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Chen C, Zhang H, Feng X, Wang H. Factors Influencing the Use and Demand of New Coronavirus Therapy Drugs Among the Adults During COVID-19 in China. Risk Manag Healthc Policy 2024; 17:1937-1945. [PMID: 39135613 PMCID: PMC11318593 DOI: 10.2147/rmhp.s468700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/03/2024] [Indexed: 08/15/2024] Open
Abstract
Background This alteration in the policy of COVID-19 resulted in widespread infections throughout China. Most people only need some antiviral drugs such as lopinavir/ritonavir or Chinese herbal preparations for treatment. In this context, the lack of drug knowledge and inadequate drug availability are evident. This study aims to explore the factors influencing drug use and demand during the COVID-19 epidemic. Methods This study used quota sampling based on gender, age, and place of residence to perform a cross-sectional survey on a sample of 771 adults. The researchers used chi-square tests to understand differences in drug use and demand across characteristics, and binary logistic regression to analyse the influencing factors. Results The study revealed that 85.9% of the participants used drugs following the COVID-19 infection. Participants with college and above, (OR=2.49, 95% CI=1.27-4.88) annual personal income between 30,000 and 80,000CNY (OR=2.19, 95% CI=1.35-3.55) and over 80,000CNY (OR=1.96, 95% CI=1.05-3.66) were more knowledgeable about using drugs. Gender, (OR=0.69, 95% CI=0.50-0.95) age, (OR=2.11, 95% CI=1.15-3.88) residence, (OR=1.58, 95% CI=1.06-2.37) chronic disease conditions (OR=0.46, 95% CI=0.27-0.78) and infection symptoms (OR=0.60, 95% CI=0.38-0.93) as factors influencing the need for drug delivery services. (P<0.05). Conclusion Research has revealed that a significant proportion of infected people in China chose drug treatment during COVID-19. Individuals with severe symptoms use more medication and require more drug delivery and storage. Low-education and low-income populations are lacking in drug knowledge, and older adults with underlying medical conditions are more likely to need drug delivery services. Therefore, governments should prioritize vulnerable groups when formulating drug policies and target drug literacy and guidance. In addition, it is recommended that a drug distribution system be set up within the community so that those in need can have quick and easy access to drugs.
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Affiliation(s)
- Cunchuan Chen
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
| | - Huifang Zhang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
| | - Xia Feng
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
| | - Haipeng Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
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Du S, Yang Y, Zheng M, Zhang H, Li T, Cai F. Health inequality of rural-to-urban migrant workers in eastern China and its decomposition: a comparative cross-sectional study. Front Public Health 2024; 12:1365241. [PMID: 38803809 PMCID: PMC11128589 DOI: 10.3389/fpubh.2024.1365241] [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: 01/05/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
Objectives As a specific group with high health inequality, it is crucial to improve the health status and health inequalities of rural-to-urban migrant workers. This study aimed to evaluate the health inequality of migrant and urban workers in China and decompose it. Methods A cross-sectional study was carried out, using a standardized questionnaire to obtain basic information, self-rated health to evaluate health status, concentration index to measure health inequalities, and WDW decomposition to analyze the causes of health inequalities. Results The concentration index of health for migrants was 0.021 and 0.009 for urban workers. The main factors contributing to health inequality among rural-to-urban migrant workers included income, exercise, and age. In contrast, the main factors of health inequality among urban workers included income, the number of chronic diseases, social support, and education. Conclusion There were health inequalities in both rural-to-urban migrant and urban workers. The government and relevant authorities should formulate timely policies and take targeted measures to reduce income disparities among workers, thereby improving health inequality.
