Objective:Taking Inflammatory Bowel Disease(IBD)patients as an example,to explore the impact of disparities in regional outpatient security policies on medication reimbursement benefits for patients,and to provide insights for promoting the reform and development of equal outpatient security policy.Methods:39 cities from 9 provinces in China were selected as research samples to analyze the types,coverage,and benefits of their outpatient security policies.Indicators such as the individual out-of-pocket ratio,deductible,and specified reimbursement rate were used to simulate the actual reimbursement ratio for IBD patients using negotiated drugs.Results:Under the general outpatient coordination policy,the average actual reimbursement rate for medications in IBD patients was 26.36%for residents and 36.47%for employees.Under the outpatient chronic and special disease policy,the average actual reimbursement rate was 42.49%for residents and 50.94%for employees,while patients receiving drug treatment under the outpatient special drug policy have an average actual reimbursement rate of 51.62%(for residents)and 64.92%(for employees).Conclusion:Under China's outpatient security policies,there are significant disparities in reimbursement benefits for IBD patients across different regions.Therefore,it is recommended to strengthen the coordination of outpatient security policies across regions,optimize policy design,and provide patients with more equitable and accessible medical coverage.

Objective:Taking Inflammatory Bowel Disease(IBD)patients as an example,to explore the impact of disparities in regional outpatient security policies on medication reimbursement benefits for patients,and to provide insights for promoting the reform and development of equal outpatient security policy.Methods:39 cities from 9 provinces in China were selected as research samples to analyze the types,coverage,and benefits of their outpatient security policies.Indicators such as the individual out-of-pocket ratio,deductible,and specified reimbursement rate were used to simulate the actual reimbursement ratio for IBD patients using negotiated drugs.Results:Under the general outpatient coordination policy,the average actual reimbursement rate for medications in IBD patients was 26.36%for residents and 36.47%for employees.Under the outpatient chronic and special disease policy,the average actual reimbursement rate was 42.49%for residents and 50.94%for employees,while patients receiving drug treatment under the outpatient special drug policy have an average actual reimbursement rate of 51.62%(for residents)and 64.92%(for employees).Conclusion:Under China's outpatient security policies,there are significant disparities in reimbursement benefits for IBD patients across different regions.Therefore,it is recommended to strengthen the coordination of outpatient security policies across regions,optimize policy design,and provide patients with more equitable and accessible medical coverage.

Objective To investigate the differences in preoperative obesity-related diseases and body composition between adolescents and adults with obesity undergoing metabolic surgery. Methods A total of 454 patients who underwent metabolic surgery in Nanjing Drum Tower Hospital from July 2016 to July 2022 were recruited and divided into the adolescent group (age ≤19 years,n=61) and the adult group (age>19 years,n=393) according to the age of surgery. Preoperative body composition,obesity-related complications and metabolic indicators were compared between the two groups. Results Compared with adolescent group,age,obesity duration,DBP,WHR,trunk body fat percentage,Android fat/Gynoid fat,FPG,HbA1c,2 hPG,TC,TG,UACR,FOL and VitB12 were increased (P<0.05 or P<0.01),while height,weight,HC,total body fat percentage,thigh body fat percentage,Gynoid body fat percentage,FIns,2 hIns,SUA,AKP,eGFR,ALB,Ca2+were decreased in the adult group(P<0.05 or P<0.01).The incidence of prediabetes,grade 1 hypertension,hyperuricemia and psychological diseases was higher(P<0.05 or P<0.01),while the incidence of T2DM,grade 2 hypertension,grade 3 hypertension,liver fibrosis,carotid plaque and OSAHS was lower in adolescent group than in adult group (P<0.05 or P<0.01). Conclusions The preoperative fat distribution is healthier in adolescent patients with obesity undergoing metabolic surgery than that of adults.Obesity-related metabolic complications have already developed in adolescent patients,but less severe than in adult patients. Psychological health and nutritional supplementation should be emphasized in adolescents after metabolic surgery.

Objective To investigate the differences in preoperative obesity-related diseases and body composition between adolescents and adults with obesity undergoing metabolic surgery. Methods A total of 454 patients who underwent metabolic surgery in Nanjing Drum Tower Hospital from July 2016 to July 2022 were recruited and divided into the adolescent group (age ≤19 years,n=61) and the adult group (age>19 years,n=393) according to the age of surgery. Preoperative body composition,obesity-related complications and metabolic indicators were compared between the two groups. Results Compared with adolescent group,age,obesity duration,DBP,WHR,trunk body fat percentage,Android fat/Gynoid fat,FPG,HbA1c,2 hPG,TC,TG,UACR,FOL and VitB12 were increased (P<0.05 or P<0.01),while height,weight,HC,total body fat percentage,thigh body fat percentage,Gynoid body fat percentage,FIns,2 hIns,SUA,AKP,eGFR,ALB,Ca2+were decreased in the adult group(P<0.05 or P<0.01).The incidence of prediabetes,grade 1 hypertension,hyperuricemia and psychological diseases was higher(P<0.05 or P<0.01),while the incidence of T2DM,grade 2 hypertension,grade 3 hypertension,liver fibrosis,carotid plaque and OSAHS was lower in adolescent group than in adult group (P<0.05 or P<0.01). Conclusions The preoperative fat distribution is healthier in adolescent patients with obesity undergoing metabolic surgery than that of adults.Obesity-related metabolic complications have already developed in adolescent patients,but less severe than in adult patients. Psychological health and nutritional supplementation should be emphasized in adolescents after metabolic surgery.