Objective:To analyze the changing trends and influencing factors of the Chronic Obstructive Pulmonary Disease(COPD)burden in China,and provide evidence for adjusting related prevention and control policies.Methods:Utilizing the 2021 Global Burden of Disease(GBD)database,it conducted a comprehensive analysis of COPD prevalence,mortality,and disease burden trends in China through disease burden assessment and Age-Period-Cohort(APC)modeling,alongside projections for future trends.Results:From 1990 to 2021,China's age-standardized COPD disease burden showed a declining trend.APC models revealed significant birth cohort effects on COPD prevalence and mortality.Air pollution and tobacco smoke exposure were identified as primary risk factors for COPD-related deaths and disease burden.Projections indicate that the age-standardized prevalence,mortality,and Disability-Adjusted Life Year(DALY)rates of COPD will continue to decrease over the next five years.Conclusion:While China's COPD disease burden has generally declined,prevention and control remain challenging.Significant population heterogeneity in disease burden necessitates targeted interventions for high-risk groups.Establishing an integrated"prevention-diagnosis-control-treatment-rehabilitation"healthcare system is critical to delivering holistic care for COPD patients.

Objectives:Accounting Total Health Expenditure(THE)in 2023,analyzing the changes of health financing in China since 2015,summarizing the main problems and challenges faced by health financing in China at present,and putting forward policy suggestions to improve health financing.Methods:Health expenditure accounting methods by financing source and by health provider were applied,and the change of total health expenditure in China is analyzed through the index analysis of time series.Results:THE in 2023 in China was 9 057.58 billion yuan,an increase of 6.77%over the previous year,accounting for 7.00%of GDP,and per capi-ta health expenditure was 6 425.32 yuan.The proportion of government health expenditure in THE decreased to 26.66%,the propor-tion of social health expenditure increased to 46.01%,and the proportion of household Out-of-Pocket(OOP)rebounded to 27.33%.Conclusions:The total scale of health expenditure in China continues to grow,but the growth rate slows down,and the stability and sustainability of health financing need to be strengthened.It is necessary to speed up the construction of a government investment mechanism based on health priority development,improve the social health insurance system,guide the rational resource allocation,and reduce the burden of medical treatment for residents.

Objectives:Accounting Total Health Expenditure(THE)in 2023,analyzing the changes of health financing in China since 2015,summarizing the main problems and challenges faced by health financing in China at present,and putting forward policy suggestions to improve health financing.Methods:Health expenditure accounting methods by financing source and by health provider were applied,and the change of total health expenditure in China is analyzed through the index analysis of time series.Results:THE in 2023 in China was 9 057.58 billion yuan,an increase of 6.77%over the previous year,accounting for 7.00%of GDP,and per capi-ta health expenditure was 6 425.32 yuan.The proportion of government health expenditure in THE decreased to 26.66%,the propor-tion of social health expenditure increased to 46.01%,and the proportion of household Out-of-Pocket(OOP)rebounded to 27.33%.Conclusions:The total scale of health expenditure in China continues to grow,but the growth rate slows down,and the stability and sustainability of health financing need to be strengthened.It is necessary to speed up the construction of a government investment mechanism based on health priority development,improve the social health insurance system,guide the rational resource allocation,and reduce the burden of medical treatment for residents.

Objective:To explore the differences in the cost structures of Hemophagocytic Lymphohistiocytosis(HLH)and Still's disease,and provide a basis for optimizing the medical insurance and hierarchical diagnosis and treatment policies for rare diseases.Methods:Based on the theories and methods of SHA 2011,the treatment costs and financing models of HLH and Still's disease in 2020 were calculated and analyzed to calculate its financing mode.Results:In 2020,the treatment cost of HLH in China was 436 million yuan,with 98.62%occurring in inpatient services;the treatment cost of Still's disease was 159 million yuan,with 82.32%occurring in inpatient services.In terms of the financing composition,the proportion of household health expenditure in outpatient services for HLH reached to 65.51%;for adult Still's disease,the proportion of household health expenditure in outpatient services was 65.13%;for pediatric Still's disease,the proportion of household health expenditure in outpatient services was as high as 93.15%,and the compensation from social medical insurance was less than 4%.Conclusion:In China,there are problems such as imbalanced cost structures,uneven distribution of diagnosis and treatment resources,heavy family burdens,and differentiation in the attention paid to rare diseases.It is necessary to improve the accounting system,strengthen grassroots diagnosis and treatment,optimize the financing mechanism,increase the attention to"non-star"rare diseases,and promote universal protection.

