Change Zhu

Change Zhu


Research Focus & Metrics

Academic Career Length

4Years (2023-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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CZChange Zhu
Change Zhu
CWChristine Walsh
Christine Walsh
ZLZhou Lu Lin
Zhou Lu Lin
XZXinjie Zhang
Xinjie Zhang
This study aimed to research the trajectory of leisure activity and the health status of older adults and analyze the effects of leisure activity on the health status of older adults. Based on the longitudinal data of CLHLS (2008–2018), the latent growth curve model (LGCM) was used; we found that the leisure activities (LA), activities of daily living (ADL) ability, instrumental activities of daily living (IADL) ability, and cognitive ability (COG) of older adults show a nonlinear downward trend over time. Furthermore, the panel binary regression analysis is used to find that leisure activities have significant inhibitory effects on ADL disorder, IADL disorder, and cognitive impairment in the older population. In addition, by using latent profile analysis (LPA), the older population is classified into three groups according to the homogeneity of the older adults’ choice of leisure activities, namely the types of relaxation, entertainment, and intellectual-learning, respectively. Based on the classification results, the analysis of one-way ANOVA shows that the rates of ADL disorder, IADL disorder, and cognitive impairment of older adults with different types are significantly different. Moreover, the inhibitory effect of leisure activities on the rate of ADL disorder, IADL disorder, and cognitive impairment of older adults is more significant in the middle-aged and high-aged groups. Therefore, older adults should be encouraged to increase leisure activities, especially those who are middle-aged and high-aged.

1 July 2023 in Healthcare
Verified
Journal Article
Open access
PDF file
CZChange Zhu
Change Zhu
ZLZhou Lu Lin
Zhou Lu Lin
XZXinjie Zhang
Xinjie Zhang
CWChristine Walsh
Christine Walsh
Objectives: to examine the causal relationship between sleep quality and life satisfaction and explore the mediating role of health status on the relationship between sleep quality and life satisfaction. Methods: A total of 1856 older Chinese people participating in 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included. A cross-lagged panel analysis (CLPA) combined with mediator analysis was utilized. Results: The average sleep quality levels for the years 2011, 2014, and 2018 were 3.70, 3.63, and 3.47 out of 5, respectively. The corresponding average levels of health status were 3.47, 3.44, and 3.39 out of 5, and the average levels of life satisfaction were 3.75, 3.86, and 3.87 out of 5, respectively. In addition, sleep quality at prior assessment points was significantly associated with life quality at subsequent assessments, and vice versa. Also, health status partially mediated this prospective reciprocal relationship. Conclusions: There is a nonlinear decreased trend in sleep quality and health status, while there exists a nonlinear increased trend in life satisfaction for older adults from 2011 to 2018. Reciprocal positive effects between sleep quality and life satisfaction in older adults exist and are mediated by health status.

5 July 2023 in Frontiers in Public Health
Verified
Journal Article
Open access
LZLulin Zhou
Lulin Zhou
CZChange Zhu
Change Zhu
CWChristine A. Walsh
Christine A. Walsh
XZXinjie Zhang
Xinjie Zhang
Background: This study aimed to explore the association between health status (physical, mental, and self-rated health) and multidimensional poverty (subjective and objective poverty) in older adults.Method: A panel binary logit regression approach was applied to four waves of CLHLS data (2008, 2011, 2014, and 2018). In total,1,445 individuals were included after data cleaning.Results: The mean values and proportion of physical, mental, and self-rated health were 5.73 (87.42%), 0.93 (93.06%), and 3.46 (86.7%), respectively, and mean values and proportion of subjective and objective poverty were 0.19 (18.51%) and 0.21(21.4%). In addition, physical, mental, and self-rated health were all found to be associated with subjective poverty among older adults (r = −0.181, r = −0.630, r = −0.321, p < 0.05), that is, the better the physical, mental, and self-rated health, the lower the probability of subjective poverty. A comparable connection between self-rated health and objective poverty also exists (r = −0.157, p < 0.05). Furthermore, medical expenditure played a mediation role in the association between the health status and poverty of older adults.Conclusion: In order to effectively alleviate the poverty of older adults, strategies should be taken to improve the health level of older adults, especially the physical and mental health of high-aged older adults, and the self-rated health of middle-aged older adults. Furthermore, social security and pensions should be further developed to adequately reimburse medical expenditures.

7 July 2023 in Healthcare
Verified
Journal Article
Open access
PDF file
CZChange Zhu
Change Zhu
ZLZhou Lu Lin
Zhou Lu Lin
XZXinjie Zhang
Xinjie Zhang
CWChristine Walsh
Christine Walsh
This study aims to provide useful insights for the Chinese government in dealing with healthcare fraud by creating an evolutionary game model that involves hospitals, third-party entities, and the government based on the government reward and punishment mechanism. This paper analyzes the evolutionary stability of each participant’s strategy choice, discusses the influence of each element on the tripartite strategy choice, and further analyzes the stability of the equilibrium point in the tripartite game system. The results show that (1) the government increasing fines on hospitals is conducive to compliant hospital operations, and the incentive mechanism has little effect on such operations; (2) the lack of an incentive mechanism for third parties results in false investigations by third parties; and (3) rewards from higher levels of government promote strict supervision by local governments, but that the high cost of supervision and rewards for hospitals inhibits the probability of strict supervision. Finally, Matlab 2020a is used for simulation analysis to provide a reference for the government to improve the supervision of healthcare fraud.