Analyze and evaluate the typical four medical alliance’s governance modes in China, and construct a set of medical alliance’s governance mode that adapt to the current status of medical resource allocation in China. We used interview-based case studies to investigate the four most representative medical alliance modes in China, and conducted in-depth analysis and discussion of key incentives affecting medical alliances under the guidance of the Preker-Harding model framework. The results show that the essence of the relationship between the government as the owner and the medical alliance is the entrustment and adjustment of power and responsibility; the government as a regulator has a normative and universal regulation of the medical alliance; the reform of the medical alliance requires the government to clarify the functional positioning of the medical alliance and determine a reasonable compensation system. China should establish the “Positive Triangle” model of medical alliance’s governance, this medical security model provides patients with various types of medical services in a horizontal dimension, covering a variety of difficult disease treatments in a vertical dimension.

The growth of internet use has greatly impacted many societal sectors, including healthcare. However, current evidence about the relationship between internet usage time and public trust on doctors is insufficient. To examine the relationship between the time spent on the internet and the level of trust in doctors, and explore its mechanism. Multiple regression models are employed, utilizing a sample of 19,193 observations from the China Family Panel Studies (CFPS) in 2020. First, we regress the relative trust in doctors compared to trust in strangers on internet usage time. Subsample results across distinct population groups are explored. Second, we examine the mechanism of using the internet as an information channel through the mediation method, and further investigate the role of the internet as a communication platform by analyzing the moderation effects of socializing activity as well as social media engagement. We find a significant negative relationship between increased internet usage time and trust in doctors. This correlation remains robust across different model specifications and variable measurements. The negative correlation is more pronounced among population groups who are elderly, male, married, with low educational levels, insured and residing in urban areas. The role of the internet as a source of information is validated as a mechanism producing the negative influence. The role of the internet as a communication platform tends to mitigate the negative consequences of internet usage, as engaging in online socializing activity can have a positive moderation effect. However, for social media engagement, its overall effect on trust in doctors is negative, potentially due to social media’s dual function as a communication platform and an information source. Although individual-focused literature tends to demonstrate a positive impact of the internet on trust in doctors in China, our study, which focuses on the general public, reveals contrasting results. Our findings imply that the primary manner in which internet usage, encompassing social media usage, influences public trust in doctors is by molding a collective perception of them. Consequently, the medical community may need to take a more proactive approach in expanding online communication channels for interacting with patients and the wider public.

This empirical study examines the impact of internet usage on the life satisfaction of spousal caregivers responsible for elderly individuals with disabilities. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), released in November 2023, we analyzed the health status and life satisfaction of these caregivers in the context of the recent rapid development of the internet. A stratified Proportionate to Size Sampling (PPS) approach was employed in this investigation. We assessed whether the life satisfaction of spousal caregivers is associated with internet use and whether internet adoption can moderate intergenerational relationships, interpersonal interactions, and political engagement among these caregivers. The study analyzed a sample of 760 individuals, with an average age of 60.31 years, and rural households comprising 77.14% of the sample. Our findings indicate a positive correlation between internet usage and the life satisfaction of spousal caregivers. This result enhances our understanding of the relationship between internet usage and life satisfaction in this context. Furthermore, this study supports the advancement of internet access for the aging population, assists elderly individuals in bridging the digital divide, and provides a theoretical foundation for the development of targeted, elderly-friendly internet policies by the government.

Health inequality poses a challenge to improving the quality of life of older adults as well as the service system. The literature rarely explores the moderating role of medical services accessibility in the association between socioeconomic deprivation and health inequality. This study examines the socioeconomic deprivation and medical services accessibility associated with health inequality among older Chinese adults, which will contribute to the medical policy reform. Using data from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyse 14,232 older adults. This paper uses a concentration index (CI) to measure the income-related health inequality among the target population and employs a recentered influence function–concentration index–ordinary least squares (RIF-CI-OLS) model to empirically analyse the correlation between socioeconomic deprivation and health inequality among older Chinese adults. Based on the correlation analysis, we discuss the moderating effect of medical services accessibility. We find that health inequality exists among older Chinese adults and that the relative deprivation in socioeconomic status (SES) is significantly associated with health inequality (⁠ $β∈[0.1109,0.1909]$⁠, P < 0.01). The correlation between socioeconomic deprivation and health inequality is moderated by medical services accessibility, which means that an increase in medical services accessibility can weaken the correlation between socioeconomic deprivation and health inequality. China needs an in-depth reform of its medical services accessibility system to promote the equitable distribution of medical services resources, strengthen medical costs and quality management, and ultimately mitigate the SES reason for health inequality among older Chinese adults.

Background: With the rapid aging of the population, the health needs of the older adult have increased significantly, resulting in the frequent occurrence of the “social hospitalization” problem, which has led to a rapid increase in hospitalization costs. This study investigates whether the “social hospitalization problem” arising from the long-term care needs can be solved through the implementation of long-term care insurance, thereby improving the overall health of the older adults and controlling the unreasonable increase in hospitalization costs.Methods: The entropy theory was used as a conceptual model, based on data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. The least-squares method was used to examine the relationship between long-term care needs and hospitalization costs, and the role that long-term care insurance implementation plays in its path of influence.Results: The results of this study indicated that long-term care needs would increase hospitalization cost, which remained stable after a series of tests, such as replacing the core explanatory variables and introducing fixed effects. Through the intermediary effect test and mediated adjustment effect test, we found the action path of long-term care needs on hospitalization costs. Long-term care needs increases hospitalization costs through more hospitalizations. Long-term care insurance reduces hospitalization costs. Its specific action path makes long-term care insurance reduce hospitalization costs through a negative adjustment of the number of hospitalizations.Conclusion: To achieve fair and sustainable development of long-term care insurance, the following points should be achieved: First, long-term care insurance should consider the prevention in advance and expand the scope of participation and coverage; Second, long-term care insurance should consider the control in the event and set moderate levels of treatment payments; Third, long-term care insurance should consider post-supervision and explore appropriate payment methods.

Background: Social transition is one of the multi-level mechanisms that influence health disparities. However, it has received less attention as one of the non-traditional social determinants of health. A few studies have examined China’s social transition and its impact on health inequality in self-rated health (SRH). Therefore, this study explores the impact of China’s market-oriented reforms—social transition and socioeconomic status (SES)—on residents’ SRH.Methods: Using the cross-sectional data from the Chinese General Social Survey (CGSS) in 2017, we analyzed the effects of social transition and SES on the SRH of Chinese residents using the RIF (Recentered influence function) method. The RIF decomposition method investigated health differences among different populations and their determinants.Results: Social transition and SES have significant positive effects on the SRH of Chinese residents. The correlation between SES and the SRH of Chinese residents is moderated by social transition, implying that social transition can weaken the correlation between SES and the SRH of Chinese residents. The impacts of SES and social transition on SRH vary across populations.Conclusion: Promoting social transition and favoring disadvantaged groups with more resources are urgently needed to promote equitable health outcomes.