Objective:To analyze the changing trends and influencing factors of the Chronic Obstructive Pulmonary Disease(COPD)burden in China,and provide evidence for adjusting related prevention and control policies.Methods:Utilizing the 2021 Global Burden of Disease(GBD)database,it conducted a comprehensive analysis of COPD prevalence,mortality,and disease burden trends in China through disease burden assessment and Age-Period-Cohort(APC)modeling,alongside projections for future trends.Results:From 1990 to 2021,China's age-standardized COPD disease burden showed a declining trend.APC models revealed significant birth cohort effects on COPD prevalence and mortality.Air pollution and tobacco smoke exposure were identified as primary risk factors for COPD-related deaths and disease burden.Projections indicate that the age-standardized prevalence,mortality,and Disability-Adjusted Life Year(DALY)rates of COPD will continue to decrease over the next five years.Conclusion:While China's COPD disease burden has generally declined,prevention and control remain challenging.Significant population heterogeneity in disease burden necessitates targeted interventions for high-risk groups.Establishing an integrated"prevention-diagnosis-control-treatment-rehabilitation"healthcare system is critical to delivering holistic care for COPD patients.

Objective:To explore the differences in the cost structures of Hemophagocytic Lymphohistiocytosis(HLH)and Still's disease,and provide a basis for optimizing the medical insurance and hierarchical diagnosis and treatment policies for rare diseases.Methods:Based on the theories and methods of SHA 2011,the treatment costs and financing models of HLH and Still's disease in 2020 were calculated and analyzed to calculate its financing mode.Results:In 2020,the treatment cost of HLH in China was 436 million yuan,with 98.62%occurring in inpatient services;the treatment cost of Still's disease was 159 million yuan,with 82.32%occurring in inpatient services.In terms of the financing composition,the proportion of household health expenditure in outpatient services for HLH reached to 65.51%;for adult Still's disease,the proportion of household health expenditure in outpatient services was 65.13%;for pediatric Still's disease,the proportion of household health expenditure in outpatient services was as high as 93.15%,and the compensation from social medical insurance was less than 4%.Conclusion:In China,there are problems such as imbalanced cost structures,uneven distribution of diagnosis and treatment resources,heavy family burdens,and differentiation in the attention paid to rare diseases.It is necessary to improve the accounting system,strengthen grassroots diagnosis and treatment,optimize the financing mechanism,increase the attention to"non-star"rare diseases,and promote universal protection.

Objective:To calculate the scale of China's mental health treatment costs,analyze its financing structure,and provide a decision-making basis for optimizing China's mental health disease financing,prevention and control policies.Methods:System of Health Account 2011 was employed to calculate mental disorders(MDs)curative expenditure,and analyze the expenditure by health function,health provider and financing schemes.Results:In 2018,MDs curative expenditure in China was 87.17 billion yuan.Of MDs curative expenditure,over 84%occurred in hospitals,and over 66%was spent on inpatient care.31.80%of MDs curative expenditure was financed by Out-of-Pocket(OOP).Conclusion:China's mental health and mental disorders treatment costs are developing rapidly,the existing resource allocation is unreasonable,and there is an urgent need to optimize the function and institutional configuration.MDs patients and their families bare a high burden on MDs curative expenditure,and the financing policy needs to be further improved.

