Search

Establishing an efficient carbon emissions trading market is a priority to achieve the goal of carbon peaking and carbon neutrality. In the context of income inequality and emissions inequality, this study examined the efficiency of carbon trading in China from the perspective of resident income. First, this paper used the Cobb–Douglas (C-D) production function to incorporate carbon intensity into the production network model and obtained the expression of household income by solving the Walras equilibrium. Secondly, this study put forward a theory that Carbon trading affects the income level of individuals. Finally, in order to test the theory, the study used the differences-in-differences (DID) method, provincial panel data from 2005 to 2019, and the quasi-natural experiment of China's carbon emissions trading pilot. The results indicated that this policy could reduce the per capita disposable income level. Further heterogeneity research showed that although the emission reduction effect was significant, the pilot policy failed to save emission reduction costs and improve residents' welfare. The low efficiency of the carbon market was mainly attributed to the insufficient liquidity of the pilot carbon market. Therefore, it not only failed to achieve efficiency but also increased unnecessary costs, which had a negative impact on income. In addition, the consumption patterns of residents and the industrial-oriented economic structure exacerbated the decline in income. [ABSTRACT FROM AUTHOR]

Green credit, a market-driven environmental policy instrument and an essential component of the green financial system, has piqued academic and policymakers' interest in whether it has successfully improved Chinese green total factor productivity (GTFP). Utilizing Chinese province panel data from 2006 to 2019, this study assesses GTFP using the slack-based model with the Global-Malmquist-Luenberger technique and investigates the influence of green credit on GTFP as well as its mechanism. The findings suggest green credit has a favorable influence on China's GTFP. Green credit can boost GTFP through three mechanisms: upgrading industrial structure, stimulating green innovation, and optimizing energy consumption structures. Furthermore, green credit improves GTFP in eastern regions but has little impact elsewhere; the promotion impact is more effective in financial developed regions and legal developed regions. As a result, the Chinese government should encourage regionally differentiated green credit policy implementation. [ABSTRACT FROM AUTHOR]

Research on decommissioned batteries emphasizes the value of lost energy in batteries. This article analyzes the leftover battery capacity after its decommissioning from electric vehicles. This analysis includes the discreteness of the battery capacity, sorting based on a QC/T‐standard and alteration among the battery capacities. The potential of decommissioned batteries in other applications is presented, and a roadmap for the circular economy is suggested. Based on the data collected in China, significant faults occurring inside electric vehicles' battery packs are reviewed. An alternative inverter is tested to solve the significant challenges in using decommissioned batteries. Advancements are made toward a new intuitive cell balancing technique to utilize maximum capacity in each cell. [ABSTRACT FROM AUTHOR]

Background: Extending service scope of primary care facilities (PCFs) has been widely concerned in China. However, no current data about association between service scope of PCFs with patient outcomes are available. This study aims to investigate association between service scope of PCFs and patient outcomes.Methods: A multistage, stratified clustered sampling method was used to collect information about service scope of PCFs from rural Guizhou, China. Claim data of 299,633 inpatient cases covered by 64 PCFs were derived from local information system of New Rural Cooperation Medical Scheme. Service scope of PCFs was collected with self-administrated questionnaires. Primary outcomes were (1) level of inpatient institutions, (2) length of stay, (3) per capita total health cost, (4) per capita out-of-pocket cost, (5) reimbursement ratio, (6) 30-day readmission. A total of 64 PCFs were categorized into five groups per facility-level service scope scores. Generalized linear regression models, logistic regression model, and ordinal regression model were conducted to identify association between service scope of PCFs and patient outcomes.Results: On average, the median service scope score of PCFs was 20, with wide variation across PCFs. After controlling for demographic and clinical characteristics, patients living in communities with PCFs of greatest service scope (Quintile V vs. I) tended to have smaller rates of admission by county-level hospitals (-6.2 % [-6.5 %, -5.9 %], city-level hospitals (-1.9 % [-2.0 %, -1.8 %]), and provincial hospitals (-2.1 % [-2.2 %, -2.0 %]), smaller rate of 30-day readmission (-0.5 % [-0.7 %, -0.2 %]), less total health cost (-201.8 [-257.9, -145.8]) and out-of-pocket cost (-210.2 [-237.2, -183.2]), and greater reimbursement ratio (2.3 % [1.9 %, 2.8 %]) than their counterparts from communities with PCFs of least service scope.Conclusions: Service scope of PCFs varied a lot in rural Guizhou, China. Greater service scope was associated with a reduction in secondary and tertiary hospital admission, reduced total cost and out-of-pocket cost, and 30-day readmission and increased reimbursement ratio. These results raised concerns about access to care for patients discharged from hospitals, which suggests potential opportunities for cost savings and improvement of quality of care. However, further evidence is warranted to investigate whether extending service scope of PCFs is cost-effective and sustainable. [ABSTRACT FROM AUTHOR]

