Optimized Reimbursement Scheme of China's New Cooperative Medical System Using Monte Carlo Simulation

China＇s Rural Cooperative Medical System collapsed alongside communal farming at the end of the Maoist period in 1976, leaving most farmers vulnerable[1]. In rural areas, where 80% of people have been without health insurance of any kind, illness has emerged as a leading cause of poverty[24]. To address the poor state of health care among the rural population, in 2003 the Chinese government launched the New Rural Cooperative Medical System （NCMS）,

Current Situation and Improvement Strategies of Teaching Engagement by Teachers in Higher Medical Colleges Under the Background of“New Medical Education”

The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of university teachers is a key issue that determines the level of teaching development of university teachers and affects the quality of talent cultivation in universities.Using the literature review method,this study analyzed 39 relevant literatures retrieved from China National Knowledge Infrastructure(CNKI)from 1997 to 2023.The concept,connotation,current situation,influencing factors,and improvement strategies of teaching engagement by university teachers were reviewed and summarized.The results showed that the issue of teaching engagement by university teachers has not received high attention in the field of higher education,especially in higher medical education,which has not yet been reported.Although the overall number of literature is not large,some of the conclusions have important implications for the next research on the influencing factors and mechanisms of double-qualified teacher engagement in higher medical colleges.

Research on the Problems and Countermeasures of New Rural Cooperative Medical System

Our country rural area has carried out broad practice on new model system of rural cooperative medical services, and the rural new medical treatment system has developed quickly. However, there are still many problems which needs us to solve. This article will analysis its present situation, problems and reasons, then give some suggestions to solve these problems. The new rural cooperative medical system has made great achievements since its implementation, which is a radical reform of the traditional medical systen. Lcd by thc govcmmcnt, trying to solve the majority of the Chinese population of the peasant groups to see the doctor difficult and expensive medical problems, and effectively protect the vital interests of farmers, so that people=oriented, establish and improve the rural medical service system. This paper analyzes the status quo of the new rural cooperative medical system, puts forward the problems, finds the reasons, and puts forward the corresponding countermeasures on the basis of this.

The impact of the New Rural Cooperative Medical Scheme on the“health poverty alleviation”of rural households in China

This study investigates the impact of the New Rural Cooperative Medical Scheme(NRCMS)on rural households to escape poverty.We employ the instrumental variable method,the IVProbit model,to analyze the national data from the rural-resident field survey by the China Family Panel Studies(CFPS)in 2016.Based on the large-scale data,we found that,first,the hospitalization of family members is the key factor in increasing the risk of the family falling into poverty.The NRCMS has significantly reduced the likely risk of falling into poverty.Second,the impact of the NRCMS on poverty alleviation varies among groups with different levels of income.There is no impact on the upper-middle and high-income groups;in contrast,the NRCMS has substantially improved the capacity of low-income rural families to prevent poverty due to illness,especially for the lower-middle-income group.Third,there exist significant regional differences in the impact of NRCMS on the health poverty alleviation of rural households in China.The NRCMS has successfully reduced the risk of rural households in the western region falling into poverty,simultaneously,no significant impact on those in the eastern and central regions.In order to diminish and eliminate poverty eventually and boost rural residents'capacity for income acquisition,we propose the following:raise the actual compensation ratio of the NRCMS,control the rising expense of NRCMS by promoting the payment method reform,construct the comprehensive healthcare system in the western region,strengthen the medical security for the poor in remote area,and enhance the living environment for rural residents.

Availability and Affordability of Therapeutic Monoclonal Antibodies After the New Medical Reform in Hubei Province,China

Objective In 2017,China launched a new round of medical reform(NMR)to address the inaccessibility of high-priced drugs for patients with serious diseases.This study explored the impact of the NMR on the accessibility and affordability of high-priced monoclonal antibodies(mAbs),and the effective promotion policies after the NMR.Methods We used a standard method developed by the World Health Organization to conduct two surveys on the availability of mAbs and their prices before and after the NMR in the public hospitals in Hubei province,China.By interviewing hospital pharmacy experts,we identified the potential value of the current NMR in improving the access to therapeutic mAbs.Results The average availability of 13 mAbs increased by 8.1%in the surveyed hospitals of Hubei province after the NMR.The median unit price of 10 mAbs dropped by 34.3%.The average affordability of a treatment cycle of 10 mAbs dropped from 680 days to 298 days of the disposable daily income for a middle-income resident(56.2%reduction).The drug price negotiation of medical insurance inclusion and the promotion of consistent evaluation of generic and original drugs could effectively promote the accessibility of mAbs.However,the zero markup of drug pricing and the limit on the proportion of drug revenues in public hospitals showed certain negative effects on the availability of mAbs.Conclusion Not all current NMR policies play a positive role in promoting the accessibility of mAbs.To further improve the accessibility of mAbs in the future in China,it is therefore critical to increase the investment in independent research and development of high-quality mAbs,establish localized guidelines for the rational use of mAbs in clinical practice,and have a cost-sharing mechanism for high-priced drugs with multiple stakeholders.

