Suchergebnisse

Facing the aggravating trend of an aging population and a fragmented medical service delivery system, the Chinese Central Government has introduced a series of policies to promote the development of integrated care against the background of the "Healthy China Strategy". The achievement of integrated care depends on the choice of policy instruments. However, few studies have focused on how policy instruments promote the practice of integrated care in China. This article aims to obtain a deeper understanding of the use of policy instruments in the development of integrated care in China. Policy documents are the carriers of policy instruments. National-level integrated care policy documents from 2009 to 2019 were selected. Using the qualitative document analysis method, this paper conducts an analysis of integrated care policy instruments. In order to comprehensively view the integrated care policy instruments, a three-dimensional analytical framework consisting of the policy instruments dimension, stakeholders dimension, and health service supply chains dimension is proposed. The results are as follows. (1) From the perspective of policy instruments, the integrated care policy has adopted supply-side policy instruments, demand-side policy instruments, and environmental policy instruments. Among the three types of policy instruments, environmental policy instruments are used most frequently, supply-side policies are preferred, while demand-side policy instruments are relatively inadequate. (2) As for the stakeholders dimension, the central policy instruments focus on the health service providers, while less attention is paid to the health service demanders. (3) In terms of health service supply chains, the number of policy instruments used in the prevention stage is the highest, followed by the treatment stage, whereas less attention paid to the rehabilitation stage. Finally, suggestions were made for the development of integrated care by better perfecting policy instruments.

AbstractThe relationship between aldehyde exposure and metabolic syndrome is unclear; hence, we aimed to investigate the association between serum aldehyde concentrations and metabolic syndrome. We analyzed the data of 1471 participants from the National Health and Nutrition Examination Survey enrolled from 2013 to 2014. The association of serum aldehyde concentrations with metabolic syndrome was assessed via generalized linear models as well as restricted cubic splines, and endpoint events were further analyzed. After adjusting for covariates, both moderate (odds ratio [OR] = 2.73, 95% confidence interval [CI]: 1.34–5.56) and high (OR = 2.08, 95% CI: 1.06–4.07) concentrations of isovaleraldehyde were associated with the risk of metabolic syndrome. Interestingly, although a moderate concentration of valeraldehyde was associated with the risk of metabolic syndrome (OR = 1.08, 95% CI: 0.70–1.65), a high concentration was not (OR = 0.55, 95% CI: 0.17–1.79). Restricted cubic splines revealed a non-linear association between valeraldehyde and metabolic syndrome, and threshold effect analysis revealed that the inflection point for valeraldehyde concentration was 0.7 ng/mL. The results of the subgroup analysis revealed differences in the relationship of aldehyde exposure with components of metabolic syndrome. High isovaleraldehyde concentrations may increase the risk of metabolic syndrome, and valeraldehyde demonstrated a J-shaped relationship with the risk of metabolic syndrome.