Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective Based on the health level,the factors affecting female labor participation were understood,and the years of delayed employment for middle-aged and elderly women were estimated.Methods Using the 2011,2013,2015,and 2018(CHARLS)data,Women aged 45～69 years were selected as subjects.The CMR health measurement model was used to estimate the delayed working years of women with different characteristics.Results The average labor force participation rate for women aged 45～69 is 66.93%,with the poorer the level of health,the more likely they are to drop out of the labor market.women aged 50～69 have an additional working capacity of 3.29～3.61 years;the urban women's group aged 50～69 have an additional working capacity of 7.86～8.36 years,and the junior high school and above women's group aged 50～69 have an additional working capacity of 5.89～6.33 years.Conclusion Women in China still have great potential for healthy work to be tapped,especially for middle-aged and elderly women with good health in cities and towns and with high education.Reasonably formulating retirement policies for women of different groups and gradually realizing the retirement of men and women at the same age will help to further promote the workplace gender equality and healthy aging.

Objective:To analyze the basic medical insurance fund balance status in China and the risk warning since the new medical reform,in order to provide decision-making references for the sustainable development of basic medical insurance fund in China.Methods:Collecting the data on the basic medical insurance fund in China from 2009 to 2022 for descriptive statistical analysis,and conduct fund balance risk warning analysis based on the risk warning interval.Results:During 2009-2021,the percentage of retirees enrolled in UEBMI has continued to increase,and there will still be a certain accumulated balance in the integrated fund.The number of participants in the URBMI has been decreased since 2020,the growth rate of fund expenditures became higher than the growth rate of fund revenues,the fund balance showed a decreasing trend.Conclusion:There are certain risks to the long-term balance of the basic medical insurance fund,which may caused by factors such as aging population,funding mechanisms,and treatment levels.

Objective To clarify the interaction among the interests and strategic choices of multiple subjects of medical insurance for the older people in China,and to provide a decision-making basis for the improvement of medical insurance policy for the older people.Methods An evolutionary game model was constructed based on evolutionary game theory and its steady state was simulated using Matlab R2021b software for the health insurer,the health care provider and the elderly.Results There is a conflict of interest between health insurance providers,healthcare providers and older people when all three parties consider maximising their own utility.In order to reach an evolutionary equilibrium,the strategic choice of the health insurance provider is to take"cost-cutting"behaviour to control the expenditure of the health insurance fund;the strategic choice of the older people is to increase the use of medical services to meet the demand for medical services;and the strategic choice of the medical service provider is related to the quantitative relationship between the reimbursement ratio of the health insurance and the cost ratio of medical services.When the reimbursement rate is 0.95,the probability that the provider will choose rational behaviour to control health care expenditure is the highest.Conclusion Healthcare providers with higher reimbursement rates have a higher probability of choosing rational behaviour.At the same time,the medical insurance reimbursement ratio cannot be raised blindly.It is recommended that the level of health insurance benefits be reasonably adjusted,the construction of a differentiation of the reimbursement ratio of medical insurance should be improved,and the measures for the management of medical behaviors should be enhanced,so as to effectively meet the health needs of the elderly population while at the same time guaranteeing medical safety.

Objective To clarify the interaction among the interests and strategic choices of multiple subjects of medical insurance for the older people in China,and to provide a decision-making basis for the improvement of medical insurance policy for the older people.Methods An evolutionary game model was constructed based on evolutionary game theory and its steady state was simulated using Matlab R2021b software for the health insurer,the health care provider and the elderly.Results There is a conflict of interest between health insurance providers,healthcare providers and older people when all three parties consider maximising their own utility.In order to reach an evolutionary equilibrium,the strategic choice of the health insurance provider is to take"cost-cutting"behaviour to control the expenditure of the health insurance fund;the strategic choice of the older people is to increase the use of medical services to meet the demand for medical services;and the strategic choice of the medical service provider is related to the quantitative relationship between the reimbursement ratio of the health insurance and the cost ratio of medical services.When the reimbursement rate is 0.95,the probability that the provider will choose rational behaviour to control health care expenditure is the highest.Conclusion Healthcare providers with higher reimbursement rates have a higher probability of choosing rational behaviour.At the same time,the medical insurance reimbursement ratio cannot be raised blindly.It is recommended that the level of health insurance benefits be reasonably adjusted,the construction of a differentiation of the reimbursement ratio of medical insurance should be improved,and the measures for the management of medical behaviors should be enhanced,so as to effectively meet the health needs of the elderly population while at the same time guaranteeing medical safety.

Objective To clarify the interaction among the interests and strategic choices of multiple subjects of medical insurance for the older people in China,and to provide a decision-making basis for the improvement of medical insurance policy for the older people.Methods An evolutionary game model was constructed based on evolutionary game theory and its steady state was simulated using Matlab R2021b software for the health insurer,the health care provider and the elderly.Results There is a conflict of interest between health insurance providers,healthcare providers and older people when all three parties consider maximising their own utility.In order to reach an evolutionary equilibrium,the strategic choice of the health insurance provider is to take"cost-cutting"behaviour to control the expenditure of the health insurance fund;the strategic choice of the older people is to increase the use of medical services to meet the demand for medical services;and the strategic choice of the medical service provider is related to the quantitative relationship between the reimbursement ratio of the health insurance and the cost ratio of medical services.When the reimbursement rate is 0.95,the probability that the provider will choose rational behaviour to control health care expenditure is the highest.Conclusion Healthcare providers with higher reimbursement rates have a higher probability of choosing rational behaviour.At the same time,the medical insurance reimbursement ratio cannot be raised blindly.It is recommended that the level of health insurance benefits be reasonably adjusted,the construction of a differentiation of the reimbursement ratio of medical insurance should be improved,and the measures for the management of medical behaviors should be enhanced,so as to effectively meet the health needs of the elderly population while at the same time guaranteeing medical safety.

