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Finance, Utilisation & Development


Diagnostic Delay and Disease Burden in Primary Aldosteronism: An International Patient Survey

Ananda RA, Gwini SM, Long KM, Lai JH, Chen G, Russell GM, Stowasser M, Fuller PJ, Yang J. Hypertension, 2024, 81 (2): 348-360. DOI: 10.1161/HYPERTENSIONAHA.123.21965.

One-third of patients with PA experienced prolonged diagnostic delays. Targeted treatment led to reduced symptom burden and improved quality of life. Gender differences in diagnostic delay and symptom burden are prominent. These findings suggest that routine screening for PA at the onset of hypertension may reduce diagnostic delay and facilitate timely diagnosis.

Public Attitudes for Quality and Funding of Long-Term Care: Findings from an Australian Survey

Milte R, Ratcliffe J, Kumaran S, Hutchinson C, Chen G, Kaambwa B, Khadka J. Health and Social Care in the Community, 2024: 5798242. DOI: 10.1155/2024/5798242

This study identified consistently high expectations for long-term care services across the general population, indicating a high level of postmaterialist expectations for these services. In terms of how to achieve this, there was broad support among the general population both for payment of a co-contribution to the cost of care by older people using services and for increased government funding for the system. This study also identified that the majority of working-age people would be willing to contribute more income tax for aged care, under the proviso that a higher quality system would be achieved.

Multi-Stakeholder Preferences for the Use of Artificial Intelligence in Healthcare: A Systematic Review and Thematic Analysis

Vo V, Chen G, Aquino YSJ, Carter SM, Do Q & Woode ME. Social Science & Medicine, 2023, 338: 116357. DOI: 10.1016/j.socscimed.2023.116357.

Patients and the general public shared similar expectations regarding AI benefits, risks, and challenges. Most participants doubted that care involving AI could be empathic. Stakeholders called for regulatory guidance to balance safety and innovation in healthcare AI. Health professionals called for more AI education, training, and clearer legal responsibilities of using AI.

Did the Integrated Urban and Rural Resident Basic Medical Insurance Improve Benefit Equity in China?

Ren Y, Zhou Z, Cao D, Ma BH, Shen C, Lai S & Chen GValue in Health, 2022, 25 (9): 1548-1558. DOI: 10.1016/j.jval.2022.03.007.

The integration of New Cooperative Medical Scheme (NCMS) and Urban Resident Basic Medical Insurance (URBMI) in rural and urban China has significantly improved benefit for outpatient care; however, we do not find significant effects of the Urban and Rural Resident Basic Medical Insurance (URRBMI) on inpatient benefit.

Beyond Dispensing: Better Integrating of Pharmacists within the Australian Primary Healthcare System

Thai T, Chen G, Lancsar E, de New S, Banwell C, Freeman, C & Spinks J. SSM - Qualitative Research in Health, 2022, 2: 100109. DOI: 10.1016/j.ssmqr.2022.100109.

Using a unique dataset generated via 33 semi-structured interviews with healthcare leaders and policymakers across relevant disciplines, we undertake a systematic and comprehensive analysis of the policy with the Multiple Stream Framework (which examines the policy process with five elements: problem, policy, political streams, policy entrepreneur, and policy window). 

A Preference for Quality: Australian General Public’s Willingness to Pay for Home and Residential Aged Care

Kaambwa B, Chen G, Khadka J, Milte R, Mpundu-Kaambwa C, Woods T-J & Ratcliffe J. Social Science & Medicine, 2021, 289: 114425. DOI: 10.1016/j.socscimed.2021.114425.

This study estimated how much Australians value quality gradations in aged care services.

Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study

Su M, Zhou Z, Si Y, Sylvia S, Chen G, Su Y, Rozelle S & Wei X. International Journal of Environmental Research and Public Health, 2021, 18, 5060. DOI: 10.3390/ijerph18105060.

Forecasting Surgical Costs: Towards Informed Financial Consent and Financial Risk Reduction

Barreto SG, Bulamu N, Chaudhary A, Chen G, Kawakami K, Maggino L, Malleo G, Pendharkar S, Trudeau MT, Salvia R, Vollmer CM & Windsor JA. Pancreatology, 2021, 21 (1): 253-262. DOI: 10.1016/j.pan.2020.12.014.

This study developed & validated a cohort-specific cost forecasting tool for predicting pancreatoduodenectomy cost in India, Italy & the USA. A proof-of-concept companion application for the iOS platform was developed using Swift 5 programming language within Xcode 10.2.1 integrated development environment (IDE) software. The forecasted cost of the operation can be available to the patient via APP before the operation and can be used as part of the informed financial consent process. This would provide the patient paying OOP with an idea of the financial implications of the surgery.

