Urban Employee Research Articles

Ride-hailing drivers’ working conditions and social protection in China

ABSTRACT This article aims to examine ride-hailing drivers’ working conditions and social protection in China. Through interviews with 25 ride-hailing drivers in Beijing, we found that their working conditions are precarious, stressful, surveilled, and their social protection exhibits features of inadequacy and fragmentation. They are excluded from social insurance for urban employees due to the lack of a formal employment relationship. Instead, they largely participate in the medical insurance for residents, but its insurance benefits are much lower than those for urban employees. Furthermore, citizens’ participation in residents’ medical insurance is determined by their hukou (i.e. household registration) residency. Internal migrant drivers are only entitled to be insured at their origin where their hukou is located. Despite working in the same occupation and living in the same city, internal migrant drivers and Beijing-native drivers have distinct social insurance benefits. Thus, we propose the binary classification of de jure/de facto residency, which contributes to a deeper understanding of social protection for non-standard forms of employment.

A potential pathway for identifying hypertension among urban residents aged 60+ years in China: the role of health insurance.

Identification is the first step for treatment of hypertension. However, the awareness rate of hypertension was not high globally. This study aimed to examine the potential role of health insurance for early-identifying hypertension among urban older residents in China. In this cross-sectional study, urban residents aged 60+ years were chosen from Nanjing municipality of China in 2018. The outcome measure was hypertension status ("no hypertension," "diagnosed hypertension" or "un-diagnosed hypertension"). Independent variable was health insurance ("Urban Employee Basic Medical Insurance scheme, UEBMI" or "Urban Resident Basic Medical Insurance scheme, URBMI"). Logistic regression models were introduced to estimate odds ratio (OR) and 95% confidence interval (CI) to examine the association between health insurance and hypertension. Totally, 19,742 participants completed the study. Among overall, URBMI and UEBMI participants, 47.2% (95%CI = 46.5, 47.9%), 38.4% (95%CI = 37.3, 39.6%) and 52.1% (95%CI = 51.2, 53.0%), separately, were diagnosed with hypertension, while the prevalence of un-diagnosed hypertension was 12.7% (95%CI = 12.2, 13.2%), 18.5% (95%CI = 17.6, 19.4%) and 9.6% (95%CI = 9.1, 10.1%), respectively. For overall participants, those with UEBMI were more likely to have hypertension identified (OR = 1.20; 95%CI = 1.11, 1.29) and at lower odds to experience un-diagnosed hypertension (OR = 0.68; 95%CI = 0.61, 0.76) compared to their counterparts with URBMI after control for potential confounders. Moreover, such associations of health insurance with diagnosed and un-diagnosed hypertension were also observed among participants stratified by age and gender. Favorable health insurance may be a pathway for identifying hypertension among urban older residents in China. This study has important public health implications that hypertension may be identified early through favorable health insurance policies for older residents in China.

The usage and costs of national drug price-negotiated anticancer medicines in a first-tier city in Northeast China: a study based on health insurance data

