Background：China has achieved universal health insurance coverage.This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the...Background：China has achieved universal health insurance coverage.This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes.Methods：The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing.We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives.Results：Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates.Under plans with an annual ceiling for insurance coverage,patients spent significantly more in the second half of the year than in the first half of the year.The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider.Conclusions：Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers.Reformation is necessary to reduce those incentives,and improve equity and efficiency in healthcare use.展开更多
Objective:In China,adult children have traditionally provided support for their aged parents.This model of care is increasingly challenged by the decline of the extended family.Recently,China’s decades-long one-child...Objective:In China,adult children have traditionally provided support for their aged parents.This model of care is increasingly challenged by the decline of the extended family.Recently,China’s decades-long one-child policy has eased.We examine the association of family size and composition with family support for nonagenarians and centenarians.Methods:Data were obtained through a questionnaire survey of 619 nonagenarians and cen-tenarians in Dujiangyan and were analyzed by chi-square tests,Student t tests,and multivariate logistic regression models.Results:This study revealed that an increased number of offspring might provide financial support for older people,but this does not necessarily translate into physical and emotional care.Conclusion:It is clear that although alternative sources of support for older people are in-creasingly needed,in China the family will continue to play an important role in supporting older people.展开更多
文摘Background：China has achieved universal health insurance coverage.This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes.Methods：The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing.We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives.Results：Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates.Under plans with an annual ceiling for insurance coverage,patients spent significantly more in the second half of the year than in the first half of the year.The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider.Conclusions：Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers.Reformation is necessary to reduce those incentives,and improve equity and efficiency in healthcare use.
文摘Objective:In China,adult children have traditionally provided support for their aged parents.This model of care is increasingly challenged by the decline of the extended family.Recently,China’s decades-long one-child policy has eased.We examine the association of family size and composition with family support for nonagenarians and centenarians.Methods:Data were obtained through a questionnaire survey of 619 nonagenarians and cen-tenarians in Dujiangyan and were analyzed by chi-square tests,Student t tests,and multivariate logistic regression models.Results:This study revealed that an increased number of offspring might provide financial support for older people,but this does not necessarily translate into physical and emotional care.Conclusion:It is clear that although alternative sources of support for older people are in-creasingly needed,in China the family will continue to play an important role in supporting older people.
