The strategic model for insured bond of firm is a new model which is developed based on options pricing model and game theory. When firm’s bond was insured against bankruptcy, some interesting results about endogenou...The strategic model for insured bond of firm is a new model which is developed based on options pricing model and game theory. When firm’s bond was insured against bankruptcy, some interesting results about endogenous bankruptcy and optimal capital structure are obtained.展开更多
A man went to an insurance(保险)office to have his life insured.The manager of the office asked him how old his parents were when they died. 'Mother had a bad heart and died at the age of thirty.Father died of tub...A man went to an insurance(保险)office to have his life insured.The manager of the office asked him how old his parents were when they died. 'Mother had a bad heart and died at the age of thirty.Father died of tuberculosis when he was thirty- five.' 'I am very sorry,'said the manager.'We cannot insure your life as your parents were not healthy.'展开更多
In the field of education, there is a need for a financing system which is affordable, yet effective, as well as profitable, and is based on user participation. This need was the main reason the author has designed th...In the field of education, there is a need for a financing system which is affordable, yet effective, as well as profitable, and is based on user participation. This need was the main reason the author has designed the model named ＂Insured Education System Model---IESM＂. The IESM is based on the principle that expenditures incurred at each stage of educational attainment should not be burdened upon the person himself/herself. There should be insurance companies willing to cover the educational expenditures of the buyers. The suggested IESM model also creates an auto-control mechanism within the financing system through which insurance companies, educational institutions （buyers）, and households will gain benefits. Furthermore, the IESM will increase the quality of service within the overall educational system, and create employment, as well as eliminating the number of school drop outs. The system will bring a significant decrease in the cost of the service. This study presents the results of the analyses on the data collected by the author on the perception of the proposed Insured Education System Models through surveys conducted in selected schools in Istanbul. The survey is unique in a sense that for the first time in literature such a model is suggested and the perception of relevant stake holders are tested through a questionnaire of 42 questions. The results show that there is an approval rate of more than 50% regarding to the IESM. And the frequency analysis suggests that the IESM is an applicable model.展开更多
The biggest problem in the world as well as in Turkey is to increase efficiency of human capital, which can only be achieved by educating all people in accordance with their capacities and demands. And, the biggest pr...The biggest problem in the world as well as in Turkey is to increase efficiency of human capital, which can only be achieved by educating all people in accordance with their capacities and demands. And, the biggest problem in education is finance. In order for everybody to have education, there is a need to develop a finance system which will help overcome the financial problems faced by households or individuals. For this purpose, the participatory, payable, profitable, and potent （4p＇s） insured education system model （IESM） is developed. This paper focuses on principles of the IESM and the analyses of frequency and variance by categories （one-way ANOVA）.展开更多
Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization ...Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization of health services. Evidences supported that institutionalized health insurance increases intensity of utilization. Methodology: The study was conducted at AKTH, Kano, and north-western, Nigeria. The study was retrospective comparative cross-sectional study. 100 patients were enrolled, 50 for each arm. Paediatric SCD clinic outpatients’ records and a specialty designed form containing the variables of interest were used. Data were analysed using Minitab 16. Proportions, percentages, tables, charts and chi squared test were used to compare the two groups. Result: The study found no association between the two groups in the likelihood of being insured based on age (χ<sup>2</sup> = 1.478), gender (χ<sup>2</sup> = 0.224) and dwellings (χ<sup>2</sup> = 0.062). On health services utilization and insurance status, the study revealed that follow up clinic visits, unscheduled clinic visits and emergency room visits were more likely among the insured group compared to the uninsured group. While the health status and insurance status of the two groups over 12 months period showed a significant association with the insured more likely to have improved health status compared to uninsured (χ<sup>2</sup> = 28.019, p = 0.0001). Similarly, health status and health services utilization were significantly associated with insurance status (χ<sup>2</sup> = 12.191, p = 0.002). Conclusion: The insurance status of children with SCD is associated with their health services utilization and health status. However, age, gender and dwellings were not associated with insurance status of children with SCD. Therefore, when expanding insurance coverage (NHIS) among children with SCD considerations have to be given to increase health services utilization and resultant improvement in health status as these have the potential of reducing morbidity and mortality among children with SCD.展开更多
