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Guo Y, Hong X, Li D, An Q, Fan W, Yang M, Xiao L. The economic effect of financial compensation in China's healthcare system: comprehensive insights regarding supply and demand factors. HEALTH ECONOMICS REVIEW 2024; 14:21. [PMID: 38491307 PMCID: PMC10943810 DOI: 10.1186/s13561-024-00496-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES We aim to analyse the effects of government subsidies on residents' health and healthcare expenditure from the perspectives of supply and demand. DATA AND METHODS According to the regional division adopted in the data query system of the National Bureau of Statistics, this study divides 31 provinces and cities into three regions: eastern, central, and western. The data used are from public databases, such as the "China Statistical Yearbook," "China Health Statistical Yearbook," and "Government Final Account Report". In this study, mathematical model derivation is used to construct a fixed effects model, and an empirical study based on cross-sectional data and general linear regression is conducted. To prevent endogeneity issues, this study introduces instrumental variables and uses 2SLS regression to further analyse the output results. RESULTS For every 1% increase in supplementary funding on the supply side, the perinatal mortality rate decreases by 1.765%, while for every 1% increase in financial compensation on the demand side, per capita outpatient expenses increase by 0.225% and per capita hospitalization expenses increase by 0.196%. Regarding medical resources, for every 1% increase in the number of beds per 1,000 people, per capita hospitalization expenses decrease by 0.099%. In the central and eastern regions, where economic levels are higher, supply-side government funding is more effective than demand-side funding. In contrast, demand-side funding is more effective in the western region. CONCLUSIONS The roles of multiple influencing factors and significant regional heterogeneity are clarified. Increasing financial compensation to providers positively impacts perinatal mortality but leads to higher per capita outpatient and hospital expenditures. Finally, this study provides targeted policy recommendations and solid theoretical support for policymakers.
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Affiliation(s)
- Yi Guo
- Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing, China
| | - Xuezhi Hong
- Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing, China.
| | - Dongmei Li
- Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing, China
| | - Qiannan An
- Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing, China
| | - Wenwen Fan
- Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing, China
| | - Minghe Yang
- Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing, China
| | - Luyang Xiao
- Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing, China
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Yu W, Wang Q, Qiao Z. Study on the time and scale of mutual aid for aging care under the background of active aging. Front Public Health 2024; 11:1196411. [PMID: 38288428 PMCID: PMC10823878 DOI: 10.3389/fpubh.2023.1196411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/26/2023] [Indexed: 01/31/2024] Open
Abstract
Background China has entered an aging society and will likely become the fastest-aging country in the world. The demand for aging care services has greatly increased. In recent years, the model of mutual aid for aging care has met the needs of older adults, especially those in rural areas. In this case, how much time should be spent on mutual aid for the older adult in terms of time and how much influence the size of the group has in terms of space are two very important questions when studying mutual aid for aging care. Methods An overlapping generations model is built in this article, which includes representative agents, representative enterprises, the endowment insurance system constructed by the government, and the behavior of representative agents in mutual aid for aging care under the background of active aging. Results In the base case, the optimal proportion of time to participate in the mutual aid group is 9.31%, and the optimal proportion of time is influenced by the benchmark time of care and the size of the care group. With the increase in the benchmark time of care, the optimal proportion of time increases correspondingly, but the increase is decreasing. With the increase in the size of the care group, the optimal proportion of time decreases, but after the size reaches 4 or 5, the impact becomes very small. When parents' psychological preference coefficient changes from 0.1 to 0.9, that is, when parents change from introverted to extroverted personalities, the optimal proportion of time and parents' utility will also change. Conclusion For children who usually take care of their parents for a long benchmark time, the optimal time to participate in the mutual aid group based on personal utility maximization is also long. Second, as the size of the group increases, the time for representative agents to participate in the mutual aid group gradually decreases. In addition, the model of mutual aid for aging care is highly correlated with parents' personalities, and extrovert parents benefit more from this model.
