pathway conditions where a broad-spectrum antibiotic was prescribed decreased from 63.6 to 34.5 % ( p < 0.01) in the Paper-based group. While after the intervention, the differences were statistically not significant in unscheduled surgery, complications and prognosis. In this study, DRUGS-supported clinical pathway for breast carcinoma, cataract, inguinal hernia, 2-diabetes mellitus was smoothly shifted from a paper-based to an electronic system, and confer benefits at the hospital level. [ABSTRACT FROM AUTHOR]

Long waiting times and crowded services are the current medical situation in China. Especially in hierarchic healthcare systems, as high-quality medical resources are mainly concentrated in comprehensive hospitals, patients are too concentrated in these hospitals, which leads to overcrowding. This paper constructs a game-theoretical queueing model to analyze the strategic queueing behavior of patients. In such hospitals, patients are divided into first-visit and referred patients, and the hospitals provide patients with two service phases of "diagnosis" and "treatment". We first obtain the expected sojourn time. By defining the patience level of patients, the queueing behavior of patients in equilibrium is studied. The results suggest that as long as the patients with low patience levels join the queue, the patients with high patience levels also join the queue. As more patients arrive at the hospitals, the queueing behavior of patients with high patience levels may have a negative effect on that of patients with low patience levels. The numerical results also show that the equilibrium behavior deviates from a socially optimal solution; therefore, to reach maximal social welfare, the social planner should adopt some regulatory policies to control the arrival rates of patients. [ABSTRACT FROM AUTHOR]

Background: The accessibility and fairness of the floating population's access to basic public health services have an important impact on improving the health level of the whole population. Existing studies have shown that medical insurance and social integration have an impact on basic public health services, but there are few studies on the specific influence path between the three. Therefore, the research purpose of this paper is to explore the effects of medical insurance for urban and rural residents and basic medical insurance for urban employees on the utilization of basic public health services, and to analyze the mediating effect of social integration. Methods: The data in this paper are derived from the 2017 China Mobile Population Dynamic Monitoring Survey data, which collects information on 31 provinces (regions, cities) and Xinjiang Production and Construction Corps mobile population 169,989 people, all of whom come from China's relatively concentrated mobile population inflow areas (NHC FPSCo. 2021. Floating Population Service Center of NHC). After deleting part of the missing data and replacing the mean value, 154,586 people were finally included in the analysis. The proportion is 90.9%. Based on the data of China's floating population dynamic survey in 2017,we used Logistic regression method to analyze the effects of basic medical insurance for urban and rural residents, basic medical insurance for urban employees and social integration on the utilization of basic public health services. Then we used the Bootstrap method of structural equation model to analyze the mediating effect of social integration. Results: Medical insurance for urban and rural residents (β = 0.236;95%CI:1.195 ~ 1.342) has positive impact on health education, it (β = 0,190;95%CI:1.150 ~ 1.272) also has positive impact on the establishment of residents' health records. Social integration (including political participation (β = 0.312;95%CI:1.324 ~ 1.410),activity participation (β = 0.724;95%CI:2.009 ~ 2.119), identity (β = 0.421; 95%CI:1.387 ~ 1.675))has positive impact on health education, it ((β = 0.312;95%CI:1.324 ~ 1.410), (β = 0.404;95%CI:1.463 ~ 1.534), (β = 0.282;95%CI:1.191 ~ 1.477)) also has positive impact on the establishment of residents' health records. In addition, BMIUE (β = 0.169;95%CI:1.150 ~ 1.219) has an impact on the establishment of residents' health records. The direct effect of medical insurance on the utilization of public health services was 0.092 (95%CI: 0.093 ~ 0.103), social integration was a partial mediator, the mediating effect was 0.127 (95%CI: 0.108 ~ 0.127), and the mediating effect size was 57.73%. Conclusions: Medical insurance can directly promote the floating population to use basic public health services, and can indirectly promote the improvement of public health service utilization level through social integration. [ABSTRACT FROM AUTHOR]

Background: Hospital chief financial officer (CFO) plays a vital role in supporting the effective management of organization. Understanding their competencies is essential to improve hospital development and health care services in China. This paper aims to explore competencies necessary for hospital CFOs to fulfil their management responsibilities and develop a competency framework for hospital CFOs in China. Methods: A qualitative study was applied by conducting in-depth interviews with 151 participants from 15 Chinese provinces, comprising 89 individuals from 67 hospitals, and 62 individuals from 39 medical universities. Interviews were anonymised, recorded and transcribed. Qualitative thematic analysis was applied through a multi-stage review process and modified via the Delphi process using a national panel of 36 experts. Results: Using content analysis, we identified 17 competencies organized into three themes (personal attitudes, leadership competencies and managerial competencies) to conduct a competency framework for hospital CFO to fulfil their management practices. Those competencies emphasized the integration of different competencies required by the hospital CFO. Conclusions: This paper identified the detailed expertise, abilities and personal traits required by hospital CFOs in China, expanding the insights and perspectives of hospital CFOs currently working in China to literature. The proposed framework will help hospitals establish selection criteria, coaching tools, and development plans for CFOs. [ABSTRACT FROM AUTHOR]

