scholarly journals The benefits of an integrated social medical insurance for health services utilization in rural China: evidence from the China health and retirement longitudinal study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaojing Fan ◽  
Min Su ◽  
Yafei Si ◽  
Yaxin Zhao ◽  
Zhongliang Zhou
Keyword(s):  
Health Services ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Health Services Utilization ◽  
Rural China ◽  
Generalized Linear Mixed Model ◽  
Horizontal Inequity ◽  
Services Utilization ◽  
Social Medical Insurance ◽  
Positive Effect

Abstract Background Improving health equity is a fundamental goal for establishing social health insurance. This article evaluated the benefits of the Integration of Social Medical Insurance (ISMI) policy for health services utilization in rural China. Methods Using the China Health and Retirement Longitudinal study (2011‒2018), we estimated the changes in rates and equity in health services utilization by a generalized linear mixed model, concentration curves, concentration indices, and a horizontal inequity index before and after the introduction of the ISMI policy. Results For the changes in rates, the generalized linear mixed model showed that the rate of inpatient health services utilization (IHSU) nearly doubled after the introduction of the ISMI policy (8.78 % vs. 16.58 %), while the rate of outpatient health services utilization (OHSU) decreased (20.25 % vs. 16.35 %) after the implementation of the policy. For the changes in inequity, the concentration index of OHSU decreased significantly from − 0.0636 (95 % CL: −0.0846, − 0.0430) before the policy to − 0.0457 (95 % CL: −0.0684, − 0.0229) after it. In addition, the horizontal inequity index decreased from − 0.0284 before the implementation of the policy to − 0.0171 after it, indicating that the inequity of OHSU was further reduced. The concentration index of IHSU increased significantly from − 0.0532 (95 % CL: −0.0868, − 0.0196) before the policy was implemented to − 0.1105 (95 % CL: −0.1333, − 0.0876) afterwards; the horizontal inequity index of IHSU increased from − 0.0066 before policy implementation to − 0.0595 afterwards, indicating that more low-income participants utilized inpatient services after the policy came into effect. Conclusions The ISMI policy had a positive effect on improving the rate of IHSU but not on the rate of OHSU. This is in line with this policy’s original intention of focusing on inpatient service rather than outpatients to achieve its principal goal of preventing catastrophic health expenditure. The ISMI policy had a positive effect on reducing the inequity in OHSU but a negative effect on the decrease in inequity in IHSU. Further research is needed to verify this change. This research on the effects of integration policy implementation may be useful to policy makers and has important policy implications for other developing countries facing similar challenges on the road to universal health coverage.

Analyzing discontinuities in longitudinal count data: A multilevel generalized linear mixed model.

2020 ◽  
Author(s):  
James L. Peugh ◽  
Sarah J. Beal ◽  
Meghan E. McGrady ◽  
Michael D. Toland ◽  
Constance Mara
Keyword(s):  
Count Data ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Generalized Linear Mixed Model ◽  
Longitudinal Count Data

Nonelective hospital admissions, discharge disposition, and health services utilization in epilepsy patients: A population‐based study

Epilepsia ◽  
2020 ◽  
Vol 61 (9) ◽  
pp. 1969-1978
Author(s):  
Churl‐Su Kwon ◽  
Bonnie Wong ◽  
Parul Agarwal ◽  
Jung‐Yi Lin ◽  
Madhu Mazumdar ◽  
...  
Keyword(s):  
Health Services ◽  
Hospital Admissions ◽  
Health Services Utilization ◽  
Population Based ◽  
Population Based Study ◽  
Services Utilization ◽  
Discharge Disposition

scholarly journals Reducing Aggression by Developing Emotional and Inhibitory Control

2021 ◽  
Vol 18 (10) ◽  
pp. 5263
Author(s):  
Miriam Romero-López ◽  
María Carmen Pichardo ◽  
Ana Justicia-Arráez ◽  
Judit Bembibre-Serrano
Keyword(s):  
Psychosocial Development ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Generalized Linear Mixed Model ◽  
Emotional Control ◽  
Control Group ◽  
Post Intervention ◽  
Mixed Model Analysis ◽  
Intervention Measures ◽  
Experimental Group