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Affiliation(s)
- Wenguang Yu
- School of Insurance, Shandong University of Finance and Economics, Jinan, China
| | - Qi Wang
- School of Statistics and Mathematics, Shandong University of Finance and Economics, Jinan, China
| | - Zhi Qiao
- School of Insurance, Central University of Finance and Economics, Beijing, China
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Xu T, Huang Z, Li B, Jin H, Zhang J, Yang H, Huang Y, Zhang X, Chen C. Association between home and community-based services utilization and self-rated health among Chinese older adults with chronic diseases: evidence from the 2018 China Health and Retirement Longitudinal Study. BMC Public Health 2024; 24:117. [PMID: 38191440 PMCID: PMC10775520 DOI: 10.1186/s12889-023-17535-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND As global aging intensifies, older adults with chronic diseases are of increasing concern. Home and community-based services (HCBSs) have been proven to promote self-rated health (SRH) in older adults, but no research explored the associations between the use of overall HCBSs, three different types of HCBSs (health care, daily care, and social support services) and SRH among older adults with chronic diseases. Consequently, this study applies a national publicly available database to examine these associations among older adults with chronic diseases. METHODS 8,623 older adults with chronic diseases (≥ 60 years old) were included in this study. SRH was evaluated applying a concise question with a 1 - 5 scale. HCBSs utilization was assessed through the question, "What kind of HCBSs were used in the community?". Univariate general linear regression models aimed to compare the mean values of SRH in terms of HCBSs utilization in each group. This study is a cross-sectional study design and the relationship between HCBSs utilization and SRH was assessed by multilevel linear regression. RESULTS The mean score for SRH among the respondents was 3.19, of whom 20.55% used one or more HCBSs, 19.47% utilized health care services, 2.44% utilized social support services, and only 0.55% utilized daily care services. The use of HCBSs was found to be linked to SRH among older adults with chronic diseases (β = 0.085, SE = 0.025, p < 0.001). SRH among older adults with chronic diseases was strongly linked to the use of health care and social support services (β = 0.068, SE = 0.025, p < 0.001; β = 0.239, SE = 0.063, p < 0.001, respectively). However, there was no significant association between the use of daily care services and SRH among older adults with chronic diseases. CONCLUSION This study revealed that HCBSs utilization was positively and significantly linked to SRH in Chinese older adults with chronic diseases. Furthermore, this study supposes the low utilization of social support and daily care services may be due to a mismatch between supply and demand. The government should offer the targeted HCBSs for older adults with chronic diseases according to their unique features to enhance their health status.
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Affiliation(s)
- Tingke Xu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Zishuo Huang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
- School of Innovation and Entrepreneurship, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Bingzhen Li
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Haojie Jin
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Jiayun Zhang
- The 2nd School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Huiting Yang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Yucheng Huang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Xiangyang Zhang
- First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China.
- Institute for County Chronic Disease Health Management Research, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
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Ma W, Wang J, Liu L, Zhang H. Factors influencing the satisfaction of community senior care services in China: an analysis based on an extended Anderson model. Front Public Health 2023; 11:1138711. [PMID: 37427287 PMCID: PMC10326384 DOI: 10.3389/fpubh.2023.1138711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/07/2023] [Indexed: 07/11/2023] Open
Abstract
Community-based senior care, as a convenient and promising care model, has gradually been accepted by the public. However, community services developed to facilitate older adults often fail to achieve the expected effect. With the fast-growing aging population in China, the problems of underutilization and low service satisfaction of senior care facilities need to be resolved urgently. In this study, we further developed an extended Anderson behavior model by incorporating social psychological factors, and the vertical and horizontal fairness perceptions. In addition, a binary logistic regression model was used to analyze factors affecting the satisfaction of older adults in life care services, health care services, and mental and spiritual comfort services. The study used data from a survey of 322 urban area seniors in Shaanxi Province. The results showed that factors influencing older adults' satisfaction of different service categories are different. Moreover, with the addition of the social psychological factors, we observed that the vertical fairness perception of the survey respondents affected their satisfaction of senior care services significantly more than the horizontal fairness perception.
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Affiliation(s)
- Wei Ma
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Junfeng Wang
- School of Public Policy and Management, University of Illinois Springfield, Springfield, IL, United States
| | - Lihong Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Han Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Chen J, Wang L, Gu T, Wang C, Hao E. Demands for Community Services and Associated Factors among Residents in Smart Communities: A Case Study of Xuzhou City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3750. [PMID: 36834442 PMCID: PMC9964050 DOI: 10.3390/ijerph20043750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Smart community enables a sustainable and livable community future, in which residents' demands play an important role in its success. Though great efforts have been made to encourage residents' participation in the implementation of smart communities, inefficient service supply still exists. Thus, this study aimed to classify residents' demands for community services in smart communities and to explore relevant influencing factors based on the developed conceptual framework. Data from 221 respondents in Xuzhou city of China were analyzed by using binary logistic regression. The results indicated that more than 70% of respondents had demands for all community services in smart communities. Moreover, the demands were influenced by distinct factors, including sociodemographic characteristics, living characteristics, economic characteristics, and individual attitude characteristics. The types of community services in smart communities are clarified and fresh insights are provided into associated factors related to residents' demands for these services in this study, through which enhanced provision of community services and effective implementation of smart communities can be achieved.