People's health is a necessary condition for the country's prosperity. Under the background of the COVID-19 pandemic and frequent natural disasters, exploring the spatial and temporal distribution, regional differences and convergence of China's provincial public health level is of great significance to promoting the coordinated development of China's regional public health and achieving the strategic goal of a "healthy China". Based on China's provincial panel data from 2009 to 2020, this paper constructs an evaluation index system for China's public health level from five dimensions: the popularization of a healthy life, optimization of health services, improvement of health insurance, construction of a healthy environment, and development of a health industry. In this paper, the entropy method, Dagum Gini coefficient, Kernel density function and spatial econometric model are used to analyze the spatiotemporal distribution, regional differences, dynamic evolution and convergence of China's public health level since the new medical reform. The study found that, first, China's public health level is generally low, structural contradictions are prominent and the construction of a healthy environment has become a shortcoming hindering the improvement of China's public health level since the new medical reform. The public health level of the four major regions showed a spatial distribution pattern of "high in the eastern, low in the northeastern, central and western" areas. Second, the overall Gini coefficient of China's public health level showed a "V-shaped" trend of first decreasing and then rising, but the overall decrease was greater than the increase, among which the regional difference was the main source of regional differences in China's public health level, but its contribution rate showed a downward trend. Third, except for the basic maintenance of a healthy environment, the Kernel density curves of China's public health level and its sub-dimensions have shifted to the right to a certain extent, and there is no polarization phenomenon. Finally, the level of public health in China has a significant spatial correlation. Except for the northeast region, the growth rate of low-level public health provinces in China and the other three major regions is higher than that of high-level public health provinces, showing a certain convergence trend. In addition, the impact of economic development, financial pressure, and urbanization on the convergence of public health levels in the four major regions is significantly heterogeneous. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of an online multidisciplinary weight loss management programme. Methods: Between July 2016 and July 2017 this randomized controlled trial recruited patients in Nanjing, China who were living with type 2 diabetes mellitus and who were obese or overweight and randomized them to online versus conventional groups. All participants were managed by a multidisciplinary team. The experimental group was managed using the Why Wait WeChat Platform for Weight Reduction Management. Results: There were 55 and 52 participants in the online and conventional groups, respectively. The decreases in fasting blood glucose (−4.26 vs. −2.99 mmol/L), 2‐h postprandial blood glucose (−4.48 vs. −2.68 mmol/L) and glycated haemoglobin (−22.11 vs. −6.21 mmol/mol) were more pronounced in the online compared to conventional group (all P < 0.05). After the intervention, self‐management ability parameters, including diet control, foot care and total score, were improved in the online group compared with the conventional group, as well as all indexes of quality of life (all P < 0.05). Conclusion: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus. Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. Summary statement: What is already known about this topic?: Multidisciplinary approaches have been introduced into weight loss management models for patients with type 2 diabetes mellitus and obese or overweight in outpatient clinics of third‐level hospitals, but their effects have not been clearly described. What this paper adds?: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus.Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. The implications of this paper: This is the first trial of an online programme in the management of type 2 diabetes mellitus in China.Trial findings might have international applicability in the management of type 2 diabetes mellitus and could lead to improvement of prognosis. [ABSTRACT FROM AUTHOR]

China has been contributing to new approaches to global governance. The Health Silk Road (HSR), a significant component of the Belt and Road Initiative (BRI), was proposed by China in 2016. This paper claims that HSR is a new institution introduced alongside the existing WHO-led multilateral health system, and its relationship with the existing system can be described as layering. Having explored the new development of HSR during COVID-19, this paper further argues that while HSR has its unique strength in making contributions to global health governance and economic recovery, it faces a prominent issue of securitisation in the context of China-U.S. strategic competition, suspicion of the quality of medical products and sectoral fragmentation. [ABSTRACT FROM AUTHOR]

Lycium barharum L. is a food and drug homologous substance, rich in polysaccharides, betaine, anthocyanins, carotenoids and other active ingredients, and has good application value in health care functions such as improving immunity, relieving visual fatigue, and antioxidant, so it has been favored by researchers and consumers at home and abroad. At present, the application frequency of Lycium barharum L. in health food in China is relatively high, but there is a lack of systematic sorting and analysis. Based on this, this paper analyzes the application status, compliance and use basis, and influencing factors of the main functional components of Lycium barharum L. in China's health food, and discusses the main health functions and mechanisms of Lycium barharum L. in detail, in order to provide a certain reference and basis for the research, development and application of Lycium barharum L. in China's health food. [ABSTRACT FROM AUTHOR]