BackgroundThe National Drug Price Negotiation (NDPN) policy has entered a normalisation stage, aiming to alleviate, to some extent, the disease-related and economic burdens experienced by cancer patients. This study analysed the use and subsequent burden of anticancer medicines among cancer patients in a first-tier city in northeast China.MethodsWe assessed the usage of 64 negotiated anticancer medicines using the data on the actual drug deployment situation, the frequency of medical insurance claims and actual medication costs. The affordability of these medicines was measured using the catastrophic health expenditure (CHE) incidence and intensity of occurrence. Finally, we used the defined daily doses (DDDs) and defined daily doses cost (DDDc) as indicators to evaluate the actual use of these medicines in the region.ResultsDuring the study period, 63 of the 64 medicines were readily available. From the perspective of drug usage, the frequency of medical insurance claims for negotiated anticancer medicines and medication costs showed an increasing trend from 2018 to 2021. Cancer patients typically sought medical treatment at tertiary hospitals and purchased medicines at community pharmacies. The overall quantity and cost of medications for patients covered by the Urban Employee Basic Medical Insurance (UEBMI) were five times higher than those covered by the Urban and Rural Resident Medical Insurance (URRMI). The frequency of medical insurance claims and medication costs were highest for lung and breast cancer patients. Furthermore, from 2018 to 2021, CHE incidence showed a decreasing trend (2.85–1.60%) under urban patients’ payment capability level, but an increasing trend (11.94%–18.42) under rural patients’ payment capability level. The average occurrence intensities for urban (0.55–1.26 times) and rural (1.27–1.74 times) patients showed an increasing trend. From the perspective of drug utilisation, the overall DDD of negotiated anticancer medicines showed an increasing trend, while the DDDc exhibited a decreasing trend.ConclusionThis study demonstrates that access to drugs for urban cancer patients has improved. However, patients’ medical behaviours are affected by some factors such as hospital level and type of medical insurance. In the future, the Chinese Department of Health Insurance Management should further improve its work in promoting the fairness of medical resource distribution and strengthen its supervision of the nation’s health insurance funds.

Study on the Impact of Delayed Retirement on the Sustainability of the Basic Pension Insurance Fund for Urban Employees in China

With the aging of China’s population, the problem of pension security has become more and more prominent, and whether delayed retirement can effectively alleviate the pension fund gap and ensure the sustainability of the pension fund has become the focus of social concern. This study predicts the income and expenditure of urban workers’ basic pension insurance fund from 2021 to 2050 by constructing an actuarial model of pension insurance fund income and expenditure, and simulates the effect of delayed retirement policy. The prediction results show that under the existing system, the basic pension insurance fund for urban workers will have a shortfall for the first time in 2027, and the shortfall will expand year by year. Compared with the non-implementation of delayed retirement policy, the simulation of the implementation of a delayed retirement program delayed the emergence of the fund gap until 2029, and the forecast period of the pension fund gap significantly narrowed, indicating that delayed retirement policy has a certain positive impact on alleviating the pressure of pension payments, but delayed retirement cannot completely eliminate the pension fund gap. In view of this, this paper suggests that a progressive and flexible delayed retirement policy should be introduced as soon as possible to better adapt to the needs of different groups. At the same time, differentiated policies should be formulated for different groups of people and a pension incentive mechanism for delayed retirement should be set up to improve public acceptance of delayed retirement policy. In addition, delayed retirement policy should be combined with other measures, such as lowering the corporate contribution rate and enhancing the value-added capacity of the pension fund, so as to ensure the sustainability of the pension fund.

Will the State‐owned Capital Transfer Policy Enhance the Sustainability of the Urban Employee Basic Pension Insurance Fund in China?

AbstractTo analyze the effect of the state‐owned capital transfer policy on the sustainability of China's urban employee basic pension insurance fund (CUEBPIF), this study develops an actuarial model for pension insurance. The results reveal the following: (i) Without policy intervention, the CUEBPIF would face a deficit in 2027 and a cumulative shortfall of RMB207.44 trillion by 2050, and the proportion of fiscal subsidies for the CUEBPIF in the total fiscal expenditure would increase to 12.86 percent in 2050. (ii) Based on a delayed retirement policy, the transfer of 10 percent of state‐owned capital can delay the onset of the fund deficit by 6 years, and the accumulated shortfall in 2050 would fall to RMB39.42 trillion, and the proportion of fiscal subsidies would decrease by 11.77 percentage points. (iii) The state‐owned capital transfer policy can improve the sustainability of the CUEBPIF and reduce the burden of enterprise social security contributions when the transfer ratio increases to 20 percent.

