scholarly journals Characteristics and implications of insurance-reimbursed inpatient care for gastric and oesophageal cancers in Anhui, China

2020 ◽  
Author(s):  
Anqi Yao ◽  
Xingrong Shen ◽  
Jing Chai ◽  
Jing Cheng ◽  
Rong Liu ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Regression Discontinuity ◽  
Medical System ◽  
Anhui Province ◽  
Disposable Income ◽  
Medical Systems ◽  
Start Time ◽  
Treatment Variable ◽  
Per Capita ◽  
Out Of Pocket Expenses

Abstract Background This study aimed to identify characteristics and trends in insurance-reimbursed inpatient care (NRIC) for gastric and oesophageal cancers and inform evaluation of medical systems reform. Methods The study extracted routinely collected records of claims for reimbursement from the New Rural Cooperative Medical System (NRCMS) in Anhui Province, China and performed descriptive and regression discontinuity analysis. Results From 2013 to 2017, NRIC in terms of person-time per million people (pmp) increased 5.60 and 20.62 times for gastric and oesophageal cancers, respectively. Total expense per episode for gastric and oesophageal cancers increased from 1130.25 and 22 697.99 yuan to 12 514.98 and 24 639.37 yuan, respectively. The ratio of out-of-pocket expenses per inpatient care episode to annual disposable income per capita was 0.43 for gastric cancer and 0.91 for oesophageal cancer and decreased by 0.17 and 0.47, respectively. Regression discontinuity modelling revealed that, when controlled for disposable income, illiteracy rate and months from start time, the treatment variable was significantly associated with person-times of NRIC pmp (β=0.613, p=0.000), length of stay per 105 people (β=−52.990, p=0.000) and total expenses per NRIC episode (β=2.431, p=0.000). Conclusions The study period witnessed substantial achievements in benefits to patients, inpatient care efficiency and equity. These achievements may be attributed mainly to the recent reforms launched in Anhui province, China.

scholarly journals Inequalities in the European Union—A Partial Order Analysis of the Main Indicators

2021 ◽  
Vol 13 (11) ◽  
pp. 6278
Author(s):  
Lars Carlsen ◽  
Rainer Bruggemann
Keyword(s):  
Indicator System ◽  
Partial Ordering ◽  
Disposable Income ◽  
The European Union ◽  
Member States ◽  
Eu Member States ◽  
Per Capita ◽  
Educational Aspect ◽  
The Eu

The inequality within the 27 European member states has been studied. Six indicators proclaimed by Eurostat to be the main indicators charactere the countries: (i) the relative median at-risk-of-poverty gap, (ii) the income distribution, (iii) the income share of the bottom 40% of the population, (iv) the purchasing power adjusted GDP per capita, (v) the adjusted gross disposable income of households per capita and (vi) the asylum applications by state of procedure. The resulting multi-indicator system was analyzed applying partial ordering methodology, i.e., including all indicators simultaneously without any pretreatment. The degree of inequality was studied for the years 2010, 2015 and 2019. The EU member states were partially ordered and ranked. For all three years Luxembourg, The Netherlands, Austria, and Finland are found to be highly ranked, i.e., having rather low inequality. Bulgaria and Romania are, on the other hand, for all three years ranked low, with the highest degree of inequality. Excluding the asylum indicator, the risk-poverty-gap and the adjusted gross disposable income were found as the most important indicators. If, however, the asylum application is included, this indicator turns out as the most important for the mutual ranking of the countries. A set of additional indicators was studied disclosing the educational aspect as of major importance to achieve equality. Special partial ordering tools were applied to study the role of the single indicators, e.g., in relation to elucidate the incomparability of some countries to all other countries within the union.

scholarly journals Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in 10 UK sites: a regression discontinuity in time design

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049721
Author(s):  
Ioannis Bakolis ◽  
Robert Stewart ◽  
David Baldwin ◽  
Jane Beenstock ◽  
Paul Bibby ◽  
...  
Keyword(s):  
Mental Health ◽  
Inpatient Care ◽  
Service Use ◽  
Regression Discontinuity ◽  
Mental Healthcare ◽  
Service Level ◽  
Community Services ◽  
Mental Health Service Use ◽  
Healthcare Data ◽  
Early Intervention In Psychosis

ObjectivesTo investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020.DesignA regression discontinuity in time (RDiT) analysis of daily service-level activity.Setting and participantsMental healthcare data were extracted from 10 UK providers.Outcome measuresDaily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites.ResultsPooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect.ConclusionsMH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.

A study on the impact of China’s urbanization on the quantity of municipal solid waste produced

2019 ◽  
Vol 38 (2) ◽  
pp. 184-192 ◽  
Author(s):  
Xuemei Han ◽  
Ci Hu ◽  
Ling Lin
Keyword(s):  
Municipal Solid Waste ◽  
Solid Waste ◽  
Central Government ◽  
National Policy ◽  
Disposable Income ◽  
Consumption Decisions ◽  
Per Capita ◽  
Recycling Policy ◽  
The Impact ◽  
Capita Disposable Income

Based on the IPAT model, this study selects the two-order lag period that is then applied to the dynamic model created to explore the impact of China’s urbanization on the quantity of municipal solid waste (MSW) produced. The study uses panel data collected from 27 provinces, autonomous regions, and municipalities in China that report directly to the central government. Results show that nationwide urbanization and urban per capita disposable income are positively correlated with the quantity of MSW produced. However, specifically, urbanization in the eastern and midwestern areas of China is insignificantly correlated with the quantity of MSW produced. It is, therefore, recommended that citizens should make sensible and environmental consumption decisions based on per capita disposable income. It is also suggested that quality development and Stead’s urbanization plan should become national policy, and that MSW categorization and a recycling policy should be implemented to treat MSW effectively.

Mexican Traditional Medicine: Application of a Traditional and Complementary Medicine System to Improve Opioid Use Treatment in Latinos

2020 ◽  
Vol 38 (4) ◽  
pp. 384-399 ◽  
Author(s):  
Tanya R. Sorrell
Keyword(s):  
Health Care ◽  
Traditional Medicine ◽  
Complementary Medicine ◽  
The United States ◽  
Medical System ◽  
Theory And Practice ◽  
Medical Systems ◽  
Opioid Use ◽  
Integrative Health ◽  
Improve Health

Background: Initially considered a primarily rural, White issue, opioid use and overdose rates have risen faster for Latinos (52.5%) than for White, non-Hispanics (45.8%) from 2014 to 2016. With an estimated 45% to 65% of Latino immigrant families using Mexican traditional medicine (MTM) practices before seeking Western medical services, these practices could be used as a method to increase access to care and improve outcomes. Practice Model: Although not well known, MTM is founded on a defined set of theoretical tenets that comprise a whole medical system as defined by the National Center for Complementary and Integrative Health. Whole medical systems are characterized as complete systems of theory and practice that develop independently and parallel allopathic medicine. Classifying MTM as a whole medical system to encourage further research and utilization of traditional and complementary medicine (T&CM) practices could help improve health outcomes for Latino patients. Specific T&CM practices that could be used in opioid treatment integration to decrease stigma and increase treatment utilization are then discussed. Conclusion: Incorporating T&CM practices will allow more effective, culturally competent and culturally sensitive health care provision for Latino immigrants in the United States to decrease stigma, improve health care outcomes, and address disparities in opioid use treatment.

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