• The wetting trend in China's drylands has regional feature based on topography. • Increased convective precipitation is one possible reason for the wetting trend. • The warming and wetting trend will be stronger under the particular scenario. A recent "warming-and-wetting" trend over China's drylands has raised widespread attention in the scientific community. Based on the observations and model projections of temperature and precipitation, this study shows that the warming and regional wetting trend in China's drylands is becoming stronger. Over the past 60 years, the temperature in China's drylands has increased at a rate of 0.34 °C/10a, much higher than that in China (0.29 °C/10a) and globally (0.22 °C/10a). The wetting trend has been primarily apparent in the western part since the 1980s, particularly in the mountainous areas. In the northeast edge of the Qinghai-Tibet Plateau, the wetting rate exceeded 30 mm/10a. The possible cause of the increase of precipitation in China's drylands may be the higher convective precipitation, also concentrating in the mountainous areas. Model projections show weak and strong warming in the future under the RCP2.6 and RCP8.5 scenarios, respectively. Precipitation will increase slightly in the mid-21st century and then decrease slowly until the end of the 21st century under the RCP2.6 scenario. In comparison, under the RCP8.5 scenario, it will increase by 15–25% at the end of the 21st century. [ABSTRACT FROM AUTHOR]

Factors influencing the development of renewable energy have emerged as a hot topic of policy discussion in recent years. However, the direct impact of natural resource dependence on renewable energy has been overlooked, especially in emerging economies. Using Chinese province data from 2005 to 2019, this study employs a nonlinear panel model and a Quantile Regression with Nonadditive Fixed Effects for Panel Data (QRPD) model to examine the impact of natural resource dependence on renewable energy development and explores the great importance of government policy support. The study indicates that the influence of natural resource dependence on renewable energy development supports the "conditional resource curse" hypothesis, showing a U-shaped nonlinear relationship. The effect of natural resource dependence and government policy support on the development of renewable energy shows a dynamic change trend. In the early stage of renewable energy development, policy support is crucial, while during the growing and mature stages, natural resource dependence exerts a stronger driving force. The results of the mechanism test indicate that natural resource dependence can boost renewable energy development through green technology innovation and environmental regulation channels. This paper's conclusion provides a theoretical foundation for fostering the sustainable development of the renewable energy industry and is vital to China's efforts to reach peak carbon and carbon neutrality. • Nonlinear panel and QRPD models are employed. • Impact of natural resource dependence (NRD) on renewable energy development is revealed. • Dynamic effect of NRD and government policy support is discussed. • NRD has a negative and then positive impact on renewable energy development. • Pathways to improve renewable energy development through NRD are identified. [ABSTRACT FROM AUTHOR]

Introduction: Within China's multi-tiered medical system, many patients seek care in higher-tiered hospitals without a referral by a primary-care provider. This trend, generally referred to as patient self-referral behavior, may reduce the efficiency of the health care system. This study seeks to test the hypothesis that having a usual primary care provider could reduce patients' self-referral behavior.Methods: We obtained medical records of 832 patients who were hospitalized for common respiratory diseases from township hospitals in Qianjiang District of Chongqing City during 2012-2014. Logit regressions were performed to examine the association between having a township hospital as a usual provider and self-referring to a county hospital after being discharged from a township hospital, while controlling for patients' gender, age, income, education, severity of disease, distance to the nearest county hospital and the general quality of the township hospitals in their community. A propensity score weighting approach was applied.Results: We found that having a usual primary care provider was associated with a lower likelihood of self-referral (odds ratio = 0.58, 95% confidence interval [CI] =0.41-0.82), and a 9% (95% CI: -14%, - 3%) reduction in the probability of patients' self-referral behavior.Discussion/conclusion: The results suggest that establishing a long-term relationship between patients and primary care providers may enhance the patient-physician relationship and reduce patients' tendency for unnecessary use of medical resources. [ABSTRACT FROM AUTHOR]

