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Article ; Online: Decomposition analysis on the equity of health examination utilization for the middle-aged and elderly people in China: based on longitudinal CHARLS data from 2011 to 2018.

Su, Min / Zhang, Tianjiao / Zhang, Weile / Li, Zhengrong / Fan, Xiaojing

2024 Volume 24, Issue 1, Page(s) 998

Abstract: Background: This study aimed to investigate the utilization rate and equity of health examination service among the middle-aged and elderly population in China from 2011 to 2018. The contribution of various determinants to the inequity in health ... ...

Abstract	Background: This study aimed to investigate the utilization rate and equity of health examination service among the middle-aged and elderly population in China from 2011 to 2018. The contribution of various determinants to the inequity in health examination service utilization was also examined. Methods: Data from the China Health and Retirement Longitudinal Survey (CHARLS) were analyzed to assess the health examination service utilization rate among the middle-aged and elderly population. A concentration curve and concentration index were employed to measure the equity of health examination service utilization and decomposed into its determining factors. Horizontal inequity index was applied to evaluate the trends in equity of health examination service. Results: The health examination service utilization rates among the middle-aged and elderly population were 29.45%, 20.69%, 25.40%, and 32.05% in 2011, 2013, 2015, and 2018, respectively. The concentration indexes for health examination service utilization were 0.0080 (95% CI: - 0.0084, 0.0244), 0.0155 (95% CI: - 0.0054, 0.0363), 0.0095 (95% CI: - 0.0088, 0.0277), and - 0.0100 (95% CI: - 0.0254, 0.0054) from 2011 to 2018, respectively. The horizontal inequity index was positive from 2011 to 2018, evidencing a pro-rich inequity trend. Age, residence, education, region, and economic status were the major identified contributors influencing the equity of health examination service utilization. Conclusions: A pro-rich inequity existed in health examination service utilization among the middle-aged and elderly population in China. Reducing the wealth and regional gap, providing equal educational opportunities, and strengthening the capacity for chronic disease prevention and control are crucial for reducing the inequity in health examination service utilization.
MeSH term(s)	Middle Aged ; Humans ; Aged ; Retirement ; Healthcare Disparities ; Socioeconomic Factors ; China ; Longitudinal Studies
Language	English
Publishing date	2024-04-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-024-18068-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Catastrophic health expenditure and its inequality in rural China: based on longitudinal data from 2013 to 2018.

Zhang, Weile / Su, Min / Li, Dongxu / Zhang, Tianjiao / Li, Wenhui

BMC public health

2023 Volume 23, Issue 1, Page(s) 1861

Abstract: Background: Catastrophic health expenditure (CHE) is an important indicator of measuring health inequality. Previous studies mainly focused on specific vulnerable populations rather than a wider range of vulnerable areas through panel data. Rural China ... ...

Abstract	Background: Catastrophic health expenditure (CHE) is an important indicator of measuring health inequality. Previous studies mainly focused on specific vulnerable populations rather than a wider range of vulnerable areas through panel data. Rural China is often associated with an underdeveloped economy and insufficient health resources. This study aims to update the information on the extent of and trends in the incidence and inequality of CHE among the households of rural China through longitudinal survey data. Methods: Data were obtained from three waves of the China Health and Retirement Longitudinal Study (CHARLS): 2013, 2015, and 2018. In total, 2,575 households were included in the analysis. CHE was defined as household health expenditures exceeding 40% of non-food expenditures. Inequality in CHE was measured using the concentration curve and concentration index. The contribution to CHE inequality was decomposed using the concentration index decomposition method. Results: The incidence of CHE was 0.2341 (95% CI: 0.22, 0.25) in 2013, 0.2136 (95% CI: 0.20, 0.23) in 2015, and 0.2897 (95% CI: 0.27, 0.31) in 2018 in rural China. The concentration curve lay above the equality line, and the concentration index was negative: -0.1528 (95% CI: -0.1941, -0.1115) in 2013, -0.1010 (95% CI: -0.1442, -0. 0577) in 2015, and -0.0819 (95% CI: -0.1170, -0.0467) in 2018. Economic status, age, and chronic diseases were the main contributors to inequality in CHE. Conclusions: The incidence of CHE in rural China displayed an upward trend from 2013 to 2018, although it was not continuous. Furthermore, a strong pro-low-economic inequality in CHE existed in rural China. Mainly economic status, age, and chronic diseases contributed to this pro-low-economic inequality. Health policies to allocate resources and services are needed to satisfy the needs of rural households and provide more accessible and affordable health services. More concern needs to be directed toward households with chronic diseases and older persons to reduce the incidence of CHE and promote health equality.
MeSH term(s)	Humans ; Aged ; Aged, 80 and over ; Health Expenditures ; Health Status Disparities ; Longitudinal Studies ; Health Promotion ; China/epidemiology ; Chronic Disease
Language	English
Publishing date	2023-09-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-16692-7
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Article ; Online: The Effect of Medical Choice on Health Costs of Middle-Aged and Elderly Patients with Chronic Disease: Based on Principal-Agent Theory.

