Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

Quality of spiritual living (QSL) in old age is closely related to the health and well-being of older adults. It is necessary to explore the psychosocial factors and mechanisms that affect the QSL of older adults. The researchers investigated 512 older Chinese people using the positive social mentalities scale, social participation scale, sense of life meaning scale, and spiritual living self-assessment questionnaire. (1) Positive social mentalities (PSMs), social participation (SP), and life meaning (LM) had significant positive correlations with QSL of older adults; (2) SP and LM had serial mediating effects between PSMs and QSL. PSMs influenced QSL through the serial mediating effects of SP and LM. It revealed the critical psychosocial factors and the mechanism affecting QSL in old age, which can provide scientific reference for implementing an active aging strategy.

The Chronic Care Model (CCM) is a framework that supports the proactive, planned, coordinated and patient-centered care of chronic diseases. The Patient Assessment of Chronic Illness Care (PACIC) scale is a valuable tool for evaluating patients' perspectives on chronic care delivery based on the CCM. Few studies have examined its application in China. This study assesses hypertension care in Chinese patients and explores how PACIC scores relate to patient compliance. A cross-sectional study was conducted in Hangzhou, China, from June to August 2021, including 253 hypertensive patients from 5 county hospitals and 13 primary healthcare centers. The study used the PACIC scale to assess hypertension care delivery and the Compliance of Hypertensive Patients scale (CHPS) to measure patient compliance. Multiple linear regression analyses were used to explore the relationship between demographic characteristics and the total and domain scores of PACIC, as well as the association between CHPS and the domain scores of PACIC. The mean value of overall the PACIC score was 3.12 (out of 5). Problem solving/contextual domain had the highest average score for each item, while follow up/coordination domain had the lowest. Patient activation had negative effects on intention (β = -.18, P < .05), attitude (β = -.21, P < .05), responsibility (β = -.17, P < .05), and the total score of CHPS (β = -.24, P < .01). Delivery system design/decision support was negatively associated with lifestyle (β = -.21, P < .05) and the total score of CHPS (β = -.26, P < .01). Hypertensive patients perceived that they sometimes received hypertension care consistent with the CCM in Chinese primary healthcare settings. A higher level of PACIC score was beneficial for improving hypertensive patient compliance.

Lockdowns were a key policy response to the COVID-19 pandemic. While they were viewed as a necessary intervention, concerns were raised about their potential for harmful economic and livelihood impacts. However, few studies have addressed the unequal economic and livelihood impacts of lockdowns. Our article reports findings from a qualitative study conducted in Uganda on economic and livelihood impacts of COVID-19 lockdowns in urban and rural settings. This study used 14 focus group discussions, 40 household, and 31 key informant interviews in both urban (Kampala district) and rural (Wakiso district) areas in central Uganda. Data analysis was conducted thematically with NVivo 2020 (QSR International). The findings emphasize the unequal impacts of the COVID-19 lockdowns across a range of dimensions: informal sector activities, formal employment, fluctuating prices alongside scarcity and surpluses, food insecurity, and government interventions. Wealthier households in urban areas were least affected, with urban households reliant on informal sector activities experiencing the most significant impacts. Our findings also suggest that longer-term development strategies, such as increased food self-sufficiency and informal sector interventions can support future pandemic preparedness and response. To address these impacts, policymakers should provide targeted support, alongside protecting key productive sectors, and supply chains.

In response to the aging population, an integrated care policy has been put forward and implemented in China. The key aspect of this policy is the reform of services within long-term care facilities, representing a significant shift and innovation. This study aims to explore the perceptions and experiences of integrated care among older residents living in long-term care facilities. A descriptive qualitative design was applied in our study. Utilizing a purposive sampling method, 18 older adults from 5 long-term care institutions in Shanghai, China were selected. Data were collected through semi-structured in-depth interviews from October 2022 to April 2023, continuing until data saturation was reached. Directed content analysis was applied to analyze the interview data, guided by the Fundamentals of Care (FoC) Framework. Five themes and 11 subthemes were identified, including (1) Policy level: positive attitude and negative feelings. (2) Physiological level: satisfied basic daily life, primary medical services accessibility and chronic care management enhancement needed. (3) Psychological level: need for psychological support and need for self-perception recognition. (4) Relationship level: enhancement of humanistic care and need for a family atmosphere. (5) Social level: interpersonal communication constrained by the times and inadequate social engagement. Strengthening the awareness and participation of older people in the integrated care policy, and fully meeting the diverse needs including advanced medical care, chronic disease management, personalized life care, psychological support, humanistic care and social engagement will contribute to the improvement of the policy, so as to better adapt the demographic shift.

As housing prices in China continue to escalate and the limitations of the "personal unlimited liability system" for housing loans become more evident, the financial stress on families has significantly increased. This stress not only impacts the physical and mental health of family members but also results in rising health care costs. This paper presents empirical research examining how housing stress influences changes in household health care costs through a panel data analysis. The study is based on the China Family Panel Study (CFPS) database and employs a panel two-way fixed effect model alongside a mediating effect model to examine the impact of housing stress, family income, and health status on health care costs. The findings reveal a significant positive correlation between housing stress and health care costs; specifically, for every 1% point increase in housing stress, health care costs rise by 0.141. Robustness tests and propensity score matching (PSM) further validate these findings, even after addressing endogeneity issues. Mediation effect analysis indicates that for every 1% point increase in housing stress, household disposable income decreases by 1.749, and health status declines by 0.468, thereby increasing household health care costs. Heterogeneity analysis demonstrates that housing stress has a more pronounced impact on health care costs among western, eastern, urban, and rental households. The government should implement various measures, such as promoting a "personal limited liability system" mortgage policy, reducing housing prices, and ensuring equal rights to rent and purchase, to alleviate housing stress, enhance family income, and improve residents' health status. These actions would contribute to the promotion of both the housing market and medical care, supporting the sustainable development of the health care sector and ultimately improving long-term social welfare.