Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the hematological phenotype and genotypic characteristics of five Chinese individuals with a rare thalassemia mutation HBB: c. 93-21G>A. Methods:A retrospective study was carried out on five individuals identified by the People′s Hospital of Yangjiang and Guangzhou Hybribio Co., Ltd. from May 2018 to September 2022. Routine blood test and hemoglobin electrophoresis were performed, and the genotypes of five subjects were determined by using PCR combined with reverse dot blotting (RDB), nested PCR, Gap-PCR and Sanger sequencing. This study was approved by Medical Ethics Cornmittee of the People′s Hospital of Yangjiang (Ethics No. 20240001).Results:Among the five individuals, hematological data of one was unavailable, and the remaining four had presented with microcytosis and hypochromia. The results of hemoglobin electrophoresis indicated that all of them had a HbA 2 level of ≥4.7%. Genetic analysis showed that one case had harbored compound heterozygous mutations of ααα anti3.7 triplet and HBB: c. 93-21G>A, one had compound heterozygous mutations of -α 3.7 and HBB: c. 93-21G>A, whilst the remaining three were heterozygous for the HBB: c. 93-21G>A mutation. Conclusion:The hematological phenotype of β-thalassemia carriers ( HBB: c. 93-21G>A) is similar to that of other β + thalassemia heterozygotes with mild β-thalassemia characteristics.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH) or insulin-like growth factor-1(IGF-1) levels and evaluate impact of different GH cut-offs on discordance rate.Methods:A retrospective analysis was conducted on data from 66 acromegaly patients treated at Nanjing Drum Tower Hospital from November 2017 to March 2023. Patients were categorized based on the nadir GH(GHn) and IGF-1 levels at the last follow-up into four groups: controlled, high GH, high IGF-1, and active. Clinical and metabolic parameters were compared across these groups, and impact of different GHn and fasting growth hormone(GHf) cut-offs on discordance rate was evaluated.Results:No statistically significant differences were observed among groups in age, duration of follow-up, imaging characteristics(all P>0.05). High IGF-1 group had higher fasting insulin and homeostasis model assessment for β cell function compared to controlled and high GH group(all P<0.05), while these parameters did not differ between high GH and controlled group. High IGF-1 group had higher carboxy-terminal cross-linked telopeptide of type 1 collagen, osteocalcin and procollagen type 1 N-terminal propeptide compared to controlled and high GH group, but differences were not statistically significant(all P>0.05). These parameters also did not differ between high GH and controlled group. Discordance rate was not significantly different when GHn cut-offs was 1.0 μg/L or 0.4 μg/L(30.3% vs 21.3%, P=0.146). Compared to 2.5 μg/L, discordance rate was lower when GHf cut-off was 1.0 μg/L(39.4% vs 24.3%, P=0.041). Conclusion:The discordance rate in treated acromegaly patients during follow-up is approximately 30%. Different GH measurement timings and cut-offs significantly impact discordance rate. Patients with normal GH and elevated IGF-1 levels are at potential risk of active disease, and require closer follow-up. This study provides a valuable reference for treatment of patients with discordant GH and IGF-1 levels.