The objective of this study is to measure the effectiveness of a program on improving inhibitory and emotional control among children. In addition, it is assessed whether the improvement of these skills has an effect on the reduction of aggressive behavior in pre-school children. The participants were 100 children, 50 belonging to the control group and 50 to the experimental group, aged between 5 and 6 years. Pre-intervention and post-intervention measures of inhibitory and emotional control (BRIEF-P) and aggression (BASC) were taken. A Generalized Linear Mixed Model analysis (GLMM) was performed and found that children in the experimental group scored higher on inhibitory and emotional control compared to their peers in the control group. In addition, these improvements have an effect on the decrease in aggressiveness. In conclusion, preventive research should have among its priorities the design of such program given their implications for psychosocial development.

scholarly journals Changes in Dairy Cow Behavior with and without Assistance at Calving

Agriculture ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 722
Author(s):  
Bethan Cavendish ◽  
John McDonagh ◽  
Georgios Tzimiropoulos ◽  
Kimberley R. Slinger ◽  
Zoë J. Huggett ◽  
...  
Keyword(s):  
Dairy Cows ◽  
Video Surveillance ◽  
Dairy Cow ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Generalized Linear Mixed Model ◽  
Behavioral Data ◽  
Behavioral Patterns ◽  
Holstein Friesian ◽  
Time Periods

The aim of this study was to characterize calving behavior of dairy cows and to compare the duration and frequency of behaviors for assisted and unassisted dairy cows at calving. Behavioral data from nine hours prior to calving were collected for 35 Holstein-Friesian dairy cows. Cows were continuously monitored under 24 h video surveillance. The behaviors of standing, lying, walking, shuffle, eating, drinking and contractions were recorded for each cow until birth. A generalized linear mixed model was used to assess differences in the duration and frequency of behaviors prior to calving for assisted and unassisted cows. The nine hours prior to calving was assessed in three-hour time periods. The study found that the cows spent a large proportion of their time either lying (0.49) or standing (0.35), with a higher frequency of standing (0.36) and shuffle (0.26) bouts than other behaviors during the study. There were no differences in behavior between assisted and unassisted cows. During the three-hours prior to calving, the duration and bouts of lying, including contractions, were higher than during other time periods. While changes in behavior failed to identify an association with calving assistance, the monitoring of behavioral patterns could be used as an alert to the progress of parturition.

scholarly journals Does the implementation of a national oral health policy reduce inequalities in oral health services utilization? The Brazilian experience

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Helena Rodrigues Galvão ◽  
Angelo Giuseppe Roncalli
Keyword(s):  
Health Policy ◽  
Oral Health ◽  
Health Services ◽  
Health Services Utilization ◽  
Age Groups ◽  
Public Access ◽  
Services Utilization ◽  
Index Of Inequality ◽  
Oral Health Services ◽  
Oral Health Policy

Abstract Background This study aimed to assess the trend in income-related inequalities in oral health services utilization by the Brazilian population from 1998 to 2013. This period represents a timeline that includes different stages of implementation of the National Oral Health Policy. Methods The design was based on repeated cross-sectional surveys using secondary data from household-based studies carried out in Brazil in 1998, 2003, 2008, and 2013. The dependent variable was “having access to a dentist appointment at least once in a lifetime (yes/no).” Monthly household per capita income, based on Brazil’s minimum wage, was included as the main independent variable. To measure the inequalities in oral health access related to economic position, the following complex indexes based on regression were used: (a) the slope index of inequality (SII) and (b) the relative index of inequality (RII). Results There was a reduction in the percentage of individuals who never had a dentist appointment for all age groups and income classifications. In general, there was a reduction trend in absolute inequality for all age groups (p < 0.001). The relative inequality and reduction trend were different between the age groups studied. Conclusions The National Oral Health Policy was very important for expanding free of charge, public access to dental appointment. However, despite policy implementation, there continues to be high levels of inequality in access to dental consultation. Assessing which strategies are necessary to overcome this challenge is discussed.

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