To solve the problem of reimbursing trans-regional medical expenses, using only cross-regional manual reimbursement but not direct medical insurance card settlement, China implemented a pilot policy of direct settlement of trans-provincial outpatient expenses (DSTOE) in the Yangtze River Delta region. Due to the differences in inter-regional medical development, patients often migrate from areas with low-level medical resources to the high-level areas, a phenomenon that we define as the “siphoning” of trans-regional patients, which can cause a variety of problems. To study whether DSTOE aggravates the siphoning effect, we analyzed the changes in the volume of trans-provincial outpatient visits and conducted a questionnaire survey and factor analysis on the willingness of trans-provincial medical treatment under DSTOE. Results showed that manual reimbursement was gradually replaced by direct settlement, while the total volume was not increased significantly, and the ratio of outpatient visits flowing into and out from Shanghai decreased. The majority of questionnaire respondents confessed that their willingness toward trans-regional medical treatment increased, while their first choice of medical location was still mainly local, with only a few indicating that they would directly choose a cross-regional, higher-level medical institution. Spatial accessibility significantly restricted the seeking of trans-regional medical treatment, whereas age, education level, and policy awareness served as significant protective factors for the choice of medical location. In conclusion, due to space accessibility constraints, insufficient policy coverage, and the rationale for choice of location, DSTOE did not aggravate the siphoning effect of trans-regional patients.

This study aimed to analyze the changes in the 10 major categories of women’s healthcare services (WHSs) in Shanghai (SH) and New York City (NYC) from 1978 to 2017, and examine the relationship between these changes and maternal mortality ratio (MMR). Content analysis of available public policy documents concerning women’s health was conducted. Two indicators were designed to represent the delivery of WHSs: The essential women’s healthcare service coverage rate (ESCR) and the assessable essential healthcare service coverage rate (AESCR). Spearman correlation was used to analyze the relationship between the two indicators and MMR. In SH, the ESCR increased from 10% to 90%, AESCR increased from 0% to 90%, and MMR decreased from 24.0/100,000 to 1.01/100,000. In NYC, the ESCR increased from 0% to 80%, the AESCR increased from 0% to 60%, and the MMR decreased from 24.7/100,000 to 21.4/100,000. The MMR significantly decreased as both indicators increased (p < 0.01). Major advances have been made in women’s healthcare in both cities, with SH having a better improvement effect. A common shortcoming for both was the lack of menopausal health service provision. The promotion of women’s health still needs to receive continuous attention from governments of SH and NYC. The experiences of the two cities showed that placing WHSs among policy priorities is effective in improving service status.

Regional regulatory policies (RPs) are a major factor in the prevention and control of chronic diseases (PCCDs) through the implementation of various measures. This study aimed to explore the impacts of RPs on PCCDs, with a focus on the mediating roles of community service. The soundness of the regulatory mechanism (SORM) was used to measure the soundness of RPs based on 1095 policy documents (updated as of 2015). Coverage provided by community service institutions (CSIs) and community health centres (CHCs) was used to represent community service coverage derived from the China Statistical Yearbook (2015), while the number of chronic diseases (NCDs) was used to measure the effects of PCCDs based on data taken from the 2015 China Health and Retirement Longitudinal Study survey. To assess the relationship between SORM, NCDs and community service, a negative binomial regression model and mediation analysis with bootstrapping were conducted. Results revealed that there was a negative correlation between SORM and NCDs. CSIs had a major effect on the relationship between RPs and PCCDs, while CHCs had a partial mediating effect. RPs can effectively prevent and control chronic diseases. Increased effort should also be aimed at strengthening the roles of CSIs and CHCs.

This study explores the opportunities and challenges associated with the One Health concept in China. Taking the practice of multi-sector health collaboration in China as an example, this study analyses the possible obstacles and opportunities. From June to August 2023, 30 semi-structured interviews were conducted with experts from the Health Commission, Centre for Disease Control and Prevention, Department of Ecology and Environment, Ministry of Agriculture and Rural Affairs, Department of Transportation, Administration for Market Regulation, and other departments. Qualitative analysis of the interview data was performed using NVivo12. The One Health concept has universal appeal and application potential, but there are many challenges in practice. First of all, cross-departmental cooperation requires clear departmental responsibilities and coordination strategies, but in reality, it is often due to the overlapping of functions between departments or the lack of effective communication mechanism, resulting in insufficient cooperation. Secondly, the low two-way interaction and the lack of effective information exchange and data sharing mechanisms also limit the full implementation of the One Health concept. In addition, the shortage of professional human resources further exacerbates the problem, and finally, the degree of awareness and emphasis of society on public Health is also a key factor affecting the implementation of the One Health concept. The concept of One Health has shown great potential and necessity in the collaborative work of multiple departments in China, but there are still significant obstacles in the implementation process of One Health concept in multiple departments. However, to fully realize this concept, more efforts are still needed in the areas of cooperation mechanisms, professional talent training, information exchange and social awareness. Future work should focus on strengthening intersectoral communication and coordination, raising public health awareness, and optimizing relevant policies and strategies to better address global public health challenges.

Tele-rehabilitation for adolescents with visual or hearing disabilities positively impacts physical rehabilitation and social integration. The relationships among the internet access environment, especially accessible technologies, digital literacy, internet attitude, and tele-rehabilitation utilization by these adolescents have not been fully established. Using data from a survey of internet use involving 3,759 adolescents with visual or hearing disabilities in China, this study investigated the impact of the internet access environment on tele-rehabilitation utilization and analyzed the roles of digital literacy and internet attitude with serial multiple mediation models. The internet access environment and level of tele-rehabilitation utilization of these adolescents need to be improved, and the internet access environment affects tele-rehabilitation utilization positively, primarily through the mediating effects of digital literacy and internet attitude. Recommendations were made on how to improve the internet access environment, especially accessible technologies, digital literacy, internet attitude, and tele-rehabilitation utilization at the macro, meso, and micro levels.