Li, Dongxu / Su, Min / Guo, Xi / Zhang, Weile / Zhang, Tianjiao

International journal of environmental research and public health

2022 Volume 19, Issue 13

Abstract: 1) Background: The discussion on how to reduce the health costs of chronic disease patients has become an important public health issue. Limited research has been conducted on how chronic disease patients' medical choice of public and private medical ... ...

Abstract	(1) Background: The discussion on how to reduce the health costs of chronic disease patients has become an important public health issue. Limited research has been conducted on how chronic disease patients' medical choice of public and private medical institutions affect health costs. (2) Methods: This study used the panel data composed of the China Health and Retirement Longitudinal Survey (CHARLS) from 2011 to 2018, adopted the quasi-natural experimental research method, and set up a control group and an experimental group that chose public medical institutions and private medical institutions, to analyze the association between the medical choice and health costs of chronic disease patients. (3) Results: Compared with chronic disease patients who chose private medical institutions, patients who chose public medical institutions increased their total cost by 44.9%, total out-of-pocket cost by 22.9%, and decreased the total out-of-pocket ratio by 0.117%, total drug cost out-of-pocket ratio by 0.075%, and drug cost ratio by 0.102%. (4) Conclusions: According to the triple principal-agent relationships, the resource advantages given by the government to public medical institutions, the salary incentive system of medical institutions, and the information asymmetry advantage held by physicians may be important factors for the increase in health costs for chronic disease patients.
MeSH term(s)	Aged ; Chronic Disease ; Drug Costs ; Health Expenditures ; Humans ; Middle Aged ; Patients ; Physicians
Language	English
Publishing date	2022-06-21
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19137570
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Article ; Online: Equity in health service utilisation among middle-aged and elderly people with multiple chronic conditions in China: evidence from longitudinal data of 2011-2018 CHARLS.

Zhang, Tianjiao / Su, Min / Li, Dongxu / Zhang, Weile / Yang, Fan / Li, Wenhui

BMJ open

2023 Volume 13, Issue 10, Page(s) e072320

Abstract: Objectives: Equity in health service utilisation is a central objective for health systems. Middle-aged and elderly patients with multiple chronic conditions (MCCs) are particularly vulnerable to healthcare inequity. This study aimed to update the ... ...

