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  1. AU="Zhang, Huyang"
  2. AU="Liao, Mu-Xi"

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  1. Article ; Online: Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example.

    Zhang, Huyang / Ning, Ke / Wang, Jinxi / Fang, Hai

    Frontiers in public health

    2023  Volume 11, Page(s) 1121772

    Abstract: Objective: The objective of this study is to assess the impact of the changes in patient cost-sharing on the medical expenses and health outcomes of patients with heart failure in China.: Methods: The claim data of patients diagnosed with heart ... ...

    Abstract Objective: The objective of this study is to assess the impact of the changes in patient cost-sharing on the medical expenses and health outcomes of patients with heart failure in China.
    Methods: The claim data of patients diagnosed with heart failure enrolled in the Urban Employees' Basic Medical Insurance (UEBMI) in the Zhejiang province, China, was used, covering the period from 1 January 2013 to 31 December 2017. The impact of the policy change was estimated through the use of the difference-in-differences method and the event study method.
    Results: A total of 6,766 patients and their electronic health insurance claim data were included in the baseline year of 2013. Following the change in the UEBMI reimbursement policies (policy change), a notable decrease was observed in the patient cost-sharing ratios, particularly in the copayment ratio within the policy. However, it did not result in a reduction of the out-of-pocket ratio, which remains a primary concern among patients. An increase was observed in annual outpatient medical expenses, while annual inpatient medical expenses decreased, leading to higher annual medical expenses in the treatment group in comparison to the control group. The effect of the UEBMI reimbursement policy change on health outcomes showed a reduction in the rehospitalization rate within 90 days; however, no significant impact was seen on the rehospitalization rate within 30 days.
    Conclusion: The impact of the policy change on medical expenses and health outcomes was found to be modest. To effectively address the financial burden on patients, it is crucial for policymakers to adopt a comprehensive approach that considers all aspects of medical insurance policies, including reimbursement policies.
    MeSH term(s) Humans ; Health Expenditures ; Outpatients ; Heart Failure/therapy ; China
    Language English
    Publishing date 2023-03-14
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2023.1121772
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Perinatal mental health services for women from minority ethnic groups: why patient-centred approach matter.

    Chen, Shanquan / Zhang, Huyang / Kuper, Hannah

    BMC medicine

    2023  Volume 21, Issue 1, Page(s) 371

    MeSH term(s) Pregnancy ; Humans ; Female ; Ethnicity ; Minority Groups/psychology ; Mental Health Services ; Qualitative Research ; Delivery of Health Care
    Language English
    Publishing date 2023-10-03
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2131669-7
    ISSN 1741-7015 ; 1741-7015
    ISSN (online) 1741-7015
    ISSN 1741-7015
    DOI 10.1186/s12916-023-02979-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Effect of Childhood Health Status on Adult Health in China.

    Wang, Qing / Zhang, Huyang / Rizzo, John A / Fang, Hai

    International journal of environmental research and public health

    2018  Volume 15, Issue 2

    Abstract: Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such ... ...

    Abstract Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects' fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13-18%), 13% (95% CI: 10-15%), and 14% (95% CI: 12-17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote childhood health will have long-term benefits in China and that health-care policies should consider their long-term impacts over the life cycle in addition to their effects on specific age groups.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Child ; Child, Preschool ; China/epidemiology ; Cognition ; Female ; Health Status ; Health Surveys ; Humans ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Middle Aged ; Nutritional Status ; Self Report ; Sex Factors ; Young Adult
    Language English
    Publishing date 2018-01-26
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1660-4601
    ISSN (online) 1660-4601
    DOI 10.3390/ijerph15020212
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Financing strategies to improve essential public health equalization and its effects in China.

    Yang, Li / Sun, Li / Wen, Liankui / Zhang, Huyang / Li, Chenyang / Hanson, Kara / Fang, Hai

    International journal for equity in health

    2016  Volume 15, Issue 1, Page(s) 194

    Abstract: Background: In 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health ...

