ObjectiveTo systematically review the current prevalence, key determinants, and prevention strategies of child and adolescent obesity in China. MethodA systematic review of the epidemiological trends, health impacts, risk factors, and intervention strategies for child and adolescent obesity was performed by analyzing recent domestic and international literature and policy documents, supplemented with national surveillance data and developments in clinical practice. ResultsThe prevalence of child and adolescent obesity in China has been rising continuously over the past four decades, with particularly high rates observed among primary school children and boys. Recent trends show a “provincial reversal” and an “urban-rural reversal”. This high-risk environment stems from complex interactions among family, school, and societal factors. China has developed a relatively comprehensive policy framework for obesity prevention and control and is promoting a three-tiered prevention strategy. Clinically, pharmacological and surgical interventions are being gradually adopted. However, challenges remain, including limited health insurance coverage for obesity management. ConclusionsChild and adolescent obesity has become a significant public health issue in China, threatening national health and social development. Future efforts should focus on enhancing intersectoral governance, improving early intervention capabilities, expanding health insurance support, and standardizing clinical practices. A multi-level, multi-pathway integrated prevention and control system is essential for effectively curbing child and adolescent obesity under the healthy China strategy.
Objective To re-estimate price elasticity of different income groups’ demand for cigarette in terms of the lastest national tobacco consumption data and provide policy-makers with evidence to make decision on public policy of tobacco control. Methods A total of 16 056 adults of different income were surveyed in 27 provinces in 2002 and the data analyzed by using two-part model (logistic and log-linear model). Results We found that the demand elasticities were -0.589, -0.234, -0.017 and 0.247 for the poor group, low income group, middle income group and high income group, respectively. Conclusions Increasing tobacco tax will result in decreasing more cigarette consumption of lower income groups than higher groups, bearing more taxation of higher income groups than lower income groups, therefore tobacco taxation is not regressive.
Objective To sort out the policies related to rare diseases in China, analyze and summarize the focus and potential problems of relevant policy texts, and provide decision-making references for the subsequent formulation and improvement of policies in the field of rare diseases in China. Methods We searched for relevant policy documents in the field of rare diseases at the national level from 2018 to 2023, constructed a three-dimensional analysis framework based on content analysis of “policy tool-stakeholder-policy strength” in the field of rare diseases in China, and conducted cross-analysis between policy tools, stakeholders, and policy strength. Results Finally, 39 policy texts were included. There were 112 policy tool dimension codes, with environment-based, supply-based, and demand-based tools accounting for 62.5%, 30.36%, and 7.14%, respectively. There were 229 stakeholder dimension codes, including 42.79% for government departments, 19.65% for medical institutions, 19.65% for corporate units, and 17.90% for patients and their families. The average score for policy strength was 2.2 points. Cross-analysis showed that government departments had the highest proportion in the dimensions of supply-based, environment-based and demand-based tools (45.76%, 43.45%, 32.00%, respectively). The policy strength of environmental tools was the strongest (124 points). The policy strength of government departments was the strongest (78 points). Conclusions There is a certain imbalance in the design and configuration of rare disease policy tools in China, and there is uneven distribution of rare disease policies among stakeholders. Although the overall effectiveness of policies in the field of rare diseases is showing a positive growth trend, there may be a mismatch between policy tools, stakeholders, and policy strength.