In sub Saharan Africa (SSA), access to affordable hypertension care through health insurance is increasing. But due to poor adherence, hypertension treatment outcomes often remain poor. Patient-centered educational in...In sub Saharan Africa (SSA), access to affordable hypertension care through health insurance is increasing. But due to poor adherence, hypertension treatment outcomes often remain poor. Patient-centered educational interventions may reverse this trend. Using a pre-test/post-test design, in this study we investigated the effects of a structured cardiovascular health education program (CHEP) on treatment adherence, blood pressure (BP) control and body mass index (BMI) among Nigerian hypertensive patients who received guideline-based care in a rural primary care facility, in the context of a community based health insurance program. Study participants included 149 insured patients with uncontrolled BP and/or poor self-reported medication adherence after 12 months of guideline-based care. All patients received three group-based educational sessions and usual primary care over 6 months. We evaluated changes in self-reported adherence to prescribed medications and behavioral advice (primary outcomes);systolic BP (SBP) and/or diastolic BP (DBP) and BMI (secondary outcomes);and beliefs about hypertension and medications (explora- tory outcomes). Outcomes were analyzed with descriptive statistics and regression analysis. 140 patients completed the study (94%). At 6 months, more participants reported high adherence to medications and behavioral advice than at baseline: respectively, 101 (72%) versus 70 (50%), (p < 0.001) and 126 (90%) versus 106 (76%), (p < 0.001). Participants with controlled BP doubled from 34 (24%) to 65 (46%), (p = 0.001). The median SBP and DBP decreased from 129.0 to 122.0 mmHg, (p = 0.002) and from 80.0 to 73.5 mmHg, (p < 0.001), respectively. BMI did not change (p = 0.444). Improved medication adherence was associated with a decrease in medication concerns (p = 0.045) and improved medication self-efficacy (p < 0.001). By positively influencing patient perceptions of medications, CHEP strengthened medication adherence and, consequently, BP reduction among insured hypertensive Nigerians. This educational approach can support cardiovascular disease prevention programs for Africa’s growing hypertensive population.展开更多
China’s healthcare system faces increasing challenges,including surging medical costs,resource allocation imbalances favoring large hospitals,and ineffective referral mechanisms.The lack of a unified strategy integra...China’s healthcare system faces increasing challenges,including surging medical costs,resource allocation imbalances favoring large hospitals,and ineffective referral mechanisms.The lack of a unified strategy integrating standardized coverage with personalized payment compounds these issues.To this end,this study proposes a risk-sharing reform strategy that combines equal coverage for the same disease(ECSD)with an individualized out-of-pocket(I-OOP)model.Specifically,the study employs a Markov model to capture patient transitions across health states and care levels.The findings show that ECSD and I-OOP enhance equity by standardizing disease coverage while tailoring costs to patient income and facility type.This approach alleviates demand on high-tier hospitals,promoting primary care utilization and enabling balanced resource distribution.The study’s findings provide a reference for policymakers and healthcare administrators by presenting a scalable framework that is aligned with China’s development goals with the aim of fostering an efficient,sustainable healthcare system that is adaptable to regional needs.展开更多
The COVID-19 pandemic,as a global public health crisis,has had profound and lasting effects on the world economy and social operating models,fundamentally changing individuals',enterprises',and governments'...The COVID-19 pandemic,as a global public health crisis,has had profound and lasting effects on the world economy and social operating models,fundamentally changing individuals',enterprises',and governments'perceptions of risk and risk management paradigms.The Chinese insurance industry has experienced short-term pain due to the impact of the pandemic,but in the long term,the pandemic has served as a"catalyst"and"accelerator"for the industry's development,greatly enhancing societal awareness of risk protection and,with unprecedented strength,promoting the industry's digital revolution and supply-side structural reform.This article aims to conduct a comprehensive and systematic analysis of the macro environment,technological background,and demand changes faced by the Chinese insurance industry in the post-pandemic era,and to deeply explore the historical opportunities inherent in key areas such as health insurance,pension insurance,digital transformation,and green insurance.Additionally,this article will objectively examine the severe challenges the industry faces in the sustainability of profit models,structural mismatches in supply and demand,rebuilding trust systems,new risk management,and regulatory adaptation.Lastly,based on the above analysis,this article will propose strategic pathways and policy recommendations from three levels:national policy,industry regulation,and corporate strategy to promote the high-quality and sustainable development of the Chinese insurance industry,better serving the needs of national governance modernization and the well-being of the people.展开更多
In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focu...In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focused on the implications of public health plans such as Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance as well as out-of-pocket ratios on patient treatment plans regarding whether they pursue surgical interventions or therapeutic treatments such as chemotherapy.While Wu et al put forth potential explanations for why patients with the UEBMI plan surprisingly had a 23.30%increased risk of oesophageal cancer-specific death,more analysis is needed to alleviate cancer burden within this group.Although it is likely that patients covered by Urban Resident Basic Medical Insurance and higher out-ofpocket ratios have stronger self-recovery awareness,more work must be done to improve outcomes for people with the UEBMI plan while simultaneously implementing international and domestic initiatives to better emphasize cancer prevention and early detection.Lastly,future research must explore the relationship between Serious Illness Medical Insurance as well as the New Rural Cooperative Medical System on the mortality rate of oesophageal cancer patients in rural China,where disease burden is significantly higher than urban areas.By unifying these public health insurance schemes,officials can significantly alleviate economic burden of treatment and better prognosis for patients with oesophageal cancer.展开更多