    Abstract Background: In 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health for all, identify the strengths and weaknesses of the different approaches, and showed evidence on equity improvement among different regions.
    Methods: We reviewed the relevant literatures and identified 208 articles after screening and quality assessment and conducted six key informants' interviews. Secondary data on national and local government health expenditures, NEPHSP coverage and health indicators in 2003-2014 were collected, descriptive and equity analyses were used.
    Results: Before 2009, the government subsidy to primary care institutions (PCIs) were mainly used for basic construction and a small part of personnel expenses. Since 2009, the new funds for NEPHSP have significantly expanded service coverage and population coverage. These funds have been allocated by central, provincial, municipal and county governments at different proportions in China's tax distribution system. Due to the fiscal transfer payment, the Central Government allocated more subsides to less-developed western regions and all the funds were managed in a specific account. Several types of payment methods have been adopted including capitation, pay for performance (P4P), pay for service items, global budget and public health voucher, to address issues from both the supply and demand sides. The equalization of NEPHSP did well through the establishment of health records, systematic care of children and maternal women, etc. Our data showed that the gap between the eastern, central and western regions narrowed. However the coverage for migrants was still low and performance was needed improving in effectiveness of managing patients with chronic diseases.
    Conclusions: The delivery of essential public health services was highly influenced by public fiscal policy, and the implementation of health reform since 2009 has led the public health development towards the right direction. However China still needs to increase the fiscal investments to expand service coverage as well as promote the quality of public health services and equality among regions. Independent scientific monitoring and evaluation are also needed.
    Keywords covid19
    Language English
    Publishing date 2016-12-01
    Publishing country England
    Document type Journal Article
    ISSN 1475-9276
    ISSN (online) 1475-9276
    DOI 10.1186/s12939-016-0482-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Strengthening health system to improve immunization for migrants in China.

    Fang, Hai / Yang, Li / Zhang, Huyang / Li, Chenyang / Wen, Liankui / Sun, Li / Hanson, Kara / Meng, Qingyue

    International journal for equity in health

    2017  Volume 16, Issue 1, Page(s) 19

    Abstract: Background: Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen ... ...

    Abstract Background: Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants.
    Methods: This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied.
    Results: China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children.
    Conclusions: Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population.
    MeSH term(s) Child ; Child, Preschool ; China ; Delivery of Health Care/organization & administration ; Humans ; Immunization/statistics & numerical data ; Infant ; Infant, Newborn ; Retrospective Studies ; Transients and Migrants/statistics & numerical data
    Language English
    Publishing date 2017--01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1475-9276
    ISSN (online) 1475-9276
    DOI 10.1186/s12939-016-0504-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

    Fang, Hai / Jin, Yinzi / Zhao, Miaomiao / Zhang, Huyang / A Rizzo, John / Zhang, Donglan / Hou, Zhiyuan

    International journal of environmental research and public health

    2017  Volume 14, Issue 10

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2017-10-20
    Publishing country Switzerland
    Document type Journal Article
    ISSN 1660-4601
    ISSN (online) 1660-4601
    DOI 10.3390/ijerph14101256
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Avoidable Hospital Admissions From Diabetes Complications In Japan, Singapore, Hong Kong, And Communities Outside Beijing.

    Quan, Jianchao / Zhang, Huyang / Pang, Deanette / Chen, Brian K / Johnston, Janice M / Jian, Weiyan / Lau, Zheng Yi / Iizuka, Toshiaki / Leung, Gabriel M / Fang, Hai / Tan, Kelvin B / Eggleston, Karen

    Health affairs (Project Hope)

    2017  Volume 36, Issue 11, Page(s) 1896–1903

    Abstract: Improving the quality of primary care may reduce avoidable hospital admissions. Avoidable admissions for conditions such as diabetes are used as a quality metric in the Health Care Quality Indicators of the Organization for Economic Cooperation and ... ...

    Abstract Improving the quality of primary care may reduce avoidable hospital admissions. Avoidable admissions for conditions such as diabetes are used as a quality metric in the Health Care Quality Indicators of the Organization for Economic Cooperation and Development (OECD). Using the OECD indicators, we compared avoidable admission rates and spending for diabetes-related complications in Japan, Singapore, Hong Kong, and rural and peri-urban Beijing, China, in the period 2008-14. We found that spending on diabetes-related avoidable hospital admissions was substantial and increased from 2006 to 2014. Annual medical expenditures for people with an avoidable admission were six to twenty times those for people without an avoidable admission. In all of our study sites, when we controlled for severity, we found that people with more outpatient visits in a given year were less likely to experience an avoidable admission in the following year, which implies that primary care management of diabetes has the potential to improve quality and achieve cost savings. Effective policies to reduce avoidable admissions merit investigation.
    MeSH term(s) China ; Diabetes Complications/therapy ; Diabetes Mellitus/therapy ; Health Expenditures ; Hong Kong ; Hospitalization/economics ; Hospitalization/trends ; Humans ; Japan ; Patient Admission/statistics & numerical data ; Primary Health Care/trends ; Primary Health Care/utilization ; Singapore ; Socioeconomic Factors
    Language English
    Publishing date 2017
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632712-6
    ISSN 1544-5208 ; 0278-2715
    ISSN (online) 1544-5208
    ISSN 0278-2715
    DOI 10.1377/hlthaff.2017.0479
    Database MEDical Literature Analysis and Retrieval System OnLINE

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