Enhancing pooling levels strengthens the risk resilience of healthcare insurance: a case study of basic medical insurance fund operations data in Gansu, China

BackgroundIn China, enhancing the pooling levels of basic health insurance has consistently been regarded as a pivotal measure to promote the refinement of the healthcare insurance system. From 2020 to 2022, the widespread outbreak of COVID-19 posed new challenges to China’s basic health insurance.MethodsThe research utilizes Data Envelopment Analysis (DEA), Malmquist index assessment, and fixed-effects panel Tobit models to analyze panel data from 2020 to 2022, assessing the efficiency of basic health insurance in Gansu Province.ResultsFrom 2020 to 2022, the average overall efficiency of the municipal pooling of Basic Medical Insurance for Urban and Rural Residents was 0.941, demonstrating a stable trend with a modest increase. The efficiency frontier regions have expanded from 5 (35.71%) to 7 (50%). Operational efficiency exhibited a negative correlation with per capita hospitalization expenses and per capita fund balance but a positive correlation with per capita accumulated fund balance and reimbursement rates for hospitalized patients. In 2021, compared to 2020, the county-pooling Basic Medical Insurance for Urban Employees saw a decline of 0.126 in overall efficiency, reducing the efficiency frontier regions from 8 to 3. However, from 2021 to 2022, the municipal-coordinated Basic Medical Insurance for Urban Employees experienced a 0.069 increase in overall efficiency, with the efficiency frontier regions expanding from 3 to 5. Throughout 2020 to 2022, the operational efficiency of the Urban Employee Basic Medical Insurance showed a consistent negative correlation with per capita fund balance.ConclusionFrom 2020 to 2022, the overall operational performance of basic health insurance in Gansu Province was satisfactory, and enhancing the pooling level is beneficial in addressing the impact of unforeseen events on the health insurance system.

Factors affecting on Agricultural Labour Supply in Davangere district of Karnataka: An economic analysis

This study conducted in Davangere district of Karnataka has analysed the factors affecting on agricultural labour supply. The study is based on the primary data collected from 200 sample agricultural labours. The study revealed that socio-economic factors like age, education, caste and land holding are negatively influenced on agricultural labour supply. As far as age is concerned, young labours of the rural area are reluctant to work as agricultural labourer even though they have no alternative works available in their locality. Participation in agricultural activities is the lowest among the young labours compared to middle age group labours. Education plays a vital role in selection of employment. Labours participation in agricultural works is found to be relatively more among the illiterate labours compared to educated labours. Educated youths are not willing to work as agricultural labour and they want to work as salaried employee in urban areas or government employee. Agricultural labour supply is also affected by the caste. This study revealed that labour participation in agricultural activities is more in scheduled caste followed by scheduled tribe and other category. And, the most significant feature is that among the all castes labours are engaged in non-agricultural works. Another important factor is land holding of the family. Labours participation in agricultural activities is more in land less (having no land) families compared to land holding (<than 2acres) families. For all these reasons agricultural labour supply has been declining drastically and it has affected the farm productivity. On the other hand wages are increasingly for agricultural operations due to labour scarcity and it has increased the production cost for the farmers.

Public expenditure on health care and the incidence of non-communicable diseases (NCDs) in China from 2008 to 2018

ObjectivesThis study investigates whether differences in individual-level and provincial-level health funding could explain or mitigate health inequalities among older people in terms of non-communicable diseases within a population served by fragmented health insurance schemes. Study designA national repeated cross-sectional analysis was done of the 2008, 2011, 2014, and 2018 Chinese Longitudinal Healthy Longevity Surveys. These provided a total of 44,623 persons aged 60 and over. Main outcome measuresRespondents were asked whether they had been diagnosed with any types of non-communicable diseases by doctors. A dichotomous outcome variable was constructed to indicate whether older people had any diagnosed non-communicable diseases. ResultsCompared with uninsured older persons, those who were enrolled in social health insurance schemes designed for civil servants as cadres, urban employees and urban residents were more likely to report a higher incidence of non-communicable diseases. There were no significant differences in the prevalence of non-communicable diseases between uninsured older people and those in the New Rural Cooperative Medical Scheme. Although the incidence of non-communicable diseases among older persons increased over the study period, greater health expenditure was significantly associated with a lower risk of non-communicable diseases. The interaction results between individual social health insurance schemes and public health expenditure indicate that disparities in the incidence of non-communicable diseases among different health insurance schemes diminish as public health expenditure increases. Older individuals with Public Free Medical Services benefited the most in provinces with higher public health expenditure compared with other health insurance schemes. ConclusionsGiven the evidence of the beneficial effects of universal health coverage on non-communicable diseases among older persons, these results should encourage policy makers to increase public health funding and to raise the overall benefit packages for social health insurance schemes.