Based on the panel data of 31 provinces (municipalities and autonomous regions) in China from 2012 to 2019, this paper constructs the evaluation index system of basic medical and health services in China from seven dimensions: medical and health facilities, health expenditure, medical services, traditional Chinese medicine hospital services, maternal and child health care, people's health and medical security, disease control and public health. The entropy method was used to measure the level of basic medical and health services in China, and its spatial differences and convergence characteristics were further investigated. In this study, we employ the entropy weight method, σ convergence, and β convergence as our primary methodologies. The entropy weight method is used to evaluate the variability of each indicator, determine the weights of indicators, and quantify the information content of the data. σ convergence illustrates the process by which the variance of a sample decreases over time. β convergence refers to the gradual approach of variables within an economic system towards their long-term equilibrium level over time. The results show that: (1) The scores of basic medical and health services in China's four major regions (including Northeast, East, Central and West) remain in a relatively stable state, with small fluctuations and great room for improvement; (2) There are significant regional differences in the level of basic medical and health services in China, and the intra-regional differences are much greater than the inter-regional differences; (3) There is no significant σ convergence observed in China and its four major regions; however, there is a notable presence of β convergence. [ABSTRACT FROM AUTHOR]

Background: In the past 40 years, China has experienced tremendous economic development, but the current situation of hematologists has rarely been reported. A landscape survey of human resources is essential for healthcare development and policy formulation in the future. Methods: The Chinese Society of Hematology initiated a survey of Chinese hematologists in mainland China for evaluating demographic and practice characteristics. Respondents were anonymous, and there were no limitations regarding their age, sex, etc. Results: Totally 2032 hematologists responded, with a median age bracket of 36–45 years. Respondents were well engaged into subspecialties, and 28.1% acquired doctorates of philosophy. Hematopoietic cell transplantation (HCT) centers have been established all over China. Higher-GDP regions reported more advantages, including bigger scale of transplant centers (P < 0.001), younger age structure (P = 0.039), better education qualifications (P = 0.001) and less turnover intentions (P = 0.004), despite of increased risk of medical disputes (P = 0.028). Although females accounted for 65.5% of hematologists, males were older (P < 0.001), and had more senior professional titles (P < 0.001), academic positions (P < 0.001), opportunities for continuing education (P < 0.001), and paper publishing in the recent two years (P = 0.001). For turnover intention, the higher GDP regions led to an independently reduced risk (HR = 0.673, 95%CI [0.482–0.940], P = 0.020), whereas medical disputes resulted in an increased the risk (HR = 2.037, 95%CI [1.513–2.743], P < 0.001). Considering the impact of the COVID-19 pandemic, majority of respondents believed that the decline in patient visits and delay in treatment was within 30%. 67.9% of respondents reported a decrease of the use of bone marrow as grafts but 18.8% reported an increase of cord blood units. 35.0% of the respondents switched their daily work to support the anti-epidemic medical activities. Conclusions: We concluded the discipline of hematology in China has flourished in recent years with a young workforce, while regional economic and gender disparities warrant further continuous optimization. Joint efforts against the impact of COVID-19 are needed in the post-pandemic era. [ABSTRACT FROM AUTHOR]

Background: Spontaneous reporting of adverse drug reactions (ADRs) is essential for the post-marketing safety evaluation of drugs. Therefore, good monitoring of ADRs is vital for strengthening drug supervision, management, and guiding rational drug use. Chinese medical institutions are the primary source of ADR case reports, but the proportion of the reports in grade IIIA hospitals is still low due to serious under-reporting. The 3rd Affiliated Hospital of Chengdu Medical College, Chengdu Pidu District People's Hospital, also has such a problem. Objective: To improve the quantity and quality of ADR reports and enhance the level of pharmacovigilance in hospitals, the Third Affiliated Hospital of Chengdu Medical College, People's Hospital of Chengdu Pidu District experienced 10 years to gradually establish a management model to improve the medical staff's reporting rate of spontaneous reporting of ADRs. The management model is led by clinical pharmacists and combines the PDCA with Teach-back methods. The purpose of this paper is to introduce the management model and discuss its advantages and shortcomings of this model. Methods: This study was conducted at the Third Affiliated Hospital of Chengdu Medical College—Chengdu Pidu District People's Hospital. From 2016, the daily management of reporting, auditing, and data improvement of adverse drug reactions in the hospital was carried out by clinical pharmacists, who used the PDCA method combined with the Teach-back method to continuously improve the reporting program of ADRs in the hospital during 2016–2021. Then, the proportion of spontaneous reports of total, new, and serious ADRs was compared before and after the intervention. Also, we performed a time series analysis using an autoregressive moving average model to assess changes in the total number of spontaneous ADR reports before the intervention (2013–2015), the first intervention (2016–2018), and the second intervention (2019–2021). Results: After the combined PDCA and Teach-back method intervention, the median number of reported ADRs per year increased from 50 (range 37–55) in the pre-intervention period to 88 (range 83–162) in the first intervention period and to 374 in the second (range 312–566). Breakpoint regression analysis of the spontaneous reporting rate of ADRs showed that the instantaneous increase after the first intervention was not statistically significant (P = 0.526). However, the reporting rate of ADRs increased at a month-by-month growth rate during the second intervention compared to the first intervention. Its spontaneous reporting rate improved 1.034 times (P = 0.002). After the second intervention, the spontaneous reporting rate of ADRs transiently increased 6.111-fold (P < 0.001), and the month-to-month growth rate increased 1.024-fold (P < 0.001) again. Conclusion: The management model that combines the PDCA and the Teach-back method significantly improves the reporting rate of adverse drug reactions. [ABSTRACT FROM AUTHOR]

