Background China implemented a universal two-child policy in 2015. It is important to understand infants’ medical utilization in the context of this policy to inform health policies and resource allocation. Methods This study utilized a 20% random sample of administrative data from China’s Urban and Rural Basic Medical Insurance (URBMI) in one of the largest southern Chinese cities from January 2015 to June 2018. Ordinary least squares models were used to estimate changes in inpatient admission rates and costs for infants between 0 and 6 months old after the implementation of China’s universal two-child policy. Results The overall inpatient admission rate was 27.2% in 2015 and 31.3% in 2017. Compared with 2015, there was an increase in inpatient admission rates for infants 1 month old or younger (coef = 0.038, 95% CI = 0.029 to 0.047, p < .001) and infants 6 months old or younger (coef = 0.041, 95% CI = 0.030 to 0.052, p < .001) in 2017. The increase was larger for male infants than for female ones. The average inpatient admission cost was 8412.3 RMB ($1320.61) (SD = 15,088.2). There was no increase in inpatient admission costs overall. The average length of hospital stay was 7.3 days, the probability of going to a tertiary hospital was 76.2%, and the share of out-of-pocket costs was 53.0% for all diseases. Conclusion After the implementation of the universal two-child policy in China, there was a significant increase in inpatient admission rates, especially for male infants. The overall associated costs did not change, but the increase in admission rates caused additional economic burdens for families and for social health insurance. Understanding the healthcare utilization of infants in the universal two-child period can provide insight for healthcare resource allocation in a time of dramatic changes in population policy.
Objective: Childhood emotional maltreatment (CEM) has been widely linked to later affective symptoms. What still remains inadequately understood are the potential nuanced differences in the consequences of childhood emotional abuse (CEM-A) versus childhood emotional neglect (CEM-N) and the implicated mechanisms. Research with non-Western, clinical samples also remains scarce. Thus, we examined the associations of CEM-A and CEM-N with later affective symptoms among Chinese male drug users and tested impulsivity and psychological resilience as potential mediators and moderators. Method: Structural equation modeling analyses were conducted with survey data obtained from 239 Chinese male adult drug users who were in a rehabilitation center. Results: The mediating rather than the moderating hypotheses were supported. CEM-A was found to be positively associated with subsequent depressive and anxious symptoms through a positive association with impulsivity. In contrast, CEM-N was positively associated only with subsequent depressive symptoms via a negative association with psychological resilience. In addition, CEM-A was also found to be directly associated with later depressive and anxious symptoms. Conclusions: CEM may pose a threat to later affective well-being partly through contributing to intrapersonal vulnerabilities as well as compromising intrapersonal strengths. Differentiating CEM-A and CEM-N appears to be critical for revealing the understudied specificity and nuance that may be inherently within such effects. Drug use treatment services should sensitively attend to the affective sequelae of CEM. Interventions targeted at the modification of impulsivity and the facilitation of psychological resilience may be effective in diminishing the affective consequences of CEM among drug users. Clinical Impact StatementChildhood emotional maltreatment poses a threat to later affective well-being through contributing to intrapersonal vulnerabilities (e.g., impulsivity) and compromising intrapersonal strengths (e.g., psychological resilience). Victimization related to childhood emotional abuse is more relevant to the later formation of an impulsive style, whereas experiences of childhood emotional neglect are more likely to disrupt the development of one's stress-coping abilities. Such findings contribute to a more nuanced understanding of the affective consequences of childhood emotional abuse versus childhood emotional neglect and the implicated mechanisms. Drug use treatments should attend to affective sequelae of childhood emotional maltreatment. Interventions targeted at modification of impulsivity and facilitation of psychological resilience may be effective in diminishing such consequences.
Unidimensional bipolar scales based on prejudice against homosexuality neglect the effect of preference for heterosexuality on attitudes toward homosexuality. Additionally, the term “homosexuality” used in these scales may compromise their validity. The current study uses person-centered and variable-centered approaches to examine the structure and classes of attitudes toward lesbians and gay men. In Study 1, we developed the Two-factor Attitudes toward Lesbians and Gay Men Scales, which have acceptable reliability and validity. The results obtained through variable-centered approaches suggested that a model comprising two factors (prejudice against homosexuality and preference for heterosexuality) was ideal. In Study 2, we explored the classes of attitudes toward lesbians and gay men through latent class analysis. The results supported a model containing three classes (purely positive, discriminatorily positive, and negative). This study validates a two-factor structure of attitudes toward lesbians and gay men and distinguishes between purely positive and discriminatorily positive attitudes, providing an important reference for future research and interventions to promote public attitudes toward lesbians and gay men.
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