Accelerating the construction of ecological civilization and promoting the management of health environment problems is one of the core elements of the implementation of the“Beautiful China”and“Healthy China”strat...Accelerating the construction of ecological civilization and promoting the management of health environment problems is one of the core elements of the implementation of the“Beautiful China”and“Healthy China”strategies with Chinese characteristics in the new era.Based on the scientific connotation of ecological civilization,this paper systematically assesses the level of interprovincial ecological civilization construction in China using the combined CRITIC empowerment method and explores the impact of ecological civilization construction on the health burden of urban and rural residents using interprovincial panel data from 2003 to 2018 with the help of panel feasible generalized least squares,simultaneous equation estimation,and the extended regression model.It is found that there is a significant inverted U-shaped relationship between provincial ecological civilization construction and urban and rural residents’economic health burden,as well as a significant U-shaped relationship between ecological civilization construction and urban and rural residents’disease burden.Fiscal decentralization,urbanization,and industrialization are the three important indirect mechanisms through which ecological civilization affects the health burden of urban and rural residents,and fiscal decentralization plays a typical role in crowding out the health effect of ecological civilization.In the eastern and central regions,ecological civilization construction has effectively reduced the health burden of urban and rural residents,but it is more significant for improving the economic health burden of rural residents.While the“catching-up trend”of the progress of ecological civilization construction in the western region is obvious,ecological civilization plays an important role in alleviating the economic health burden of urban residents.After the robustness test,the conclusion still holds.This study provides an important empirical basis for local governments to improve the accuracy of their policies in promoting the“Beautiful China”and“Healthy China”strategies.展开更多
Background Getting medical treatment is still difficult and expensive in western China. Improving the equity of basic health services is one of the tasks of the new healthcare reform in China. This study aimed to anal...Background Getting medical treatment is still difficult and expensive in western China. Improving the equity of basic health services is one of the tasks of the new healthcare reform in China. This study aimed to analyze the parallel and vertical equity of health service utilization of urban residents and then find its influencing factors. Methods In August 2011, a household survey was conducted at 18 communities of Baoji City by multi-stage stratified random sampling. Based on the survey data, we calculated a concentration index of health service utilization for different income residents and a difference index of different ages. We then investigated the influencing factors of health service utilization by employing the Logistic regression model and log-linear regression model. Results The two-week morbidity rate of sampled residents was 19.43%, the morbidity rate of chronic diseases was 21.68%, and the required hospitalization rate after medical diagnosis was 11.36%. Among out-patient service utilization, the two-week out-patient rate, number of two-week out-patients, and out-patient expense had good parallel and vertical equity, while out-patient compensation expense had poor parallel and vertical equity. The inpatient service utilization, hospitalization rate, number of inpatients, days stayed in the hospital, and inpatient expense had good parallel equity, while inpatient compensation expense had poor parallel equity. While the hospitalization rate and number of inpatients had vertical equity, the days stayed in hospital, inpatient expense, and inpatient compensation expense had vertical inequity. Conclusions Urban residents＇ health was at a low level and there was not good health service utilization. There existed rather poor equity of out-patient compensation expense. The equity of inpatient service utilization was quite poor. Income difference and the type of medical insurance had great effects on the equity of health service utilization.展开更多
Objective:The purpose of the current study was to determine the types of community health services selected by urban and suburban residents in Nanjing and the influencing factors in an ef-fort to improve the community...Objective:The purpose of the current study was to determine the types of community health services selected by urban and suburban residents in Nanjing and the influencing factors in an ef-fort to improve the community health services to better meet the residents’demands.Methods:Between 15 May 2013 and 15 June 2013,eight community health service centers from four districts in Nanjing(Gulou District and Baixia District in urban areas and Jiangning District and Pukou District in suburban areas;two centers from each district)were selected using a stratified random sampling method of investigation sites.After an intercept interview with 487 community residents,univariate and multivariate analyses were performed by means of logistic regression.Results:Among the 487 users of community health services,there were 241 residents from urban areas(49.5%)and 246 residents from suburban areas(50.5%).Among the respondents,there were 191(39.2%)who usually received medical treatment from community health service institutions,including 74(38.7%)from urban areas and 117(61.3%)from suburban areas.The analysis showed that the factors which influenced urban residents in Nanjing to choose community health services for medical treatment included income,payment terms of medical fees,reasonable prices,medical fees,and expenses for medications,while factors influencing suburban residents to choose community health services for medical treatment included income,level of education,carrier,medical institutions selected when feeling severely ill,availability of preventive health services,availability of health counseling services,medical fees,and expenses for medications.Based on an analysis of the results by means of unconditioned binary logistic stepwise regression,the factors influencing whether or not the urban residents chose community health services for medical treatment included gender,age,level of education,payment terms of medical fees,treat-ment environment,and expenses for medications,while the factors influencing suburban residents included availability of preventive health services and expenses for medications.Conclusion:There was a difference between the types of community health services selected by residents in urban and suburban areas of Nanjing and factors influencing the selection of ser-vices were different.Community health service institutions in different areas should strengthen their own service capability according to the local residents’health demands.展开更多
基金supported by the key program of the National Social Science Foundation of China“Research on the Theoretical Basis and Index System of Building a Modern Economic System in the New Era”[Grant number.18XKS009]the Foundation of Sichuan Provincial Soft Science Research“Research on the transformation path of high-quality development of new economy enterprises in Sichuan from the perspective of double cycle”[Grant number.2022JDR0261].