China is in a period of rapid population aging. The total population of the elderly aged 60 and above in mainland China was 264 million in 2020, and is the country with the largest elderly population in the world, which is home to 1/5 of the world's older people. The urgency of actively coping with the aging population has never been greater, and China has raised it to the height of national strategy. To this end, China has issued several plans and projects on aging work. Many of them include multiple overlapping components. The management of physical illness and mental illness in the elderly is over-differentiated and segmented. However, it is common for older adults with complex health problems. The body and mind are inherently integrated and interact with each other, and should not be separated. There is an urgent need for integrated healthcare services for the physical and mental health of the elderly population. The national basic public health services play an important role in early detection and awareness of health problems for the elderly in community health services. This paper introduces the elderly health management services, one of the national basic public health projects, and the psychological care project for the elderly in Shenzhen, Guangdong Province, China. Taking Long-gang District's exploration of the joint management of physical and mental health of the elderly as an example, this review discusses the difficulties of the elderly health work, and the feasibility of integrating the elderly mental health and physical health in medical care. We outlook to build an integrated platform for physical and mental health of the elderly in China. Focus on the needs of older population, strengthen community health services, build a integrative team, fully publicize and improve health literacy of the elderly, link up and down and work together, improve coordination between providers of medical care and social services. It is of great significance to construct a strong public health system for the elderly and promote the realization of the grand goal of Healthy China. [ABSTRACT FROM AUTHOR]

With the continuous prominence of medical problems, the construction of a smart medical system has received more and more attention. With coronavirus disease 2019 in a state of regular prevention and control, the epidemic prevention and control in China had produced favorable effects. Therefore, a comprehensive evaluation of the emergency governance mechanism in China was crucial to epidemic prevention and control worldwide. This paper empirically analyzed the effects of epidemic prevention and control based on the dual perspective of epidemic governance and capital market, taking the daily outbreak data at the provincial level in China as the sample. The findings were as follows: (1) The accumulation of epidemic medical treatment experience in each province and city produced a positive emergency effect on preventing and controlling the dissemination of epidemic. The effective medical security mechanism was one of the most important mechanisms for the significant emergency effect, with the effective material security as a critical supplement. (2) Companies and corporations with stronger capabilities for emergency medical treatment received more positive responses from the capital market comparatively. Aiming at diversifying directions and measurements for the improvement of emergency governance, this paper provided theoretical bases for improving the emergency governance system against major public health emergencies by using the Chinese characteristics. [ABSTRACT FROM AUTHOR]

Background: Knowledge translation (KT) theories, frameworks, and models (TFMs) can help guide and explain KT processes, and facilitate the evaluation of implementation outcomes. They play a critical role in conducting KT research and practice. Currently, little is known about the usage of TFMs in KT in Chinese healthcare settings. The aim of this scoping review is to identify which TFMs had been used for KT in healthcare settings in China, and how these TFMs were used. Methods: The protocol for this scoping review is in accordance with the Arksey and O'Malley framework and further enhanced by the recommendations suggested by Levac et al. We will search 8 databases (4 Chinese and 4 English) to identify relevant studies. Four reviewers (2 for Chinese, 2 for English) will independently screen studies based on the eligibility criteria. The basic characteristic of studies and the TFMs utilization (i.e., what, why, and how) will be extracted. Methodological quality and reporting quality will be assessed using the Mixed Method Appraisal Tool (MMAT) and the Standards for Reporting Implementation Studies (StaRI) (or Standards for Quality Improvement Reporting Excellence, SQUIRE 2.0 for quality improvement studies), respectively. All the retrieved TFMs will be categorized into Nilsen's classifications of TFMs for KT research. We will employ the qualitative content analysis approach to summarize how these TFMs have been used, and the rationale. A consultation will be conducted through a 1-h interactive virtual meeting with an expert panel of knowledge users. Discussion: By conducting this scoping review, we expect to gain a comprehensive and in-depth understanding of why and how TFMs have been used in KT research and practice in China, and to identify gaps and provide recommendations for more efficient and meaningful use of TFMs in the future. Systematic review registration: This review has been registered with the Open Science Framework (10.17605/OSF.IO/8NXAM). [ABSTRACT FROM AUTHOR]

