Medical Security System Research Articles

Effect of Outpatient Pooling Scheme on the Medical Costs of Patients with Chronic Diseases -- Based on Multi-period DID Modeling

The establishment of a sound mechanism for covering outpatient medical bills under the basic medical insurance for urban employees is one of the major livelihood projects to deepen the reform of China's medical security system. This study utilizes the China Health and Retirement Longitudinal Study (CHARLS), combines the interview data from four periods from 2011 to 2018, empirically analyzes the impact of the outpatient pooling scheme on the total outpatient costs and personal burden of patients with chronic diseases by using a multi-period double-difference model and further validates it by using the double-difference propensity score matching method (PSM-DID). The results show that the implementation of the outpatient pooling scheme is conducive to reducing the healthcare burden of chronically ill patients. Although the outpatient co-ordination did not have a significant impact on the reduction of outpatient costs for patients with chronic diseases, it significantly reduced the self-treatment costs of patients with chronic diseases. Further research found that the policy had a greater impact on chronic disease patients with poorer health. Combined with the results of the study, this paper suggests gradually eliminating the differences in basic policy treatment between regions, guaranteeing the level of outpatient treatment for insured patients in different places, and promoting better utilization of the outpatient co-ordination policy effect.

Presence of Anxiety or Depression Feelings and Its Associated Risk Factors among Immigrants in Korea: A Nationwide Cross-Sectional Study.

The influx of immigrants into Korea has increased in recent years, affecting Korean society and the healthcare system. This study analyzed the frequency of anxiety and depression in immigrants, which negatively affects their quality of life. We analyzed data from a 2020 survey on the Health Rights of Migrants and the Improvement of the Medical Security System. Bivariate analyses and a multiple logistic regression model were used to identify the risk factors associated with the presence of anxiety or depression among immigrants. We included 746 immigrants, 55.9% of whom were female. The overall rate of anxiety or depression was 31.77%, with 38.3% in females, which was significantly higher than the 26.62% in males. The frequency of anxiety and depression was also strongly associated with certain immigrant groups, including immigrants of African or Western Asian origin (over 64%); those with student visas (60.53%); those who self-reported poor health (52%), physical or mental disabilities (69.23%), or chronic diseases (58.43%); and those facing difficulties accessing medical services (59.47%). This study showed the frequency of feelings of anxiety or depression and associated risk factors among immigrants. These findings may have implications for policymakers in reducing the likelihood of developing anxiety or depression in the future and improving the quality of life of immigrants in Korea.

The impacts of basic medical insurance for urban–rural residents on the perception of social equity in China

BackgroundBased on CSS 2019 data, this article analyzes the impact of Basic Medical Insurance for Urban and Rural Residents (BMIUR) on perceived social equity of residents.MethodUsing the CSS data of 2019, this article analyzes the influence of BMIUR on the perception of social equity of residents, on the basis of 2SLS model and mediating effect model.ResultsWe find that BMIUR has a significantly positive impact on the perception of social equity. That is to say, BMIUR can improve residents’ evaluation of social equity and further promote the level of social equity, which makes residents more happiness. The conclusion remains valid after using robustness test and propensity score matching to conduct counterfactual reasoning. The discussion of mechanism indicates that the influence of BMIUR is mediated by enhancing social capital, improving satisfaction of income distribution and reducing self-paid medical expenses. This study also finds that the influence of BMIUR is more obvious in the low-income, low-skilled and mid-west groups.ConclusionThe reform of the medical security system should be regarded as a foothold for improving people’s well-being and promoting social equity; Expanding people’s social capital through multiple channels and improving income distribution mechanisms; Strengthen vocational skills training, especially to provide more public services and social security for low-income groups, low-skilled groups, and groups in the western region of China, in order to improve the welfare and policy effectiveness of China's social security reform.