As a city-customized supplementary medical insurance bridging basic medical insurance and commercial health insurance,Huimin Insurance has expanded to 30 provinces and served 168 million people within four years,emerg...As a city-customized supplementary medical insurance bridging basic medical insurance and commercial health insurance,Huimin Insurance has expanded to 30 provinces and served 168 million people within four years,emerging as a phenomenal success in China's inclusive insurance landscape.This paper examines its evolution,operational mechanisms,and effectiveness,identifying core challenges including declining participation and renewal rates,adverse selection,uneven benefit compensation,and insufficient information disclosure.It proposes sustainable development pathways across five dimensions:government role,financing and payment,product stratification,service value-added,and technology empowerment.The study demonstrates that the future of Huimin Insurance will likely evolve towards a model characterized by provincial-level co-ordination,stratified benefit design,dynamic pricing,and integrated health management.Its success or failure will ultimately determine the integration depth of China's multi-tiered medical security system and significantly impact the realization of common prosperity goals.展开更多
This article investigates the development process and current status of policy-based agricultural insurance in Chongqing.Based on recent data-including premium income,compensation amounts,the number of insured househo...This article investigates the development process and current status of policy-based agricultural insurance in Chongqing.Based on recent data-including premium income,compensation amounts,the number of insured households,and insurance penetration,the article analyzes the primary challenges faced in the system's operation and proposes recommendations from two dimensions:institutional optimization and practical interventions.These recommendations include establishing a differentiated participation incentive mechanism,optimizing the composition of insurance products,enhancing risk diversification and reinsurance systems,creating an agricultural disaster risk reserve fund,developing a dynamic fiscal subsidy distribution mechanism based on risk and performance,improving information-sharing platforms,strengthening the rural grassroots power grid infrastructure,and accelerating the adoption of modern technologies in underwriting and claims settlement processes.The findings suggest that the coordinated advancement of institutional optimization and technological empowerment can substantially enhance the inclusiveness,sustainability,and operational efficiency of policy-based agricultural insurance in Chongqing,thereby providing substantial support for agricultural modernization and the Rural Revitalization Strategy.展开更多
With the rapid development of China's insurance market,the high-quality development of the insurance market is faced with many different challenges and various problems.This paper aims to deeply analyze the actual...With the rapid development of China's insurance market,the high-quality development of the insurance market is faced with many different challenges and various problems.This paper aims to deeply analyze the actual problems in China's insurance market and put forward supporting countermeasures.First,by understanding the background of highquality insurance development,we can explain the research significance of this paper in combination with the existing national policies.Secondly,by summarizing the current situation of high-quality insurance development,the paper puts forward the shortage of insurance talents in the expansion of insurance scale,the continuous improvement of insurance density and depth,and the growth of insurance compensation in the development of high-quality insurance.Finally,from the perspective of differentiated customized insurance products,training professionals,and providing financial subsidies,we will put forward the corresponding suggestions for the problem and look forward to the future development prospects.展开更多
BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal ...BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.展开更多
Marxist and social science methodologies provide scientific conceptual tools and analytical perspectives for research across various disciplines.Among these,the methodology of quantitative and qualitative changes reve...Marxist and social science methodologies provide scientific conceptual tools and analytical perspectives for research across various disciplines.Among these,the methodology of quantitative and qualitative changes reveals the fundamental laws governing the development of things,offering significant guidance for exploring the relationship between Huimin Insurance and basic medical insurance,and for promoting the sustainable development of the medical security system.Based on this methodology and the practical context of the medical security field,this paper provides an in-depth analysis of the impact of Huimin Insurance on the sustainable development of basic medical insurance.展开更多
