Although China launched long-term care insurance (LTCI) pilot program in 2016, there are great challenges associated with developing a sustainable LTCI system due to limited financial resources and a rapid increase in the aging population. This study constructed an LTCI policy–population–economics (PPE) system to assess the sustainability of the LTCI system in China. Based on the latest 76 LTCI policy documents published between 2016 and 2021, this study evaluated the strength of LTCI policy modeling in 14 pilot cities by constructing a policy modeling consistency (PMC) index containing 9 main variables and 36 sub-variables. The coupling coordination model was used to evaluate the interaction between LTCI policy, population aging, and economic development. The results showed that the PMC index ranged from 0.527 to 0.850. The policy strength of Qingdao, Nantong, and Shanghai was the highest (PMC > 0.8). Anqing, Qiqihaer, Chongqing, and Chengdu had the lowest level of policy strength (PMC < 0.6). The main policy weaknesses were the coverage of the LTCI, the sources of funds, the scope of care services, and benefit eligibility. The coupling coordination degree of PPE systems varied from 0.429 to 0.921, with a mean of 0.651. Shanghai, Nantong, and Suzhou had the highest level of coordination. The coordination between subsystems of PPE in most pilot cities (12 of 14 cities) was at a basic or low level. The findings from this study concluded that the coordination within the PPE system should be improved to develop a sustainable LTCI system. To improve the coordination of the PPE system, it is suggested that the country should maintain sustainable economic growth and modify LTCI policies based on demographic transitions and economic development.

Backgroud: China has introduced series of policies to improve the professional self-image of GPs, however, Chinese general practitioners (GPs) generally have a low professional identity. This study evaluated the effects of on-job-training for medical health professionals that focuses on the recognition of GPs’ roles. Methods At a representative training base in Guangdong Province, the most economically developed province in Southern China, 62 workers from community health service centers underwent training for 6 months according to a before-after self-controlled design. A specific module related to professional value recognition was integrated into the training course. Trainees were invited to participate in the open-ended self-questionnair survey. Thematic analysis was used to explore themes within the data. Kappa test was used to compare consistency of career prospects before and after the training. Results Before training, participants generally lacked a full and clear understanding of the professional responsibilities of GPs. After the training, participants showed increased awareness of six aspects of general medical practice including a broad understanding of the term, disease treatment, disease prevention, service mode, role of general services in promoting public health, and role of GPs in a service team. Moreover, 84% of participants had a positive opinion of GPs’ career prospects and 90.3% preferred general practice to specialization as a career choice after the training. Current GPs preferred to become a specialist mainly for the higher salary, but current specialists preferred to be a GP for self-growth and sense of community. Conclusions These results demonstrate that appropriate on-the-job training can improve GPs’ professional identity in China, and should therefore be included in policies and integrated into programs for medical health professionals.