Purpose: Medical insurance is a disease risk-sharing mechanism that can improve residents' financial access to medical treatment and thus increase their utilization of health services. This paper aims to identify the impact of different kinds of medical insurances on the use of healthcare for Chinese mid-aged and older urban residents from four aspects: outpatient behaviour, outpatient costs, inpatient behaviour and inpatient costs. Materials and Methods: The data used in this study were from 2015 China Health and Retirement Longitudinal Study (CHARLS) conducted by Peking University. Binary logit model and multiple linear regression model were used to analyse the impact of health insurance on the use of healthcare, and the PSM method was used to test the robustness of the results. Results: Participating in either BMIUSE or BMISURR can significantly improve all kinds of healthcare utilization for mid-aged and older urban groups. However, there are huge differences on the healthcare utilization between BMISUE and BMISURR. Specifically, the probability of using inpatient care and inpatient costs of urban residents enrolled in the BMISUE are 4.2% and 45% higher, respectively, than those covered by the BMISURR, but there are no differences in outpatient care utilization and outpatient costs between these two health insurance programs. Conclusion: This paper suggests that the large gaps between BMISUE and BMISURR only reflect on inpatient care and inpatient costs, there is no difference in outpatient services between these two health insurance programs. "Excessive demand", "induced demand" and other moral hazard phenomena in BMISUE should be avoided when receiving hospitalization services. [ABSTRACT FROM AUTHOR]

Background: Health service managers are integral to supporting the effective and efficient delivery of services. Understanding their competencies is essential to support reform and improvement of healthcare provision in China. This paper examines the characteristics and educational background of senior managers working in the community health and hospital sectors in China. We also examine their levels of commitment to continued professional development and continuous education.Methods: A self-administered paper-based questionnaire was administered to 477 level I, II and III managers in community health services and public hospitals in China. The response rate was over 80%.Results: Findings demonstrate significant differences in terms of educational background and commitment to ongoing professional development between the managers in China across levels of management, and between the community and hospital sectors. Hospital managers tend to be older; hospital managers at higher management levels are predominantly male but predominantly female in the community health services. A greater proportion of hospital managers have postgraduate qualifications. In addition, the participants identified specific management tasks that they considered important.Conclusions: This is the first large scale study examining the educational background and commitment to professional development of senior health service managers in China. This study determined that there are differences between the demographics of managers in China across levels of management, but more importantly between the CHC and the hospital sectors. The identification of important managerial tasks will facilitate the development of appropriate education and training for Chinese healthcare managers. All sectors and levels reported the need for informal education focussed on the core roles of developing organisation image and public relations, improving quality and safety of service provision and provision of leadership. Further research to explore the underlying reasons for the above differences is needed to design appropriate professional development for China's health services managers. In addition, the importance of managerial tasks across sectors and management levels requires further investigation. [ABSTRACT FROM AUTHOR]

This paper examines caregiving for sick older family members in the context of socio‐economic transformations in rural China, combining empirical investigation with normative inquiry. The empirical part of this paper is based on a case study, taken from fieldwork in a rural Chinese hospital, of a son who took care of his hospitalized mother. This empirical study highlighted family members' weiqu (sense of unfairness)—a mental status from experiencing mistreatment and oppression in family care, yet with constrained power to explicitly protest or make care‐related choices. Underpinning people's weiqu and constrained choice, as informed by the conception of structural injustice, is the impact of unjust social structures, organized by unfavourable norms, discriminatory social policies and institutions targeting rural populations. By restraining individual choices and capacities in supporting health care for aging populations, these unjust structures create additional difficulties for and discriminations against rural families and their older members. Some policy recommendations are proposed to mitigate structural injustice so as to empower families and promote care for older people in rural settings. [ABSTRACT FROM AUTHOR]

PAPER SUBMISSION INSTRUCTIONS: Submissions to the special issue will be handled by email. Please include a separate title page file with the title, names of the authors, their affiliations, and contact author's email, and be sure not to reveal author information in the manuscript file. B I The Chinese Economy i b is a bimonthly publication that offers an objective and analytical account of economic issues concerning China. [Extracted from the article]

Background: The purpose of this paper is to explore a change strategy for lean success in hospitals based on a comprehensive review of the Chinese literature.Methods: The methodology is a systematic review of the Chinese literature which identified 212 case study papers about lean implementation. We did a thematic content analysis of the 212 papers.Results: Lean applications in Chinese hospitals show significant increases and are mainly used in the fields of outpatient services, operating rooms, pharmacy and logistics. Most hospitals applied lean as a single project but some were beginning to use lean as a systemic path for improvement with an emphasis on lean and strategy. The main goals were to increase the operating efficiency and reduce operating costs. Patients were not central to lean applications. Chinese hospitals appear to lack a full understanding of lean. Four factors appear to be critical for lean success - organizational leadership, adequate technology, stakeholder involvement and individual and organizational benefits. The relationship of these factors changes over time.Conclusions: This is the first paper to provide a comprehensive view of lean application in Chinese hospitals. The findings presented in this paper provide a systemic evidence to the application of lean in healthcare. [ABSTRACT FROM AUTHOR]