Objective To discuss the epidemiological characteristics of young and middle-aged people infected with COVID-19 in Gansu province under the new epidemic policy. Methods A total of 1800 people were collected from two tertiary hospitals in Gansu province from November 8, 2022 to January 28, 2023. The vaccination status, nucleic acid antigen detection, the specific time of infection, main symptoms and severity of the disease were investigated. Results Among 1800 participants, 1685 (93.6%) were vaccinated and 1565 (86.9%) were infected with COVID-19. Among the 1565 infected persons, 523 (33.4%) completed both nucleic acid and antigen testing, 382 (24.4%) completed nucleic acid testing, 490 (31.3%) completed antigen testing, 170 (10.9%) received IgG testing. 1490 (95.2%) were slight ill, 75 (4.8%) were critical ill, and 96 (6.1%) were hospitalized, and no one died. In 2022, 92 cases (5.9%) were infected in the first half of November, 141 cases (9.1%) in the second half of November, 630 cases (40.3%) in the first half of December, and 553 cases (35.4%) in the second half of December. 109 cases (7.0%) were infected in the first half of January, 38 cases (2.2%) in the second half of January, and 2 cases (0.1%) in the first half of February of 2023. and no cases in the second half of February. Among the 1565 infected persons, 825 (52.7%) had respiratory symptoms, 293 (18.7%) had gastrointestinal symptoms, 257 (16.4%) had autonomic disorders, 140 (8.9%) had other symptoms such as decreased smell and taste, and 48 (3.3%) had no symptoms after infection. Conclusions The vaccination rate of young and middle-aged people in Lanzhou city of Gansu Province is high. Since the new policy, the infection rate of the novel coronavirus among young and middle-aged people is high, the number of antigen tests is more than nucleic acid tests, most of the infected patients are slight, with fewer critical patients, and the hospitalization rate is low. The peak of infection occurred in early December 2022, and the infection rate was basically zero by February 2023. The main symptoms of COVID-19 infection are mainly respiratory tract, followed by digestive tract and autonomic nervous system disorders, and few patients are completely asymptomatic.
Avoidable mortality (AM) is an important indicator of health system performance. It is also an effective tool for evaluating the effectiveness of health measures and allocation of health resources. The concept development, analytical methods, and research contents of avoidable mortality are introduced in this study. This study investigated the applicability of avoidable mortality analysis in determining priority health-service intervention areas, determining priority health-service intervention populations and evaluating the quality of those services. This paper also discussed the significance and limitations of avoidable mortality analysis. The investigation provided references for further research and application of avoidable mortality analysis.
Objective To analyze the current research status, hotspots and development trends in the field of evidence-based health policy briefs at home and abroad. Methods Computer searches of Web of Science Core Collection and CNKI databases for studies related to evidence-based health policy briefs were conducted, and the timeframe of the searches was from the establishment of the databases to August 6, 2024. Charticular, VOSviewer and CiteSpace software were used to visualize and analyze the countries, institutions, journals, authors and keywords of the included literature. Results A total of 145 relevant studies were included, of which 141 were in English and 4 were in Chinese. The number of articles in English showed an overall increasing trend; the country with the largest number of articles was the United States; the organization with the largest number of articles was the World Health Organization; the journal with the largest number of articles was Frontiers in Public Health; and the hot keywords in recent years focused on the food and nutritional safety system, cardiovascular disease, obesity, impact, and public health policy. The research related to "healthcare" and "knowledge translation" is expected to become a frontier hotspot. The number of Chinese studies was relatively small, and the research content involved policy briefs and policy brief methodology in the field of public health. Conclusion Future research may focus on policy briefs on health care, food and nutrition, cardiovascular disease, obesity and other health issues, their impact and the use of policy briefs in the formulation of public health policies. Currently, there is a significant difference between domestic and foreign research in the field of evidence-based health policy briefs, foreign research has tended to mature, while the domestic is still in the embryonic stage, there is an urgent need to enrich the methodological system, enrich the content of the study, and in the future, we can learn from the advanced experience of foreign countries and integrate multidisciplinary research methods, in order to promote the improvement and sustainable development of the field of evidence-based health policy briefs in China.
In the context of actively coping with aging, China has introduced a series of health care integration policies. Using the advocacy coalition framework theory, this paper aims to analyze the process of health care integration policy changes in China from three dimensions: policy beliefs, external events and policy learning. The policy subsystem of health care integration in China includes two coalitions: top-down cascade promotion and bottom-up absorption and radiation. External events and policy learning triggered policy change, where policy learning included endogenous learning within the coalition and exogenous learning between the coalitions. A policy impasse occurs when the two advocacy coalitions are at odds, and policy brokers and professional forums can get rid of the policy impasse. In the process of policy change in China’s health care integration, the two major advocacy coalitions have reached a certain consensus. It is recommended to alleviate the problems in the integration of health care by strengthening the external factors in the change of health care policy, enhancing the policy learning in the change of health care policy, and making full use of the information resources in the change of health care policy, so as to promote the high-quality development of the integration of health care.
