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Shanghai Medical Resource Allocation Analysis

Chinese Journal of Health Statistics.2009;(5):466-469,472. doi:10.3969/j.issn.1002-3674.2009.05.005

Objective Through investigating the situation of health care resources in Shanghai ,from the point of population and geographical area distribution, the article analyze the fair allocation of medical resources in Shanghai to provide the basis of decision-making in rational allocation of medical resources. Methods Use Lorenz curve and the Gini coefficient indicators, as well as Chain Proportion Method. Results The allocation of medical resources in population of Shanghai is fairly,and the trend of fairness will be enhanced. In the geographical allocation in space is more unfairness in Shanghai,and the fairness will be reduced. Conclusion The allocation of medical resources Municipal Population has few gap between urban and rural areas in the Shanghai which reached a fair comparison, but in the geographic distribution of has a larger gap between urban and rural areas. Most of the medical resources concentrated in large hospitals in the urban centers. The distribution of Medical resources should be rational and the health service system should be improved to improve medical and health service accessibility.

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The Study and Application of Nonparametric Bayesian Methods for Benchmark Dose Estimation

Caijiao GU ; Tao WANG ; Tong WANG

Chinese Journal of Health Statistics.2017;34(6):861-865.

Objective Comparing the performance of the two nonparametric Bayesian methods for benchmark dose estimating under different dose response data,then comparing them with traditional parametric methods.Methods Introduce the basic principle of the nonparametric Bayesian method based on weighted process and stochastic process separately,then compared the estimations through simulate study and instance analysis.Results The simulate study shows that the posterior estimates were reasonably close to the target true BMD value for the two nonparametric methods,and NBP2 is more desirable compared to NPB1.The nine examples indicate that the BMD estimates from the nonparametric approaches generally fall into or very near the interval of those obtained from BMDS and nonparametric approaches tend to produce lower BMDLs than the parametric modeling approaches.Conclusion The posterior estimates were reasonably close to the target true BMD value for the two nonparametric methods,especially when standard parametric models fail to fit to the data adequately.The NPB2 method is slightly bet-ter than the NPB1 method in the aspect of estimation result and the software operation speed.

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Analysis on Prevalence, Disease Spectrum and Its Influencing Factors of Chronic Disease in the Elderly Residents in Xiamen

Yaofeng HAN ; Ping WANG ; Ya FANG

Chinese Journal of Health Statistics.2017;34(6):873-876,880.

Objective To examine the prevalence,disease spectrum of non-communicable chronic diseases and its risk factors among the elderly residents in Xiamen.Methods The elderly residents aged 60 or over in Xiamen were selected by stratified randomly sampling to analyze the spectrum of chronic disease.The data were analyzed by x2 test,trend x2 test and unconditional logistic regression.Results A total of 14292 elderly were investigated.The prevalence of chronic diseases was 63.3 ％.With the age increasing,the prevalence was also increased,the female residents had a higher prevalence compared with male,and the city was higher than the rural area(P ＜0.001).While suffering from two or more chronic diseases accounted for 31.9 ％.The top 5 of the most prevalent chronic diseases were osteoarthritis (30.5 ％),hypertension (30.1％),diabetes mellitus (9.7 ％),heart disease (7.9 ％),and gastrointestinal disease (7.6％).Sex,age,residence,marital status,loneliness,self-rated health are the influencing factors of the elderly in Xiamen.Conclusion More attention should be paid to the impact of osteoarthritis,hypertension,diabetes,heart disease and gastrointestinal gallbladder disease on the health of the elderly,especially osteoarthritis,and targeted to multiple chronic diseases comprehensive prevention and control and management.

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Confidence Intervals for Cumulative Incidence Function with Competing Risks Data

Jinbao CHEN ; HouYawen ; Zheng CHEN

Chinese Journal of Health Statistics.2018;35(1):22-25.

Objective The cumulative incidence function (CIF) is an important descriptive indicator for competing risk data in medical follow-up study.However,the upper and lower limits of the classic confidence interval (CI) of CIF may be exclusive the boundaries.In this paper,the CI estimators based on five different transformations and their performances are studied.Methods The CIs of CIF are constructed based on the linear (classical),log,log (-log),arcsine and logit transformation,respectively.Through the simulation study,the average deviations of the false coverage probabilities for all CIs are comprehensively investigated by the ANOVA technology.Results The simulation results show that the CIs based on linear and arcsine transformation have a large positive deviation.Log transformation is prone to fluctuations and has a minimum negative deviation,only log (-log) transformation is closest to the expected constant 0,and most robust and reliable.Conclusion Combined with the simulation results and example,CIs base on linear and log transformation are easy to have wide range and unstable performance,and can not overcome the bounds being negative or above 1;the arcsine and logit is slightly fluctuated,but their performances are relatively balanced;only performance of log(-log) is the most robust and reliable.