Research on health expenditure in Kazakhstan

Objective To understand and study Kazakhstan's resource planning and budget allocation in the field of health care through data related to Kazakhstan's health expenditure, to ensure the sustainable development of the health field between China and Kazakhstan, and to promote the medical and health undertakings among countries along the Belt and Road Initiative. Learn from each other's strengths and complement each other's weaknesses to promote cooperation. Methods Using the literature review method and comparative method, the per capita health expenditure in Kazakhstan and the other five Central Asian countries and China from 2001 to 2021 was compared with the proportion of GDP per capita, the proportion of self-pay expenditure in per capita health expenditure, and the total government health expenditure in the country. The proportion of GDP, per capita health expenditure and its proportion to per capita GDP, and the average actual growth average of per capita government health transfer expenditure and self-pay expenditure are compared with each other's medical and health security systems, health expenditures, national health levels and health resources. Results From 2001 to 2021, Kazakhstan's per capita health expenditure accounted for per capita GDP fluctuated between 2% and 4%, while other countries had growth trends of varying degrees. China's growth trend was relatively stable; Kazakhstan's per capita out- of -pocket health expenditure grew on average. The value is the lowest, only 1.05%, and the growth of government health transfer expenditures is at a medium level; the proportion of Kazakhstan's self-pay expenditures in per capita health expenditures and the proportion of total government health expenditures in GDP are also at a medium level. Conclusion (a) Kazakhstan's medical and health security system has certain effectiveness, and China's medical and health security system also has its advantages. There is a need for in-depth cooperation and development between China and Kazakhstan. (b)Kazakhstan needs to maintain a low proportion of per capita health expenditure in per capita GDP. The low growth rate of self-pay health expenditure and the low proportion of self-pay expenditure in per capita health expenditure are conducive to maintaining social equity and social welfare levels. (c)It is necessary for Kazakhstan to increase investment in the health field, promote medical research and innovation, and deepen cooperation in the medical and health field with countries along the "Belt and Road".

Multimedia healthcare cloud personal archives security system based on compressed sensing and multi-image encryption

Cloud services in the medical process have become commonplace, and the semi-trusted nature of the healthcare cloud makes security in the communication process particularly important. This paper summarizes the four major pain points in the process of collecting, storing in the cloud, and communicating information in the medical process, and proposes a multimedia medical cloud information security system. The pressure of channel transmission is reduced by compressing two-dimensional information images with compressed sensing (CS) technology. The multimedia information type conversion technology can convert multimedia information into 2D images, and the converted 2D images are merged into a multi-image cube, which realizes the “one-person-one-cube” medical information archives management mode. A chaotic multi-image encryption (MIE) based on Identity Mutual Recognition Keys (IMRKs) is designed to encrypt the cube by transmitting it to the edge cloud, which ensures security and solves the problem of unauthorized use of medical information. The 3D Positioning Fifth Generation Message-Digest (3DPMD5) tamper determination algorithm is utilized to generate 32-bit hexadecimal numbers that are transmitted back to the medical terminal to achieve cloud tamper resistance. It is able to be demonstrated from the simulation results that the system has good reconstruction results, relatively safe performance, and high encryption and decryption efficiency.

Dilemma in primary care facility development:a qualitative study based on grounded theory in Guilin city

BackgroundSince the new medical reform, remarkable progress was achieved in primary care facilities in the number of consultations and essential public health service program. However, the problems including low quality and high mobility of personnel, weakened capacity and low efficiency of service still remain. Therefore, it has become an urgent task to solve the dilemma in primary care facility development. ObjectiveTo analyze the development dilemma of primary care facilities and propose corresponding countermeasures. MethodsFrom April to May 2021 the managers of 16 primary care facilities in 6 counties and 2 districts in Guilin were selected using multi-stage sampling method and invited to attend semi-structured interviews, which main contents included resource allocation, service capacity building, health insurance policy implementation, and development dilemmas. Grounded theory method was applied to classify, summarize and refine the original interview data at each level by NVivo 11.0 software. ResultsA total of 38 initial concepts, 9 initial categories, 4 main categories, and 1 core category were extracted, and nodes of stagnation in four dimensions including "Constraints in Resource Allocation," "Deviation in Functional Positioning," "Obstacles in the approach of the joint reform of 3Ms(medical service system, medical security system and medicine system)," and "Lack of Cohesion in Hospital Group Construction" were obtained. ConclusionThe development of primary care facilities is constrained by a variety of factors, with resource allocation balance and compensation mechanism improvement as core issue, "approach of the joint reform of 3Ms" as an external condition, "adjustment of functional positioning"(adjustment of functional positioning of primary care facilities) as key link, and the construction of cohesion hospital group as important approach.