Objective: To estimate the effects of expanding outpatient benefit package on ameliorating the issues of over-reliance on inpatient services and seeking higher level medical services in rural China., Design: A quasi-experimental design., Setting and Participants: 1673 pairs of patients with hypertension were selected after using propensity score matching from Dangyang county (intervention group) and Zhijiang (control group) county, Hubei province., Intervention: The outpatient annual reimbursement capping line was expanding from ¥300 to ¥600, daily capping line from ¥10/12 to ¥150. The compensation scope and institution were also enlarged from January 2016., Outcome Measures: The difference-in-differences model was used to estimate the effects on medical service type selection. χ 2 test was used to verify the effects on medical institution selection. We also examined the effects on health outcomes through the length of stay and blood pressure changes., Results: The intervention was associated with 3.225 times (p=0.001) increase in total visits. Outpatient visits increased by 3.3 times (p=0.008), whereas the township level presented a maximum increase of 1.932 times (p=0.001). The inpatient visits declined by 0.075 times (p=0.000), whereas county-level inpatient visits reached a maximum decrease of 0.042 times (p=0.033). Meanwhile, the township level exhibited a maximum proportion growth of 14.8% in outpatient (p=0.000) and 13.3% in inpatient visits (p=0.048). Outpatient visits at the county level dropped at 13.2% (p=0.000), whereas inpatients visits declined by 7.7% (p=0.040). The length of stay and blood pressure were decreased, respectively, compared with the control group., Conclusion: Improving outpatient benefit package alleviated patient dependence on inpatient services through motivating outpatient service utilisation, consolidated the primacy of township health centres and guided patients to return to primary medical institutions. The health insurance reform should 'take the long view' in the future, and more attention should be paid to the rationality of medical service utilisation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Through a review of the literature, we have observed that existing studies primarily focus on defining and measuring poverty, identifying the factors that affect poverty, and proposing anti-poverty strategies. The impact of health on income in the context of extreme poverty has not been adequately studied. In China, 30 million people live below the poverty line, and poverty caused by illness accounts for nearly 44% of the total number of recorded incidents. Health impaired by disease has become the largest obstacle to escaping extreme poverty., Objective: To determine whether health has a greater effect on the incomes of individuals in the extreme poverty group compared with the nonimpoverished group., Methods: The poverty threshold of China in 2010 was adopted for the definition of extreme poverty. The China Health and Nutrition Survey (CHNS) Database 2014 was selected as the data source. Ordinary least squares (OLS) test was conducted to estimate the model, and the endogeneity of the variables was analyzed by the random effects model. Waist-to-hip ratio (WHR) was used instead of body mass index (BMI) to perform the robustness test., Results: We found that the influence of individual health conditions on income was augmented in the case of extreme poverty, which indicates that health indeed influences income more strongly for individuals in the extreme poverty group., Conclusions: In addition to education, investment, and social security projects, further public policy attention should be given to the improvement of the health status of the extremely impoverished population., (© 2019 John Wiley & Sons, Ltd.)

Objective: This study aimed to define the end-of-life (EOL) healthcare utilisation and its cost and determinants for cancer patients and to proactively inform related strategies in mainland China., Design: A population-based retrospective study., Setting and Participants: Data from 894 cancer patients were collected in urban Yichang, China from 01 July 2015 to 30 June 2017., Outcome Measures: Emergency department (ED) visits, outpatient and inpatient hospitalisation services, intensive care unit (ICU) admission and total costs were used as the main outcomes., Results: In this study, 66.8% of the 894 patients were male, and the average age was 60.4 years. Among these patients, 37.6% died at home, and patients had an average of 4.86 outpatient services, 2.23 inpatient hospitalisation services and 1.44 ED visits. Additionally, 5.9% of these patients visited the ICU at least once. During the EOL periods, the costs in the last 6 months, 3 months, 1 month and 1 week were US$18 234, US$13 043, US$6349 and US$2085, respectively. The cost increased dramatically as death approached. The estimation results of generalised linear regression models showed that aggressive care substantially affected expenditure. Patients with Urban Employee Basic Medical Insurance spent more than those with Urban Resident-based Basic Medical Insurance or the New Rural Cooperative Medical Scheme. The place of death and the survival time are also risk factors for increased EOL cost., Conclusion: The findings suggested that the EOL cost for cancer patients is associated with aggressive care, insurance type and survival time. Timing palliative care is urgently needed to address ineffective and irrational healthcare utilisation and to reduce costs., Ethics and Dissemination: This study was approved by the Ethics Committee of the Tongji Medical College, Huazhong University of Science and Technology (IORG No.: IORG0003571). All the data used in this study were de-identified., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Home blood pressure telemonitoring (HBPT) has great potential in improving blood pressure (BP) control among patients with hypertension. However, the longitudinal use trajectories of HBPT have not been identified yet. In addition, there has been a lack of understanding of the relationship between developmental trajectories of HBPT and BP control over time. The primary goal of this study was to identify the longitudinal trajectories of using HBPT among hypertensive patients and to explore the relationship between longitudinal trajectories of HBPT use patterns and BP control., Methods: A total of 122 hypertensive patients were enrolled consecutively in Xiling, Huayan, Baisha and Xueyuan communities in Yichang City, Hubei Province, China. Each patient was provided with a portable monitoring device which has unlimited data service at the time of enrollment. Socio-demographics (e.g. name, age, sex, marital status) were collected at baseline. Real-time data including systolic and diastolic blood pressure were automatically uploaded to cloud platform through devices. Latent class growth analysis was conducted to determine the latent trajectory of HBPT use. Joint trajectory method was used to correlate the longitudinal trajectories of HBPT utilization and BP control status., Results: Five trajectories were identified which are persistently low (47.1%), moderate with decreasing (23.9%), sharply decreasing (11.2%), high with decreasing (11.3%) and persistently high with increasing (6.6%). There was no statistically significant difference among 5 trajectories in the baseline survey in terms of age, marital status, BP (both SBP and DBP) and BP control status. However, there was a strong positive correlation between the HBPT utilization pattern and BP control status over time., Conclusions: The latent trajectories of HBPT utilization were identified in our study. However, no predictors of trajectory membership were identified. Nevertheless, we have demonstrated that HBPT was to some extent positively correlated with improved BP control, and this correlation still needs to be further proved., (Copyright © 2018 Elsevier B.V. All rights reserved.)