1.Development of premium healthcare industry:International experience and implications
Xinye FANG ; Lili SHI ; Xianji WANG ; Linan WANG ; Chen FU ; Chunlin JIN ; Da HE
Chinese Journal of Health Policy 2015;8(3):5-9
Premium healthcare is the key area of healthcare industry and private medical institutions. Howev-er, with the expansion of VIP services in public hospitals and policy barriers to private medical institutions, the de-velopment of premium healthcare in China is still in its early stage. The premium healthcare industry has in fact be-gun to take shape in some developed countries, accumulating rich experience in the aspects of developing bases, op-erating modes and security systems. Therefore, this paper introduces the experiences of premium healthcare develop-ment in several countries:the United Kingdom, the United States, Germany, Singapore, Australia, and India: the building of safety net hospitals;the setting of hierarchical pricing and differential financial assistance;the use of pub-lic-private partnership based on commercial health insurance to determine prioritization. Based on the actual situation in China, this paper provides some implications to develop premium healthcare, including the implementation of dif-ferential payment policies built on the provision of basic healthcare services, the promotion of commercial health in-surance and public-private partnerships, and the determination of preferential areas.
2.Concept, connotation and priorities of premium healthcare:A case study of Shanghai
Chunlin JIN ; Da HE ; Chen FU ; Linan WANG ; Xinye FANG ; Lili SHI ; Xianji WANG
Chinese Journal of Health Policy 2015;8(3):1-4
Premium healthcare is one of the major components of private healthcare, a key part of the health service industry, and one of the significant areas of the Thirteenth Five-Year Plan of health. However, there is no clear definition of premium healthcare that is widely accepted based on a Chinese literature review, and to define the concept of premium healthcare is the basis and premise for research. This paper adopted the methods of systematic re-view, field investigation and key person interviews to clarify the definition of premium healthcare and the results sug-gested that areas of health management, medical care for the elderly, mobile medical care, and so on should be the priorities of premium healthcare development.
3.Status quo and trend of VIP services in the tertiary public hospitals of Shanghai
Da HE ; Linan WANG ; Xianji WANG ; Lili SHI ; Xinye FANG ; Zhenyi SHAO ; Zhihui XIE ; Chen FU ; Chunlin JIN
Chinese Journal of Health Policy 2015;8(3):17-23
Objective:To analyze status quo and trends of VIP services in the tertiary public hospitals of Shang-hai and provide references for health administrative departments. Methods:Health policies of VIP services in tertiary public hospitals were searched and analyzed, and the number of medical institutions, services, prices and service fees were analyzed from 2011 to 2013 . Results:There is a clear demand for VIP services in the tertiary public hospi-tals of Shanghai, and fees for rooms, nursing, and examinations for outpatient and inpatient care are decided by the hospitals. 89. 7% of the tertiary public hospitals in Shanghai offered VIP services, and the trend was steadily grow-ing. The four services that could be decided by hospitals varied greatly, and the service fees for inpatient care in-creased significantly. The total cost of VIP services in the tertiary public hospitals of Shanghai accounted 6. 2% of all costs, and the percentage of income from drugs was lower. Conclusions:VIP services in public hospitals have a his-torical necessity;management should be strengthened in the short term;public hospitals should strengthen their own management and provide VIP services regularly, and health administration departments should strengthen regulation. In the long run, it is suggested that public hospitals should draw lessons from international experiences to form a pat-tern of multi-level medical services and actively carry out cooperation with private medical institutions.
4.Status quo and trend of premium private health services in Shanghai
Da HE ; Xianji WANG ; Linan WANG ; Zhenyi SHAO ; Zhihui XIE ; Xinye FANG ; Lili SHI ; Chen FU ; Chunlin JIN
Chinese Journal of Health Policy 2015;8(3):10-16
Objective:To study status quo of premium private health services and analyze the trend of its devel-opment. Method:The scope of premium private medical institutions was first defined. Then, seven indicators were used to analyze the allocation of resources;two indicators were used to analyze services;eight indicators were used to analyze costs. The entire situation of different styles of institutions through 2011 to 2013 was compared. Results:The results indicated that in the allocation of resources, the current level of premium private medical institutions is not high enough;large-scale construction is still at its early stages;and the medical personnel structure is not reasonable enough;as for service quantity, the total growth rate of premium private medical institutions is high but the service quantity is still far below that of the VIP services in public hospitals;as for medical expenses, premium private medi-cal institutions are charging high service fees, and the internal structure of the expenses is reasonable. Conclusions:Although the development of premium private health services is at an early stage, development prospects are promis-ing. Premium private health services should strengthen the aspects of medical technology, service levels, management capabilities, human resource building, and brand development.
5.Independent and joint effect of brachial-ankle pulse wave velocity and body mass index level on incident diabetes with hypertension
Jie WANG ; Yu PEI ; Kang CHEN ; Wenhua YAN ; Anping WANG ; Yijun LI ; Weijun GU ; Haibing WANG ; Ping AN ; Xinye JIN ; Guang NING ; Yiming MU
Chinese Journal of Endocrinology and Metabolism 2018;34(4):287-294
Objective To investigate whether brachial-ankle pulse wave velocity(baPWV),independently and jointly with the level of body mass index(BMI),affect the risk of incident diabetes with hypertension. Methods The effects of baPWV and BMI level on incident diabetes with hypertension were evaluated using Kaplan-Meier curves (log-rank test) and multi logistical regression models after adjustment for various confounding factors. Results A total of 2 222 participants were recruited in this study. Higher baPWV (Q4) was associated with a greater risk of incident diabetes with hypertension simultaneously compared with baPWV in the lower quartiles(Q1-Q3),with HR 4.16(95% CI 2.14,8.09)in the crude model,2.52(95% CI 1.10,5.78) in modelI,and 2.45(95% CI 1.05, 5.70)in modelⅡ.The highest risk of diabetes with hypertension simultaneously was in the group with high baPWV and BMI≥25 kg/m2,with HR 11.50(95% CI 4.5,29.9)in the crude model,4.20(95% CI 1.4,13.1)in modelI,and 4.30(95% CI 1.4,13.3) in modelⅡ. Conclusions The joint effect of baPWV and BMI level on incident diabetes with hypertension simultaneously is a better predictor than their independent effect. The risk of incident diabetes with hypertension markedly increases in the subjects with BMI≥25 kg/m2and higher baPWV.
6.Pedigree analysis of a osteogenesis imperfect and prolactinoma family caused by a newly found gene mutation in COL1A1
Songmei HAN ; Qiong LIU ; Xinye JIN ; Haiying XIAO ; Kang CHEN ; Xianling WANG ; Yonghong LEI ; Qinghua GUO
Chinese Journal of Endocrinology and Metabolism 2018;34(9):778-783
Objective To explore the collagen, typeⅠ, α 1 chain ( COL1A1) gene mutation in a family with type 1 osteogenesis imperfect. Methods The medical records and DNA samples of an osteogenesis imperfect patient and her family members were collected, and their DNA sequencing were performed and compared with 50 non-relative healthy control from the same area. Results The proband and her three family members ( father, younger brother, and younger nephew) with clinical features of osteogenesis imperfect as well as prolactinoma were confirmed of COL1A1 gene mutation at the 24th intron with a shear mutation of c. 1669-1 G>A which was not reported previously. Other family members were genetically normal compared with the normal. Conclusions We found a new COL1A1 gene mutation family and mutation site, but the relationship between osteogenesis imperfect and prolactinoma was unknown.