Can Basic Medical Insurance Reduce Elderly Family Income Inequality in China?

Drug supply and assurance: a cross-sectional study of drug shortage monitoring varieties in China

BACKGROUND

Drug shortage is a worldwide problem that seriously threatens public health. China released the most comprehensive list of key drug shortage monitoring varieties ever in 2022. We aim to analyze the attributes and characteristics of the medicines within the list to provide a reference for improving China's supply security of shortage drugs.

METHODS

We used public data to extract information on drug types, dosage forms, indications, classification of clinical uses, whether they were included in medical catalogs such as the National Essential Drugs, and the number of drug and active pharmaceutical ingredient (API) manufacturers. A descriptive statistical analysis was used.

RESULTS

Of the 980 drugs on the list, 99.59% were chemicals and 92.65% were injectables. Drugs for blood and hematopoietic organs, the cardiovascular system, and the digestive tract and metabolism ranked among the top three shortages. Verification of the medical catalogs showed that 90.41% of the drugs belonged to the national essential drugs, 95.10% were medicare drugs, 2.55% were volume-based procurement drugs, and 14.70% were for rare diseases, and 42.04% were for children. In terms of drug supply capacity, 21.33% of drug approvals are less than 10, and there were even 26 drugs for exclusive production, close to 90% of manufacturers need to purchase APIs from outside. Among the 256 APIs included in the list, 152 APIs had less than 10 manufacturers, and there were even 5 APIs produced by only one enterprise nationwide.

CONCLUSIONS

The situation of drug shortages in China was severe and complex, with serious shortages of medicines adapted to basic medical and healthcare needs and clinically necessary medicines, and a need to improve the production capacity of drugs and the ability to supply APIs. We recommend strengthening drug monitoring and stockpiling and accelerating the approval of shortage drugs to improve drug supply security.

Help or Hurt? The Impact of Digital Finance on the Physical Health of the Elderly in China

Under the backdrop of global aging, the escalating number of elderly individuals in poor health poses a growing social burden and impacts economic development and social stability. A fundamental question arises as to whether the advancements of digital finance (DF) can effectively enhance the physical health of the elderly. This study aims to investigate the impact of DF on the physical health of the elderly by utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015, and 2018. The results reveal a significant positive impact of DF on enhancing the physical health of the elderly. Furthermore, the study demonstrates that this impact is particularly pronounced among the elderly with higher educational attainment, stronger intergenerational links, and those residing in central cities. A mechanism analysis further reveals that DF contributes to improving the physical health of the elderly by augmenting household disposable income, alleviating liquidity constraints, and enhancing the utilization of medical services. These findings offer valuable insights for the future development of DF and the implementation of policies promoting healthy aging and active aging.

The effect of urban-rural resident basic medical insurance on physical health of the rural older adult in China

Introduction

Urban-Rural Resident Basic Medical Insurance (URRBMI) is an important system for effectively transferring disease risks to the rural older adult. As China experiences rapid aging, maintaining the physical health of the rural older adult is key to achieving the goal of healthy aging.

Methods

The study explores the impact of URRBMI on physical health of the rural older adult in China using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018. Ordinary least square models were used to analyze the relationship between URRBMI and physical health of the rural older adult, and we used instrumental variable method to address the potential endogenous problem.

Results

We find that URRBMI greatly improves physical health of the rural older adult. The heterogeneity analysis indicates that URRBMI contributes more significantly to the rural older adult in eastern areas and the advanced rural older adult. The results also suggested that URRBMI improves physical health of the rural older adult through increasing life satisfaction and enhancing the timeliness of medical services.

Recommendations

This study implies that we need to further improve the participation rate, increase the actual reimbursement ratio and increase financial subsidies for URRBMI in central and western areas, and further integrate the distribution of medical resources to promote physical health of the rural older adult.

Does digital technology make people healthier: the impact of digital use on the lifestyle of Chinese older adults

BACKGROUND

With the arrival of the era of large-scale production, sharing and application of data, digital use has gradually changed people's daily entertainment, consumption, social interaction, learning and other behaviors in its efficient form. This paper mainly discusses whether this fast and convenient behavior leads Chinese older adults to adopt healthier lifestyles.

METHODS

Using the most recent information from the Chinese Family Panel Studies (CFPS) in 2020, this paper conducted a descriptive statistical analysis on the basic situation of digital use and lifestyles among Chinese older adults and used a structural equation model to analyse the influence of frequency and types of digital use in a variety of different aspects of the real life of Chinese older adults.