The Systematic Construction of Emergency Medical Security System in Long-Distance Walking Movement on Urban Paved Roads

Objective To explore the scope of building emergency medical security mechanism in urban paved road environment, and to provide reference, sample data and improvement suggestions for building emergency medical security mechanism in such specific environment. Methods The data of rescue personnel deployment, rescue materials allocation, rescue force monitoring, actual rescue situation, emergency plan and relevant regulations setting, training and other aspects of the emergency medical security mechanism in March and April 2023 were collected, and the data were analyzed. Results (1) The hiking distance was 40km and the road conditions were urban paved roads. There were 1150 official trekkers and 65 people were treated medically. (2) The most common symptoms of outdoor hiking included skeletal muscle injury (19.48%), foot skin and soft tissue injury (18.17%), fever (2.61%) and diarrhea (0.61%). (3) In March, 18.36% of the core medical team members and 20.41% of the first aid volunteers who underwent systematic training took up the task of supporting hiking activities. In April, the core medical team personnel who undertook the task of supporting hiking activities accounted for 1.23% of the total number of the security team, and the first aid volunteers who underwent systematic training accounted for 37.04%. (4) According to local conditions, the multi-vehicle rescue and transport mode was adopted, which was combined with the modified commercial rescue vehicle (42.86%) with the on-board emergency medical unit (EMU) and the ordinary ambulance (28.57%). (5) More than 700 pieces of 34 kinds of medical materials and 40 sets of mobile communication equipment, which were put into use after the feasibility study of the expert group and the technical group, guaranteed the competition from the hardware level. Conclusion The construction of emergency medical support mechanism in outdoor walking sports needs to pay attention to environmental characteristics, operation mode of support team, personnel and adaptability training, equipment and deployment of medical support materials, deployment and cooperation of communication and transport capacity, reasonable support plan and other factors. Medical volunteers who have been systematically trained can undertake part of outdoor medical rescue work. Pre-activity training and regular re-training of medical volunteers can ensure the safety of outdoor activities.

Social Medical Insurances, Choices of Medical Institutions and the 'Siphon Effect' in the Health Service Market: Evidence from 2021 Yangtze River Delta Region of China.

The siphon effect in the health service market is notably pronounced in many countries. How to measure and identify the determinants contributing to the siphon effect presents a substantial challenge. This study aimed to analyse the effect of two different social medical insurances, the Basic Medical Insurance System for Urban Employees (BMISUE), and the Basic Medical Insurance System for Urban and Rural Residents (BMISURR), on the siphon effect in the health services market. The data used in this study were from the 2021 Health Life Satisfaction Survey of Yangtze River Delta (HLSSYRD) conducted by Shanghai Jiao Tong University. The logistic model was used to evaluate the association between social medical insurances and individual choices of medical institutions, and the Propensity Score Matching method (PSM) was used to check the robustness of basic results. Residents covered by BMISUE were more likely to choose a general hospital when they first sought medical treatment (OR = 5.377, 95% CI: 4.887, 5.915) relative to those insured by BMISURR. Further analysis showed that BMISUE would accelerate the siphon effect of general hospitals, people insured by BMISUE were still more likely to choose general hospitals despite being close to primary hospitals compared to those insured by BMISURR (OR = 3.240, 95% CI: 2.945, 3.565). Heterogeneity analysis indicated BMISUE had a greater impact on residents aged 15-59 years and those with high income compared to older people and individuals with low income. Different social medical insurances can substantially affect residents' first choice of medical institutions. BMISUE with higher benefits level could exacerbate the siphon effect in the health service market. More equitable medical security system should be strengthened to bridge the benefits gap between BMISUE and BMISURR.

Influence of intergenerational support on the mental health of older people in China.