Obstetric service demand is the main health need of the Vietnamese population in Guangxi, China: A cross-sectional study.

China has become an emerging destination for international migration, especially in some Association of South East Asian Nations countries, but the situation of migrants seeking medical care in China remains unclear. A retrospective cross-sectional study was conducted in a hospital in Chongzuo, which provides medical services for foreigners, to investigate the situation of Vietnamese people seeking health care in Guangxi, China. Vietnamese patients who visited the hospital between 2018 and 2020 were included in the study. Demographic characteristics, clinical characteristics, characteristics of payment for medical costs, and characteristics of hospitalization were compared between outpatients and inpatients. In total, 778 Vietnamese outpatients and 173 inpatients were included in this study. The percentages of female outpatients and inpatients were 93.44% and 88.44% (χ2 = 5.133, P = .023), respectively. Approximately 30% of outpatients and 47% of inpatients visited the hospital due to obstetric needs. The proportions of outpatients with basic medical insurance for urban residents, basic medical insurance for urban employees, and new cooperative medical schemes were 28.02%, 3.21%, and 2.31%, respectively. In comparison, the proportion of inpatients with the above 3 types of medical insurance was 16.76%, 1.73%, and 2.31%, respectively. The proportion of different payments for medical costs between outpatients and inpatients were significantly different (χ2 = 24.404, P < .01). Middle-aged Vietnamese females in Guangxi, China, may have much greater healthcare needs. Their main medical demand is for obstetric services. Measurements should be taken to improve the health services targeting Vietnamese female, but the legitimacy of Vietnamese in Guangxi is a major prerequisite for them to access more and better healthcare services.

The impact of basic health insurance participation characteristics on the health of mobile populations: the mediating role of health service utilization behavior.

It is a pivotal element of China's health system reform to improve the health security of health insurance for the mobile population. Achieving this objective is integral to the success of the reform. The aim of this study was to analyze the impact of different enrollment characteristics of basic health insurance on the health of the mobile population and to investigate the mediating role of health service utilization behavior. This cross-sectional study included 135,372 migrants who participated in the 2018 China Migrants Dynamic Survey (CMDS). Two indicators were employed in this study to assess the characteristics of the mobile population's involvement in basic health insurance-namely, whether or not they participated in local health insurance and the type of health insurance in which they participated. The health status of the mobile population was measured using self-assessed health. Health service utilization behavior was divided into public health service utilization and medical service utilization. Multivariate ordered logistic regression was employed to examine the effect of health insurance on the health of the mobile population. Subsequently, the Bootstrap method was applied to analyze the mediating effect of health service utilization behavior in the relationship between health insurance and the health of the mobile population. Health insurance had a positive impact on health, public health services, and health service utilization among the mobile population. However, enrollment in local health insurance (OR = 1.088, 95% CI = 1.043-1.134) and enrollment in Basic Medical Insurance for Urban Employees (OR = 1.178, 95% CI = 1.090-1.273) were more likely to be associated with higher levels of health and a greater likelihood of receiving health service utilization. The results of the mediating mechanism analysis indicated that health education, health records, family doctor contracting, receiving inpatient services, and being hospitalized locally all played a partially mediating role in the impact of the place of enrollment on health. Regarding the effect of the type of enrollment on health, three types of services-namely, health education, health records, and contracting with a family doctor-played a partially mediating role, while receiving inpatient services and being hospitalized locally did not exhibit a mediating effect. The effect of the type of participation on health is partially mediated. Based on the impact of the different enrolment characteristics of basic health insurance on the health of the mobile population and the mediating role of health service utilization in this impact, furthermore, improvement of health insurance coverage for the mobile population should focus on improving the accessibility of health services, increasing the level of health insurance coverage, mitigating differences in treatment between the different insurance systems, and simplifying the process of transferring the health insurance relationships.