The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of heal...The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of health insurance on treatment availability and patient outcomes,demonstrating that the type of insurance can affect the financial burden on patients.This study investigates the effects of different types of health care coverage,namely Urban Employee Basic Medical Insurance vs Urban-Rural Resident Basic Medical Insurance,and the personal spending ratio on treatment decisions and survival outcomes.The database used is derived from esophageal tumor patient continuation from Chongqing University Hospital in China.A total of 2543 patients were included in the study,allowing for the formation of research cohorts.Patient information included demographic characteristics.The study followed various processes to maintain consistency,including data sources,inclusion and exclusion criteria,follow-up duration,health insurance,and statistical analysis.The average age at diagnosis ranged from 57-74 years,and predominantly included men,married people,and those of Han ethnic background,comprising 2088 and 2519 individuals,respectively.Upon controlling for age,sex,relationship status,country of origin,pathological evaluation,tumor stage,and biochemical indicators,individuals who had Urban Employee Basic Medical Insurance exhibited a higher propensity to opt for radiotherapy,chemotherapy,immunotherapy,and targeted therapy compared to those covered by the Urban-Rural Resident Basic Medical Insurance.During the follow-up phase of the study,a total of 1438 deaths were documented,with 1106 ascribed to esophageal cancer.Additionally,individuals with Urban-Rural Resident Basic Medical Insurance had a significantly elevated risk of esophageal cancer,particularly mortality,compared to those without Urban-Rural Resident Basic Medical Insurance.展开更多
BACKGROUND Private insurance coverage is associated with higher rates of living donor kidney transplantation(LDKT)but whether this is attributable to confounding is not known.AIM To study the association between incre...BACKGROUND Private insurance coverage is associated with higher rates of living donor kidney transplantation(LDKT)but whether this is attributable to confounding is not known.AIM To study the association between increased access to private health insurance and LDKT.METHODS Retrospective cohort study using United States transplant registry data.We identified incident candidates aged 22-29 years who were waitlisted for a kidneyonly transplant from 2005-2014,excluding prior transplant recipients and those with missing data.We calculated the hazard of LDKT after waitlisting for those with private insurance vs other insurance pre-Affordable Care Act(ACA)vs post-ACA,using death and delisting as competing events,for candidates affected by the policy change(age 22-25 years)vs those who were not(age 26-29 years).RESULTS A total of 13817 candidates were included,of whom 46%were age 22-25 years and 54%were age 26-29 years.Among candidates aged 22-25 years at listing,those listed post-ACA were more likely to have private insurance compared to those listed pre-ACA(42%vs 35%),but there was no difference in private insurance coverage between eras among candidates aged 26-29 years at listing.In adjusted competing risk regression,privately insured patients age 22-25 years were less likely to receive a LDKT post-ACA compared to pre-ACA[hazard ratio(HR)=0.88,95%CI:0.78-1.00],as were those aged 22-25 years old with other insurance types(HR=0.80,95%CI:0.69-0.92).These associations were not seen among candidates age 26-29 years.CONCLUSION Candidates age 22-25 years were likelier to have private insurance post-ACA,without an increased rate in LDKT.Demonstrations of associations between insurance and LDKT are likely attributable to residual confounding.展开更多
Cancer patients in China navigate a complex and uneven insurance landscape,making plan choice critical for equitable financial protection.This study conducts a structured narrative review(2010-2025)of the Web of Scien...Cancer patients in China navigate a complex and uneven insurance landscape,making plan choice critical for equitable financial protection.This study conducts a structured narrative review(2010-2025)of the Web of Science,PubMed,CNKI,and Wanfang databases,focusing on empirical research on insurance plan choice,enrollment,or switching among cancer patients and their households in China.Two reviewers independently screened studies and extracted information on key determinants and identification strategies.The evidence converges on five main determinants:insurance literacy,health knowledge,prior coverage,financial capability,and policy promotion intensity(PPI).However,most studies are cross-sectional and descriptive,with inconsistent operationalization of determinants,weak or absent mediation tests for PPI,and limited coverage of rural,elderly,and low-literacy populations.Building on these gaps,we synthesize an evidence map,propose an operational PPI index,and highlight quasi-experimental opportunities(such as staggered NRDL updates and variation in local publicity efforts)to identify mechanisms and inform more inclusive,patient-centered insurance design in China.展开更多
The purpose of this paper is to study the influencing factors of flexible employment personnel's participation in urban-rural residents'pension insurance.After reading a large number of literature and research...The purpose of this paper is to study the influencing factors of flexible employment personnel's participation in urban-rural residents'pension insurance.After reading a large number of literature and research results on flexible employment personnel and analyzing and interpreting the urban-rural residents'pension insurance policy of Zhuhai,we take the flexible employment personnel of Zhuhai City as the object of the study,combined with questionnaire survey method,and analyze the difficulties of the flexible employment personnel's participation in the insurance by analyzing the collected data,and find out that Zhuhai's flexibly employed people have cognitive bias towards urban and rural residents'pension insurance,the government's business personnel have a vague understanding of the insurance,and some of the flexibly employed people think that the subsidy is low,etc.The government of Zhuhai City has provided the suggestions of expanding the scope of the publicity of the urban and rural residents'pension insurance,increasing publicity efforts,and providing regular training for the counterpart service personnel in order to increase the rate of the flexibly employed people's participation in the insurance,and improve the inherent bad impression of the insurance by the flexibly employed people.personnel's inherent bad impression of insurance,and further improve China's insurance system.展开更多
基金Financial support from the National Natural Science Foundation of China (70271069).