Does Inpatient Health Services Utilization Vary by Remoteness in the Medical Financial Assistance population? Evidence from Shaanxi Province, China

Ren Y, Zhou Z, Liu G, Shen C, Cao D, Xu T, Fry JM, Nawaz R, Zhao D, Su M, Ge T, Si Y & Chen G. BMC Health Services Research, 2020, 20: 1051. DOI: 10.1186/s12913-020-05907-x.

New Health Care Reform and Impoverishment among Chronic Households in China: A Random-Intercept Approach

Xu Y, Garrib A, Zhou Z, Wang D, Gao J, Yang X, Fan X & Chen G. International Journal of Environmental Research and Public Health, 2019, 16(6), 1074. DOI: 10.3390/ijerph16061074.

Direct Medical Costs for Patients with Schizophrenia: A 4-year Cohort Study from Health Insurance Claims Data in Guangzhou City, Southern China

Zhang H, Sun Y, Zhang D, Zhang C & Chen G. International Journal of Mental Health Systems, 2018, 12: 72. DOI: 10.1186/s13033-018-0251-x.

The Distribution of Benefits under China’s New Rural Cooperative Medical System: Evidence from Western Rural China

Lai S, Shen C, Xu Y, Yang X, Si Y, Gao J, Zhou ZChen G. International Journal for Equity in Health, 2018, 17: 137. DOI: 10.1186/s12939-018-0852-7.

​Catastrophic Health Expenditure in Households with Chronic Disease Patients: A Pre-Post Comparison of the New Health Care Reform in Shaanxi Province, China

Xu Y, Ma J, Wu N, Fan X, Zhang T, Zhou Z, Gao J, Ren J & Chen G. PLoS ONE, 2018, 13 (3): e0194539. DOI: 10.1371/journal.pone.0194539.

Exploring Status and Determinants of Prenatal and Postnatal Visits in Western China: In the Background of the New Health System Reform

Fan X, Zhou Z, Dang S, Xu Y, Gao J, Zhou Z, Su M, Wang D & Chen G. BMC Public Health, 2018, 18: 39. DOI: 10.1186/s12889-017-4601-4.

Assessing the Effects of the Percentage of Chronic Disease in Households on Health Payment-Induced Poverty in Shaanxi Province, China

Lan X, Zhou Z, Si Y, Shen C, Fan X, Chen G, Zhao D & Chen X. BMC Health Services Research, 2018, 18: 87. DOI: 10.1186/s12913-018-3698-1

Prevalences and Trends of Chronic Diseases in Shaanxi Province, China: Evidence from Representative Cross-sectional Surveys in 2003, 2008 and 2013

Lai S, Gao J, Zhou Z, Yang X, Xu Y, Zhou Z & Chen G. PLoS ONE, 2018, 13 (8): e0202886. DOI: 10.1371/journal.pone.0202886.

Oral Health, Dental Insurance and Dental Service Use in Australia

Srivastava P, Chen G & Harris A. Health Economics, 2017, 26 (1): 35-53. DOI: 10.1002/hec.3272.

This study adopted a simultaneous equation framework to investigate the interrelationships between dental health, private dental insurance and the use of dental services. The results show that insurance participation is influenced by social and demographic factors, health and health behaviours. In turn, these factors affect the use of dental services, both directly and through insurance participation. Our results suggest that having supplementary insurance is associated with some 56 percentage points higher probability of seeing the dentist in the general population. For those who did not have private insurance cover, we predict that conditional on them facing the same insurance conditions, on average, having insurance would increase their visits to the dentist by 43 percentage points.

Assessing the Effects of the New Cooperative Medical Scheme on Alleviating the Health Payment-Induced Poverty in Shaanxi Province, China

Yang X, Gao J, Zhou Z, Yan J, Lai S, Xu Y & Chen G. PLoS ONE, 2016, 11 (7): e0157918. DOI: 10.1371/journal.pone.0157918.

​Measurement and Explanation of Socioeconomic Inequality in Catastrophic Health Care Expenditure: Evidence from the Rural Areas of Shaanxi Province

Xu Y, Gao J, Zhou Z, Xue Q, Yang J, Luo H, Li Y, Lai S & Chen G. BMC Health Services Research, 2015, 15: 256. DOI: 10.1186/s12913-015-0892-2.

The Impact of the Urban Resident Basic Medical Insurance on Health Services Utilisation in China

Chen G, Liu GG & Xu F. PharmacoEconomics, 2014, 32 (3): 277-292. DOI: 10.1007/s40273-013-0097-7.

This study aims to assess the impact of the Urban Resident Basic Medical Insurance (URBMI) on health services access (especially inpatient utilisation) in urban China. Probit and recursive bivariate probit models have been adopted to handle the possible endogeneity of medical insurance in the utilisation equations. Results suggest that the URBMI had significantly increased the likelihood of receiving inpatient treatment in the past year; however, the insurance effect on reducing the refused hospitalisation was insignificant.