Outpatient depression current care expenditure changes in Liaoning Province from 2015 to 2020: a study based on the "system of health accounts 2011".

Introduction: Depression is the leading cause of disability worldwide and has become a health issue of global concern. Based on the "System of Health Accounts 2011" (SHA 2011) for patients with depression, this paper studies the changes in the current curative expenditure (CCE) of outpatient depression in Liaoning Province, China, and provides policy recommendations. Method: A stratified multistage random sample of 56,994 patients with depression included from 1,227 healthcare facilities in Liaoning Province were included. The significance of differences in variables within groups was analyzed by univariate analysis (including descriptive statistics analysis, Mann-Whitney U test and Kruskal-Wallis H test), and factors influencing depression outpatient CCE were analyzed by multiple linear regression analysis and constructing structural equation models (SEM). Results: The CCE of outpatient depression was ranging from CNY 75.57 million to CNY 100.53 million in 2015-2020, with the highest of CNY 100.53 million in 2018, CNY 103.28 million in 2019. Medical expenditures are mainly concentrated in general hospitals and provincial healthcare institutions, accounting for about 90% of all provincial scope expenditures. The multiple regression results show that provincial healthcare institutions, purchase of drug, select medical treatment for depression, general hospitals and urban employees' health insurance are the main influencing factors for depression outpatient CCE. The results of SEM show that insurance status negative impact outpatient expenditure. Conclusion: Health insurance is an important factor in equitable access to healthcare resources for patients, and medication expenditure is the influential factor affecting the high expenditure of outpatient clinics. It is of great importance to reduce the medical burden of patients by increasing the coverage of medical insurance, increasing the proportion of bills that are eligible for reimbursement, and improving the system by guaranteeing the supply of psychotropic medication.

Health insurance as a moderator in the relationship between financial toxicity and medical cost-coping behaviors: Evidence from patients with lung cancer in China.

This study investigates the relationship between financial toxicity and medical cost-coping behaviors (MCCB) in Chinese patients with lung cancer, with a particular focus on the moderating role of health insurance. We surveyed 218 patients with lung cancer and assessed their Comprehensive Score for Financial Toxicity (COST) and self-reported MCCB. Patients were categorized into Urban Employee's Basic Medical Insurance (UEBMI) group and Urban-Rural Resident Basic Medical Insurance Scheme (URRBMI) groups by their medical insurance, and matched for socioeconomic, demographic, and disease characteristics via propensity score. Significant different characteristics were noted between UEBMI patients and URRBMI patients. Patients with UEBMI had higher COST scores but lower levels of MCCB compared to URRBMI patients in the original dataset. After data matching, multivariate logit regression analysis showed that better financial toxicity was associated with lower levels of MCCB (OR = 0.95, 95% CI: 0.92-0.99). Health insurance type did not have a direct association with cost-coping behaviors, but an interaction was observed between health insurance type and financial toxicity. Among patients with URRBMI, better financial toxicity was associated with lower levels of cost-coping behaviors (OR = 0.89, 95% CI: 0.83-0.95). Patients with UEBMI had a lower probability of engaging in any cost-coping behaviors insituations of worse financial toxicity compared to patients with URRBMI. The findings suggest that financial toxicity is correlated with MCCB in Chinese patients with lung cancer. The type of health insurance, specifically UEBMI and URRBMI, plays a moderating role in this relationship. Understanding these dynamics is essential for developing targeted interventions and policies to mitigate financial toxicity and improve patients' management of medical costs.

Risk and attributable fraction estimation for the impact of exposure to compound drought and hot events on daily stroke admissions.

