Economic burden of irritable bowel syndrome in China

AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct(including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.RESULTS A total of 105 IBS patients(64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNy18262.84(USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similarto published studies in other countries. Nationally, the total costs of managing IBS would amount to CNy123.83 billion(USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNy18891.18(USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes(P = 0.031).CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.

社区高血压治疗进展

非药物治疗措施适合于各型高血压,可使血压有一定程度的下降。药物治疗的原则是:"最低有效剂量、长效、联合、终身",1999年WHO/ISH提出6类可作为初始治疗的一线抗高血压药物,即利尿剂、B受体阻滞剂、钙通道阻滞剂、血管紧张素转换酶抑制剂、血管紧张素II受体拮抗剂、a受体阻滞剂。但高血压患者往往重视药物控制高血压,而忽略非药物治疗[1]。这需要基层医务工作者在社区健康教育中加以宣传、引导,包括强调合理膳食、限制钠盐、减轻体重、适量运动、保持健康心态[2]。

Effects of the Resident Basic Medical Insurance Reform on Household Consumption in China

This paper investigates the causal relationship between the Urban and Rural Resident Basic Medical Insurance(URRBMI)reform and household consumption in urban China using data from the Chinese Household Income Project survey and employing combination of the propensity score matching and difference-in-differences methods.The results yield three conclusions.First,the reform affected both the amount and share of household consumption.Specifically,the reform led to an increase in total household consumption,encompassing both medical and nonmedical expenditures.Among these,the proportion of medical consumption increased,while the proportion of nonmedical consumption reduced.Second,the impact of the URRBMI reform varied across consumption categories within nonmedical expenditure.Specifically,consumption for education and entertainment industries are positively impacted by the URRBMI reform in terms of both quantity and proportion.Third,low-income households benefit more from the URRBMI reform compared to middle-and high-income households.The main channels through which the URRBMI reform affects household consumption were the price effect and the crowding out effect on precautionary savings.

Usage of a Reward System for Dealing with Pediatric Dental Fear

Background： Pediatric dental fear, if left unchecked, can persist for a lifetime and adversely impact the physical and psychological health of a patient. In this study, a feasible nonmedical method for relieving pediatric dental fear was investigated. Methods： A randomized, single-blind, controlled trial model was applied. The juvenile patients experiencing dental fear, whose parents or guardian had signed an informed consent form, were randomly divided into two groups. Group A （n = 50） was the control group, while Group B （n = 50） was the reward group. Participants in Group A accepted routine treatment. Participants in Group B were told that they would obtain a gift as a reward for their good behavior if they were compliant during their dental treatments. The Chinese version of the Children＇s Fear Survey Schedule-Dental Subscale （CFSS-DS） was used to evaluate the level of dental fear of each patient both before and after each treatment. A contrast analysis and a correlation analysis of the results were used to assess the efficacy of the reward mechanism. Results： All participants in Group B, were obedient during the dental treatment, and they also successfully chose the present they wanted at the end of their dental treatment. Children at different ages showed different reward preferences. Significant difference in the fear scores of the participants in Group B before the treatment and after receiving the reward was found （independent samples t-test, t = 14.72, P 〈 0.001）. In Group A, 86% children＇s fear score did not undergo a noticeable change. Conclusions： A reward system is proved feasible to relieve pediatric dental fear, and the form of reward should meet the demand of patients.