Aging in COVID-19: Vulnerability, immunity and intervention.

https://research.birmingham.ac.uk/portal/files/89926789/THELANCET_D_19_05919_R1.pdf

Quality of primary health care in China: challenges and recommendations.

A research agenda for ageing in China in the 21st century (2nd edition): Focusing on basic and translational research, long-term care, policy and social networks

Long-term care system for older adults in China: Policy landscape, challenges, and future prospects

Purpose The goal of this study was to assess the effectiveness of healthcare spending among the leading Asian economies. Methods We have selected a total of nine Asian nations, based on the strength of their economic output and long-term real GDP growth rates. The OECD members included Japan and the Republic of Korea, while the seven non-OECD nations were China, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand. Healthcare systems efficiency was analyzed over the period 1996-2017. To assess the effectiveness of healthcare expenditure of each group of countries, the two-way fixed effects model (country- and year effects) was used. Results Quality of governance and current health expenditure determine healthcare system performance. Population density and urbanization are positively associated with a healthy life expectancy in the non-OECD Asian countries. In this group, unsafe water drinking has a statistically negative effect on healthy life expectancy. Interestingly, only per capita consumption of carbohydrates is significantly linked with healthy life expectancy. In these non-OECD Asian countries, unsafe water drinking and per capita carbon dioxide emissions increase infant mortality. There is a strong negative association between GDP per capita and infant mortality in both sub-samples, although its impact is far larger in the OECD group. In Japan and South Korea, unemployment is negatively associated with infant mortality. Conclusion Japan outperforms other countries from the sample in major healthcare performance indicators, while South Korea is ranked second. The only exception is per capita carbon dioxide emissions, which have maximal values in the Republic of Korea and Japan. Non-OECD nations' outcomes were led by China, as the largest economy. This group was characterized with substantial improvement in efficiency of health spending since the middle of the 1990s. Yet, progress was noted with remarkable heterogeneity within the group.

/pdf/predictors-of-in-efficiencies-of-healthcare-expenditure-22sc8a8wet.pdf

Predictors of (in)efficiencies of Healthcare Expenditure Among the Leading Asian Economies – Comparison of OECD and Non-OECD Nations

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)32136-1.pdf

10 years of health-care reform in China: progress and gaps in Universal Health Coverage

Health care in China suffers from substantial allocative inefficiency in the delivery system and technical inefficiency within hospitals. To ameliorate this problem in rural areas, the Analysis of Provider Payment Reforms on Advancing China's Health (APPROACH) project shifted the payment method of China's rural health insurance scheme for county hospitals from fee-for-service to a novel global budget. In particular, APPRAOCH global budget incentivized system-level allocative efficiency by reimbursing county hospitals at higher tariffs for gatekeeping and averting out-of-county (OOC) admissions among local patients they could treat. APPROACH conducted a large-scale randomized controlled trial of the global budget in 56 counties (22 million enrollees) of Guizhou province during 2016-2017. Applying randomization inference to claims data, we find a significant shift of inpatient utilization and expenditure from OOC hospitals to county hospitals. At county hospitals, average expenditure per admission and length of stay decreased, though not significantly. Effects on readmissions show no clear sign of compromised quality. We further find limited effect heterogeneity with respect to treatment and hospital characteristics. Overall, APPROACH global budget may offer a framework for improving health care efficiency without sacrificing quality.

Can a global budget improve health care efficiency? Experimental evidence from China.

https://doi.org/10.1016/j.invent.2022.100541

Roman Xu

Papers

10 years of health-care reform in China: progress and gaps in Universal Health Coverage

Can a global budget improve health care efficiency? Experimental evidence from China.

Psychological stress self-help interventions for healthcare workers in the context of COVID-19 in China: A randomized controlled trial protocol