Health insurance system has been proved to be an effective way to promote the quality of health service in many countries. However, how to control health expenditure under health insurance system remains a problem to be resolved. Some developed countries like UK, Canada and Sweden linked their health technology assessment results with decision making and health insurance management, and made prominent achievements in both expenditure control and quality improvement. China is carrying out its health system reform and running a new health insurance project. Using the experiences of other countries is undoubtedly of great importance in developing and managing our health insurance system.
ObjectiveTo systematically review the current prevalence, key determinants, and prevention strategies of child and adolescent obesity in China. MethodA systematic review of the epidemiological trends, health impacts, risk factors, and intervention strategies for child and adolescent obesity was performed by analyzing recent domestic and international literature and policy documents, supplemented with national surveillance data and developments in clinical practice. ResultsThe prevalence of child and adolescent obesity in China has been rising continuously over the past four decades, with particularly high rates observed among primary school children and boys. Recent trends show a “provincial reversal” and an “urban-rural reversal”. This high-risk environment stems from complex interactions among family, school, and societal factors. China has developed a relatively comprehensive policy framework for obesity prevention and control and is promoting a three-tiered prevention strategy. Clinically, pharmacological and surgical interventions are being gradually adopted. However, challenges remain, including limited health insurance coverage for obesity management. ConclusionsChild and adolescent obesity has become a significant public health issue in China, threatening national health and social development. Future efforts should focus on enhancing intersectoral governance, improving early intervention capabilities, expanding health insurance support, and standardizing clinical practices. A multi-level, multi-pathway integrated prevention and control system is essential for effectively curbing child and adolescent obesity under the healthy China strategy.
Objective To compare the similarities and differences in the policy frameworks of outpatient chronic diseases and special critical diseases of urban employed basic medical insurance across 22 regions (including the provincial-level region) in Sichuan Province, and provide reference for promoting unified planning of basic medical insurance at the provincial level. Methods Policy documents and relevant materials related to outpatient chronic diseases and special critical diseases which were released as of December 31, 2024 were retrieved from the official websites of the Sichuan Provincial Medical Security Administration and those regions. A structured database was constructed, and content analysis was employed to compare regional policy variations in terms of disease coverage, identification and management criteria, and benefit levels. Results Considerable disparities were observed across regions in insured disease scope, identification management and benefit levels. The number of insured diseases ranged from 37 to 66, with a range of 29. While 14 diseases were covered by all regions, the identification criteria for the same diseases were inconsistent. Moreover, the deductible standards, reimbursement ratios, and reimbursement cap lines varied among regions. The deductible standards ranged from 0 to 1000 yuan, the reimbursement ratios ranged from 50% to 100%, and the cap lines ranged from 800 to 36000 yuan. Conclusions There are pronounced regional disparities in the benefit levels for outpatient chronic diseases and special critical diseases under Sichuan Province’s urban employed basic medical insurance scheme, raising concerns regarding horizontal equity. Given that benefit levels are influenced by regional economic development and the financial levels of insurance funds, it is recommended to gradually standardize the disease list and identification criteria at the provincial level, and to develop appropriate benefit policies to narrow regional gaps.