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A Research on Methods of Balance Evaluation among the Covariates of Multiple Groups

Fuqiang HUANG ; Jun XU ; Shengli AN

Chinese Journal of Health Statistics.2018;35(2):172-176.

Objective To construct a new index(abbreviate FQ statistic) for testing the balance of covariates among 3 groups;to compare the power of hypothesis testing,standardized difference and FQ statistics to test the balance of covariates among 3 groups.Methods Using pooled variance to build FQ Statistic;Calculating propensity score for each individual by using ordinal logistic regression and multinomial logistic regression;Comparing the power of hypothesis testing,standardized difference and FQ statistics to test the balance of covariates among 3 groups by Monte Carlo simulation.Results The distribution of a covariate can be considered balanced among the 3 groups if FQ statisticsis less than 0.2.The power of hypothesis test is affected by sample size but FQ statistics and standardized difference.The power of FQ statistics and standardized difference to test the balance of covariates among 3 groups are higher than hypothesis testing,and both highly consistent.Conclusion FQ statistics and standardized differences are valid methods to test the balance of covariates among 3 groups.With more convenient calculating step than standardized difference,FQ statistic has more advantages in applications.

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Analysis of Direct Economic Burden and Average Hospitalization Cost of Lung Cancer in China in 2011 -2015

Yue CAI ; Baohu YAN ; Gongwei ZHOU

Chinese Journal of Health Statistics.2018;35(3):334-337.

Objective To analyze the direct economic burden and average hospitalization cost of lung cancer in China from 2011 to 2015, to provide data support for the prevention and control of lung cancer and health insurance policies. Methods By using inpatient medical record home page dataset to estimate the total hospital expenses of lung cancer. Using the outpatient hospitalization cost ratio of cancer specialized hospitals to estimate the overall medical expenses of lung cancer. Based on the inpatient medical record home page dataset, and analyzed the average hospitalization cost of lung cancer. Results The total cost of lung cancer in China reached 24.31 billion yuan in 2015, accounting for about 0.6％ of the total health expenses; from 2011 to 2015, lung cancer medical costs have concentrated in the grade 3 general hospitals; people over 60 consumed the major medical costs of lung cancer and the proportion was still rising year by year; the average hospitalization cost of lung cancer was reduced in 2015; drug proportion in various hospitals declined steadily from 2011 to 2015; the average hospitalization cost was the highest in the 18 -40 age group. Conclusion The effect of health care reform was gradually revealed, and the increase of medical expenses was controlled within the tolerable range. Notably, we should accelerate the improvement of the price compensation mechanism, and at the same time, we should aim to improve the level of catastrophic health care for the elderly.

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The Application of Auto Regressive Time Varying Models to the Network Building of Time Series Microarray Data

Huijuan LIU ; Yan HOU ; Kang LI

Chinese Journal of Health Statistics.2018;35(5):642-645.

Objective To explore the application of auto regressive time varying models in network building of time se-ries microarray data.Methods We used actual data to carry out a preliminary discussion about the properties of auto regressive time varying models.Results Analysis results of actual data suggested that auto regressive time varying models can perform well whether the number of timepoint is large or small,and it can recognize the network’s dynamic variation rule.Conclusion Auto regressive time varying models is applicable to network building of time series microarray data.

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Analyzing the Impact of the NRCMS Polices on the Utilization of Outpatient Services in Rural Resident Based on the Balanced Panel Data

Juan ZHENG ; Jianqiang XU

Chinese Journal of Health Statistics.2018;35(5):689-694.

Objective To analyze the influence of NRCMS polices evolutionon residents’utilizationof outpatient serv-ices.Methods Based on the same individual balance panel data in two years of three counties in Ji＇nan city,we build panel dat-amodel and conductrandom effects of binary choice panel data model,random effects Poisson regression model,difference in differences(DID)model to analyze the influence.Results Our study shows that the four-week consultation rate in 2011 in-creased by 4. 1% compared to 2008.Age,self-ratedhealthstatus,suffering from chronic diseases or not,the distance to the nearest medical institution have an influence on outpatient service utilization.The new rural cooperative medical outpatient reimburse-ment policy has an effect on thefour-week consultation rate of middle-income residents and high-income residents.The NCMS policy tends to benefit middle and high-income groups.Conclusion we should increase NCMS outpatient compensation level of low-income residents appropriately.