文摘The strategic model for insured bond of firm is a new model which is developed based on options pricing model and game theory. When firm’s bond was insured against bankruptcy, some interesting results about endogenous bankruptcy and optimal capital structure are obtained.
文摘A man went to an insurance(保险)office to have his life insured.The manager of the office asked him how old his parents were when they died. 'Mother had a bad heart and died at the age of thirty.Father died of tuberculosis when he was thirty- five.' 'I am very sorry,'said the manager.'We cannot insure your life as your parents were not healthy.'
文摘In the field of education, there is a need for a financing system which is affordable, yet effective, as well as profitable, and is based on user participation. This need was the main reason the author has designed the model named ＂Insured Education System Model---IESM＂. The IESM is based on the principle that expenditures incurred at each stage of educational attainment should not be burdened upon the person himself/herself. There should be insurance companies willing to cover the educational expenditures of the buyers. The suggested IESM model also creates an auto-control mechanism within the financing system through which insurance companies, educational institutions （buyers）, and households will gain benefits. Furthermore, the IESM will increase the quality of service within the overall educational system, and create employment, as well as eliminating the number of school drop outs. The system will bring a significant decrease in the cost of the service. This study presents the results of the analyses on the data collected by the author on the perception of the proposed Insured Education System Models through surveys conducted in selected schools in Istanbul. The survey is unique in a sense that for the first time in literature such a model is suggested and the perception of relevant stake holders are tested through a questionnaire of 42 questions. The results show that there is an approval rate of more than 50% regarding to the IESM. And the frequency analysis suggests that the IESM is an applicable model.
文摘The biggest problem in the world as well as in Turkey is to increase efficiency of human capital, which can only be achieved by educating all people in accordance with their capacities and demands. And, the biggest problem in education is finance. In order for everybody to have education, there is a need to develop a finance system which will help overcome the financial problems faced by households or individuals. For this purpose, the participatory, payable, profitable, and potent （4p＇s） insured education system model （IESM） is developed. This paper focuses on principles of the IESM and the analyses of frequency and variance by categories （one-way ANOVA）.
文摘Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization of health services. Evidences supported that institutionalized health insurance increases intensity of utilization. Methodology: The study was conducted at AKTH, Kano, and north-western, Nigeria. The study was retrospective comparative cross-sectional study. 100 patients were enrolled, 50 for each arm. Paediatric SCD clinic outpatients’ records and a specialty designed form containing the variables of interest were used. Data were analysed using Minitab 16. Proportions, percentages, tables, charts and chi squared test were used to compare the two groups. Result: The study found no association between the two groups in the likelihood of being insured based on age (χ<sup>2</sup> = 1.478), gender (χ<sup>2</sup> = 0.224) and dwellings (χ<sup>2</sup> = 0.062). On health services utilization and insurance status, the study revealed that follow up clinic visits, unscheduled clinic visits and emergency room visits were more likely among the insured group compared to the uninsured group. While the health status and insurance status of the two groups over 12 months period showed a significant association with the insured more likely to have improved health status compared to uninsured (χ<sup>2</sup> = 28.019, p = 0.0001). Similarly, health status and health services utilization were significantly associated with insurance status (χ<sup>2</sup> = 12.191, p = 0.002). Conclusion: The insurance status of children with SCD is associated with their health services utilization and health status. However, age, gender and dwellings were not associated with insurance status of children with SCD. Therefore, when expanding insurance coverage (NHIS) among children with SCD considerations have to be given to increase health services utilization and resultant improvement in health status as these have the potential of reducing morbidity and mortality among children with SCD.
