The Healthy China 2030 Plan set the goal of reducing premature deaths from diabetes by 30% by 2030. However, there has been a lack of assessment of premature mortality for diabetes since the action plan was issued. This study used data from the Global Burden of Disease Study 2021, calculated the premature deaths for diabetes by sex, provinces, and subtypes from 1990 to 2021. We explored the temporal trend of premature mortality using the average annual percent change (AAPC) for different sexes, provinces, and subtypes from 1990 to 2021. Furthermore, we predicted premature mortality for diabetes through 2030 for China and its provinces according to the average annual change rate from 2010 to 2021. There was a first slow upward trend in premature mortality for diabetes from 0.5% in 1990 to 0.6% in 2004, and then a decline until 2021 with premature mortality of 0.4%. By 2030, only Fujian (30.3%) will achieve the desired level of reduction, with only seven provinces meeting the target for females and none for males. There is a large range in the degree of decline between inland and coastal regions, showing obvious geographic differences, and there should be a focus on balancing medical resources.
Humans ; China/epidemiology* ; Female ; Male ; Mortality, Premature/trends* ; Diabetes Mellitus/mortality* ; Goals ; Middle Aged ; Adult

Objective:To analyze premature deaths from malignant tumors among Chinese residents from 1990 to 2021, and to quantify the extent to which changes in premature mortality from malignant tumors affect life expectancy among people aged 30 to 69 years.Methods:Using the Global Burden of Disease 2021 data on selected causes of death in China, the malignant tumor mortality rate was estimated for Chinese residents aged 30-69 years from 1990 to 2021, and life expectancy and de-malignant cause-of-death life expectancy were calculated based on the abridged life table for the Chinese population. Arriaga's decomposition method was used to assess the extent to which changes in malignant tumors mortality contributed to changes in life expectancy for people aged 30-69 years and Potential gains in life expectancy (PGLEs) for people aged 30- 69 years.Results:From 1990 to 2021, the standardized mortality rate of malignant tumors among Chinese people aged 30-69 years decreased from 154.29/100 000 to 98.58/100 000, and the change in the mortality rate of malignant tumors among people aged 30-69 years contributed to the increase of life expectancy of about 0.78 years, and the largest contribution was made by the age group aged 55-59 years, which was about 0.17 years. Among the top 10 malignant tumors, the largest "positive contributions" are stomach cancer, esophageal cancer, and liver cancer, with a cumulative contribution of 0.55 years, while pancreatic cancer hurts the increase of overall life expectancy. The PGLEs of malignant tumors for the population aged 30-69 years will be 1.69 years in 2021, which is higher for men (1.97 years) than for women (1.32 years). The top 5 malignant tumors causing loss of life expectancy in the population were tracheal, bronchus, and lung cancer, stomach cancer, esophageal cancer, colorectal cancer, and liver cancer, in that order. Compared with 1990, in 2021, PGLEs for malignant tumors among people aged 30-69 years increased in seven provinces (autonomous regions and municipalities), including Yunnan and Guizhou, and the rest saw a decline, with the largest decrease in Anhui Province.Conclusions:The standardized mortality rate of malignant tumors among Chinese residents aged 30-69 years declined from 1990 to 2021;the change in mortality rate of malignant tumors showed a positive effect on the growth of life expectancy, the change in PGLEs of malignant tumors varied among provinces (autonomous regions and municipalities), and premature deaths from tracheal, bronchus, and lung cancer and gastrointestinal malignant tumors still need to be paid attention to.

Objective:To analyze premature deaths from malignant tumors among Chinese residents from 1990 to 2021, and to quantify the extent to which changes in premature mortality from malignant tumors affect life expectancy among people aged 30 to 69 years.Methods:Using the Global Burden of Disease 2021 data on selected causes of death in China, the malignant tumor mortality rate was estimated for Chinese residents aged 30-69 years from 1990 to 2021, and life expectancy and de-malignant cause-of-death life expectancy were calculated based on the abridged life table for the Chinese population. Arriaga's decomposition method was used to assess the extent to which changes in malignant tumors mortality contributed to changes in life expectancy for people aged 30-69 years and Potential gains in life expectancy (PGLEs) for people aged 30- 69 years.Results:From 1990 to 2021, the standardized mortality rate of malignant tumors among Chinese people aged 30-69 years decreased from 154.29/100 000 to 98.58/100 000, and the change in the mortality rate of malignant tumors among people aged 30-69 years contributed to the increase of life expectancy of about 0.78 years, and the largest contribution was made by the age group aged 55-59 years, which was about 0.17 years. Among the top 10 malignant tumors, the largest "positive contributions" are stomach cancer, esophageal cancer, and liver cancer, with a cumulative contribution of 0.55 years, while pancreatic cancer hurts the increase of overall life expectancy. The PGLEs of malignant tumors for the population aged 30-69 years will be 1.69 years in 2021, which is higher for men (1.97 years) than for women (1.32 years). The top 5 malignant tumors causing loss of life expectancy in the population were tracheal, bronchus, and lung cancer, stomach cancer, esophageal cancer, colorectal cancer, and liver cancer, in that order. Compared with 1990, in 2021, PGLEs for malignant tumors among people aged 30-69 years increased in seven provinces (autonomous regions and municipalities), including Yunnan and Guizhou, and the rest saw a decline, with the largest decrease in Anhui Province.Conclusions:The standardized mortality rate of malignant tumors among Chinese residents aged 30-69 years declined from 1990 to 2021;the change in mortality rate of malignant tumors showed a positive effect on the growth of life expectancy, the change in PGLEs of malignant tumors varied among provinces (autonomous regions and municipalities), and premature deaths from tracheal, bronchus, and lung cancer and gastrointestinal malignant tumors still need to be paid attention to.