Objective To clarify the interaction among the interests and strategic choices of multiple subjects of medical insurance for the older people in China,and to provide a decision-making basis for the improvement of medical insurance policy for the older people.Methods An evolutionary game model was constructed based on evolutionary game theory and its steady state was simulated using Matlab R2021b software for the health insurer,the health care provider and the elderly.Results There is a conflict of interest between health insurance providers,healthcare providers and older people when all three parties consider maximising their own utility.In order to reach an evolutionary equilibrium,the strategic choice of the health insurance provider is to take"cost-cutting"behaviour to control the expenditure of the health insurance fund;the strategic choice of the older people is to increase the use of medical services to meet the demand for medical services;and the strategic choice of the medical service provider is related to the quantitative relationship between the reimbursement ratio of the health insurance and the cost ratio of medical services.When the reimbursement rate is 0.95,the probability that the provider will choose rational behaviour to control health care expenditure is the highest.Conclusion Healthcare providers with higher reimbursement rates have a higher probability of choosing rational behaviour.At the same time,the medical insurance reimbursement ratio cannot be raised blindly.It is recommended that the level of health insurance benefits be reasonably adjusted,the construction of a differentiation of the reimbursement ratio of medical insurance should be improved,and the measures for the management of medical behaviors should be enhanced,so as to effectively meet the health needs of the elderly population while at the same time guaranteeing medical safety.

Objective To clarify the interaction among the interests and strategic choices of multiple subjects of medical insurance for the older people in China,and to provide a decision-making basis for the improvement of medical insurance policy for the older people.Methods An evolutionary game model was constructed based on evolutionary game theory and its steady state was simulated using Matlab R2021b software for the health insurer,the health care provider and the elderly.Results There is a conflict of interest between health insurance providers,healthcare providers and older people when all three parties consider maximising their own utility.In order to reach an evolutionary equilibrium,the strategic choice of the health insurance provider is to take"cost-cutting"behaviour to control the expenditure of the health insurance fund;the strategic choice of the older people is to increase the use of medical services to meet the demand for medical services;and the strategic choice of the medical service provider is related to the quantitative relationship between the reimbursement ratio of the health insurance and the cost ratio of medical services.When the reimbursement rate is 0.95,the probability that the provider will choose rational behaviour to control health care expenditure is the highest.Conclusion Healthcare providers with higher reimbursement rates have a higher probability of choosing rational behaviour.At the same time,the medical insurance reimbursement ratio cannot be raised blindly.It is recommended that the level of health insurance benefits be reasonably adjusted,the construction of a differentiation of the reimbursement ratio of medical insurance should be improved,and the measures for the management of medical behaviors should be enhanced,so as to effectively meet the health needs of the elderly population while at the same time guaranteeing medical safety.

Objective To clarify the interaction among the interests and strategic choices of multiple subjects of medical insurance for the older people in China,and to provide a decision-making basis for the improvement of medical insurance policy for the older people.Methods An evolutionary game model was constructed based on evolutionary game theory and its steady state was simulated using Matlab R2021b software for the health insurer,the health care provider and the elderly.Results There is a conflict of interest between health insurance providers,healthcare providers and older people when all three parties consider maximising their own utility.In order to reach an evolutionary equilibrium,the strategic choice of the health insurance provider is to take"cost-cutting"behaviour to control the expenditure of the health insurance fund;the strategic choice of the older people is to increase the use of medical services to meet the demand for medical services;and the strategic choice of the medical service provider is related to the quantitative relationship between the reimbursement ratio of the health insurance and the cost ratio of medical services.When the reimbursement rate is 0.95,the probability that the provider will choose rational behaviour to control health care expenditure is the highest.Conclusion Healthcare providers with higher reimbursement rates have a higher probability of choosing rational behaviour.At the same time,the medical insurance reimbursement ratio cannot be raised blindly.It is recommended that the level of health insurance benefits be reasonably adjusted,the construction of a differentiation of the reimbursement ratio of medical insurance should be improved,and the measures for the management of medical behaviors should be enhanced,so as to effectively meet the health needs of the elderly population while at the same time guaranteeing medical safety.

Objective To clarify the interaction among the interests and strategic choices of multiple subjects of medical insurance for the older people in China,and to provide a decision-making basis for the improvement of medical insurance policy for the older people.Methods An evolutionary game model was constructed based on evolutionary game theory and its steady state was simulated using Matlab R2021b software for the health insurer,the health care provider and the elderly.Results There is a conflict of interest between health insurance providers,healthcare providers and older people when all three parties consider maximising their own utility.In order to reach an evolutionary equilibrium,the strategic choice of the health insurance provider is to take"cost-cutting"behaviour to control the expenditure of the health insurance fund;the strategic choice of the older people is to increase the use of medical services to meet the demand for medical services;and the strategic choice of the medical service provider is related to the quantitative relationship between the reimbursement ratio of the health insurance and the cost ratio of medical services.When the reimbursement rate is 0.95,the probability that the provider will choose rational behaviour to control health care expenditure is the highest.Conclusion Healthcare providers with higher reimbursement rates have a higher probability of choosing rational behaviour.At the same time,the medical insurance reimbursement ratio cannot be raised blindly.It is recommended that the level of health insurance benefits be reasonably adjusted,the construction of a differentiation of the reimbursement ratio of medical insurance should be improved,and the measures for the management of medical behaviors should be enhanced,so as to effectively meet the health needs of the elderly population while at the same time guaranteeing medical safety.