Today, population aging is the main trend of population development. Home-based care is mainly adopted in Chinese society, and scholars have paid ample attention to the effect of intergenerational support on the mental health of older people. However, research conclusions differ. This study uses data from the 2018 China Health and Pension Tracking Survey (CHARLS), which we analyzed with STATA software to construct least squares regression and two-stage least squares regression models. The regression model included 6,647 respondents to investigate the mental health status of older people based on depression status. Intergenerational support was defined as economic support, emotional support, and daily care provided by the children of older people. We studied the impact of three aspects of intergenerational support on the mental health of the elderly. We performed a robustness test using the variable replacement and propensity score matching methods, and analyzed age, gender, and urban-rural heterogeneity. The results showed that economic support had no significant impact on the mental health of older people, while emotional support and daily care had a positive effect. The heterogeneity results indicated that the relationship between intergenerational support and mental health of older people differed significantly based on age, gender, and urban and rural areas. Therefore, children should raise their awareness of supporting their parents, pay attention to their parents' mental health, and provide emotional support and daily care. Furthermore, community work improves family relations, creates a good social environment, and encourages young people to respect and be filial to older people. The government should improve the medical security system and old-age service system, and provide policy support to help the mental health of older people.

Geriatric cardiology: general provisions

The increase in life expectancy, thanks not least to the success of disease prevention and treatment, has led to a global restructuring of the population structure with a dramatic increase of the elderly and long-livers. Characteristics for elderly patients are the spectrum of age-associated types of pathology, disease-nonspecific symptoms and syndromes, polypharmacy, and functional in capacity which require a fundamentally different approach from the «disease-centered» approach in modern medicine. The review examines the history of geriatric cardiology and its demographic factors, the tasks of geriatric cardiology at the current stage of the development of clinical medicine, focuses on a number of specific geriatric conditions such as multimorbidity, polypharmacy, geriatric syndromes, and the limited representation of geriatric aspects of cardiovascular diseases in the recommendations of the European Society of Cardiology. It is emphasized that the organic incorporation of principles and methods of comprehensive geriatric assessment into the traditional cardiological diagnostic and treatment process using methods of geriatric screening, geriatric diagnosis, creation of individual treatment and recovery programs will allow to improve the quality of life, functional status, to prevent traumatic events and acute conditions in of elderly patients, to reduce the burden on the medical and social security system.

Survival probability function as a supporting element in automated triage system on the battlefield

Mass events are incidents involving a large number of casualties. They are an integral part of combat operations. These events are characterized by exceeding the capabilities of the rescuers present at the scene during a specific phase of the operation. The difference in triage applied in combat compared to triage used in civilian mass events is directly related to their specific nature and intended objectives. The article presents an innovative segregation algorithm that takes into account the value of the so-called "survival function," which is a component of a medical evacuation decision support system based on the integration of monitoring and analysis of soldier's vital parameters with the medical security system.

The Impact of the Age Structure of the Population and the Price of Housing on the Savings of the Population: An Empirical Study from China

Purpose: The purpose of this paper is to explore the relationship between housing prices, population age structure and savings rate by analyzing the variables of housing prices, population age structure and savings rate, which is of great theoretical and practical significance for the formulation of policies to alleviate the aging population and childlessness in China. Theoretical framework: Most of the studies on the relationship among the consumer price of commercial housing, the old-age dependency ratio, the child dependency ratio, and the savings rate of the residents in China are based on the GMM model, while this study constructs a quadratic VAR model to empirically analyze and test the four variables of the consumer price of commercial housing, the old-age dependency ratio, the child dependency ratio, and the savings rate of the residents, and to study whether there is a long-term stable relationship among these four variables and other general patterns that exist among these four variables. other general laws that exist among these four variables. Design/Methodology/Approach: This study decides to start from the perspective of residents' saving rates. It conducts descriptive statistical analysis and empirical analysis by using 33 macroeconomic data (samples) from 1990-2022, official data of the National Bureau of Statistics (NBS), and housing price data from Jurassic Data Network (JDN). The hypotheses are initially set up by descriptive analysis, and then the VAR function model is constructed to analyze and test the hypotheses empirically. Findings: It is found that the sales price of commercial housing is positively correlated with the savings rate of residents; the child dependency ratio is positively correlated with the savings rate of residents; the old-age dependency ratio is insignificantly correlated with the savings rate of residents; and there is a long-term and stable correlation among the four variables of the sales price of commercial housing, the child dependency ratio, the old age dependency ratio and the savings rate of residents. Research, Practical & Social implications: This study improves the relevant theoretical research of economics, demography, sociology and other interdisciplinary disciplines, complements the existing research paths and methods of empirical analysis, and obtains relevant empirical research conclusions. The significance of the study is to provide assistance to the formulation of national macroeconomic and monetary policies, and to contribute to the adjustment of population policies, the reform of the pension security system, and the revision of the medical security system. It also contributes to the adjustment of the population policy, the reform of the pension security system, and the revision of the medical security system. Originality/Value: The study is able to enrich the research practices on the sales price of commercial properties, the dependency ratio of young children, the dependency ratio of the elderly and the savings rate of the population, and make a new contribution to the improvement of people's livelihood, the development of the real estate industry's transformation and upgrading, and the formulation of rational population and economic policies.