Abstract	Objectives: Equity in health service utilisation is a central objective for health systems. Middle-aged and elderly patients with multiple chronic conditions (MCCs) are particularly vulnerable to healthcare inequity. This study aimed to update the information on the trends in the incidence and equity of outpatient health service utilisation (OHSU) and inpatient health service utilisation (IHSU) for middle-aged and elderly MCCs patients in China, identify socioeconomic determinants that may contribute to inequity, and suggest optimisation strategies to mitigate this disparity. Methods: Panel data obtained from four waves of the China Health and Retirement Longitudinal Study (CHARLS) were used to determine the trends in OHSU and IHSU. The inequity in OHSU and IHSU was measured by the Concentration Index (CI) and Horizontal Inequity Index (HI), which is a valid measure of health service utilisation equity. The decomposition model of the CI was set up to explore the contribution of various determinants of overall equity. Results: The annual rate of OHSU gradually decreased from 29.32% in 2011 to 27.27% in 2018. The HI remained positive and decreased from 0.0803 in 2011 to 0.0662 in 2018, indicating the existence of pro-rich inequity. The annual rate of IHSU gradually increased from 13.31% in 2011 to 19.89% in 2018. The HI remained positive and showed a declining trend from 0.2363 in 2011 to 0.0574 in 2018, evidencing pro-rich inequity; however, a trend towards the easing of inequity was observed. Conclusions: Pro-rich inequity was present in both OHSU and IHSU among middle-aged and elderly MCCs patients in China. Economic status, area, education and age were the main contributors to pro-rich inequity. Concerted efforts are needed to allocate resources for mitigating health service utilisation inequity in middle-aged and elderly people with MCCs.
MeSH term(s)	Middle Aged ; Aged ; Humans ; Retirement ; Multiple Chronic Conditions ; Longitudinal Studies ; Healthcare Disparities ; Socioeconomic Factors ; China/epidemiology ; Ambulatory Care
Language	English
Publishing date	2023-10-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-072320
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Article ; Online: Barriers and facilitators of implementing electronic monitors to improve adherence and health outcomes in tuberculosis patients: protocol for a systematic review based on the Consolidated Framework for Implementation Research.

Li, Wenhui / Su, Min / Zhang, Weile / Fan, Xiaojing / Li, Renzhong / Gao, Yulong / Wei, Xiaolin

Health research policy and systems

2023 Volume 21, Issue 1, Page(s) 115

Abstract: Background: Tuberculosis (TB) has been regarded as 'a relentless scourge', increasing morbidity and mortality and burdening vulnerable populations. Poor adherence to TB treatment and ineffective traditional interventions hinders TB control. A novel TB ... ...

Abstract	Background: Tuberculosis (TB) has been regarded as 'a relentless scourge', increasing morbidity and mortality and burdening vulnerable populations. Poor adherence to TB treatment and ineffective traditional interventions hinders TB control. A novel TB approach called 'electronic monitors', equipping medication boxes with daily audio or visual reminders for electronically monitoring medication intake, seems promising in improving adherence and health outcomes and overcoming the weaknesses of traditional interventions. However, no review has systematically examined and synthesized the influencing factors of implementing electronic monitors. Implementation research offers the means to analyse the influencing factors of the implementation and its process, fitting well with the aim of this review. Therefore, the widely recognized Consolidated Framework for Implementation Research (CFIR), which offers a common taxonomy for evaluating intervention implementation, will be adopted to systematically identify barriers and facilitators of the electronic monitors for improving adherence and health outcomes in patients with TB. Methods and analysis: The systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature research will be conducted in five electronic databases (Ovid MEDLINE, CINAHL, EMBASE, Cochrane Library and Web of Science) to identify the barriers and facilitators of implementing electronic monitors in patients with TB. The CFIR will be used as a guide for categorizing and synthesizing the barriers and facilitators. Study screening, data extraction, quality appraisal and data analysis will be conducted by two independent reviewers. The use of additional reviewers will solve any disagreements between the two reviewers. Discussion: Given the increased prominence of TB epidemiology and the adherence problem of electronic monitors, there is a solid rationale for synthesizing the existing studies via the CFIR. The findings and conclusion of this review will lay bare the achievements and effectiveness of implementing electronic monitors, as well as the attendant gaps and limitations. Further strategies for facilitating the implementation of electronic monitors will also be explored. This review will be of essential significance for research and practice, supporting future academic research initiatives centred on patients with TB and aiding electronic monitor design in lowering the morbidity and mortality associated with TB disease. Trial registration number: PROSPERO: CRD42023395747.
MeSH term(s)	Humans ; Systematic Reviews as Topic ; Tuberculosis/drug therapy ; Outcome Assessment, Health Care ; Electronics ; Review Literature as Topic
Language	English
Publishing date	2023-11-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2101196-5
ISSN	1478-4505 ; 1478-4505
ISSN (online)	1478-4505
ISSN	1478-4505
DOI	10.1186/s12961-023-01054-x
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Book ; Online: STAR-RIS Enhanced UAV-Enabled MEC Networks with Bi-Directional Task Offloading