文摘In sub Saharan Africa (SSA), access to affordable hypertension care through health insurance is increasing. But due to poor adherence, hypertension treatment outcomes often remain poor. Patient-centered educational interventions may reverse this trend. Using a pre-test/post-test design, in this study we investigated the effects of a structured cardiovascular health education program (CHEP) on treatment adherence, blood pressure (BP) control and body mass index (BMI) among Nigerian hypertensive patients who received guideline-based care in a rural primary care facility, in the context of a community based health insurance program. Study participants included 149 insured patients with uncontrolled BP and/or poor self-reported medication adherence after 12 months of guideline-based care. All patients received three group-based educational sessions and usual primary care over 6 months. We evaluated changes in self-reported adherence to prescribed medications and behavioral advice (primary outcomes);systolic BP (SBP) and/or diastolic BP (DBP) and BMI (secondary outcomes);and beliefs about hypertension and medications (explora- tory outcomes). Outcomes were analyzed with descriptive statistics and regression analysis. 140 patients completed the study (94%). At 6 months, more participants reported high adherence to medications and behavioral advice than at baseline: respectively, 101 (72%) versus 70 (50%), (p < 0.001) and 126 (90%) versus 106 (76%), (p < 0.001). Participants with controlled BP doubled from 34 (24%) to 65 (46%), (p = 0.001). The median SBP and DBP decreased from 129.0 to 122.0 mmHg, (p = 0.002) and from 80.0 to 73.5 mmHg, (p < 0.001), respectively. BMI did not change (p = 0.444). Improved medication adherence was associated with a decrease in medication concerns (p = 0.045) and improved medication self-efficacy (p < 0.001). By positively influencing patient perceptions of medications, CHEP strengthened medication adherence and, consequently, BP reduction among insured hypertensive Nigerians. This educational approach can support cardiovascular disease prevention programs for Africa’s growing hypertensive population.
基金The National Natural Science Foundation of China(No.72071042)。
文摘China’s healthcare system faces increasing challenges,including surging medical costs,resource allocation imbalances favoring large hospitals,and ineffective referral mechanisms.The lack of a unified strategy integrating standardized coverage with personalized payment compounds these issues.To this end,this study proposes a risk-sharing reform strategy that combines equal coverage for the same disease(ECSD)with an individualized out-of-pocket(I-OOP)model.Specifically,the study employs a Markov model to capture patient transitions across health states and care levels.The findings show that ECSD and I-OOP enhance equity by standardizing disease coverage while tailoring costs to patient income and facility type.This approach alleviates demand on high-tier hospitals,promoting primary care utilization and enabling balanced resource distribution.The study’s findings provide a reference for policymakers and healthcare administrators by presenting a scalable framework that is aligned with China’s development goals with the aim of fostering an efficient,sustainable healthcare system that is adaptable to regional needs.
文摘The COVID-19 pandemic,as a global public health crisis,has had profound and lasting effects on the world economy and social operating models,fundamentally changing individuals',enterprises',and governments'perceptions of risk and risk management paradigms.The Chinese insurance industry has experienced short-term pain due to the impact of the pandemic,but in the long term,the pandemic has served as a"catalyst"and"accelerator"for the industry's development,greatly enhancing societal awareness of risk protection and,with unprecedented strength,promoting the industry's digital revolution and supply-side structural reform.This article aims to conduct a comprehensive and systematic analysis of the macro environment,technological background,and demand changes faced by the Chinese insurance industry in the post-pandemic era,and to deeply explore the historical opportunities inherent in key areas such as health insurance,pension insurance,digital transformation,and green insurance.Additionally,this article will objectively examine the severe challenges the industry faces in the sustainability of profit models,structural mismatches in supply and demand,rebuilding trust systems,new risk management,and regulatory adaptation.Lastly,based on the above analysis,this article will propose strategic pathways and policy recommendations from three levels:national policy,industry regulation,and corporate strategy to promote the high-quality and sustainable development of the Chinese insurance industry,better serving the needs of national governance modernization and the well-being of the people.