The Disease Experience of Women with Granulomatous Lobular Mastitis. A Qualitative Interview Study.

The incidence of granulomatous lobular mastitis (GLM) is increasing year by year, and the breast wounds of women patients with GLM can develop into abscesses, fistulas, sinuses, and sometimes orange-like degeneration similar to malignant tumors, which seriously affects the quality of life of women patients with GLM. In China, breast wounds in women patients with GLM have not been better managed. Therefore, the purpose of this study is to explore the disease experience of women patients with GLM, to provide a basis for the development of precise intervention and support strategies for women patients with GLM, and to further improve the quality of nursing management and enrich the research types of GLM. In this study, 10 cases of GLM women patients from a tertiary hospital in Hangzhou, Zhejiang Province were selected by purposive sampling. After obtaining the informed consent of GLM women patients, semi-structured interviews were conducted with GLM women patients using the interview outline to collect qualitative data. The interview was recorded, transcribed verbatim in the local language, and then translated into English, and the content analysis method was used to analyze the data. The Consolidated Criteria for Reporting Qualitative Research (CORE-Q) checklist follows the report 's findings. Our study identified six themes: (a) Perception of the disease, (b) Emotional discomfort (c) Variety of changes (d) Lack of specific skills (e) Coping strategies adopted to rebuild health, (f) Expectation. The experience of women with GLM is characterized by diversity and specificity. After experiencing physical trauma, most patients use support systems to change negative attitudes and rebuild physical and mental health. Family, hospital and society should be fully linked to strengthen the prevention of GLM and the popularization of nursing management knowledge; nurses should provide targeted nursing services. Nursing leaders should improve the medical security system, broaden the medical channels, and reduce the pain experience and pressure of patients.

Analysis of the Main Stakeholders in the Development of China 's Inclusive Insurance

Objective The development of Inclusive Insurance is an important measure for the government to improve the level of catastrophic illness and improve the multi-level medical security system in China. Therefore, this paper is aimed at putting forward countermeasures and suggestions to promote the development of Inclusive Insurance by analyzing the main stakeholders involved. Method Based on the stakeholder theory, the stakeholders in the development of Inclusive Insurance were defined, and the driving and hindering factors of the development of Inclusive Insurance were clarified from the different demands of stakeholders. Conclusion Government departments, insurance institutions, and third-party platform companies are the main driving forces for the development of Inclusive Insurance, insured persons and medical institutions are the beneficiaries of the development of Inclusive Insurance, and pharmaceutical enterprises are potential promoters. However, the self-interest motivation of medical institutions may make it a resistance factor, and insurance institutions and insured persons are also easy to become a resistance factor when they suffer loss of interests. In this regard, in order to promote the formation of collaboration among multiple subjects and jointly promote the healthy and sustainable development of Inclusive Insurance, the following suggestions are put forward: establishing an effective data sharing mechanism to help insurance institutions achieve customer development and in-depth operation; clarifying the role of government functions and the boundaries of government and enterprise responsibilities to safeguard the rights and interests of insurance companies; using incentive tools to mobilize the enthusiasm of insurance institutions and the public; strengthening product publicity to establish a correct insurance awareness; making full use of the resources of pharmaceutical enterprises to further ensure the accessibility of patients ' medication.