RESULTS

Research revealed that the quality of life of Chinese older adults improved significantly as a result of their use of digital technology. The frequency of digital use (FDU) significantly improved Chinese older adults' diet, sleep, exercise, smoking and drinking, and relieved their depression. The types of digital use (TDU) had a significant positive correlation with the lifestyle of Chinese older adults, especially in the influence of digital entertainment (DE), digital consumption (DC) and digital social interaction (DI) on the lifestyle of Chinese older adults.

CONCLUSIONS

Digital use can improve the health of Chinese older adults by promoting a healthy lifestyle through various means. The findings of this study have a substantial positive impact on bridging the digital divide that Chinese older adults face, as well as fostering the integration of digital use into their healthy lifestyles.

Does basic medical insurance promote public health? Evidence from China family panel study

Background

To promote common prosperity, China government has devoted much financial resources to the basic medical insurance system, it is of great significance to improve the health level of the insured groups to prevent them from returning to poverty due to illness. Whether or not the basic medical insurance can improve health status is an important policy issue after China has win the absolute poverty alleviation movement.

Methods

Based on the data of China Family Panel Studies this paper constructs a strong balanced panel data with two levels information, which including variables from family level and personal level. This paper uses the panel data fixed effect model and propensity score matching model to analysis.

Results

This paper finds that after controlling the family and personal confounding variables, the basic medical insurance has positive effect toward health status. With propensity score matching model, this paper finds that there is causality between basic medical insurance and public health.

Conclusion

Basic medical insurance has a significant health effect, that is, basic medical insurance has a significant positive impact on individual self-rated health. Participating in basic medical insurance can significantly improve the ability of families to face risk shocks, promote the accumulation of health capital in families, promote the diversification of livelihood strategies, and effectively prevent the occurrence of returning to poverty due to illness.

Impact of the new rural social pension insurance on the health of the rural older adult population: based on the China health and retirement longitudinal study

The health issues of China's older adult population in rural areas have been receiving increasing attention with the continuous expansion of the nation's ageing population and the continuous promotion of urban-rural integration. The impact of the new rural social pension insurance (NRSPI) on the health of the rural older adult population, the mechanism of its action and how old-age service can be improved and optimised according to the health needs of the rural older adult population are urgent and realistic challenges. Based on survey data from the China Health and Retirement Longitudinal Study in 2015 and 2018, this study applies a multivariate ordered logistic regression model to explore the impact mechanism and effect of the NRSPI on the older adult population health in rural China while controlling for endogeneity. The results show that participation in the NRSPI can significantly improve the health of the rural older adult population at a 1% level. The results of the heterogeneity test reveal that the NRSPI has a significant impact on the self-reported health of the rural older adult at a 1% level, with a significantly positive impact on the mental and physical health of rural female older adult, whereas the impact on male older adult is not significant. The mediating effect test results show that medical services, food access and entertainment activities have a mediating effect on the new rural social endowment insurance. The results of the moderating effect test indicate that the NRSPI regulates 7.8% of the effect of physical health on mental health and 10.7% of the effect of mental health on physical health. Based on these findings, this study proposes to strengthen the construction of healthy lifestyle guidance and emotional support systems while improving the NRSPI's participation rate and treatment level to meet the diverse health service needs of different older adult groups.

The heterogeneous relationship between public health expenditures and household medical expenditures: evidence from relative poverty households in China

Exploring the heterogeneous relationship between public health expenditures and household medical expenditures from the perspective of relative poverty has positive significance for improving the ability of relative poverty households to cope with the risk of large rigid expenditures and optimizing the public health resource allocation. This paper uses the China Family Panel Studies (CFPS) from 2016 to 2020 to identify relative poverty standard from the perspective of medical needs, analyzes the impact of public health expenditures on medical expenditures of different household types, and evaluates the effect of public health expenditures on ensuring the medical needs of relative poverty households. The panel threshold regression result shows that 19.36% of the provinces per capita disposable where the household is located is the identification standard of relative poverty households. Public health expenditures have a crowding-in effect on household medical expenditures and have a stronger impact on relative poverty households, an effect that is also confirmed by two-stage least squares regression. In addition, ensuring household medical needs through public health expenditures focuses on the level of basic medical needs, and the role of household healthcare expenditures that reflects high-level medical needs is not obvious. In the future, the government should establish a monitoring mechanism for relative poverty households, ensure the basic medical needs of relative poverty households, and clarify the heterogeneity among different types of households, provide targeted public health services.

