Financing strategies to improve essential public health equalization and its effects in China.

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

Strengthening health system to improve immunization for migrants in China.

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

Analysis of Key Chemical Components in Aqueous Extract Sediments of Panax Ginseng at Different Ages

Panax ginseng beverages have been some of the most popular plant drinks among consumers in recent years, but they become turbid and sediment are easily formed during production and marketing, these are some of the key issues that affect the quality of the beverages. In this study, we analysed the physicochemical properties of sediments in aqueous extracts of 3- to 6-year-old ginseng, and by tracing the sediment formation process from 0–40 days, we observed that the sediment was gradually beginning on day 10. The solid content of ginseng aged 5 and 6 years was significantly higher than that of ginseng aged 3 and 4 years. There was no significant difference in the sediment amount sediment in the extracts of ginseng of different ages. The light transmittance of the extracts after centrifugation was significantly higher than before centrifugation. Colour-difference analysis found that there was a significant positive correlation between ginseng age and colour-difference value (ΔE). Chemical composition analysis showed that total sugar and proteins were the main components of the sediment. In addition, ginsenosides, amino acids and minerals were also involved in sediment formation to different degrees. A stepwise regression model was established through principal component analysis (PCA), and the regression equation for predicting the sediment amount was obtained as follows: sediment amount (mg/mL) = 2.906 − 0.126 × CTotal saponins − 0.131 × CFree amino acids

Examining the Impact of Rehospitalization on Healthcare Cost of Myocardial Infarction Patients in Beijing: A Retrospective Observational Study

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