A Cross-sectional Survey of Urban and Rural Residents' Perceptions About the Medical System Services in a Middle Province of China

Background: To investigate urban and rural residents' perceptions on the issue of "difficult access to quality medical services and expensive medical bills" (difficult and expensive medical services) 10 years after the implementation of medical and health care system reform in China.Methods: we conducted a cross-sectional questionnaire survey of residents in a middle province of China. Multi-stage stratified random sampling was utilized to sample a total of 1968 residents of three cities in the middle province in July 2019. Results: Residents in the province were highly satisfied with the solution of "difficult and expensive medical services", with the satisfaction rate reaching 70%. However, satisfaction differed among the surveyed cities. 83.4% of the residents reported "difficult and expensive medical services"as their current major concern. Complex medical procedures (31.25%) and high inspection costs (51.68%) were the main reasons for "difficult and expensive medical services". Other reasons include the provision of medical and health resources, the service awareness of medical and health care personnel, people's health needs, and the perceptions of health, etc. Conclusions: The issue of "difficult and expensive medical services" is a social issue requiring constant attention.

Peculiarities of the Spread of HIV infection among Urban and Rural Residents of the Tyumen Region

Relevance. The geographical spread of HIV infection among the population of various administrative territories is very heterogeneous. The Tyumen region, due to its vast territory and the significant remoteness of some areas from the regional center, is of particular interest in the framework of considering the territorial features of the spread of HIV.Aims. To consider peculiarities of the spread of hiv infection among urban and rural residents of the Tyumen region in 1993–2019.Materials & Methods. Statistical data of the «Center for the Prevention and Control of AIDS» in the period from 1993 to 2019, annual form No. 61 «Information on the contingents of HIV patients» for 2006–2019, materials of the state report «On the sanitary and epidemiological situation in the Tyumen region» for 2013–2019. Methods of epidemiological observation were used in the work: analytical and descriptive-evaluative with the use of methods of retrospective and operational analysis and statistical methods.Results and Discussions. A specific feature of the spread of HIV infection among urban and rural residents is the tendency to exceed the regional incidence rate in a number of territories. Analysis of epidemiological data for the period under review showed that all territories of the region are involved in the epidemiological process of HIV infection, and in a number of territories the prevalence rate exceeds the average Russian level. HIV prevalence as of December 31, 2019 was 728.2 per 100 thousand people in Russia. In 17 administrative territories of the Tyumen region the infection rate is higher than the national average level and is per 100 thousand population in the city of Tobolsk – 1903.3, in the districts of Uvat – 1486.2, Tobolsk – 1440.5, Nizhnetavda – 1354.9, Tyumen – 1344.1, Yalutorovsk – 1327.6), in the city. Tyumen – 1249.3, in the districts: Vagay – 1195.2, Zavodoukovsky – 1119.2, in Ishim – 951.8, in the districts: Yarkovsky – 889.6, Vikulovsky – 881.3, Yurginsky – 846.9, Ishimsky district – 842.1, Aromashevsky – 851.6, Isetovsky – 754.4, Uporovsky district – 734.7.Conclusions. The HIV epidemic in the Tyumen region is determined by its economic and geographic location and by the presence of exceptional epidemiologically significant prerequisites for the intensive spread of HIV, in particular, by the routes through which large quantities of drugs are illegally transported (drug trafficking from the northeast).

Application of BIM and GIS Technology in Urban and Rural Planning

For a long time, geographic information system (GIS) technology has been widely used in urban and rural planning. This paper first analyzes the background of urban and rural planning, introduces the concept of building information (BIM), and puts forward the building information model. Then the application of mobile off-line GIS is studied, and the characteristics of mobile GIS are known. Secondly, the concept of urban-rural integration is put forward, and two functions of urban-rural planning are found: macro-control means and public interest protection. Finally, the application of information technology in urban and rural planning management shows that the disposable income of urban and rural residents increases year by year, and the fastest growth in 2020 is 120 million yuan.

Research On Medical Insurance Policies Against Serious Illness Among Urban And Rural Residents In Shanghai Based On Micro-Simulation

Background: Urban and rural residents’ basic medical insurance (URRBMI) is an institutional arrangement for rural residents and unemployed urban residents in China. The serious illness medical insurance system (SIMIS) was established to provide additional medical cover. There are two ways in which medical expenses are covered. One is based on large expenses and provides proportional compensation for the individual’s own expenses after the URRBMI payment; the other is to pay for the treatment of some serious diseases after the URRBMI payment. At present, the SIMIS payment method in China is based on large expenses, and only a few areas, such as Shanghai, pay according to the treatment of serious diseases. This study aims to simulate and analyse the effect of the two payment methods on SIMIS in Shanghai. Methods: We developed a micro-simulation model to predict the number and characteristics of SIMIS participants among urban and rural residents in Shanghai and to simulate the process of medical treatment, medical consumption, and medical insurance payments for each insured person from 2020 to 2025. We then summarised and analysed the payment compensation effect, and compared it with Shanghai’s current policies.Results: Under the current financing standard, the payment of SIMIS according to high expenses is not sustainable and the compensation is insufficient and cannot effectively prevent or alleviate poverty.Conclusions: The policy of designing SIMIS according to national guidelines does not meet the development needs of Shanghai. Shanghai should take the current policy of paying compensation according to the treatment of serious illness as the policy basis, consider the security needs of patients with large medical expenses outside the scope of protection, and adjust policies appropriately to prevent poverty caused by illness.

One country, two systems: evidence on retirement patterns in China

This paper documents the patterns and correlates of retirement in China using a nationally representative survey, the China Health and Retirement Longitudinal Study. After documenting stark differences in retirement ages between urban and rural residents, the paper shows that China's urban residents retire earlier than workers in many Organization for Economic Co-operation and Development countries and that rural residents continue to work until advanced ages. Differences in access to generous pensions and economic resources explain much of the urban–rural difference in retirement rates. The paper suggests that reducing disincentives created by China's Urban Employee Pension system, improving health status, providing childcare and elder care support may all facilitate longer working lives. Given spouse preferences for joint retirement, creating incentives for women to retire later may facilitate longer working lives for both men and women.