In 2019, the Chinese government implemented the first round of the National Centralized Drug Procurement (NCDP) pilot (so-called “4 + 7” policy) in mainland China, in which 25 drugs were included. We conducted this study to examine the impacts of NCDP policy on drug utilization and expenditures, and to clarify the main factors contributing to drug expenditure changes. This study used drug purchasing order data from the Centralized Drug Procurement Survey in Shenzhen 2019. Drugs related to the “4 + 7” policy were selected as study samples, including 23 “4 + 7” policy-related varieties and 15 basic alternative drugs. Driving factors for drug expenditures changes were analyzed using A.M. index system analysis (Addis A. & Magrini N.’ method). After the implementation of the NCDP policy, the volume of “4 + 7” policy-related varieties increased by 73.8%, among which winning products jumped by 1638.2% and non-winning products dropped by 70.8%; the expenditures of “4 + 7” policy-related varieties decreased by 36.9%. Structure effects (0.47) and price effects (0.78) negatively contributed to the increase in drug expenditures of “4 + 7” policy-related varieties, while volume effects (1.73) had positive influence. NCDP policy successfully decreased drug expenditures of “4 + 7” policy-related varieties with structure effects playing a leading role. However, total drug expenditures were not effectively controlled due to the increasing use of alternative drugs.

Elderly mental health promotion is an important task in the current “Healthy China Action”. This study aims to (a) clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states, (b) examine the associated factors of psychological pain and suicidal ideation, and (c) examine the relationship between psychological pain and suicidal ideation. A sample of 4622 adults aged 60 years and older were included in this study, from the China’s Health-related Quality of Life Survey for Older Adults 2018. Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation. Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation. In addition, higher psychological pain significantly associated with the occurrence of suicidal ideation. In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive. Moreover, the associated factors above should be considered to develop targeted health interventions.

Background: Physical activity (PA)-related knowledge, attitudes, and behaviors (KABs) are important content of health management. We conducted this study to (a) describe PA-related KABs of Chinese older adults, and (b) examine the association between PA-related KABs and mental health.Methods: This study used data from the 2015 China Health and Nutrition Survey (CHNS). 4048 residents aged 60 years and older were included as study subjects, assessing their PA-related knowledge, attitudes, behaviors, and mental health. Comparison of PA-related KABs in urban and rural areas, as well as in different mental health groups were conducted using chi-square test. Ordinal logistic regression analysis was applied to assess the associations between PA-related KABs and mental health.Results: The proportion for knowing about the benefits of physical activity, knowing about appropriate exercise intensity, and knowing about healthy weight were 76.7%, 44.3%, and 75.4%, respectively. 89.2% of the participants hold positive attitude towards physical activity. 45.0%, 12.1%, and 12.9% of the participants reported preferring walking & Tai Chi, ball games, and body building, respectively. Participants in urban areas had significantly better PA-related KABs than those in rural areas (all p-values < 0.001). Adjusted ORs with 95% CI showed that participants who knew about the benefits of physical activity (OR = 1.19, 95% CI = 1.02-1.38); hold positive attitude towards physical activity (OR = 1.31, 95% CI = 1.08-1.59); and reported preferring walking & Tai Chi (OR = 1.40, 95% CI = 1.23-1.60), ball games (OR = 1.45, 95% CI = 1.17-1.79), body building (OR = 1.33, 95% CI = 1.09-1.63) had significant better mental health.Conclusions: Elderly residents in rural areas experienced significant poorer PA-related KABs than those in urban areas, especially for PA-related behaviors. Better PA-related knowledge, attitudes, and behaviors were associated with higher mental health in Chinese elderly residents.