文摘In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focused on the implications of public health plans such as Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance as well as out-of-pocket ratios on patient treatment plans regarding whether they pursue surgical interventions or therapeutic treatments such as chemotherapy.While Wu et al put forth potential explanations for why patients with the UEBMI plan surprisingly had a 23.30%increased risk of oesophageal cancer-specific death,more analysis is needed to alleviate cancer burden within this group.Although it is likely that patients covered by Urban Resident Basic Medical Insurance and higher out-ofpocket ratios have stronger self-recovery awareness,more work must be done to improve outcomes for people with the UEBMI plan while simultaneously implementing international and domestic initiatives to better emphasize cancer prevention and early detection.Lastly,future research must explore the relationship between Serious Illness Medical Insurance as well as the New Rural Cooperative Medical System on the mortality rate of oesophageal cancer patients in rural China,where disease burden is significantly higher than urban areas.By unifying these public health insurance schemes,officials can significantly alleviate economic burden of treatment and better prognosis for patients with oesophageal cancer.
文摘As a city-customized supplementary medical insurance bridging basic medical insurance and commercial health insurance,Huimin Insurance has expanded to 30 provinces and served 168 million people within four years,emerging as a phenomenal success in China's inclusive insurance landscape.This paper examines its evolution,operational mechanisms,and effectiveness,identifying core challenges including declining participation and renewal rates,adverse selection,uneven benefit compensation,and insufficient information disclosure.It proposes sustainable development pathways across five dimensions:government role,financing and payment,product stratification,service value-added,and technology empowerment.The study demonstrates that the future of Huimin Insurance will likely evolve towards a model characterized by provincial-level co-ordination,stratified benefit design,dynamic pricing,and integrated health management.Its success or failure will ultimately determine the integration depth of China's multi-tiered medical security system and significantly impact the realization of common prosperity goals.
基金Supported by Chongqing Social Science Planning Project(Doctoral Project)"Research Support on the Impact of Policy-based Agricultural Insurance on the Production Behavior of Chinese Farmers"(2020BS39).
文摘This article investigates the development process and current status of policy-based agricultural insurance in Chongqing.Based on recent data-including premium income,compensation amounts,the number of insured households,and insurance penetration,the article analyzes the primary challenges faced in the system's operation and proposes recommendations from two dimensions:institutional optimization and practical interventions.These recommendations include establishing a differentiated participation incentive mechanism,optimizing the composition of insurance products,enhancing risk diversification and reinsurance systems,creating an agricultural disaster risk reserve fund,developing a dynamic fiscal subsidy distribution mechanism based on risk and performance,improving information-sharing platforms,strengthening the rural grassroots power grid infrastructure,and accelerating the adoption of modern technologies in underwriting and claims settlement processes.The findings suggest that the coordinated advancement of institutional optimization and technological empowerment can substantially enhance the inclusiveness,sustainability,and operational efficiency of policy-based agricultural insurance in Chongqing,thereby providing substantial support for agricultural modernization and the Rural Revitalization Strategy.
文摘With the rapid development of China's insurance market,the high-quality development of the insurance market is faced with many different challenges and various problems.This paper aims to deeply analyze the actual problems in China's insurance market and put forward supporting countermeasures.First,by understanding the background of highquality insurance development,we can explain the research significance of this paper in combination with the existing national policies.Secondly,by summarizing the current situation of high-quality insurance development,the paper puts forward the shortage of insurance talents in the expansion of insurance scale,the continuous improvement of insurance density and depth,and the growth of insurance compensation in the development of high-quality insurance.Finally,from the perspective of differentiated customized insurance products,training professionals,and providing financial subsidies,we will put forward the corresponding suggestions for the problem and look forward to the future development prospects.
基金Supported by the Chongqing Science and Health Joint Medical Research Project,No.2024MSXM065.
文摘BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.
文摘Marxist and social science methodologies provide scientific conceptual tools and analytical perspectives for research across various disciplines.Among these,the methodology of quantitative and qualitative changes reveals the fundamental laws governing the development of things,offering significant guidance for exploring the relationship between Huimin Insurance and basic medical insurance,and for promoting the sustainable development of the medical security system.Based on this methodology and the practical context of the medical security field,this paper provides an in-depth analysis of the impact of Huimin Insurance on the sustainable development of basic medical insurance.