Common prosperity level evaluation: A comprehensive method based on probabilistic linguistic ordered weighted distance measure, prospect theory, and TOPSIS

Introduction

Common prosperity is a major research project in China, and the scientific measurement and evaluation of common prosperity is very important.

Methods

In this study, firstly, we construct a comprehensive evaluation index system for the common prosperity level (CPL). We then develop an evaluation model of CPL based on prospect theory, probabilistic linguistic ordered weighted distance measure, and the TOPSIS method, wherein we use a probabilistic linguistic term set (PLTS) to describe the uncertainty and complexity of the assessment process. Above all, we use prospect theory to reflect the preferences of experts to meet the unique needs for the evaluation of common prosperity. Moreover, we apply the proposed evaluation index system and model to evaluate the CPL of Zhejiang Province, China's first common prosperity demonstration zone, as an example to conduct relevant research. The advantages and effectiveness of the proposed method are verified by the sensitivity and comparative analysis.

Results

The findings prove that the application of the new PLTS evaluation framework in CPL assessment is robust.

Discussion

We propose specific suggestions for improving the development of common prosperity.

Health shocks, basic medical insurance and common prosperity: Based on the analysis of rural middle-aged and elderly groups

Health is a major part of human welfare. The index system of common prosperity was constructed for middle-aged and elderly people in rural areas. Besides, the impart of health shocks and rural basic medical insurance on common prosperity was explored. The data for this study came from China Health and Retirement Longitudinal Survey (CHARLS) in 2013, 2015, and 2018. The finding shows that health shocks hindered the improvement of the common prosperity of the middle-aged and elderly in rural areas, among which daily activities produced the greatest negative effect. The heterogeneity analysis shows that health shocks have a stronger negative effect on the common prosperity of low-income groups than that of high-income ones. The shock of daily activity ability has the greatest influence on the middle-aged and elderly between 45 and 55 years old. However, acute health shocks have a strong negative effect on those aged above 56. The mechanism analysis shows that rural basic medical insurance can alleviate the health shocks to middle-aged and elderly people, but the effect is limited. In general, low-income groups benefit more. Therefore, China should speed up the promotion of the Healthy China Strategy and the reform of the rural basic medical insurance system, and prompt changes from an inclusive to a targeted policy to provide more precise safeguards for vulnerable groups.

Knowledge mapping of population health: A bibliometric analysis

In recent years, population health has aroused great interest, especially after the outbreak of Covid-19. The related research increases substantially year by year. There are many kinds of research about population health, but few scholars use the bibliometric method to discuss them. Motivated by keeping abreast of emerging trends and critical turns in population health, this study adopts the bibliometric method to analyze the development history and status quo of population health, providing a summary description for it. This study adopts CiteSpace to conduct a bibliometric analysis of publications related to population health in Web of Science from 1971 to 2021. The most productive countries, authors, institutions, and research direction changes are analyzed. The research results show that: First, the number of publications and citations related to population health increases for years, especially in Canada, the United States, the United Kingdom, and Australia. Second, the number of publications by different countries or institutions in population health varies greatly, and they cooperate closely. Third, the co-occurrence of disciplines and keywords in population health is displayed. Finally, this study reveals the primary research force, the major themes, significant milestones, landmarks, and the evolution of the hot fronts. In all, the comprehensive analysis of this study would provide some enlightenment for future research.

Household clean energy consumption and health: Theoretical and empirical analysis

The impact of energy consumption on health has become a widely debated topic around the world. However, much of the current research on this topic lacks a theoretical basis. As a result, this paper employs both theoretical and empirical analysis to investigate the impact of household clean energy consumption on residents' health. First, based on the theories of health economics and energy economics, this paper believes that the usage of clean energy can improve the health of residents. Then, the sample for this study is comprised of data from the 2018 China Health and Retirement Longitudinal Study, and the Order Probit Model is applied for the empirical analysis. The outcomes of basic regression, robustness testing, and the treatment of endogenous factors reveal that the usage of clean energy has greatly benefited the health of residents. Furthermore, the heterogeneity analysis shows that long-term use of clean energy greatly improved the health of non-religious people and had a more pronounced impact on the health of women and low-income residents. In addition, the mechanistic analysis indicates that subjective happiness and air quality played a partial mediating role in the impact of cleaner energy consumption on health. Finally, cleaner household energy reduced the prevalence of hypertension, hyperlipidemia, lung disease, asthma, and depression. The conclusion of this paper supports the view of some existing literature, and several policy recommendations are made based on the research findings.