The projection indicates that compound drought and hot events (CDHEs) will intensify, posing risks to cardiovascular health by potentially increasing stroke incidents. However, epidemiological evidence on this topic remains scarce. This study investigates the association between exposure to CDHEs and the risk of daily stroke admissions, specifically examining the effects on various stroke categories such as Subarachnoid Hemorrhage (SAH), Intracerebral Hemorrhage (ICH), Ischemic Stroke (IS), Transient Ischemic Attack (TIA), and other types of stroke. Data on daily stroke admissions from 2010 to 2015 were obtained from the Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) claims databases in Guangzhou, China. Hot events were identified as days when the daily mean temperature exceeded the 75th percentile during the warm season (May to October) over the study period. The Standardized Precipitation Evapotranspiration Index (SPEI) was utilized to identify drought conditions, with thresholds set at -1 and -1.5 for low-severity and high-severity drought events, respectively. Through a generalized additive model (GAM), we analyzed the cumulative effects of CDHE exposure on daily stroke admissions and calculated the Attributable Fraction (AF) related to CDHEs. The analysis included 179,963 stroke admission records. We observed a significant increase in stroke admission risks due to exposure to hot events coupled with high-severity drought conditions (RR = 1.18, 95%CI: 1.01-1.38), with IS being the most affected category (RR = 1.20, 95%CI: 1.03-1.40). The AF of total stroke admission attributed to hot events in conjunction with high-severity drought conditions was 24.40% (95%CI: 1.86%-50.20%). The combination of hot events with high-severity drought conditions is likely linked to an increased risk of stroke and IS admissions, which providing new insights into the impact of temperature and climate-related hazards on cardiovascular health.

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.

Analysis of the Sustainability and Influencing Factors of Urban Employee Pension Insurance among Provinces in China

Analysis of the Sustainability and Influencing Factors of Urban Employee Pension Insurance among Provinces in China

Patient preferences and willingness to pay for central venous access devices in breast cancer: A multicenter discrete choice experiment

BackgroundDespite being a significant management decision in clinical or nursing practice, there is limited understanding of the preferences regarding risks, benefits, costs, and other attributes of patients with breast cancer when selecting peripherally inserted central catheters or totally implanted ports. The objective of this study is to investigate the preferences of patients with breast cancer who require chemotherapy when selecting an optimal central venous access device. MethodsData on patients' preferences for central venous access devices were collected using a face-to-face discrete choice experiment from the oncology departments of three public hospitals in China representing the eastern (Zhejiang province), central (Henan province), and western (Sichuan province) regions. The study used six attributes to describe the preferences of breast cancer patients for central venous access devices, including out-of-pocket cost, limitations in activities of daily living, catheter maintenance frequency, risk of catheter-related thrombosis, risk of catheter-related infection, and size of incision. Data were analyzed using a conditional logit model and mixed logit model. The marginal willingness to pay (mWTP) was calculated by assessing the ratio of the preference for other attributes to the preference for out-of-pocket cost. ResultsA total of 573 respondents completed the survey. The discrete choice experiment results showed that respondents strongly preferred a central venous access device with a catheter maintenance frequency of one time a month (vs four times a month, β = 1.188, p < 0.001), the lower risk of catheter-related thrombosis (2 % vs 10 %, β = 1.068; p < 0.001) and lower risk of catheter-related infection (2 % vs 8 % risk: β = 0.824; p < 0.001). Respondents were willing to pay CNY ¥11,968.1 (US$1776.5) for a central venous access device with a catheter maintenance frequency of one time a month rather than four times a month, ¥10,753.6 (US$1596.2) for a central venous access device with 2 % thrombosis risk over one with 10 %, and ¥8302.0 (US$1232.3) for a central venous access device with 2 % infection risk over one with 8 %. Respondents with longer travel time to the hospital, younger than 50 years old, and with urban employee basic medical insurance were willing to pay more for an improvement in the attributes. ConclusionsThese findings suggest that patients with breast cancer were mainly concerned with the out-of-pocket cost, catheter maintenance frequency, risk of catheter-related thrombosis and risk of catheter-related infection when choosing a central venous access device for the delivery of chemotherapy. In clinical or nursing practice, when making central venous access device recommendation for young patients and those who live far from hospitals, totally implanted ports may be a preferable choice.