With the gradual intensification of aging in China, the issue of elderly care has become the primary issue that needs to be urgently solved in society. The construction of a reasonable and scientific integrated medical and care service system can not only efficiently allocate medical resources and services, but also better meet the needs of the elderly. Due to the involvement of multiple disciplines such as architecture, sociology, psychology, and behavioral science in the construction of the system, as well as the restriction of various objective factors such as medical capacity, spatial scale, and operating costs, the government and elderly care institutions have always been unable to find the best solution for how to scientifically and reasonably construct an integrated medical and care service system. This paper is based on Anshan City, Liaoning Province, which has prominent aging issues and distinct characteristics of the elderly population. Through extensive field research in elderly care institutions, and face-to-face communication with personnel from relevant government departments such as the Municipal Commission on Aging, the Civil Affairs Bureau, the Health Commission, the Medical Insurance Bureau, and the Human Resources and Social Security Bureau, it truly understands the problems that arise in the construction of the urban integrated medical and care service system. From three aspects: urban situation, institutional situation and the needs of the elderly, it is proposed to establish a clear departmental linkage mechanism with clear rights and responsibilities, a policy guarantee mechanism tailored to local conditions, a multi-measure operation mechanism, a technology first intelligent response mechanism, a warm and efficient service mechanism for the people, an overall layout mechanism, an evaluation and supervision mechanism for full process control, and a talent supply mechanism of external introduction and internal training. It aims to provide reference for the construction of an integrated medical and care service system in similar cities. [ABSTRACT FROM AUTHOR]

Geographic accessibility plays a key role in health care inequality but remains insufficiently investigated in China, primarily due to the lack of accurate, broad-coverage data on supply and demand. In this paper, we employ an innovative approach to local supply-and-demand conditions to (1) reveal the status quo of the distribution of health care provision and (2) examine whether individual households from communities with different housing prices can acquire equal and adequate quality health care services within and across 361 cities in China. Our findings support previous conclusions that quality hospitals are concentrated in cities with high administrative rankings and developmental levels. However, after accounting for the population size an "accessible" hospital serves, we discern "pro-poor" inequality in accessibility to care (denoted as GAPSD) and that GAPSD decreases along with increases in administrative rankings of cities and in community ratings. This paper is significant for both research and policy-making. Our approach successfully reveals an "unexpected" pattern of health care inequality that has not been reported before, and our findings provide a nationwide, detailed benchmark that facilitates the assessment of health and urban policies, as well as associated policy-making. [ABSTRACT FROM AUTHOR]

This paper develops a DEA-Tobit regression model to explore the efficiency of healthcare system of coastline provinces (or provincial cities) in China using 11 provincial data. According to the external explanatory variables obtained through the constrained dependent Tobit model analysis, this paper recommends the future reform of China's healthcare system strengthen the rational distribution of resources to improve the scale and structure of the healthcare system. [ABSTRACT FROM AUTHOR]

Objectives: With the rapid development and spread of information technology, mobile healthcare (M-healthcare) is emerging as a feasible option for improved monitoring and treatment of patients with chronic diseases such as diabetes, particularly for those with limited access to medical institutions. Our study group has developed and evaluated an M-healthcare system that provides remote guidance for diabetic patients. This paper introduces the diabetic M-healthcare system and describes progress in implementation for remote and mobile healthcare in China. We provide evidence that this system improves diabetic patient management and can contribute to the establishment of a new model for patient-centered mobile healthcare. Target audience: The main groups that this paper is aimed at are doctors, nurses, nutritionists, and sportspersons engaged in the design of mobile medical systems, and computer engineers involved in the construction of intelligent medical software systems. Scope: The present article has as its scope designing the M-healthcare clinical follow-up system, identifying the advantages that the M-healthcare system has in comparison with traditional medical treatment, the clinical application effect of the M-healthcare system, and the development status of remote/mobile medical research in China and abroad. [ABSTRACT FROM AUTHOR]

In the wake of COVID-19, mental health providers and treatment programs are adapting rapidly to the challenges in engaging people and delivering treatment with limited guidance. This paper will explore the challenges associated with delivering treatment within coordinated specialty care (CSC) programs for people with first episode psychosis. Suggestions for treatment will take into consideration experiences with stress, changes to the pursuit of work and school, and increased time spent with families. Drawing on the experience of several CSC programs in the United States, Israel, and China, we describe the impact and modifications to the core treatment elements in CSC including medication, family interactions, supported employment and education, individual therapy, peer support and the way they are delivered. The paper includes recommendations based on experiences from CSC programs to help staff members, participants, and family members better identify, prepare, cope and respond to the unique new challenges and suggests modifications that can be made during various stages of the coronavirus pandemic. [ABSTRACT FROM AUTHOR]

