Objective To re-estimate price elasticity of different income groups’ demand for cigarette in terms of the lastest national tobacco consumption data and provide policy-makers with evidence to make decision on public policy of tobacco control. Methods A total of 16 056 adults of different income were surveyed in 27 provinces in 2002 and the data analyzed by using two-part model (logistic and log-linear model). Results We found that the demand elasticities were -0.589, -0.234, -0.017 and 0.247 for the poor group, low income group, middle income group and high income group, respectively. Conclusions Increasing tobacco tax will result in decreasing more cigarette consumption of lower income groups than higher groups, bearing more taxation of higher income groups than lower income groups, therefore tobacco taxation is not regressive.
Objective To sort out the policies related to rare diseases in China, analyze and summarize the focus and potential problems of relevant policy texts, and provide decision-making references for the subsequent formulation and improvement of policies in the field of rare diseases in China. Methods We searched for relevant policy documents in the field of rare diseases at the national level from 2018 to 2023, constructed a three-dimensional analysis framework based on content analysis of “policy tool-stakeholder-policy strength” in the field of rare diseases in China, and conducted cross-analysis between policy tools, stakeholders, and policy strength. Results Finally, 39 policy texts were included. There were 112 policy tool dimension codes, with environment-based, supply-based, and demand-based tools accounting for 62.5%, 30.36%, and 7.14%, respectively. There were 229 stakeholder dimension codes, including 42.79% for government departments, 19.65% for medical institutions, 19.65% for corporate units, and 17.90% for patients and their families. The average score for policy strength was 2.2 points. Cross-analysis showed that government departments had the highest proportion in the dimensions of supply-based, environment-based and demand-based tools (45.76%, 43.45%, 32.00%, respectively). The policy strength of environmental tools was the strongest (124 points). The policy strength of government departments was the strongest (78 points). Conclusions There is a certain imbalance in the design and configuration of rare disease policy tools in China, and there is uneven distribution of rare disease policies among stakeholders. Although the overall effectiveness of policies in the field of rare diseases is showing a positive growth trend, there may be a mismatch between policy tools, stakeholders, and policy strength.
With the establishment and development of regional healthcare big data platforms, regional healthcare big data is playing an increasingly important role in health policy program evaluations. Regional healthcare big data is usually structured hierarchically. Traditional statistical models have limitations in analyzing hierarchical data, and multilevel models are powerful statistical analysis tools for processing hierarchical data. This method has frequently been used by healthcare researchers overseas, however, it lacks application in China. This paper aimed to introduce the multilevel model and several common application scenarios in medicine policy evaluations. We expected to provide a methodological framework for medicine policy evaluation using regional healthcare big data or hierarchical data.
Health insurance system has been proved to be an effective way to promote the quality of health service in many countries. However, how to control health expenditure under health insurance system remains a problem to be resolved. Some developed countries like UK, Canada and Sweden linked their health technology assessment results with decision making and health insurance management, and made prominent achievements in both expenditure control and quality improvement. China is carrying out its health system reform and running a new health insurance project. Using the experiences of other countries is undoubtedly of great importance in developing and managing our health insurance system.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
ObjectiveTo investigate the variations in patient hospitalization expenses before the enforcement of the centralized procurement policy, after the implementation of the drug centralized procurement policy, and after the introduction of the consumables centralized procurement policy. The efficacy of the centralized procurement policy will also be examined. MethodsThis retrospective study utilizes data obtained from the medical records homepage of the Health Information Statistics Center under the Health Commission of Gansu Province. It included 32 938 inpatients who underwent PCI surgery for coronary heart disease in Gansu province between January 1, 2018, and December 31, 2022. A double-breakpoint interrupted time series model was employed to analyze the fluctuation trends in hospitalization costs among patients across various stages of the centralized procurement policy's implementation. ResultsThroughout the three phases of implementing the centralized procurement policy, the average total hospitalization costs were RMB 46 149.49 yuan, RMB 46 629.12 yuan, and RMB 28 771.76 yuan, respectively. After the centralized procurement policy with a focus on drug volume was initiated, there was an immediate reduction in average total hospitalization costs, drug costs, consumable costs, and medical service fees by 4.64%, 5.62%, 18.12%, and 8.85%, respectively. However, there was a subsequent increase of 25.28% in average medical service fees. Following this phase, average out-of-pocket costs, treatment costs, and other expenses exhibited a consistent upward trajectory, increasing by an average of 2.23%, 1.51%, and 1.21% per month. Upon the introduction of the centralized procurement policy for consumables, there was an immediate surge of 23.75% in average medical service fees, while average total hospitalization costs, out-of-pocket costs, consumable costs, treatment costs, and rehabilitation costs experienced a gradual decline. ConclusionThe enforcement of centralized procurement policies for drugs and consumables has effectively managed to reduce hospitalization costs for patients undergoing PCI surgery due to coronary heart disease, thereby easing the financial burden on patients. However, changes in consumable costs and average medical service fees were relatively modest. Going forward, it is essential to refine the centralized procurement policy concerning consumables, improve the compensation mechanism for medical service pricing, and enhance the overall value proposition of medical services.