Impact of the New Cooperative Medical Scheme on Health Care Service Utilization in Rural China

Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.

The New Rural Cooperative Medical Scheme and Its Implications on Rural Labor Migration in China：Evidence from Longitudinal Surveys

In 2003, China initiated the New Rural Cooperative Medical Scheme （NRCMS） in order to provide basic health care coverage for the rural population. However, the NRCMS has had a marked impact on rural-urban labor migration as its current regulations present a barrier for cross-region participation in the NRCMS, and its reimbursement system is biased when the enrollees seek medical services outside their location of hukou, a household registration system in China. This paper performs a variety of empirical tests on a panel data set from the China Health and Nutrition Survey （CHNS） to study how the NRCMS affects rural residents＇ work location choices. We observed a ＂locking effect＂ on potential rural migrant workers and a ＂pulling effect＂ on existing ones. According to the results, the NRCMS has discouraged rural residents from working outside their location of hukou, lowering the probability of relocation by 3.52 percent. Meanwhile, the NRCMS system actually encourages existing migrant workers to return home. This paper concludes that the NRCMS has to some extent restrained the free flow of the labor force and exacerbated the migrant worker shortage.

加强新医科内涵建设提升人才自主培养质量

聚焦“健康中国”“教育强国”国家战略需求,围绕新医科建设内涵、人才培养学科专业、医学学制学位制度、临床医生培养体系、医教协同育人机制,系统全面梳理医学教育创新发展相关国家文件政策,论述如何以新医科统领医学教育创新发展,推进“科教结合”“产教融合”,促进医工、医理、医文学科交叉融合,全面提升“医学+X”拔尖创新医学人才和卓越临床医生的自主培养质量,为推进健康中国建设提供强有力的人才保障。

Health Insurance and Its Reimbursement Arrangements： Policy Evaluation on New Cooperative Medical System in Rural China

Disease has been one of the top reasons accounting for impoverishment in rural China. The government subsidizes health care through the New Cooperative Medical System since 2003 （ NCMS ）. The paper studies the effectiveness of various reimbursement arrangements in reducing the financial burden caused by health care in rural China. Using data from China Health and Nutrition Survey（CHNS） , it finds that the severity of illness, the type of illness, medical cost and other costs of the treatment are significantly influencing the choice of a type of treatment. Based on the estimated demand function, the paper concludes that the reimbursement for inmpatient care only has little effect on reducing the financial burden and the incidence of catastrophic expenditure and that expending subsidies to outpatient care is a more effective policy.

New medical reform and the sustainable development of the pharmaceutical industry in China

The national economy development and the demanding of the drugs request the pharmaceutical industry in China to keep sustainable development especially under the background of the new medical reform. According to the status of industry development and drug consumption in China, the trend and the driving factors for pharmaceutical industry in the future were estimated. Based on the analysis of the background and conditions for pharmaceutical industry sustainable development in China, the problems and challenges, the goal as well as the main measures for the sustainable development of pharmaceutical industry were put forward.

Effects of New Rural Cooperative Medical Scheme on Medical Service Utilization and Medical Expense Control of Inpatients： A 3-year Empirical Study of Hainan Province in China

Background： The New Rural Cooperative Medical Scheme （NCMS） has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we aimed to explore the impact of NCMS on medical service utilization and medical expense of inpatients in recent years. Methods： The research data of Hainan Province were extracted from the Chinese NCMS platform from 2012 to 2014. Detailed information included total expenditure, average inpatients costs, average out-of-pocket payments, actual reimbursement rate, and average annual growth rate of the above indicators. Descriptive analysis was used to gauge the effects of NCMS. Results： In the utilization of medical services, NCMS inpatients in tertiary hospital decreased from 25.49% in 2012 to 20.39% in 2014, inpatients in county hospitals increased from 39.49% to 55.92%, simultaneously. The total expenditure in county hospitals rose steadily from 28.46% to 46.66%, meanwhile, the total expenditure in tertiary hospitals fell from 60.44% to 44.51%.The average out-of-pocket costs of rural inpatients remained stable over the years. Furthermore, the compensation fund ofNCMS inpatients grew significantly. The actual inpatient reimbursement rate at township health centers increased from 76.93% to 84.04%. Meanwhile, the rate at county hospitals and tertiary hospitals increased slightly from 59.37% and 46.10% to 61.25% and 47.71%, respectively. Conclusions： With the improvement of the reimbursement ability, especially after the new health care reform in 2009, the NCMS have been playing a prominent role in alleviating the economic burden of farmers＇ medical treatment. Meanwhile, more patients go to primary hospitals than tertiary hospitals, and the capability of primary hospitals has been greatly improved.

