Purpose The aim of this study is to measure the trajectory of healthy ageing among Chinese middle-aged and older population, and explore the disparity of the trajectory, as well as contributing factors, between urban and rural areas in China. Methods A total of 9402 respondents aged 45 years and older interviewed in four waves (2011, 2013, 2015 and 2018) were selected from the China Health and Retirement Longitudinal Study. Healthy ageing score was calculated through item response theory. A latent growth mixture model (LGMM) was applied to distinguish the trajectory of healthy aging. A multinomial logistics regression model (MLRM) was used to explore the relationship between urban-rural areas and healthy aging trajectories, and further to explore associated factors in rural and urban areas separately. Results The healthy ageing score was lower in rural areas than urban areas in each survey wave. Five classes (“continuing-low”, “continuing-middle”, “continuing-middle-to-high”, “significantly-declining”, “continuing-high”) were grouped through LGMM. The MLRM results showed that urban living was significantly associated with a higher likelihood of being healthy (for [continuing-low/continuing-high]: β = − 1.17, RRR = 0.31, P < 0.001, 95% CI = 0.18–0.53; and for [continuing-middle/continuing-high]: β = − 0.53, RRR = 0.59, P < 0.001, 95% CI = 0.49–0.71). Conclusion Healthy ageing is a prominent objective in the development of a country, and rural-urban disparities are an essential obstacle to overcome, with the rural population more likely to develop a low level of healthy ageing trajectory. Prevention and standardized management of chronic diseases should be enhanced, and social participation should be encouraged to promote healthy ageing. The policy inclination and resource investment should be enhanced to reduce disparity in healthy ageing between urban and rural areas in China.

ObjectivesThis study aims to examine the mediation role of satisfaction with children on the association between contact with children (CCT) and healthy aging among middle-aged and older parents in China.MethodsData from 9,575 parents over 45 years old were obtained from the 2018 China Health and Retirement Longitudinal Survey. A multinomial logistic regression model was applied to measure the association between contact, satisfaction, and healthy aging with potential confounders controlled. We used the Sobel–Goodman Mediation test to analyze the mediation role of satisfaction on the association between types of CCT and healthy aging.ResultsParents with contact with adult children had higher satisfaction with children [for contact weekly (satisfied/unsatisfied): relative risk ratio (RRR) = 2.44, CI = 1.92–3.10] and higher healthy aging [for contact weekly (Q5/Q1): RRR = 1.41, CI = 1.13–1.77]. Satisfaction was strongly related to healthy aging [for satisfied (Q5/Q1): RRR = 3.44, CI = 2.14–5.51], and mediated 19.05% of healthy aging for weekly contact (Sobel test z = 4.338; indirect role = 0.014, CI = 0.011–0.018; direct role = 0.061, CI = 0.029–0.094). Subgroup analysis further revealed that satisfaction with contact played a partial mediating role between monthly contact and healthy aging in female and rural groups.ConclusionsMonthly CCT is more appropriate for older parents. Satisfaction with children in older parents seems to act as a significant and partial mediator of the relationship between contact and healthy aging. The contribution of satisfaction to healthy aging could be important to be considered and promoted in women and rural older parents, independent of CCT.

Purpose: This study aimed to assess the DIP reformation effects among cancer inpatients. Materials and methods: A total of 13085 observations from a tertiary hospital in Guangzhou city were evaluated by mortality, 30-day readmission rate, length of stay (LOS), disease severity, total expenditures (TE), and out-of-pocket (OOP) and OOP ratio. We used interrupted time-series analysis (ITSA) to evaluate the effect for control for the confounding factors. Results: A slightly increasing trend of 30-day readmission rate, LOS, comorbidity, and OOP were showed at the time of intervention. TE showed an apparent increase at the time of intervention (9159.580, 95% confidence interval [CI]: 6543.959~11775.200, P < 0.001). OOP ratio showed an apparent decrease at the time of intervention (-0.0889, 95% CI: -0.1119~-0.0659, P < 0.001). Conclusion: Our study shows that DIP has been effective in alleviating the personal economic burden of health and maintaining the quality of healthcare services. Keywords: Diagnosis-Intervention Packet (DIP); medical insurance payment reform; evaluate

Purpose: The aim of this study is to explore the differences and evaluate the equity in healthy aging trajectories between urban and rural areas in China. The hypothesis of this study is that there are differences in healthy aging trends between urban and rural areas, with inequity. Methods: A total of 9402 respondents aged 45 years and older interviewed in four waves were selected from the China Health and Retirement Longitudinal Study. A latent growth mixture model (LGMM) was applied to distinguish the trajectory of healthy aging. A multinomial logistics regression model (MLRM) was used to explore the relationship between urban-rural areas and healthy aging trajectories, and a concentration index was used to evaluate equity. Results: Urban-rural respondents differed in socioeconomic background, family characteristics, and personal lifestyle ( P < 0.05). Three classes (“low risk”, “middle risk”, and “high risk”) were grouped through LGMM. The MLRM results showed that urban living was significantly associated with a healthy aging trajectory (for [middle risk/low risk]: β=-0.41, RRR =0.66, P < 0.001, 95% CI =0.55–0.80, and for [high risk/low risk]: β=-1.10, RRR =0.33, P < 0.001, 95% CI =0.26–0.41). The concentration index was -0.022 and significantly indicated the inequity of healthy aging between rural and urban areas. Conclusion: Combined health status showed an irreversible downward trend with age, and this trajectory differed between urban and rural areas, with the rural population more likely to develop a high risk trajectory. Policy inclination and resource investment should be enhanced to reduce inequity in healthy aging between urban and rural areas in China.