Research on Medical Security System Based on Zero Trust.

With the rapid development of Internet of Things technology, cloud computing, and big data, the combination of medical systems and information technology has become increasingly close. However, the emergence of intelligent medical systems has brought a series of network security threats and hidden dangers, including data leakage and remote attacks, which can directly threaten patients' lives. To ensure the security of medical information systems and expand the application of zero trust in the medical field, we combined the medical system with the zero-trust security system to propose a zero-trust medical security system. In addition, in its dynamic access control module, based on the RBAC model and the calculation of user behavior risk value and trust, an access control model based on subject behavior evaluation under zero-trust conditions (ABEAC) was designed to improve the security of medical equipment and data. Finally, the feasibility of the system is verified through a simulation experiment.

Research on the Effect of Commercial Health Insurance Development on Economic Efficiency.

In the process of comprehensively promoting the construction of a multi-level medical security system in China, it is very important to clarify the impact of commercial health insurance. In order to better promote the development of commercial health insurance, we explore the effect of commercial health insurance development on economic efficiency. Theoretical analysis shows that, in addition to providing health risk protection for residents, commercial health insurance can also promote the coordinated development of the health industry chain, promote risk reduction, accumulate capital, and contribute to high-quality economic development. Empirically, this study indexes a commercial health insurance development index that is more in line with China's development reality. In addition, this study compiles the economic efficiency index from the three dimensions of economic development basis, social benefits and industrial changes. We measure the commercial health insurance development index and economic efficiency index in 31 regions from 2007 to 2019, and further econometric analysis is carried out on this basis. It is found that the development of commercial health insurance can promote economic efficiency, and this result is robust. Meanwhile, the impact of commercial health insurance on economic efficiency is restricted by the economic environment itself, and the more developed the economy is, the more obvious this effect will be. Therefore, the development of commercial health insurance will significantly benefit the construction of China's multi-level medical security system and promote regional economic efficiency.

Evaluation of the Medical Resource Allocation: Evidence from China.

Medical resource allocation is an increasingly crucial issue. It is vital to understand residents' (people living in the local area) evaluation of it. This study explores residents' evaluation of medical resource allocation and its determinants with the dimensions of medical resource adequacy, balance, publicness, and accessibility. We used data from the China General Social Survey (CGSS). Binary logistic regression models were constructed from the four dimensions separately, and we compared the differences among them. The study's results showed that accessibility and publicness are the highest and lowest dimensions of residents' evaluation, respectively. The high evaluation of social equity may be a positive contributor to a higher evaluation of publicness and accessibility. The central region residents had the lowest evaluation of adequacy (OR = 0.697, p = 0.010) and balance (OR = 0.642, p = 0.008). To sum up, perceived social equity, social trust, and social class are crucial factors. Based on the results, the government should strengthen the supervision of the medical market, increase financial support for the health field in the central region, and establish a multi-level medical security system that may help optimize the allocation.

The status of emotional labour and its influence on job burnout among village doctors during the COVID-19 pandemic in China: a cross-sectional study

BackgroundVillage doctors in China are not only the gatekeepers of rural residents' health but also the net bottom of the medical security system. However, emotional labour is increasingly threatening the stability of the rural primary medical system. In addition, the ongoing coronavirus disease 2019 (COVID-19) pandemic has further exposed the vulnerability of human resources in China's rural health system. This study aims to evaluate the current situation of emotional labour among village doctors and explore the impact of emotional labour on job burnout during the COVID-19 pandemic in China.MethodsA cross-sectional survey was conducted in December 2021 in Shandong Province. We used structured questionnaires to collect data, including sociodemographic characteristics, emotional labour, and job burnout. Data were analysed by t test, analysis of variance (ANOVA), Pearson correlation analysis, and hierarchical multiple linear regression.ResultsA total of 1,093 village doctors from Shandong Province participated in the study. More than half of the participants were male (62.40%) and were between 41 and 50 years old (53.43%). The total mean score of emotional labour was 3.17 ± 0.67, of which the surface acting (SA) score was 2.28 ± 0.90, and the deep acting (DA) score was 3.91 ± 0.93. There were significant differences in SA according to gender and work content (P < 0.05) and in DA according to gender, age, education level, and work content (P < 0.05). Pearson correlation analysis showed that SA was positively correlated with job burnout (P < 0.001), and DA was negatively correlated with job burnout (P < 0.001). Hierarchical multiple linear regression analysis revealed that 29% of the variance in job burnout is attributable to SA (β = 0.530, P < 0.001) and DA (β = -0.154, P < 0.001).ConclusionVillage doctors in Shandong Province performed moderate levels of emotional labour during the COVID-19 pandemic. SA had a significant positive effect on job burnout, while DA had a significant negative effect on job burnout among village doctors. Administrators should enhance training on emotional labour for village doctors to play a positive role in alleviating their job burnout.