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Affiliation(s)
- Sisi Du
- College of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yufan Yang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Miaomiao Zheng
- College of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Haiyan Zhang
- College of Nursing, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Wenzhou, China
| | - Tingting Li
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fuman Cai
- College of Nursing, Wenzhou Medical University, Wenzhou, China
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Inequality of opportunity in health service utilization among middle-aged and elderly community-dwelling adults in China. Arch Public Health 2023; 81:13. [PMID: 36698213 PMCID: PMC9878938 DOI: 10.1186/s13690-022-01010-1] [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: 07/06/2022] [Accepted: 12/06/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The inequality caused by circumstances is known as "inequality of opportunity" (IOp). Many scholars have studied IOp in the health field, but few studies have quantified contributors to the IOp of health service utilization among middle-aged and elderly people. This study measured the IOp of health service utilization and decomposed the contributors to IOp present among Chinese middle-aged and elderly people. METHODS Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015 and 2018. A mean-based regression method was adopted to measure the IOp of health service utilization. Shapley-Shorrocks decomposition was used to analyze the main contributors to IOp seen among the middle-aged and elderly. RESULTS Although the absolute IOp of health service utilization decreased over time, IOp still explains the total inequality to a large extent. The absolute IOp and relative IOp were greatest in the areas of self-treatment and inpatient care utilization, respectively. Shapley decomposition results showed that the out-of-pocket (OOP) ratio contributed most to the IOp of outpatient care utilization; and the residence area highly explains the IOp of inpatient service utilization. Meanwhile, social and economic factors such as work status and income contribute more to the IOp of inpatient care utilization than outpatient and self-treatment. CONCLUSIONS Strategies aimed at achieving equal opportunities remain necessary to ensure the fairness of health service utilization. Policies and measures should further adjust the medical insurance compensation policies, and pay more attention to the middle-aged and elderly residents in rural areas, optimize health resource allocation, improve the social security systems, and narrow the socioeconomic gap between urban and rural areas in China.
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Peng B, Ling L. Health service behaviors of migrants: A conceptual framework. Front Public Health 2023; 11:1043135. [PMID: 37124818 PMCID: PMC10140430 DOI: 10.3389/fpubh.2023.1043135] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/14/2023] [Indexed: 05/02/2023] Open
Abstract
Universal health coverage is vital to the World Health Organization's (WHO's) efforts to ensure access to health as a human right. However, it has been reported that migrants, including both international immigrants and internal migrants, underuse health services. Establishing a conceptual framework to facilitate research on the health service behaviors (HSB) of migrants is particularly important. Many theoretical frameworks explaining the general population's HSB have been published; however, most theoretical frameworks on migrants' HSB only focus on international immigrants without the inclusion of internal migrants. Of note, internal migrants are much more abundant than immigrants, and this group faces similar barriers to HSB as immigrants do. Based on theoretical frameworks of immigrants' HSB and Anderson's behavior model, the author proposes a new conceptual framework of migrants' HSB that includes both immigrants and internal migrants. The new conceptual framework divides the determinants into macro-structural or contextual factors, health delivery system characteristics, and characteristics of the population at risk and describes subgroup-specific factors. The author added some variables and reclassified variables in some dimensions, including characteristics of health delivery systems and access to healthcare. The characteristics of health delivery systems comprise the volume, organization, quality, and cost of the health delivery system, while the characteristics of access to healthcare include time accessibility, geographic accessibility, and information accessibility. The outcomes of HSB have been expanded, and relationships between them have been reported. The mediating effects of some variables have also been described. This conceptual framework can facilitate a deep and comprehensive understanding of the HSB determination process for migrants, including internal migrants.
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Affiliation(s)
- Boli Peng
- Department of Actuarial Science, School of Insurance, Guangdong University of Finance, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Li Ling,
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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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Nie J, Fan R, Wu Y, Li D. By Internal Network or by External Network?-Study on the Social Network Mechanism of Reducing the Perception of Old-Age Support Risks of Rural Elders in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15289. [PMID: 36430008 PMCID: PMC9690998 DOI: 10.3390/ijerph192215289] [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: 10/24/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
Nowadays, it is a general trend for China to enter a deep aging society, and the aging situation of the rural population is particularly severe. As informal endogenous resources in rural areas, social networks play an essential role in ensuring elders' later life. Data were drawn from a questionnaire survey of 1126 rural elders in 11 provinces of China. Descriptive statistics and an ordinary least square regression model were conducted to explore the impact of social networks on the perception of old-age support risks of rural elders. There was a significant positive association between the social network size and the reduction in perception of old-age support risks of rural elders. The reduction effect was mainly reflected in the internal network size, whereas it was not evident in the external network size. There was a significant positive association between the heterogeneity of the network and the perceived level of old-age support risks of rural elders. There was a significant positive association between the communication frequency of external network relationships and the perceived level of old-age support risks of rural elders. We found a significant negative association between the ratio of communication frequency between the internal and external network relationships and the perception of old-age support risks of rural elders. Compared with the external network, the internal network had a more evident reduction effect on the social network mechanism of perception of old-age support risks of rural elders.