The reform of medical insurance payment is a critical part of deepening the medical reform.It plays an important role in guiding the behavior of healthcare providers.The latest progress in the reform of health insurance payment in the US.is the imple-mentation of value-based payment models.The literature research method is applied to review the development of value-based pay-ment practices in the US.It finds the main value-based payment models in the United States are targeted hospitals and physicians as the incentive object,with the characteristics of the combination of reward and punishment,the combination of horizontal and ver-tical evaluation,the continuous improvement of evaluation system,and the full use of information means.On this basis,combined with the national conditions of China,it puts forward four suggestions on establishing effective incentive mechanism,formulating scientific evaluation system,insisting on continuous improvement mechanism and strengthening medical information construction for future reform of medical insurance.

As one of the flexible means of drug supervision， the “compassionate medicine use system” has become a new way to meet the drug accessibility of patients at present. The “compassionate medicine use system” in Britain， that is， Early Access to Medicine Scheme， intervenes in the drug development process of the applicant enterprises at an early stage through the cooperation of different government departments， which not only ensures patients obtain innovative drugs in time， but also accelerates the drug listing and payment and reimbursement process. At present， China has only made principled provisions on the “compassionate medicine use system”， but has not issued specific implementation rules. It is suggested that the access conditions of “compassionate medicine use”， the responsibilities and obligations of different subjects， the payment mechanism of expenses and how to promote the cooperation of relevant departments should be clearly defined as soon as possible in combination with the system experience of Britain， so as to form a standardized and operable “compassionate medicine use system” suitable for China’s national conditions.

The reform of medical insurance payment is a critical part of deepening the medical reform.It plays an important role in guiding the behavior of healthcare providers.The latest progress in the reform of health insurance payment in the US.is the imple-mentation of value-based payment models.The literature research method is applied to review the development of value-based pay-ment practices in the US.It finds the main value-based payment models in the United States are targeted hospitals and physicians as the incentive object,with the characteristics of the combination of reward and punishment,the combination of horizontal and ver-tical evaluation,the continuous improvement of evaluation system,and the full use of information means.On this basis,combined with the national conditions of China,it puts forward four suggestions on establishing effective incentive mechanism,formulating scientific evaluation system,insisting on continuous improvement mechanism and strengthening medical information construction for future reform of medical insurance.

The reform of medical insurance payment is a critical part of deepening the medical reform.It plays an important role in guiding the behavior of healthcare providers.The latest progress in the reform of health insurance payment in the US.is the imple-mentation of value-based payment models.The literature research method is applied to review the development of value-based pay-ment practices in the US.It finds the main value-based payment models in the United States are targeted hospitals and physicians as the incentive object,with the characteristics of the combination of reward and punishment,the combination of horizontal and ver-tical evaluation,the continuous improvement of evaluation system,and the full use of information means.On this basis,combined with the national conditions of China,it puts forward four suggestions on establishing effective incentive mechanism,formulating scientific evaluation system,insisting on continuous improvement mechanism and strengthening medical information construction for future reform of medical insurance.

The reform of medical insurance payment is a critical part of deepening the medical reform.It plays an important role in guiding the behavior of healthcare providers.The latest progress in the reform of health insurance payment in the US.is the imple-mentation of value-based payment models.The literature research method is applied to review the development of value-based pay-ment practices in the US.It finds the main value-based payment models in the United States are targeted hospitals and physicians as the incentive object,with the characteristics of the combination of reward and punishment,the combination of horizontal and ver-tical evaluation,the continuous improvement of evaluation system,and the full use of information means.On this basis,combined with the national conditions of China,it puts forward four suggestions on establishing effective incentive mechanism,formulating scientific evaluation system,insisting on continuous improvement mechanism and strengthening medical information construction for future reform of medical insurance.

The reform of medical insurance payment is a critical part of deepening the medical reform.It plays an important role in guiding the behavior of healthcare providers.The latest progress in the reform of health insurance payment in the US.is the imple-mentation of value-based payment models.The literature research method is applied to review the development of value-based pay-ment practices in the US.It finds the main value-based payment models in the United States are targeted hospitals and physicians as the incentive object,with the characteristics of the combination of reward and punishment,the combination of horizontal and ver-tical evaluation,the continuous improvement of evaluation system,and the full use of information means.On this basis,combined with the national conditions of China,it puts forward four suggestions on establishing effective incentive mechanism,formulating scientific evaluation system,insisting on continuous improvement mechanism and strengthening medical information construction for future reform of medical insurance.

The reform of medical insurance payment is a critical part of deepening the medical reform.It plays an important role in guiding the behavior of healthcare providers.The latest progress in the reform of health insurance payment in the US.is the imple-mentation of value-based payment models.The literature research method is applied to review the development of value-based pay-ment practices in the US.It finds the main value-based payment models in the United States are targeted hospitals and physicians as the incentive object,with the characteristics of the combination of reward and punishment,the combination of horizontal and ver-tical evaluation,the continuous improvement of evaluation system,and the full use of information means.On this basis,combined with the national conditions of China,it puts forward four suggestions on establishing effective incentive mechanism,formulating scientific evaluation system,insisting on continuous improvement mechanism and strengthening medical information construction for future reform of medical insurance.