China's health care system reform: Progress and prospects

Li, Ling; Fu, Hongqiao

doi:10.1002/hpm.2424

Cited by 200 publications

(186 citation statements)

References 27 publications

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“…The public hospitals in China previously have been criticized for profit‐seeking . The delivery of quality services at accepted level of cost‐effectiveness is a key direction of the healthcare reform in China . A number of approaches are implemented in the China public hospital reform including restructuring of payment mechanism and adjusting pricing policies to reduce the prices of high technologies for diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Potential cost‐effectiveness of wearable cardioverter‐defibrillator for patients with implantable cardioverter‐defibrillator explant in a high‐income city of China

Jiang

Ming

You

2019

Cardiovasc electrophysiol

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Introduction Wearable cardioverter‐defibrillator (WCD) is recommended for patients with implantable cardioverter‐defibrillator (ICD) removal. This study aimed to investigate the potential cost‐effectiveness of WCD for patients with ICD explant in a high‐income city of China. Methods and Results A 5‐year decision‐analytic model was developed to simulate outcomes of three strategies during the period between ICD explant and reimplantation: discharge‐to‐home without WCD (home group), discharge‐to‐home with WCD (WCD group), and stay‐in‐hospital (hospital group). Outcome measures were mortality rates (during the period between ICD explant and reimplantation), direct medical costs, quality‐adjusted life years (QALYs), and incremental cost per QALY saved (ICER). Model inputs were derived from literature and public data. Base‐case analysis was performed at four cost levels of WCD. Robustness of model results was examined by sensitivity analyses. In base‐case analysis, the 8‐week mortality rates of WCD, hospital, and home groups were 7.3%, 8.1%, and 9.4%, respectively. WCD group gained the highest QALYs (3.0990 QALYs), followed by hospital group (3.0553 QALYs) and home group (3.0132 QALYs). The WCD group was the cost‐effective option with ICERs less than willingness‐to‐pay (WTP) threshold (57 315 USD/QALY) at WCD daily cost ≤USD48. In probabilistic sensitivity analysis, the WCD group at daily cost of USD24, USD48, USD72, and USD96 were cost‐effective in 100%, 94.16%, 22.08%, and 0.16% of 10 000 Monte Carlo simulations, respectively. Conclusions Use of WCD during the period between ICD explant and reimplantation is likely to save life and gain higher QALYs. Cost‐effectiveness of WCD is highly subject to the daily cost of WCD in China.

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Section: Discussionmentioning

confidence: 99%

Potential cost‐effectiveness of wearable cardioverter‐defibrillator for patients with implantable cardioverter‐defibrillator explant in a high‐income city of China

Jiang

Ming

You

2019

Cardiovasc electrophysiol

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“…This might cause more mental illness and post-traumatic stress disorder (PTSD) [12,14,16]. But at the same time, Health China 2030 Plan calls for continuing enhancement of quality of health care [17]. Therefore, in this supply-side analysis, we examined the effects of challenge stress and hindrance stress on the quality of health care among Chinese healthcare workers.…”

Section: Introductionmentioning

confidence: 99%

Do Challenge Stress and Hindrance Stress Affect Quality of Health Care? Empirical Evidence from China

Yang

Guo

et al. 2018

IJERPH

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Severe job stress has adverse effects on the health of Chinese healthcare workers. We investigated associations between job stress, health, and quality of health care among Chinese healthcare workers. To analyze associations between stress, health, and quality of health care among healthcare workers in 74 Chinese hospitals, we surveyed 2426 healthcare workers of primary, secondary, and tertiary hospitals in Western, Central, and Eastern China in 2017. Structural equation modelling was used to examine relationships between job stress, health, and quality of health care. The mediating effect of health on the association between job stress and quality of health care was examined with the Sobel test. In the final model, health had a moderate direct positive effect on the quality of health care (β = 0.24; p < 0.001). Challenge stress had a direct inverse effect on health (β = −0.05; p < 0.05) and a significant direct positive effect on the quality of health care (β = 0.26; p < 0.001). Hindrance stress had a significant inverse effect on health (β = −0.37; p < 0.001) and a moderate inverse effect on the quality of health care (β = −0.19; p < 0.001). The correlation between challenge stress and hindrance stress was significant and positive (β = 0.59; p < 0.001). A partial mediation effect was in the final model. The health status of healthcare workers is an important concern at all levels of Chinese hospitals. To improve quality of healthcare, appropriate challenge stress is recommended among young staff, and interventions targeting hindrance stress should be developed and implemented in all hospital departments.

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“…C-BAT, Chinese-BAT; HA, haemophilia A; HB, haemophilia B; ISTH-BAT, International Society on Thrombosis and Haemostasis Bleeding Assessment Tool somewhat fragmented, which is often a barrier for patients to consult a doctor 10. A, Association between factor levels and ISTH-BAT.…”

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confidence: 99%

Bleeding assessment in haemophilia carriers—High rates of bleeding after surgical abortion and intrauterine device placement: A multicentre study in China

Fang²,

et al. 2019

Haemophilia

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Introduction: An increased bleeding tendency has been shown in female haemophilia carriers compared to healthy females. Bleeding assessment tools (BATs) have mainly been performed in western cultures. It is unclear how they perform in populations with different healthcare, health/wellness concepts and awareness, as well as family planning practices. Aim: To (a) describe and compare the bleeding symptoms in carriers with healthy females, particularly for bleeding after surgical abortion and intrauterine device (IUD) placement which are performed frequently for family planning in China; (b) quantify scores of International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH-BAT) and Chinese-BAT (C-BAT) developed to include surgical abortion and IUD placement as separate categories in Chinese haemophilia carriers;(c) correlate bleeding scores (BS) with factor levels. Methods:We conducted a multicentre, cross-sectional study on obligate haemophilia carriers and healthy controls using ISTH-BAT and C-BAT. Results:We enrolled 125 haemophilia carriers and 106 controls. Carriers, compared to controls, had significantly higher median BS (3 vs 1 by both ISTH-BAT and C-BAT) and lower factor level (63.5 vs 101.8 IU/dL). Bleeding after surgical abortion and IUD placement was significantly associated with carrier status. Bleeding scores from neither ISTH-BAT nor C-BAT showed significant correlation with factor levels. Conclusion: Haemophilia carriers in China experienced abnormal bleeding. Uniqueto the Chinese carriers is significant bleeding after surgical abortion (3rd highest incidence of bleeding symptom) and IUD placement (4th highest). However, both ISTH-BAT and C-BAT exhibited no correlation between BS and factor levels in this population and neither could identify carriers with low factor level (of <50 IU/dL).

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China's health care system reform: Progress and prospects

Cited by 200 publications

References 27 publications

Potential cost‐effectiveness of wearable cardioverter‐defibrillator for patients with implantable cardioverter‐defibrillator explant in a high‐income city of China

Potential cost‐effectiveness of wearable cardioverter‐defibrillator for patients with implantable cardioverter‐defibrillator explant in a high‐income city of China

Do Challenge Stress and Hindrance Stress Affect Quality of Health Care? Empirical Evidence from China

Bleeding assessment in haemophilia carriers—High rates of bleeding after surgical abortion and intrauterine device placement: A multicentre study in China

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