Inequality in benefit distribution of reducing the outpatient cost-sharing: evidence from the outpatient pooling scheme in China.

The implementation of the outpatient pooling scheme in China has substantially elevated the compensation levels for outpatient expenses. This study aims to assess whether socioeconomically disadvantaged enrollees benefit proportionally compared to their non-disadvantaged counterparts. A cohort comprising 14,581 Urban and Rural Resident Basic Medical Insurance (URRBMI) enrollees and 830 Urban Employee Basic Medical Insurance (UEBMI) enrollees was derived from the China Health and Retirement Longitudinal Study 2018. Outpatient pooling scheme benefits were evaluated based on two metrics: the probability of obtaining benefits and the magnitude of benefits (reimbursement amounts and ratios). Two-part models were employed to adjust outpatient benefits for healthcare needs. Inequality in benefit distribution was assessed using the concentration curve and concentration index (CI). Following adjustments for healthcare needs, the CI for the probability of receiving outpatient benefits for URRBMI and UEBMI enrollees were - 0.0760 and - 0.0514, respectively, indicating an evident pro-poor pattern under the outpatient pooling scheme. However, the CIs of reimbursement amounts (0.0708) and ratio (0.0761) for URRBMI recipients were positive, signifying a discernible pro-rich inequality in the degree of benefits. Conversely, socioeconomically disadvantaged UEBMI enrollees received higher reimbursement amounts and ratios. Despite a higher likelihood of socioeconomically disadvantaged groups receiving outpatient benefits, a pro-rich inequality persists in the degree of benefits under the outpatient pooling scheme in China. Comprehensive strategies, including expanding outpatient financial benefits, adopting distinct reimbursement standards, and enhancing the accessibility of outpatient care, need to be implemented to achieve equity in benefits distribution.

Precarious Employment, Pension Participation, and Retirement Deferment in China

Recent changes in the relationship between the postponement of the statutory retirement age, pension participation, and the precariousness of employment in China may conceal the lasting negative effects on workers’ current and ongoing welfare. Grounded on China’s normalised precarious employment with individualisation, insecurity, and instability, and identifying the current Urban Employee Basic Pension (UEBP) as based on traditional industrialism, the empirical evidence from 68 workers in precarious employment shows how limited UEBP participation even extends working life. Under the institutionalised inequality of UEBP, and without long-term coworkers who can promote understanding of the system, the uncertainties of future livelihood and “voluntary” participation in the UEBP (re)shape the rationality of precarious workers towards minimum participation. Hence, raising the statutory retirement ages is unlikely to improve their UEBP participation, but rather lengthen the period of precarious employment.

A Study on Human Rights Awareness Among Quarry Mining Employees

Human rights are universal basic rights that give equal rights to all individuals irrespective of caste, creed, religion, language, color, or culture. Human rights include all fundamental rights such as the right to equality, education, work and to lead a life with dignity. Human rights help to resolve conflicts and address grievances and discrimination to create a sustainable society. The objective of the present study is to understand the level of human rights awareness among quarry mining employees particularly from the mining sector. There are very few studies that focused on the mining employees on social aspects. Hence, the study was undertaken to assess the level of understanding and awareness among quarry mining employees in urban Bangalore, Karnataka, India. For the said purpose, a descriptive quantitative study using survey–based method was applied and data was collected through random sampling using survey questionnaires. Statistics and thematic analysis on quantitative data indicate urban employees had a general awareness of the subject, but lacked the essential awareness, particularly in terms of economic, social, and cultural rights.

Improving Financial Administration in Urban Perfume Point MSMEs

MSMEs in running their business need to pay attention to a number of management aspects, one of which is financial management. The aim of this activity is to improve financial administration at Urban Perfume Point and increase the knowledge of Urban Perfume Point employees in recording business finances both conventionally and based on information technology. The method used is the transfer of knowledge ad technology through outreach and training activities as well as work internships. The results of the activity show that the administration of financial management at Urban Perfume Point has experienced an improvement as shown by the orderliness of business financial records.