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Analysis of the Disease Burden of Lung Cancer Attributable to Air Pollution in China from 1990 to 2021

Yueyi LIU ; Zhenling CUI

Chinese Journal of Health Statistics.2025;42(3):350-354. doi:10.11783/j.issn.1002-3674.2025.03.006

Objective To analyze the disease burden of lung cancer attributable to air pollution among the Chinese population from 1990 to 2021,providing a scientific basis for the prevention and control strategies of lung cancer.Methods Data on deaths,mortality rates,disability-adjusted life years(DALY)of lung cancer,and world population data attributable to air pollution in China from 1990 to 2021 were extracted from the global burden of disease study 2021(GBD 2021).The Joinpoint regression model was used to calculate the annual percentage change(APC)and average annual percentage change(AAPC)for analysis of disease burden.The age-period-cohort model was employed to investigate the effects of age,period,and cohort on the trends in lung cancer disease burden attributable to air pollution.Results The population attributable fraction(PAF)of lung cancer in China due to air pollution has shown a trend of decrease,with an average AAPC value of-1.16%(P<0.001).The numbers of death and DALYs generally increased by years,with an AAPC value of 2.14%and 1.54%,respectively(both P<0.001).However,the standardized mortality rate and standardized DALY rate initially increased and then decreased,with an AAPC value of 0.34%and-0.14%,respectively,showing no statistical significance.The mortality rate,standardized mortality rate,DALY rate,and standardized DALY rate of lung cancer attributable to air pollution were higher in males than in females.Age-period-cohort model analysis showed that the net drifts of lung cancer mortality rates attributable to air pollution for the overall population,males,and females were-1.52%,-1.33%,and-1.88%,respectively(all P<0.001).The death risk increased with age.There are higher mortality rates in males across all age groups compared to females,especially in the population over 50 years.The period effect showed a U-shape trend from 1990 to 2004,and a decreasing trend after 2005.There was a decreasing trend of death risk with the progression of birth cohorts.Conclusion From 1990 to 2021,the relative contribution of air pollution to lung cancer in China has gradually decreased,and the risk of lung cancer death attributable to air pollution has generally shown a downward trend.The risk is higher in males than in females,higher in elderly population,and lower with the progression of birth cohorts.Increased attention should be paid to high-risk groups such as males and the elderly population,and early screening and intervention for the disease should be strengthened to reduce the risk of lung cancer.

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A Study on the Effects of the Integration Policy of Basic Medical Insurance for Urban and Rural Residents on the Health and Health Inequality of Middle and Elderly People

Liangwen ZHANG ; Rui CHEN ; Ying DUAN

Chinese Journal of Health Statistics.2025;42(3):322-327. doi:10.11783/j.issn.1002-3674.2025.03.001

Objective To explore the impact of urban and rural resident basic medical insurance(URRBMI)integration policy on the health and health inequality of middle-aged and elderly people,and to provide an evidence-based basis for further improving the URRBMI system.Methods Based on data from the China health and retirement longitudinal study(CHARLS)from 2013 to 2018,the impact of the URRBMI integration policy on the self-rated health,disability,and depression of middle-aged and elderly people was investigated using the staggered differences-in-differences method.The health inequality status of middle-aged and elderly people and its change trend were analyzed by the concentration index,and the index was decomposed according to different years and different integration modes to explore the impact of URRBMI on health inequality of middle-aged and elderly people.Results A study was conducted on 7589 middle-aged and elderly individuals,which found that the URRBMI integration policy had a significant positive impact on the self-rated health of this population(OR=1.309,P<0.001).Additionally,the policy had a significant negative impact on the occurrence of depression(OR=0.696,P<0.001).However,it was found to increase the disability score of middle-aged and elderly individuals(β=0.354,P<0.001)and did not improve their disability status.In addition,health disparity exists among middle-aged and elderly people in China,and middle-aged and elderly people with health problems are mainly concentrated in groups with lower socioeconomic status,and health disparity has been increasing over time.Health insurance for urban and rural residents has a certain effect on alleviating health inequality,the contribution rate of disability inequality and depression inequality decreased from 1.21%and 1.20%in 2013 to-0.58%and 0.31%in 2018,respectively,and compared with the one-tier model,the split-tier system has a greater negative impact on the health status of low-income groups.Conclusion The URRBMI integration policy improved the self-rated health and depression status of middle-aged and elderly people,but had a limited effect on improving the disability status.The policy can reduce the health inequality of middle-aged and elderly people to some extent,but the health inequality varies widely within the population.It is recommended to strengthen the top-level design of URRBMI,to shift from a strategy that emphasizes medicine over prevention to one that emphasizes prevention and combines prevention and treatment,and to shift from formal equity based on the elimination of household boundaries to substantive equity based on the elimination of reimbursement policies and other barriers.

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