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Affiliation(s)
| | - Linxiu Wang
- School of Mechanics and Civil Engineering, China University of Mining and Technology, Xuzhou 221116, China
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Zhou H, Hong J, Yang S, Huang Y. The Impact of Social Capital on Rural Residents' Medical Service Utilization in China-An Empirical Study Based on CFPS Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15989. [PMID: 36498060 PMCID: PMC9738421 DOI: 10.3390/ijerph192315989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/26/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Based on CFPS data, the article analyzes the impact of social capital on the utilization of medical services by rural residents in China using binary logit and multinomial logit models. The social capital includes two dimensions: cognitive social capital and structural social capital, and the indicators of medical service utilization are "whether to seek medical treatment when sick" and "choice of medical institution". This paper concludes that: (1) among the cognitive social capital, special trust and religious beliefs have a significant positive influence on whether rural residents choose to seek medical treatment when they are sick; (2) among the structural social capital, social participation has a significant positive influence on choice of medical institution, and social network has a significant positive influence on the choice of township health center, specialty hospital, and general hospital. According to the empirical results, this paper proposes the following suggestions. The trust mechanism of rural society should be reconstructed, the positive role of religious beliefs should be given full play, the healthy development of social networks should be promoted, and the rural social organizations should be fostered and developed.
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Affiliation(s)
- Hongyun Zhou
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Jiqing Hong
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Su Yang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Yuxuan Huang
- School of Environment, Education and Development, The University of Manchester, Manchester M13 9PL, UK
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Gong N, Meng Y, Hu Q, Du Q, Wu X, Zou W, Zhu M, Chen J, Luo L, Cheng Y, Zhang M. Obstacles to access to community care in urban senior-only households: a qualitative study. BMC Geriatr 2022; 22:122. [PMID: 35164708 PMCID: PMC8842867 DOI: 10.1186/s12877-022-02816-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 02/01/2022] [Indexed: 01/02/2023] Open
Abstract
Background The increased number of older adults living alone has created a substantial care need. However, the utilization rate of services and facilities to meet these needs are surprisingly low. Many of older adults experience difficulties accessing these services, although it remains unclear how these obstacles impede access to services. This study explored the obstacles and difficulties experienced by urban older adults in seeking community care. Methods A phenomenological study was carried out and participatory observation and in-depth interviews were employed to investigate the process of seeking care of older adults in urban communities. A total of 18 urban community-dwelling older adults aged 75 years and over were included. Data collected were analysed by content analysis. Results We identified the pathways by which senior-only households sought community care and encountered obstacles. (1) lack of community care information: older adults did not know where and how to get services, even though the care institutions scattered throughout the community; (2) limited mobility: older adults often suffered from various chronic diseases, which physically hindered their access to care resources; (3) complex process of achieving care: the functional fragmentation and geographical dispersion of care institutions made the care-seeking process challenging and confusing for older adults; (4) incomprehension of needs expression: limited interaction time and communication barriers between staff of institutions and the older adults were the final obstacle. Only by surmounting these obstacles one by one can older adults access the care resources effectively. Conclusions When older adults in the community initiated calls for help, they encountered several obstacles. Their physiological and social disadvantages limited their ability to seek care physically. Lack of integration and clear guidance in the process of providing community care exacerbated these difficulties. Reform of care services should focus on the visibility and accessibility of services for older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02816-y.
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Affiliation(s)
- Ni Gong
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Ya Meng
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qin Hu
- School of Sociology and Anthropology, Sun Yat-sen University, Xingang West Road, Haizhu District, Guangzhou, 510399, Guangdong, China
| | - Qianqian Du
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Xiaoyu Wu
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Wenjie Zou
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Mengyao Zhu
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Jiayan Chen
- Qizhi Social Work Service Center, Tianhe District, Guangzhou, Guangdong, China
| | - Lan Luo
- Hongshan Street Community Health Service Center, Huangpu District, Guangzhou, Guangdong, China
| | - Yu Cheng
- School of Sociology and Anthropology, Sun Yat-sen University, Xingang West Road, Haizhu District, Guangzhou, 510399, Guangdong, China.
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China.
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