Object: To analyze the trend of the coupling and coordination of the supply and demand of healthcare resources between the elderly population and healthcare resources in China during the period of 2012–2022, to reveal the impact of the growth of the elderly population on the relationship between the supply and demand of healthcare resources, and to put forward suggestions to improve the coupling and coordination between the supply and demand of healthcare resources and the elderly population, in order to cope with the challenges of an aging society. Methods: By obtaining relevant data from authoritative data sources such as China Statistical Yearbook, Health and Health Statistics Yearbook, and the Chinese government website from 2012 to 2022, we constructed a comprehensive measurement index for the three systems of elderly population, healthcare resource supply, and healthcare resource demand; Using the entropy value method to assign weights to the indicators, combined with the coupling coordination degree model, to reveal the changes of the elderly population change and the supply and demand of medical and health resources; using ArcGIS technology, to study the spatial characteristics of the elderly population change and the supply and demand of medical and health resources. Results: From 2012 to 2022, the supply and demand of healthcare resources and the variation of the elderly population in China show a continuous growth trend, and the comprehensive development level of the system gradually climbs from a low level to a high level. The fluctuation of coupling degree and coordination degree rises, although the coordination degree has always been lower than the coupling degree, but the distance between the coordination degree and the coupling degree gradually narrows with the passage of time. The coordination degree between population aging and medical and health resources development shows spatial heterogeneity in China, with the eastern region significantly higher than the western region/. Conclusions: The coupling degree between population aging and healthcare resource supply and demand in China from 2012 to 2022 shows a general upward trend from low coupling to medium-high coupling, but it is worth noting that even though the degree of coupling increases, the degree of coordination is still relatively lagging behind, suggesting that the government and relevant departments need to pay more attention to coordinated allocation and management of healthcare resources. At the same time, the spatial differences in the degree of coordination among provinces suggest that future policymakers should take regional differences into full consideration in policymaking and sustainable development. [ABSTRACT FROM AUTHOR]

Acknowledging the extreme risk COVID-19 poses to humans, this paper attempted to analyze and compare case fatality rates, identify the existence of learning curves for COVID-19 medical treatments, and examine the impact of vaccination on fatality rate reduction. Confirmed cases and deaths were extracted from the "Daily Situation Report" provided by the World Health Organization. The results showed that low registration and low viral test rates resulted in low fatality rates, and the learning curve was significant for all countries except China. Treatment for COVID-19 can be improved through repeated experience. Vaccinations in the U.K. and U.S.A. are highly effective in reducing fatality rates, but not in other countries. The positive impact of vaccines may be attributed to higher vaccination rates. In addition to China, this study identified the existence of learning curves for the medical treatment of COVID-19 that can explain the effect of vaccination rates on fatalities. [ABSTRACT FROM AUTHOR]

The article offers information on the call for papers for the special issue of the "Chinese Journal of Communication," entitled "Communicating Health in China: The Role of Health Communication Research."

Depending on the strategy of "Healthy China", more and more people pay attention to health issues. The integration and development of sports industry and health service industry is an inevitable outcome of industrial transformation and upgrading and healthy life in the new era. Through constructing the evaluation index system of the coupling and coordination development degree between sports industry and health service industry, using entropy evaluation method and coupling and coordination degree model, this paper explore the comprehensive level and coupling and coordination development status of sports industry and health service industry in thirty-one provinces, municipality cities and autonomous regions of China from 2013 to 2017. The results of this paper show that the comprehensive China's sports industry and health service industry both present an incremental development trend year by year, and are characterized by the distribution of "high in the east and low in the west" in space. The government's policy support provides superior industrial supporting conditions for the development of sports industry. However, it is not conducive to the promotion of industrial economic benefits. In the health service industry, the rapid development of health insurance is beneficial to the integration of industrial resources and the perfection of industrial chain. Whereas as the core content of health service industry, health service has greater space for development; the coupling and coordination degree between the two industries rises from mild maladjustment to basic coordination, which is characterized by the distribution of "high in the east and low in the west" in space; among provinces, with Beijing, the Yangtze River Delta and Guangdong as the three development center points, it shows the spatial evolutionary process from "dispersion-type plaques" to "gathering type scattered surfaces". [ABSTRACT FROM AUTHOR]