The Campbell collaboration (C2) is an international research network that produces and disseminates systematic reviews of the effects of interventions in education, criminal justice, and social welfare. It aims to generate the best research evidence to support policy and practice in order to bring about positive social change. This issue introduces the experiences of the author while taking part in the ninth annual Campbell colloquium, and tries to increase awareness about C2.
In order to understand the latest progress of health decision support system (HDSS) construction, grasp the law of HDSS development and adopt the international advanced experience, this paper took Australia for example, presented a comparative analysis on the construction practices, including the contents, features and system functions of national construction guidelines for HDSS in different periods, and showed the integral development level of Australia HDSS was still in the exploratory stage, and its construction goal, function orientation and construction mechanism got improved gradually with the deep development of public health information. Additionally, to assure the accuracy and safety of HDSS function, Australia has been laying stress on the standard specification construction and system function authentication.
Objective To analyse the content and structure of the health management policy text for chronic obstructive pulmonary disease (COPD) in China, and to provide a reference for the optimization and improvement of subsequent relevant policies. Methods We searched for relevant policy documents on COPD health management at the national level from January 2017 to December 2023, constructed a two-dimensional analysis framework for policy tools and chronic disease health management processes, coded and classified policy texts, and used content analysis method to analyze policy texts. Results Twenty-four policy texts were included. There were 183 codes for policy tool dimension, with supply based, environmental based, and demand based tools accounting for 43.72%, 47.54%, and 8.74%, respectively. There were 124 codes for the dimension of health management processes, with health information collection and management accounting for 12.10%, risk prediction accounting for 14.52%, intervention and treatment accounting for 66.13%, and follow-up and effectiveness evaluation accounting for 7.26%. Conclusions At present, the proportion of policy tools related to the management of COPD in China needs to be dynamically adjusted. Environmental tools should be appropriately reduced, the internal structure of supply tools should be optimized, the driving effect of demand tools should be comprehensively enhanced, the coupling of COPD health management processes should be strengthened, and the relevant policy system and overall quality should be continuously improved.
ObjectivesTo analyze the economic burden caused by delay in the diagnosis and treatment of diabetes.MethodsThe employee/non-employee health insurance and medical examination data from Japan Medical Data Center (JMDC) and Milliman Inc. were used to analyze the health economic burden of the situation in case the diabetic population receives timelydiagnosis and treatment with real world data.ResultsThe overall population delaying the diabetes diagnosis and treatment in Japan was estimated to be 916 000, and the average time of delay was 39.6 months. The increase in time of delay was related with the increase in monthly medical costs after diabetes diagnosis. If the whole delayed population could receive timely diagnosis and treatment, it can totally save about 38.24 billion yuan (1.5% of the annual Japanese national medical expenditure.ConclusionsThe current study suggests a huge potential health economic burden that can be improved by promoting the diagnosis and treatment of diabetes, which provides reference for the economic evaluation of similar health policies and also the application of real world data in China in future.