Objective To establish a cost-benefit evaluation (CBE) index system which is suitable for health enterprise construction, and provide an effective tool for conducting economic evaluation of health enterprise development. Methods The index pool of CBE index system for health enterprise construction was initially established by comprehensive use of field surveys, key informant interviews and literature review. The improved Delphi method was used to conduct two rounds of expert correspondences with 21 experts, through which the evaluation indicator system was adjusted and refined based on the experts' opinions, ultimately the CBE indicator system suitable for health enterprise construction was determined. Results The effective questionnaire recovery rates of the two rounds of expert consultations were 100.0%. The expert authority coefficients was 0.88, and the Kendall's W coordination coefficients of the cost input indicator and benefit indicator in the second round of expert consultation were 0.14 and 0.15 (all P<0.001), with Cronbach's α coefficient of reliability evaluation of index system were all >0.80. The final CBE index system for health enterprise construction includes cost input indicators focusing on four dimensions: “improving management systems”, “building a healthy environment”, “enhancing health management and services”, and “cultivating a healthy culture”. It covered four primary indicators, ten secondary indicators, and 22 tertiary indicators. The benefit indicators mainly focused on the four primary indicators, including “health productivity”, “clinical output”, “economic output”, and “cultural output”, ten secondary indicators, and 23 tertiary indicators. Conclusion The CBE indicator system for health enterprise construction developed in this study is highly reliable, scientific, and practical. It can serve as a tool for the preliminary evaluation and general application of the cost-benefit evaluation of health enterprise construction and provide strong support for future research.

Objective:To analyze the disease burden and trend of osteoporosis in China from 1990 to 2021,and provide theoretical basis for the prevention and control of osteoporosis. Methods:Using the Global Burden of Disease 2021 (GBD 2021) database,the descriptive analysis of the mortality and disease burden of osteoporosis in different sex and age groups in China from 1990 to 2021 was conducted,the annual change percentage and the average annual change percentage were calculated using Joinpoint Software,and the Age-Period-Cohort (APC) model was used to evaluate the impact of age,period and birth cohort factors on disease burden. Results:The mortality and disease burden of Low Bone Mineral Density (LBMD) in male is higher than that of female,and the mortality and disease burden increases with age,and the mortality and disease burden is the highest in people over 80 years old. The gross rate of Disability Adjusted Life Years (DALYs) in female is higher than that in male after the age of 65;falls are the leading cause of LBMD-related deaths. The mortality rate,DALY rate and YLL rate showe a downward trend. The burden of LBMD mortality and disease in China is higher than that in the world. The age effect coefficient shows an upward trend,the period effect coefficient shows a first increasing and then decreasing trend,and the birth cohort effect coefficient shows a downward trend. Conclusion:With the intensification of aging,the burden of osteoporosis-related diseases in China will still be very heavy in the future. It is needed to actively carried out fall prevention and control strategies to reduce the occurrence of osteoporotic fractures and related deaths;take multiple measures to strengthen the monitoring and prevention of osteoporosis.

Objective:To analyze the disease burden and trend of osteoporosis in China from 1990 to 2021,and provide theoretical basis for the prevention and control of osteoporosis. Methods:Using the Global Burden of Disease 2021 (GBD 2021) database,the descriptive analysis of the mortality and disease burden of osteoporosis in different sex and age groups in China from 1990 to 2021 was conducted,the annual change percentage and the average annual change percentage were calculated using Joinpoint Software,and the Age-Period-Cohort (APC) model was used to evaluate the impact of age,period and birth cohort factors on disease burden. Results:The mortality and disease burden of Low Bone Mineral Density (LBMD) in male is higher than that of female,and the mortality and disease burden increases with age,and the mortality and disease burden is the highest in people over 80 years old. The gross rate of Disability Adjusted Life Years (DALYs) in female is higher than that in male after the age of 65;falls are the leading cause of LBMD-related deaths. The mortality rate,DALY rate and YLL rate showe a downward trend. The burden of LBMD mortality and disease in China is higher than that in the world. The age effect coefficient shows an upward trend,the period effect coefficient shows a first increasing and then decreasing trend,and the birth cohort effect coefficient shows a downward trend. Conclusion:With the intensification of aging,the burden of osteoporosis-related diseases in China will still be very heavy in the future. It is needed to actively carried out fall prevention and control strategies to reduce the occurrence of osteoporotic fractures and related deaths;take multiple measures to strengthen the monitoring and prevention of osteoporosis.