China's 2009 health care reform agenda has been referred to as one of the most ambitious health policy programmes in modern history. Significant investment has combined with new structures, incentives, and regulations that have aimed to improve access, as well as gain greater control over a health care market much criticised for putting profit before patients. A range of health services research has been undertaken to analyse these efforts. Sociological perspectives have also been documented yet up to now a review and synthesis combining these various contributions has not been undertaken. By drawing on the lens of McDonaldization, the paper presents a narrative review that analyses the extent to which China's 2009 reform agenda has increased efficiency, calculability, predictability, and control over service provision. The review identifies elements of McDonaldization within China's 2009 reform agenda, however, notable gaps remain. In response to the limits of McDonaldization as a lens for understanding China's health care reform, the paper calls for alternative perspectives that are better able to understand the sociocultural dynamics shaping service provision, as well as an interdisciplinary research agenda that is able to generate new insights and understanding regarding health care in China. [ABSTRACT FROM AUTHOR]

This paper is aimed to make sense of the real effect of implement of social healthcare insurance on one’s medical expense in China. Due to previous studies drew various and inconsistent conclusions on this issue, this works intend to apply meta-analysis to the problem. For 31 related studies, we first implement an advanced conditional Dirichlet-based Bayesian semi-parametric model specific to meta-analysis, and come to a primary conclusion that healthcare possesses little probability reducing one’s medical expense in China. Further, the authors conduct random effects meta-regression and find that heterogeneity exists among the observed effect sizes. Mixed effects model shows that the age variation may is actually the heterogeneity source. The coefficients for Non-old and Old are respectively 0.29 and 0.54, implying that when researching on the medical expense for the elderly, it is more likely to conclude the medical insurance could increase medical spending. The coefficients for IV and OLS are both remarkably negative at 90% confidence level. This suggests when directly using Instrument Variable (IV) approach and OLS method to assess the implementation effect for the healthcare insurance, it is inclined to result in the reduced impact on medical expense. We deduce this is because this two methods can’t solve the sample-selection bias when compared with the Two-part model and difference-in-difference (DID) model. Based on the results and discussion, we finally propose suggests for the government. [ABSTRACT FROM AUTHOR]

This paper examines the factors affecting the receipt of informal care among older people in China. It uses the second wave data of the China Health and Retirement Longitudinal Survey, which collected ageing and health-related information on a nationally representative sample of 8,906 older people aged 60 and over in 2013. Apart from the factors that have been examined in the contexts of developed countries, the paper further investigates two factors specific to Chinese society: rural–urban residence and regular financial assistance from children. Based on binary and multinomial logit regression analyses, the research findings are threefold: the determinants of receiving informal care differ remarkably according to the sources of care; disability and living arrangements are the most important determinants; rural–urban residence plays a vital role in the Chinese context, but regular financial assistance from children makes little difference. It is estimated that 53 million older people are receiving informal care each year, a figure equivalent to the entire population of England. With continuous population ageing, Chinese society will face huge pressure to meet the demand for social care among older people in the future. The Chinese government needs to build a well-rounded welfare system that tackles this challenge from multiple dimensions. The formal care services should aim to complement informal care in the short run and reduce inequality in social care in the long run. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is a promising technology to transform the healthcare industry. Due to the highly sensitive nature of patient data, federated learning (FL) is often leveraged to build models for smart healthcare applications. Existing deployed FL frameworks cannot address the key issues of varying data quality and heterogeneous data distributions across multiple institutions in this sector. In this paper, we report our experience developing and deploying the Contribution‐Aware Federated Learning (CAreFL) framework for smart healthcare. It provides an efficient and accurate approach to fairly evaluate FL participants' contributions to model performance without exposing their private data, and improves the FL model training protocol by allowing the best performing intermediate sub‐models to be distributed to participants for FL training. Since its deployment by Yidu Cloud Technology Inc. in March 2021, CAreFL has served eight well‐established medical institutions in China to build healthcare decision support models. It can perform contribution evaluations close to three times faster than the best existing approach and has improved the average accuracy of the resulting models by more than 2% compared to the previous system (which is significant in industrial settings). To the best of our knowledge, it is the first CAreFL successfully deployed in the healthcare industry. [ABSTRACT FROM AUTHOR]

In order to optimize the Chinese medical and health system and improve people's health level, the SFA Malmquist model, the spatial econometric model, and the standard deviation ellipse method were used to measure the efficiency of medical and health services in China's 31 provinces between 2010 and 2020. Study results indicated that the average efficiency value of the 31 provinces generally exceeded 0.8. Specifically, the average efficiency values in the eastern and central regions increased from 0.852 to 0.875 and from 0.858 to 0.88, respectively. In the western and northeastern regions, these values rose from 0.804 to 0.835 and from 0.827 to 0.854, respectively. From the perspective of spatial distribution, there were high-high and low-low clusters in most provinces with significant spatial dependence among them. This analysis reveals that medical and health services efficiency in China demonstrates a spatial pattern extending from northeast to southwest. [ABSTRACT FROM AUTHOR]