The impact of increased reimbursement rates under the new cooperative medical scheme on the financial burden of tuberculosis patients

Background:Tuberculosis(TB)is still a major public health problem in China.To scale up TB control,an innovative programme entitled the'China-Gates Foundation Collaboration on TB Control in China was initiated in 2009.During the second phase of the project,a policy of increased reimbursement rates under the New Cooperative Medical Scheme(NCMS)was implemented.In this paper,we aim to explore how this reform affects the financial burden on TB patients through comparison with baseline data.Methods:In two cross-sectional surveys,quantitative data were collected before(January 2010 to December 2012)and after(April 2014 to June 2015)the intervention in the existing NCMS routine data system.Information on all 313 TB inpatients,among which 117 inpatients in the project was collected.Qualitative data collection included 11 focus group discussions.Three main indicators,non-reimbursable expenses rate(NER),effective reimbursement rate(ERR),and out-of-pocket payment(OOP)as a percentage of per capita household income,were used to measure the impact of intervention by comprising post-intervention data with baseline data.The quantitative data were analysed by descriptive analysis and non-parametric tests(Mann-Whitney U test)using SPSS 22.0,and qualitative data were subjected to thematic framework analysis using NvivolO.Results:The nominal reimbursement rates for inpatient care were no less than 80%for services within the package.Total inpatient expenses greatly increased,with an average growth rate of 11.3%.For all TB inpatients,the ERR for inpatient care increased from 52 to 66%.Compared with inpatients outside the project,for inpatients covered by the new policy,the ERR was higher(78%),and OOP showed a sharper decline.In addition,their financial burden decreased significantly.Conclusions:Although the nominal reimbursement rates for inpatient care of TB patients greatly increased under the new reimbursement policy,inpatient OOP expenditure was still a major financial problem for patients.Limited diagnosis and treatment options in county general hospitals and inadequate implementation of the new policy resulted in higher inpatient expenditures and limited reimbursement.Comprehensive control models are needed to effeaively decrease the financial burden on all TB patients.

Initiating Hehe （和合） Medical System of Traditional Chinese Medicine and Biomedicine to Realize Health Cycle of Human Beings

This paper suggests a novel approach concerning the medical treatment of human beings, which appears to be economically and practically superior to either biomedicine or traditional medicine. A brand new medical system--Hehe （和合） medicine, has been proposed based on a preventive-biomedical-psycho-social treatment model. This is characterized by a dual approach in which life nurturing is consistently practised and medical treatment is applied when necessary in order to maintain a healthy life. Its core value would facilitate the self-restoration to health and self-adaptation to nature through health cultivation and medical means. Medical services would be firstly provided to the prevention of potential disease germinating in the human body, and clinical medical treatment would be the last resort of systematic medical practice. This paper discusses not only this new concept but also the advantages of traditional Chinese medicine and biomedicine, especially how both medical systems compare in cognitive style, on a cultural level, and on a technical level.

从东西方传统思维方式探讨中医药理论的特色及其前景(续)

七、中医药理论中的个案性原则与现代科学的统计学原理 《内经》一再强调临床诊断治疗必须因时制宜、因地制宜和因人制宜。历代医家也颇多发挥,如“运气不齐,古今异规”,“古方不能治今病”、“师其法而不拘其方”、“板方不能治活病”,等等,这些论述都是强调特殊性和个体性原则的。事实上,世界上没有两个人是完全一样的,因此更没有两个病是完全一样的,即使是同一个人,前后二次患同样的病,二次病情也不会完全一样。因为人本身在变,病因在变,其病变必然随之亦要变。

New Journal Citation Report of Chinese Medical Journal

According to the recently released Journal Citation Report(JCR),Chinese Medical Journal’s impact factor(IF)increasedyear by year.The new IF in 2006 is 0.615,increased by 9.6% compared to 2005(0.561),meanwhile the total cite in 2006is 1948,increased by 12.2% compared with 2005(1736).The top cited papers published in our journal from 2004 to2006 are listed as follows.We would like to present our acknowledgements to all the authors and reviewers.

Chengdu-Montpellier Medical Cooperation Moves Up to New Level

On the morning of May 22, Dr.Cong Huiquan, international project leader under the French Health Ministry’s Medical Service, led a delegation from Montpellier University Hospital on a visit to Chengdu. During the visit, the cooperation MOU was renewed with the