Health Investment and Economic Output in Regional China

Chen G, Inder B & Hollingsworth B. Contemporary Economic Policy, 2014, 32 (2): 261-274. DOI: 10.1111/coep.12022.

This article investigates the role of health capital in a human capital model of economic output. Robust evidence is found through panel cointegration analysis that health capital has a significant and positive effect on the Gross Regional Product. This article highlights and discusses the potential role of diminishing returns to health investment in this globally important area.

The Effects of China's Urban Basic Medical Insurance Schemes on the Equity of Health Service Utilisation: Evidence from Shaanxi Province

Zhou Z, Zhu L, Zhou Z, Li Z, Gao J & Chen G. International Journal for Equity in Health, 2014, 13: 23. DOI: 10.1186/1475-9276-13-23.

This study analysed the effects of the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) on the equity of outpatient and inpatient utilisation. Results suggest that the implementation of UEBMI increased the pro-rich inequity of outpatient utilisation and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation.

Association between Economic Fluctuations and Road Mortality in OECD Countries

Chen G. European Journal of Public Health, 2014, 24 (4): 612-614. DOI: 10.1093/eurpub/cku014.

This article investigates the association between annual variations in road mortality and the economic fluctuations. The cross-country data analyses suggested that road mortality is pro-cyclical and that the cyclicality is symmetric. Based on data from 32 OECD countries, an increase of on average 1% in economic growth is associated with a 1.1% increase in road mortality, and vice versa.

The Effect of Urban Basic Medical Insurance on Health Service Utilisation in Shaanxi Province, China: A Comparison of Two Schemes

Zhou Z, Zhou Z, Gao J, Yang X, Yan J, Xue Q & Chen G. PLoS ONE, 2014, 9 (4): e94909. DOI: 10.1371/journal.pone.0094909.

This paper studied the effects of the Urban Employee Basic Medical Insurance (UEBMI) and the Urban Resident Basic Medical Insurance (URBMI) on health services utilisation in Western China. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Results suggest that basic medical insurance schemes have shown a positive but limited effect on increasing health services utilisation. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.

The Cyclical Behaviour of Public and Private Health Expenditure in China

Chen G, Inder B, Lorgelly P & Hollingsworth B. Health Economics, 2013, 22 (9): 1071-1092. DOI: 10.1002/hec.2957.

This paper studies short-run cyclical behaviour of public (government and social) and private health expenditure and GDP using both time series and panel data techniques. Results suggest that current public health expenditure is pro-cyclical while there is no clear evidence of a correlation between cycles in private health expenditure and in GDP growth.

Does Generic Entry Lower the Prices Paid for Pharmaceuticals in Australia? A Comparison Before and After the Introduction of the Mandatory Price Reduction Policy

Spinks J, Chen G & Donovan L. Australian Health Review, 2013, 37 (5): 675-681. DOI: 10.1071/AH13024.

This study investigates the relationship between the number of generic medicines and pharmaceutical prices over time in Australia. An instrumental-variables method was used to account for potential endogeneity. Results suggest that although increased generic entry may lower prices over time in the Australian context, the price reduction gained is likely to be very small. Therefore, whilst generic entry should be encouraged, it is important not to assume that this price-lowering effect is realised without question and that the magnitude of such an effect is comparable with other price-regulated countries.

Demand for Voluntary Basic Medical Insurance in Urban China: Panel Evidence from the Urban Resident Basic Medical Insurance Scheme

Chen G & Yan X. Health Policy and Planning, 2012, 27 (8): 658-668. DOI: 10.1093/heapol/czs014.

This paper investigates the key factors associated with the demand for Urban Resident Basic Medical Insurance (URBMI), which was established in 2007 and aims to cover all Chinese urban residents. Results suggest for both the adult and the child samples that income, health status, age and health risk behaviours are key influencing factors for basic medical insurance demand. The household head's characteristics are also significantly related to other household members’ medical insurance demands. Specifically, household heads who are more educated or retired are more likely to purchase medical insurance for their children. 

The Urban Resident Basic Medicine Insurance: A Landmark Reform Step towards Universal Insurance Policy in China

Lin W, Liu GG & Chen G. Health Economics, 2009, 18 (S2): S83-S96. DOI: 10.1002/hec.1500.

This study presents the first economic analysis of Urban Resident Basic Medical Insurance (URBMI), following a national household survey in 9 representative Chinese cities. Results suggest that: firstly, there is a U-shaped relationship between URBMI participation rate and income. Secondly, in reducing financial barriers to care, URBMI most significantly benefits the poor and those with previous inpatient care. Finally, those participants in the bottom 20% of family incomes are happier with URBMI than are their more affluent counterparts. 

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