ObjectivesTo evaluate the intention of having a second child among females of childbearing age after the implementation of China’s universal two-child policy so as to provide evidence for further studies.MethodsCNKI, VIP, WanFang Data, CSSCI, PubMed, EMbase and ScienceDirect databases were electronically searched to collect cross-sectional studies on the intention of females of childbearing age to have a second child from January 1st, 2016 to August 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using R software.ResultsA total of 15 studies involving 18 820 cases were included. The results of meta-analysis showed that the fertility rate for the second child of females of childbearing age was 0.42 (95%CI 0.37 to 0.47), and the result was stable. Subgroup analysis showed that the fertility rate of second child in eastern region was higher than that in western region (0.44 vs. 0.40), in rural areas was higher than that in non-rural areas (0.46 vs. 0.35), females aged 18 to 34 was higher than those aged above 35 (0.49 vs. 0.29), and non-working females was higher than that among working females (0.48 vs. 0.40). The fertility rate of the sex of the first child being female was higher than the sex of the first child was male (0.48 vs. 0.39). The fertility rate of the couple who were both the non-only child was higher than the couple who were both the only child and who was only child while the other was non-only child (0.46 vs. 0.41 vs. 0.40).ConclusionsSince the implementation of the “universal two-child policy” in China, the fertility rate of females of childbearing age with the intention of having a second child is lower, especially those females who are from the western regions and non-rural areas, aged above 35 and the sex of the first child is male and non-dual-non-couples. Due to the quantity and quality of the included studies, more high quality studies are required to verify the above conclusions in future.
Objective To understand the basis and status of setting up the dispensing fee at home and abroad, and to ascertain the scope of dispensing service, so as to offer references to the setting up and implement of dispensing fee in China. Methods According to the evidence-based principle, the descriptive method was adopted to demonstrate the basis of setting up the dispensing fee. The different definition, payment mode and standard were compared at home and abroad. Results Separation of prescribing and dispensing was the basis of setting up the dispensing fee. In western countries, the charge of dispensing fee was almost at the same level, though its definition and scope were different among countries. It was more reasonable to determine the level of dispensing fee according to the visiting frequency, compared with the price, the number and the type of drugs in the prescription. Conclusion China’s calculation of dispensing fee should be based on the prescription fee, the cost of drug administration and store. Dispensing fee should be implemented in the pilot hospitals firstly. Institutions providing primary health care services (rural health clinics, community health service centers etc) which follow a policy of “separating revenue from expenditures” may not adopt the dispensing fee temporarily. In urban hospitals, it is advisable to promote the separation of prescribing and dispensing gradually and bring pharmacists to provide prescription auditing, dispensing and advisory services. For retail pharmacies, pharmacists should be gradually fully staffed as one of the necessary conditions for operating. Performance evaluation of pharmacist’s services and pharmacy administration also should be developed.
ObjectivesTo explore the poor population’s cognition and satisfaction on medical assistance policies in Sichuan province, so as to provide evidence for improving health poverty alleviation policies.Methods A telephone survey was conducted between October and December 2017 among 1 280 poor individuals in Sichuan Province, with multi-stage stratified random sampling. The contents of the survey included general demographics of the poor population, and knowledge and satisfaction of health poverty alleviation policies.ResultsThe awareness rate of medical assistance policy was 91.80%, and the satisfaction rate was 91.88%. Poor individuals from non-poor counties, who had been out of poverty, and who reported that they had not signed up for family doctors, had low awareness of poverty alleviation policies. Poor individuals from non-poor counties, who usually went to the municipal hospital, who reported that they have not signed up for family doctors, and who do not know about health policies for poverty alleviation had a lower satisfaction rate.ConclusionsThe overall awareness rate and satisfaction rate of medical assistance policies in Sichuan province are relatively high, however, there are still some shortage. In the future, more attention should be paid to strengthen the promotion of health poverty alleviation policies for non-poor areas and those who had been lifted out of poverty, speeding up the contract service of family doctors and exploring ways to further alleviate the burden of medical expense of patients with serious diseases.