文摘Accelerating the construction of ecological civilization and promoting the management of health environment problems is one of the core elements of the implementation of the“Beautiful China”and“Healthy China”strategies with Chinese characteristics in the new era.Based on the scientific connotation of ecological civilization,this paper systematically assesses the level of interprovincial ecological civilization construction in China using the combined CRITIC empowerment method and explores the impact of ecological civilization construction on the health burden of urban and rural residents using interprovincial panel data from 2003 to 2018 with the help of panel feasible generalized least squares,simultaneous equation estimation,and the extended regression model.It is found that there is a significant inverted U-shaped relationship between provincial ecological civilization construction and urban and rural residents’economic health burden,as well as a significant U-shaped relationship between ecological civilization construction and urban and rural residents’disease burden.Fiscal decentralization,urbanization,and industrialization are the three important indirect mechanisms through which ecological civilization affects the health burden of urban and rural residents,and fiscal decentralization plays a typical role in crowding out the health effect of ecological civilization.In the eastern and central regions,ecological civilization construction has effectively reduced the health burden of urban and rural residents,but it is more significant for improving the economic health burden of rural residents.While the“catching-up trend”of the progress of ecological civilization construction in the western region is obvious,ecological civilization plays an important role in alleviating the economic health burden of urban residents.After the robustness test,the conclusion still holds.This study provides an important empirical basis for local governments to improve the accuracy of their policies in promoting the“Beautiful China”and“Healthy China”strategies.
基金This study was supported by grants from the China Medical Board （No. 10-029）, the National Natural Science Foundation of China （No. 70873093）, the Humanities and Social Science Foundation of Chinese Ministry of Education （No. 09YJAZH071）.
文摘Background Getting medical treatment is still difficult and expensive in western China. Improving the equity of basic health services is one of the tasks of the new healthcare reform in China. This study aimed to analyze the parallel and vertical equity of health service utilization of urban residents and then find its influencing factors. Methods In August 2011, a household survey was conducted at 18 communities of Baoji City by multi-stage stratified random sampling. Based on the survey data, we calculated a concentration index of health service utilization for different income residents and a difference index of different ages. We then investigated the influencing factors of health service utilization by employing the Logistic regression model and log-linear regression model. Results The two-week morbidity rate of sampled residents was 19.43%, the morbidity rate of chronic diseases was 21.68%, and the required hospitalization rate after medical diagnosis was 11.36%. Among out-patient service utilization, the two-week out-patient rate, number of two-week out-patients, and out-patient expense had good parallel and vertical equity, while out-patient compensation expense had poor parallel and vertical equity. The inpatient service utilization, hospitalization rate, number of inpatients, days stayed in the hospital, and inpatient expense had good parallel equity, while inpatient compensation expense had poor parallel equity. While the hospitalization rate and number of inpatients had vertical equity, the days stayed in hospital, inpatient expense, and inpatient compensation expense had vertical inequity. Conclusions Urban residents＇ health was at a low level and there was not good health service utilization. There existed rather poor equity of out-patient compensation expense. The equity of inpatient service utilization was quite poor. Income difference and the type of medical insurance had great effects on the equity of health service utilization.
基金Philosophy and Social Science Fund Project in Jiangsu Province:“Research on Evaluation Index System of Excessive Medical Behavior in Jiangsu Provincial Public Hospitals”[2011SJB630042]Philosophy and Social Science Special Fund Project in Nanjing Medical University:“Establishment of Rating Scale for Doctor’s Professional Behavior in Chinese Public Hospital under the New Health Care Reform”[2013NJZS02]Project Supporting for Training Talents in“Jiangsu Provincial Advantageous Discipline”[JX10331801].
文摘Objective:The purpose of the current study was to determine the types of community health services selected by urban and suburban residents in Nanjing and the influencing factors in an ef-fort to improve the community health services to better meet the residents’demands.Methods:Between 15 May 2013 and 15 June 2013,eight community health service centers from four districts in Nanjing(Gulou District and Baixia District in urban areas and Jiangning District and Pukou District in suburban areas;two centers from each district)were selected using a stratified random sampling method of investigation sites.After an intercept interview with 487 community residents,univariate and multivariate analyses were performed by means of logistic regression.Results:Among the 487 users of community health services,there were 241 residents from urban areas(49.5%)and 246 residents from suburban areas(50.5%).Among the respondents,there were 191(39.2%)who usually received medical treatment from community health service institutions,including 74(38.7%)from urban areas and 117(61.3%)from suburban areas.The analysis showed that the factors which influenced urban residents in Nanjing to choose community health services for medical treatment included income,payment terms of medical fees,reasonable prices,medical fees,and expenses for medications,while factors influencing suburban residents to choose community health services for medical treatment included income,level of education,carrier,medical institutions selected when feeling severely ill,availability of preventive health services,availability of health counseling services,medical fees,and expenses for medications.Based on an analysis of the results by means of unconditioned binary logistic stepwise regression,the factors influencing whether or not the urban residents chose community health services for medical treatment included gender,age,level of education,payment terms of medical fees,treat-ment environment,and expenses for medications,while the factors influencing suburban residents included availability of preventive health services and expenses for medications.Conclusion:There was a difference between the types of community health services selected by residents in urban and suburban areas of Nanjing and factors influencing the selection of ser-vices were different.Community health service institutions in different areas should strengthen their own service capability according to the local residents’health demands.