文摘The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of health insurance on treatment availability and patient outcomes,demonstrating that the type of insurance can affect the financial burden on patients.This study investigates the effects of different types of health care coverage,namely Urban Employee Basic Medical Insurance vs Urban-Rural Resident Basic Medical Insurance,and the personal spending ratio on treatment decisions and survival outcomes.The database used is derived from esophageal tumor patient continuation from Chongqing University Hospital in China.A total of 2543 patients were included in the study,allowing for the formation of research cohorts.Patient information included demographic characteristics.The study followed various processes to maintain consistency,including data sources,inclusion and exclusion criteria,follow-up duration,health insurance,and statistical analysis.The average age at diagnosis ranged from 57-74 years,and predominantly included men,married people,and those of Han ethnic background,comprising 2088 and 2519 individuals,respectively.Upon controlling for age,sex,relationship status,country of origin,pathological evaluation,tumor stage,and biochemical indicators,individuals who had Urban Employee Basic Medical Insurance exhibited a higher propensity to opt for radiotherapy,chemotherapy,immunotherapy,and targeted therapy compared to those covered by the Urban-Rural Resident Basic Medical Insurance.During the follow-up phase of the study,a total of 1438 deaths were documented,with 1106 ascribed to esophageal cancer.Additionally,individuals with Urban-Rural Resident Basic Medical Insurance had a significantly elevated risk of esophageal cancer,particularly mortality,compared to those without Urban-Rural Resident Basic Medical Insurance.
基金Supported by National Institute of Diabetes and Digestive and Kidney Diseases,United States,No.K23DK133729。
文摘BACKGROUND Private insurance coverage is associated with higher rates of living donor kidney transplantation(LDKT)but whether this is attributable to confounding is not known.AIM To study the association between increased access to private health insurance and LDKT.METHODS Retrospective cohort study using United States transplant registry data.We identified incident candidates aged 22-29 years who were waitlisted for a kidneyonly transplant from 2005-2014,excluding prior transplant recipients and those with missing data.We calculated the hazard of LDKT after waitlisting for those with private insurance vs other insurance pre-Affordable Care Act(ACA)vs post-ACA,using death and delisting as competing events,for candidates affected by the policy change(age 22-25 years)vs those who were not(age 26-29 years).RESULTS A total of 13817 candidates were included,of whom 46%were age 22-25 years and 54%were age 26-29 years.Among candidates aged 22-25 years at listing,those listed post-ACA were more likely to have private insurance compared to those listed pre-ACA(42%vs 35%),but there was no difference in private insurance coverage between eras among candidates aged 26-29 years at listing.In adjusted competing risk regression,privately insured patients age 22-25 years were less likely to receive a LDKT post-ACA compared to pre-ACA[hazard ratio(HR)=0.88,95%CI:0.78-1.00],as were those aged 22-25 years old with other insurance types(HR=0.80,95%CI:0.69-0.92).These associations were not seen among candidates age 26-29 years.CONCLUSION Candidates age 22-25 years were likelier to have private insurance post-ACA,without an increased rate in LDKT.Demonstrations of associations between insurance and LDKT are likely attributable to residual confounding.
文摘Cancer patients in China navigate a complex and uneven insurance landscape,making plan choice critical for equitable financial protection.This study conducts a structured narrative review(2010-2025)of the Web of Science,PubMed,CNKI,and Wanfang databases,focusing on empirical research on insurance plan choice,enrollment,or switching among cancer patients and their households in China.Two reviewers independently screened studies and extracted information on key determinants and identification strategies.The evidence converges on five main determinants:insurance literacy,health knowledge,prior coverage,financial capability,and policy promotion intensity(PPI).However,most studies are cross-sectional and descriptive,with inconsistent operationalization of determinants,weak or absent mediation tests for PPI,and limited coverage of rural,elderly,and low-literacy populations.Building on these gaps,we synthesize an evidence map,propose an operational PPI index,and highlight quasi-experimental opportunities(such as staggered NRDL updates and variation in local publicity efforts)to identify mechanisms and inform more inclusive,patient-centered insurance design in China.
文摘The purpose of this paper is to study the influencing factors of flexible employment personnel's participation in urban-rural residents'pension insurance.After reading a large number of literature and research results on flexible employment personnel and analyzing and interpreting the urban-rural residents'pension insurance policy of Zhuhai,we take the flexible employment personnel of Zhuhai City as the object of the study,combined with questionnaire survey method,and analyze the difficulties of the flexible employment personnel's participation in the insurance by analyzing the collected data,and find out that Zhuhai's flexibly employed people have cognitive bias towards urban and rural residents'pension insurance,the government's business personnel have a vague understanding of the insurance,and some of the flexibly employed people think that the subsidy is low,etc.The government of Zhuhai City has provided the suggestions of expanding the scope of the publicity of the urban and rural residents'pension insurance,increasing publicity efforts,and providing regular training for the counterpart service personnel in order to increase the rate of the flexibly employed people's participation in the insurance,and improve the inherent bad impression of the insurance by the flexibly employed people.personnel's inherent bad impression of insurance,and further improve China's insurance system.
