1.An Analysis of the Curative Expenditure and Economic Burden of Mental Health and Mental Retardation Disorders in China
Li WANG ; Peipei CHAI ; Quan WAN ; Wenbin GAO
Chinese Health Economics 2024;43(2):41-44
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.
2.International Comparison of the Medical Economic Burden among Populations Based on System of Health Accounts 2011
Chinese Health Economics 2024;43(5):72-78
Objective:Based on"the System of Health Account 2011",it aimed to analyze the differences and causes of the medical economic burden between domestic and foreign population,and provide reference for the medical economic risk protection policies in China.Methods:Data of recurrent health expenditure of China and OECD member states were collected and descriptive statistical analysis was used to explore the relationship between the population's economic burden of medical treatment and medical security system and health service system.Results:In 2020,the average proportion of personal health expenditure in household con-sumption expenditure in OECD member countries was 3%,and the proportion in China was 5.24%.In China,public financing ac-counted for 54.81%of recurrent health expenses,which was lower than the average of OECD member states.Personal health expendi-ture of OECD member states was mainly spent on medical supplies and outpatient services,and China's personal health expenditure was mainly spent on outpatient services and inpatient services.Conclusion:Difference of medical security system is the important factor of the uneven medical burden.An appropriate health service delivery system is the basis to reduce the medical economic bur-den,a perfect hierarchical medical service system can guide the demand for medical service,and the collaborative chain of"pre-vention-diagnosis-control-care-rehabilitation"is fundamental to alleviate the medical economic burden.
3.Analysis on the Trends of Regional Differences in Total Health Expenditure in China in the New Era
Feng GUO ; Yuchen ZHOU ; Peipei CHAI
Chinese Health Economics 2024;43(6):54-58,74
Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.
4.Practice and Enlightenment of Strengthening Health System Resilience through Investment in OECD Countries
Guochun XIANG ; Weilin CHEN ; Xiaocan SUN ; Quan WAN ; Peipei CHAI
Chinese Health Economics 2024;43(6):89-92,96
Sound financing mechanism is an important support for the development of health system.In response to the problems exposed in the health system during the COVID-19 pandemic,OECD countries have proposed intervention directions and investment strategies to strengthen the resilience of the health system.The investment allocation in strengthening core public health capabilities,proactive material reserves,and coordinated supply from OECD countries were analyzed,in order to explore the characteristics and effectiveness,which could provide a reference for strengthening the resilience of China's health system.
5.Study on the Chronic Disease Comorbidities Pattern and the Distribution of Catastrophic Health Expenditure among the Elderly in China
Chinese Health Economics 2024;43(8):47-50
Objective:Clarifying the comorbidity patterns of chronic disease and its distribution of catastrophic health expenditure in the elderly,in order to provide scientific data support for the development of chronic disease management strategies in various regions.Methods:Data were selected from China Health and Retirement Survey.Latent class model and Geoda were used to analyze the mode of chronic disease comorbidities in the elderly and the spatial distribution of catastrophic health expenditures.Results:The comorbidity pattems of chronic diseases in the elderly included circulatory and metabolic diseases,digestive disease,skeletal diseases,respiratory diseases,tumors,digestive and psychiatric diseases,and multisystem diseases.The incidence of catastrophic health expenditure with chronic disease comorbidities was 30.12%,and Moran's I value was 0.854(P<0.05),indicating spatial autocorrelation.Qinghai,Inner Mongolia and Tianjin etc.were high-high areas,while Liaoning,Jilin and Zhejiang etc.were low-low areas.Conclusion:The occurrence of catastrophic health expenditures was characterized by sociodemographic differences and regional and comorbidity pattems of inequality.It is suggested that we should pay more attention to the management of chronic diseases,dynamically adjust the old-age chronic disease insurance policy and explore medical security system with a comorbidity model.