Xiao, Han / Hu, Xiaoyan / Mu, Pengcheng / Zhang, Weile / Wang, Wenjie / Wong, Kai-Kit / Yang, Kun

2024

Abstract: A simultaneously transmitting and reflecting reconfigurable intelligent surface (STAR-RIS) enhanced unnamed aerial vehicle (UAV)-enabled multi-user mobile edge computing (MEC) scheme is proposed in this paper. Different from the existing MEC works, the ... ...

Abstract	A simultaneously transmitting and reflecting reconfigurable intelligent surface (STAR-RIS) enhanced unnamed aerial vehicle (UAV)-enabled multi-user mobile edge computing (MEC) scheme is proposed in this paper. Different from the existing MEC works, the proposed scheme allows bi-directional offloading where users can simultaneously offload their computing tasks to the MEC servers situated at the ground base station (BS) and aerial UAV with the assistance of the STARRIS. Specifically, we formulate an optimization problem aiming at maximizing the energy efficiency of the system while ensuring the quality of service (QoS) constraint by jointly optimizing the resource allocation, user scheduling, passive beamforming of the STAR-RIS, and the UAV trajectory. An iterative algorithm designed with the Dinkelbach's algorithm and the successive convex approximation (SCA) is proposed to effectively handle the formulated non-convex optimization problem. Simulation results indicate that the proposed STAR-RIS enhanced UAV-enabled MEC scheme possesses significant advantages in enhancing the system energy efficiency over other baseline schemes including the conventional RIS-aided scheme.
Keywords	Computer Science - Information Theory ; Electrical Engineering and Systems Science - Signal Processing
Publishing date	2024-01-11
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Degree-of-Freedom Strengthened Cascade Array for DOD-DOA Estimation in MIMO Array Systems.

Yao, Bobin / Dong, Zhi / Zhang, Weile / Wang, Wei / Wu, Qisheng

Sensors (Basel, Switzerland)

2018 Volume 18, Issue 5

Abstract: In spatial spectrum estimation, difference co-array can provide extra degrees-of-freedom (DOFs) for promoting parameter identifiability and parameter estimation accuracy. For the sake of acquiring as more DOFs as possible with a given number of physical ... ...

Abstract	In spatial spectrum estimation, difference co-array can provide extra degrees-of-freedom (DOFs) for promoting parameter identifiability and parameter estimation accuracy. For the sake of acquiring as more DOFs as possible with a given number of physical sensors, we herein design a novel sensor array geometry named cascade array. This structure is generated by systematically connecting a uniform linear array (ULA) and a non-uniform linear array, and can provide more DOFs than some exist array structures but less than the upper-bound indicated by minimum redundant array (MRA). We further apply this cascade array into multiple input multiple output (MIMO) array systems, and propose a novel joint direction of departure (DOD) and direction of arrival (DOA) estimation algorithm, which is based on a reduced-dimensional weighted subspace fitting technique. The algorithm is angle auto-paired and computationally efficient. Theoretical analysis and numerical simulations prove the advantages and effectiveness of the proposed array structure and the related algorithm.
Language	English
Publishing date	2018-05-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s18051557
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Book ; Online: High-Mobility Massive MIMO Communications:Doppler Compensation and Transmit Diversity

Zhang, Weile / Hu, Zhinan / Zhang, Shun / Wang, Gongpu

2019

Abstract: High-mobility wireless communications have been receiving a lot attentions. In this paper, we consider the highmobility uplink transmission from a high-speed terminal (HST) to a base station (BS). We propose two transmit diversity schemes for high- ... ...