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Affiliation(s)
| | | | | | - Dan Li
- Correspondence: ; Tel.: +86-150-0291-7385
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Zeng W, Wang C, Chen H, Tong B, Li D, Zou Z, Liu P, Yao Y, Shang S. Health status and public health education for internal older migrants in China: Evidence from a nationally representative survey. Front Public Health 2022; 10:937361. [PMID: 35937236 PMCID: PMC9353578 DOI: 10.3389/fpubh.2022.937361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background Self-rated health has been widely used as a useful screening tool to subjectively evaluate individuals' health status. Under the context of the rapid growth of aging, there was a dramatic rapid expansion in internal older migrants in China. Serious concerns on the issues of health status continue to attract quite a lot of attention over the past decades. Public health education is one of the most important health care services and methods to improve individuals' health status. However, most previous studies focus on the utilization of public health services such as visiting to doctors, physical examination, and hospitalization. There was limited evidence on the self-rated health and public health education of older migrants. Objectives The study aimed to evaluate self-rated health and the associated determinants in older migrants, as well as to gain a deeper insight into the current status of public health education received by older migrants. Methods We derived the data from the National Migrants Population Health and Family Planning Dynamic Monitor Survey 2018, a cross-sectional study, for secondary analysis. Internal migrants aged 60 years old or over were included in the study. Self-rated health was the dependent variable, while sociodemographic characteristics were the independent variable. The univariate and multivariate analyses were performed by Stata 15.1. Results A total of 5,589 older migrants were included in the study. Eighty-two percentage of older migrants reported healthy self-rated health. There was a significant association between age, gender, minzu, education level, monthly income, public health education, and self-rated health (P < 0.5). However, the proportion of older migrants that received specific public health education was <50%. The most common approach to receiving public health education was through the leaflet, while <20% of older migrants received public health education through public consultation and one-to-one education. Conclusions It was necessary to promote the publicity of public health education in older migrants through easy access and diverse approaches in order to effectively spread health-related knowledge to older migrants to satisfy their health needs and maintain their health.
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Affiliation(s)
- Wen Zeng
- Nursing School of Peking University Health Science Center, Beijing, China
- Guizhou Provincial People's Hospital, Guiyang, China
| | - Cui Wang
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Hongbo Chen
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Beibei Tong
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Dan Li
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Ziqiu Zou
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Peiyuan Liu
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Yuanrong Yao
- Guizhou Provincial People's Hospital, Guiyang, China
- Yuanrong Yao
| | - Shaomei Shang
- Nursing School of Peking University Health Science Center, Beijing, China
- *Correspondence: Shaomei Shang
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Li D, Zhang J, Yang J, Xu Y, Lyu R, Zhong L, Wang X. Socio-economic inequalities in health service utilization among Chinese rural migrant workers with New Cooperative Medical Scheme: a multilevel regression approach. BMC Public Health 2022; 22:1110. [PMID: 35659640 PMCID: PMC9164856 DOI: 10.1186/s12889-022-13486-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background While reducing inequity in health service utilization is an important goal of China’s health system, it has been widely acknowledged that a huge number of rural migrant workers cannot be effectually protected against risks with the New Rural Cooperative Medical Insurance (NCMS). Method Data of the 2016 China Labor-force Dynamic Survey and the Chinese Urban Statistical Yearbook were used. The multilevel regression approach was implemented with a nationally representative sample of rural migrant workers with NCMS. Our study adopted the concentration index and its decomposition method to quantify the inequality of their health service utilization. Result The multilevel model analysis indicated that impact variables for health service utilization were not concentrated, especially the contextual and individual characteristics. The concentration indices of the probability of two weeks outpatient and the probability of inpatient were -0.168 (95%CI:-0.236,-0.092) and -0.072 (95%CI:-1.085,-0.060), respectively. The horizontal inequality indices for the probability of two-week outpatient and the probability of inpatient were -0.012 and 0.053, respectively. Conclusion The health service utilization of rural migrant workers with NCMS is insufficient. Our study highlighted that substantial inequalities in their health service utilization did exist. In addition, their need of health service utilization increased the pro-poor inequality. Based on the findings, our study offered notable implications on compensation policies and benefit packages to improve the equality among rural migrant workers with NCMS.