Regional disparities and influencing factors of high quality medical resources distribution in China

BackgroundWith the gradual increase of residents’ income and the continuous improvement of medical security system, people’s demand for pursuing higher quality and better medical and health services has been released. However, so far little research has been published on China's high quality medical resources (HQMR). This study aims to understand the spatiotemporal variation trend of HQMR from 2006 to 2020, analyze regional disparity of HQMR in 2020, and further explore the main factors influencing the distribution of HQMR in China.MethodsThe study selected Class III level A hospitals (the highest level medical institutions in China) to represent HQMR. Descriptive statistical methods were used to address the changes in the distribution of HQMR from 2006 to 2020. Lorentz curve, Gini coefficient (G), Theil index (T) and High-quality health resource density index (HHRDI) were used to calculate the degree of inequity. The geographical detector method was used to reveal the key factors influencing the distribution of HQMR.ResultsThe total amount of HQMR in China had increased year by year, from 647 Class III level A hospitals in 2006 to 1580 in 2020. In 2020, G for HQMR by population was 0.166, while by geographic area was 0.614. T was consistent with the results for G, and intra-regional contribution rates were higher than inter-regional contribution rates. HHRDI showed that Beijing, Shanghai, and Tianjin had the highest allocated amounts of HQMR. The results of the geographical detector showed that total health costs, government health expenditure, size of resident populations, GDP, number of medical colleges had a significant impact on the spatial distribution of HQMR and the q values were 0.813, 0.781, 0.719, 0.661, 0.492 respectively. There was an interaction between the influencing factors.ConclusionsChina's total HQMR is growing rapidly but is relatively inadequate. The distribution of HQMR by population is better than by geography, and the distribution by geography is less equitable. Population size and geographical area both need to be taken into account when formulating policies, rather than simply increasing the number of HQMR.

Management of Country’s Social Brand Under Conditions of Uncertainty in the Health Domain

The coronavirus pandemic confirmed that national systems of medical and social provision for the population of various countries could not quickly adapt and implement effective measures to prevent the negative consequences from achieving a state of resilience. The article empirically substantiates the impact of the COVID-19 pandemic on national social brand to form effective mechanisms for countering risks in public health and supporting the social brand of the country for its main internal stakeholders in a period of uncertainty. The article is devoted to analyzing the channels through which the COVID-19 pandemic affected various aspects of the national management systems of Austria, Slovenia, France, and Ukraine. The analysis used a combination of correlation analysis, causal modeling, and the construction of cognitive maps to visualize dependencies. It was revealed that the key indicators that verify the mentioned impact are the satisfaction of the needs for medical examination and care, the availability of hospital beds in the medical system, and the general costs of social protection of the population. The indicator of the social attractiveness of the country for its internal stakeholders is the indicator of net migration, and it is empirically determined that this indicator is significantly influenced by the security of the medical system and the efficiency of its functioning, especially during the period of data analysis, taking into account the existence of the COVID-19 pandemic. The dependence between the social and economic well-being of the population and its tendency to critically assess one's health, readiness for disease prevention, and the formation of higher requirements for medical care was revealed. The determined regularities are useful in developing a national strategy for building an effective medical and social security system for the population in conditions of uncertainty, which is a significant component of the overall attractiveness of the country and its brand management.