Abstract	High-mobility wireless communications have been receiving a lot attentions. In this paper, we consider the highmobility uplink transmission from a high-speed terminal (HST) to a base station (BS). We propose two transmit diversity schemes for high-mobility massive communications with angle domain Doppler compensation. In the first scheme, we propose the idea of block-wise angle domain Doppler compensation, such that the uplink equivalent channel would exhibit the feature of nearly perfect independent block fading. The signal space diversity encoding technique is then exploited to achieve transmit diversity. In the second scheme, the multiple parallel beamformers with Doppler compensation are exclusively occupied to transmit multiple orthogonal space-time block coding (OSTBC) data streams. Both analysis and numerical results verify that both the proposed schemes can achieve transmit diversity and outperform the conventional scheme. Comment: 4 pages,4 figures
Keywords	Electrical Engineering and Systems Science - Signal Processing
Subject code	003
Publishing date	2019-05-24
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Multi-Antenna Covert Communications with Random Access Protocol

Zhang, Weile / Zhao, Nan / Zhang, Shun / Yu, F. Richard

2019

Abstract: In this paper, we consider the issue of covert communications with random access protocol. We consider that the legitimate user Bob has no priori knowledge about packet arrival time and thus employs data-aided frame detection based on reference sequence. ...

Abstract	In this paper, we consider the issue of covert communications with random access protocol. We consider that the legitimate user Bob has no priori knowledge about packet arrival time and thus employs data-aided frame detection based on reference sequence. The warden user Willie tries to detect this covert communication by using a radiometer. The detection performance analysis is provided for both Bob and Willie under Rayleigh fading channel. It is demonstrated that the covert performance can benefit from the increase of the frame length or the number of receive antennas from frame detection perspective. Numerical results are provided to verify the proposed studies.
Keywords	Computer Science - Information Theory
Publishing date	2019-07-17
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Beamforming Network Optimization for Reducing Channel Time Variation in High-Mobility Massive MIMO

Ge, Yinghao / Zhang, Weile / Gao, Feifei / Zhang, Shun / Ma, Xiaoli

2018

Abstract: Communications in high-mobility environments have caught a lot of attentions recently. In this paper, fast time-varying channels for massive multiple-input multiple-output (MIMO) systems are addressed. We derive the exact channel power spectrum density ( ... ...

Abstract	Communications in high-mobility environments have caught a lot of attentions recently. In this paper, fast time-varying channels for massive multiple-input multiple-output (MIMO) systems are addressed. We derive the exact channel power spectrum density (PSD) for the uplink from a high-speed railway (HSR) to a base station (BS) and propose to further reduce the channel time variation via beamforming network optimization. A large-scale uniform linear array (ULA) is equipped at the HSR to separate multiple Doppler shifts in angle domain through high-resolution transmit beamforming. Each branch comprises a dominant Doppler shift, which can be compensated to suppress the channel time variation, and we derive the channel PSD and the Doppler spread to assess the residual channel time variation. Interestingly, the channel PSD can be exactly expressed as the product of a pattern function and a beam-distortion function. The former reflects the impact of array aperture and is the converted radiation pattern of ULA, while the latter depends on the configuration of beamforming directions. Inspired by the PSD analysis, we introduce a common configurable amplitudes and phases (CCAP) parameter to optimize the beamforming network, by partly removing the constant modulus quantized phase constraints of matched filter (MF) beamformers. In this way, the residual Doppler shifts can be ulteriorly suppressed, further reducing the residual channel time variation. The optimal CCAP parameter minimizing the Doppler spread is derived in a closed form. Numerical results are provided to corroborate both the channel PSD analysis and the superiority of beamforming network optimization technique. Comment: Double columns, 13 pages, 10 figures, transactions paper
Keywords	Electrical Engineering and Systems Science - Signal Processing
Subject code	003
Publishing date	2018-09-01
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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