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Han B, Guan H. Associations between new health conditions and healthcare service utilizations among older adults in the United Kingdom: effects of COVID-19 risks, worse financial situation, and lowered income. BMC Geriatr 2022; 22:356. [PMID: 35459104 PMCID: PMC9030688 DOI: 10.1186/s12877-022-02995-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/31/2022] [Indexed: 11/21/2022] Open
Abstract
Background Health services are critically important for older adults, particularly during the Coronavirus disease-19 (COVID-19) pandemic. However, COVID-19 risks, worse financial situation, and lowered income may seriously impact health services by feasibility and accessibility. Therefore, the aim of the present study was empirically to explore how health-seeking behaviors are influenced by new health conditions through COVID-19 risks, worse financial situation, and lowered income. Methods Data were from ELSA COVID-19 waves 1 and 2 which included a sample of 6952 and 6710 older adults in the United Kingdom, respectively. The frequency distribution analyses were conducted by Chi-square analysis by gender groups. Zero-inflated Poisson regressions were used to examine how worse financial situation and lowered income were associated with COVID-19 risks and new health conditions. Logistic regressions were employed to examine the associations of COVID-19 risks, worse financial situation, and lowered income with treatment cancellation and accessible care. Cross-sectional mediation models, cross-sectional moderation models, longitudinal mediation models, and longitudinal moderation models were conducted based on Hayes model 6, Hayes model 29, Montoya model 1, and Montoya model 2, respectively. Results Most of the sample was >65 years old, females, located in urban place, and involved in long-standing condition. Regression analysis showed that COVID-19 risks, worse financial situation, and lowered income were associated with treatment cancellation and accessible care. In the longitudinal mediations, effect coefficients of ‘X’ → (treatment cancellation in wave 1 (Tcn1)- treatment cancellation in wave 2 (Tcn2))(β = −.0451, p < .0001, low limit confidence interval (LLCI) = −.0618, upper limit confidence interval (ULCI) = −.0284), ‘X’ → (COVID-19 risks in wave 1 (Csk1)- COVID-19 risks in wave 2 (Csk2)) (β = .0592, p < .0001, LLCI = .0361, ULCI = .0824), and ‘X’ → (lowered income in wave 1 (CIn1)- lowered income in wave 2 (CIn2)) (β = −.0351, p = .0001, LLCI = -.0523, ULCI = -.0179) were significant. Additionally, effect coefficients of ‘X’ → (accessible care in wave 1 (Acr1)- accessible care in wave 2 (Acr2)) (β = .3687, p < .0001, LLCI = .3350, ULCI = .4025),'X’ → (Csk1- Csk2) (β = .0676, p = .0005, LLCI = .0294, ULCI = .1058), and ‘X’ → (worse financial situation in wave 1- worse financial situation in wave 2) (β = −.0369, p = .0102, LLCI = -.0650, ULCI = -.0087) were significant. Conclusions There were longitudinal mediating effects of COVID-19 risks, worse financial situation, and lowered income on the relationship between new health conditions and treatment cancellation and relationship between new health conditions and accessible care. These findings suggest that worse financial situation, lowered income, and COVID-19 risks exerted an influence on the relationship between new health conditions and treatment cancellation and relationship between new health conditions and accessible care among older adults. Findings suggest that longitudinal mediations may be important components of interventions aiming to meet service needs. Long-term health policy implications indicate the need for reducing COVID-19 risks, improving financial situation, and increasing income among the targeted population. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02995-8.
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Affiliation(s)
- Bingxue Han
- International Issues Center, Xuchang University, Xuchang, Henan, China. .,Family Issues Center, Xuchang University, Xuchang, Henan, China. .,Xuchang Urban Water Pollution Control and Ecological Restoration Engineering Technology Research Center, Xuchang University, Xuchang, China. .,College of Urban and Environmental Sciences, Xuchang University, Xuchang, China.
| | - Hongyi Guan
- Grade 6 Class 7, Xuchang Municipal Xingye Road Primary School, Xuchang, Henan, China
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