6.Strategies for Reducing Potentially Preventable Hospitalizations in U.S.Long-Term Care Facilities and Implications for China
Ran XIN ; Xueyu LI ; Peipei CHAI
Chinese Health Economics 2024;43(10):91-96
Based on discussing the U.S.strategies for reducing potentially preventable hospitalizations(PPHs)among elderly residents in long-term care facilities,the experiences are explored to provides insights for policy development in China.The U.S.has effectively lowered PPH rates and healthcare costs through a comprehensive long-term care service system,clinical interventions,and incentives.Analyzing the effectiveness and challenges of these measures suggests that China should conduct the reform by clarifying the roles of care institutions,strengthening incentive mechanisms,improving caregiver training,establishing evaluation systems,and enhancing data-driven decision support.It aims to develop a long-term care system tailored to China,reduce PPH rates,and improve the quality and efficiency of nursing services.
7.International Comparison of the Medical Economic Burden among Populations Based on System of Health Accounts 2011
Chinese Health Economics 2024;43(5):72-78
Objective:Based on"the System of Health Account 2011",it aimed to analyze the differences and causes of the medical economic burden between domestic and foreign population,and provide reference for the medical economic risk protection policies in China.Methods:Data of recurrent health expenditure of China and OECD member states were collected and descriptive statistical analysis was used to explore the relationship between the population's economic burden of medical treatment and medical security system and health service system.Results:In 2020,the average proportion of personal health expenditure in household con-sumption expenditure in OECD member countries was 3%,and the proportion in China was 5.24%.In China,public financing ac-counted for 54.81%of recurrent health expenses,which was lower than the average of OECD member states.Personal health expendi-ture of OECD member states was mainly spent on medical supplies and outpatient services,and China's personal health expenditure was mainly spent on outpatient services and inpatient services.Conclusion:Difference of medical security system is the important factor of the uneven medical burden.An appropriate health service delivery system is the basis to reduce the medical economic bur-den,a perfect hierarchical medical service system can guide the demand for medical service,and the collaborative chain of"pre-vention-diagnosis-control-care-rehabilitation"is fundamental to alleviate the medical economic burden.
8.Analysis on the Trends of Regional Differences in Total Health Expenditure in China in the New Era
Feng GUO ; Yuchen ZHOU ; Peipei CHAI
Chinese Health Economics 2024;43(6):54-58,74
Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.
9.Practice and Enlightenment of Strengthening Health System Resilience through Investment in OECD Countries
Guochun XIANG ; Weilin CHEN ; Xiaocan SUN ; Quan WAN ; Peipei CHAI
Chinese Health Economics 2024;43(6):89-92,96
Sound financing mechanism is an important support for the development of health system.In response to the problems exposed in the health system during the COVID-19 pandemic,OECD countries have proposed intervention directions and investment strategies to strengthen the resilience of the health system.The investment allocation in strengthening core public health capabilities,proactive material reserves,and coordinated supply from OECD countries were analyzed,in order to explore the characteristics and effectiveness,which could provide a reference for strengthening the resilience of China's health system.
10.Study on the Chronic Disease Comorbidities Pattern and the Distribution of Catastrophic Health Expenditure among the Elderly in China
Chinese Health Economics 2024;43(8):47-50
Objective:Clarifying the comorbidity patterns of chronic disease and its distribution of catastrophic health expenditure in the elderly,in order to provide scientific data support for the development of chronic disease management strategies in various regions.Methods:Data were selected from China Health and Retirement Survey.Latent class model and Geoda were used to analyze the mode of chronic disease comorbidities in the elderly and the spatial distribution of catastrophic health expenditures.Results:The comorbidity pattems of chronic diseases in the elderly included circulatory and metabolic diseases,digestive disease,skeletal diseases,respiratory diseases,tumors,digestive and psychiatric diseases,and multisystem diseases.The incidence of catastrophic health expenditure with chronic disease comorbidities was 30.12%,and Moran's I value was 0.854(P<0.05),indicating spatial autocorrelation.Qinghai,Inner Mongolia and Tianjin etc.were high-high areas,while Liaoning,Jilin and Zhejiang etc.were low-low areas.Conclusion:The occurrence of catastrophic health expenditures was characterized by sociodemographic differences and regional and comorbidity pattems of inequality.It is suggested that we should pay more attention to the management of chronic diseases,dynamically adjust the old-age chronic disease insurance policy and explore medical security system with a comorbidity model.
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